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Professional Liability: Analysis of the Supreme Court, Section III, Order No. 5490 of 2023

The Supreme Court of Cassation, with Order No. 5490 of 2023, addressed a complex case regarding professional liability in the healthcare sector, highlighting fundamental legal principles related to the burden of proof and the liability of healthcare facilities. The case in question involved the death of a patient, C.C., following a staphylococcal infection contracted during a surgical procedure.

The Context of the Ruling

The Court of Appeal of Turin had declared inadmissible the appeal filed by the patient's family, confirming the rejection of the damages claim by the Court of Verbania. The decision was based on the finding that the infection was attributable to an unforeseeable and unavoidable event, thus excluding the liability of the healthcare facility and the involved doctors.

The liability of the care facility is contractual in nature and must be demonstrated through clear and specific evidence.

The appellants contested the ruling, arguing that a causal link between the surgery and the patient's death had been established, and that the facility had not provided sufficient evidence to exclude its liability. The Court accepted the appeal, highlighting that the infection contracted by C.C. should be considered a foreseeable event in the context of the surgical procedure.

The Legal Principles Involved

The ruling of the Cassation refers to several articles of the Civil Code, particularly Articles 1218, 2697, 2727, and 2729, concerning contractual liability and the burden of proof. In particular, the Court emphasizes that:

  • The contractual liability of healthcare operators is linked to the obligation to ensure the safety of care.
  • It is the responsibility of the facility to demonstrate that the harmful event was caused by external factors and not attributable to its conduct.
  • The evidence used to exclude liability must be serious, precise, and consistent.

The Consequences of the Ruling

The Cassation held that the judge of merit had not adequately considered the evidence presented, limiting himself to a superficial assessment of the proofs. The decision to refer the case back to the Court of Appeal of Turin implies that the case will need to be re-examined with a more in-depth analysis of the specific circumstances and the safety measures adopted by the facility. This represents an important reminder of the need for a rigorous application of the rules on professional liability in the healthcare sector.

Conclusions

Order No. 5490 of 2023 from the Cassation offers an important opportunity for reflection on professional liability in the healthcare sector. It highlights the importance of a rigorous approach in evaluating evidence and demonstrating the non-attributability of harmful events. The legal principles emphasized by the Court are fundamental to ensuring patient safety and protecting their rights, in accordance not only with Italian regulations but also with European and international laws.