Healthcare Liability and Causal Link: Commentary on the Judgment of the Court of Cassation, Section III, No. 21530 of 2021
The judgment No. 21530 of July 27, 2021, of the Court of Cassation represents an important analysis of healthcare liability and the causal link in the civil context. In this specific case, the Court examined an appeal concerning the death of a patient due to Lyell's syndrome, which was diagnosed late by the healthcare professionals.
The Case and Previous Decisions
The case originated from the condemnation of local Health Authorities for compensation of damages suffered by the patient's family. The Court of Oristano had accepted the claim, but the Court of Appeal of Cagliari, during the appeal phase, held that the responsibility lay solely with the doctors at the Oristano hospital. In particular, the Court argued that the incorrect diagnosis and the failure to suspend a medication contributed to the patient's death.
The Court of Cassation confirmed the importance of the 'more likely than not' criterion in establishing the causal link.
The Principle of 'More Likely Than Not'
A crucial point of the judgment is represented by the 'more likely than not' principle, applied to verify the causal link between the conduct of the healthcare professionals and the harmful event. This criterion implies a not only statistical but also logical evaluation, that is, the necessity to consider the available confirming and excluding elements in the specific case. The Court referred to previous jurisprudential rulings that have outlined a stable orientation on the proof of the causal link, emphasizing that the assessment cannot be anchored to a mere quantitative probability.
Implications of the Judgment
The judgment of the Court of Cassation is significant for several reasons:
- It reiterates that the burden of proof rests on the injured party, but the judge must rely on consistent and well-founded evidentiary reasoning.
- It establishes that, in the case of an omission, a counterfactual judgment is necessary to assess whether the required behavior could have prevented the harmful event.
- It highlights that healthcare liability is not limited to cases of gross negligence but also extends to negligence or imprudence, as revealed by the conduct of the doctors in the examined case.
Conclusions
In conclusion, judgment No. 21530 of 2021 offers an important reflection on civil liability in the healthcare field, clarifying the assessment criteria for the causal link. This approach emphasizes the need for a concrete and detailed analysis of medical acts and decisions made, in order to ensure adequate protection for patients and their families.
