Contract Termination and Professional Liability: Commentary on the Judgment of the Court of Cassation, Section III, No. 16919/2018
The judgment of the Court of Cassation No. 16919 of June 27, 2018, provides important insights into the responsibility of healthcare professionals and the interpretation of damages for loss of chance. In this case, the relatives of a patient who died from a heart attack requested compensation for the diagnostic omission by a doctor. The Court upheld the appeal, highlighting how the omission could constitute a compensable damage, even if the patient might have had a limited life span.
Context of the Judgment
In the case at hand, the patient S. had gone to the emergency room for retrosternal pain, receiving an incorrect diagnosis. Only later, as his condition worsened, was a heart attack confirmed. The relatives, believing that the doctor's negligence had caused the death of their loved one, initiated legal action to obtain compensation. However, the Court of Appeal of Cagliari had initially rejected the claim, arguing that timely intervention would not have changed the fatal outcome.
The existence of compensable damage to a person is determined by the omission of the diagnosis of a terminal disease process, when it is shown that, as a result of the omission, the patient lost the possibility of survival for several weeks or months, or in any case for a limited period, in addition to the actual time lived.
Analysis of Loss of Chance Damage
The Court of Cassation emphasized a fundamental principle: a diagnostic omission can lead to compensable damage, even if the patient had a limited probability of survival. Indeed, the doctor's error deprived the patient of the possibility of living for a period, even if brief. This view aligns with the principle of jurisprudence that considers the loss of chance as a standalone damage, distinct from the mere possibility of a better outcome. In this sense, the Court referred to previous rulings (Cass. September 18, 2008, No. 23846) that stated the loss of chance should be understood as a harmful event, not as an uncertain future expectation.
- The causal link must be examined in relation to the loss of survival.
- The responsibility of the doctor is not limited to the mere diagnosis but extends to the quality of life of the patient.
- The damage from loss of chance must be quantified in terms of time and quality of life.
Conclusions
The judgment of the Court of Cassation No. 16919/2018 represents an important step forward in protecting the rights of patients and their families. It clarifies that professional liability is not limited to the patient's death but can also extend to the loss of periods of life, however brief. The Court reiterated the need to evaluate the healthcare professional's conduct not only concerning the final outcome but also regarding the immediate and future consequences of their omission. This approach could have a significant impact on future medical-legal disputes, reinforcing the necessity for adequate and timely diagnosis.
