Professional Liability and Damages: Commentary on Judgment No. 6386 of 2023
The judgment no. 6386 of March 3, 2023, of the Court of Cassation is set in a complex legal context regarding professional liability in the healthcare sector. In this case, the Court accepted the appeal of A.A. and others, who had reported the death of their relative, F.F., attributing it to negligence on the part of the healthcare professionals at the Monte Tabor Foundation. The Court's decision offers interesting insights into the causal link and the burdens of proof in such disputes.
The Context of the Judicial Proceedings
The case originated from the death of F.F., who was hospitalized for an eye surgery at San Raffaele and, after an accidental fall, developed a nosocomial infection from Staphylococcus aureus. Despite evidence of negligence, the Court of Milan and subsequently the Court of Appeal had excluded the causal link between the conduct of the healthcare professionals and the patient's death, considering the evidence provided by the family to be insufficient. However, the Court of Cassation overturned this assessment.
The Court of Cassation emphasizes that the causal link must be evaluated on the basis of logical probability and not absolute certainty.
The Principle of Causal Link
The Court stated that, in cases of medical liability, it is up to the plaintiffs to provide proof of the causal link between the failure of the healthcare facility and the harm suffered. However, the Court also clarified that such proof does not need to be provided in terms of certainty, but rather according to a criterion of probability. This point is crucial, as it is often difficult in the healthcare sector to demonstrate with certainty that a different behavior from the healthcare professionals could have prevented the patient's death.
Burden of Proof and Extracontractual Liability
Another relevant aspect of the ruling concerns the burden of proof regarding extracontractual liability. The Court clarified that, although the patient may not have the ability to provide all necessary evidence, the healthcare facility has the obligation to demonstrate that it has complied with care standards. Otherwise, liability may be attributed even in the presence of a nosocomial infection contracted during hospitalization.
- The liability of the healthcare facility is based on various factors, including:
- Infection prevention protocols.
- Methods of managing hygiene procedures.
- Behavior of the healthcare staff during the hospitalization.
Conclusions
The judgment no. 6386 of 2023 of the Court of Cassation represents an important step forward in the jurisprudence on medical liability. It highlights the need to consider probability as a fundamental criterion for establishing the causal link and the burden of proof on the healthcare facility. Moreover, this decision could have significant repercussions on future cases of professional liability, emphasizing the importance of ensuring high standards of care and safety in hospital settings.
