Medical professional liability: commentary on Cass. civ. no. 21245 of 2012

Judgment no. 21245 of 2012 by the Court of Cassation represents an important ruling on medical professional liability. The case in question concerns the appeal filed by B.C. and T.A. against the Liquidating Management of the dissolved USSL of Rho, following the death of their relative, B.A. The Court addressed crucial issues regarding the causal link and the possibility of compensation for loss of chance.

The context of the case

The case originated from a claim for damages due to the death of B.A., which occurred due to an alleged diagnostic error and failure to intervene by healthcare professionals. Initially, the Court of Milan rejected the claim for damages, a decision confirmed by the Court of Appeal. The appellants then appealed to the Court of Cassation, which annulled the judgment and referred it back, emphasizing the importance of examining whether there was a diagnostic error and whether the patient had reasonable chances of survival.

Loss of chance is not a mere factual expectation, but a distinct asset, legally and economically capable of independent valuation.

The Court's arguments

In the 2012 judgment, the Court reiterated that to establish medical liability, it is necessary to demonstrate a material causal link between the doctor's conduct and the harmful event. In this case, the Court ruled that even with a timely diagnosis, B.A.'s chances of survival would have been reduced to a minimum, around 10%. Therefore, it was not possible to attribute liability to the hospital entity. The Court also recalled that loss of chance, considered as a concrete possibility of achieving a positive outcome, must be expressly requested in the appeal, as it cannot be automatically inferred.

Implications of the judgment

• Clarity on liability criteria: The Court clarified that the causal link in civil law has a lower probability threshold than in criminal law.
• Recognition of loss of chance: This judgment emphasizes the importance of recognizing loss of chance as compensable damage, provided it is explicitly requested.
• Relevance of technical consultancy: The evaluation of evidence and expert reports plays a crucial role in the decision-making process.

Conclusions

Judgment no. 21245 of 2012 by the Court of Cassation has had a significant impact on case law regarding healthcare professional liability. It clarifies that, in order to obtain compensation, it is essential to demonstrate not only the negligent conduct of the doctors but also the causal link connecting such conduct to the harmful event. Furthermore, the issue of loss of chance must be adequately formulated and substantiated in the appeal for the judge to examine it. This ruling represents an important step towards greater protection for patients and accountability for healthcare professionals.