Health Care Liability and Loss of Chance: An Analysis of Cass. No. 28993 of 2019

The ruling of the Court of Cassation No. 28993 of 2019 represents an important reference in the field of health care liability and damage compensation. In this case, the Court examined the appeal presented by the heirs of a patient who died following a surgical procedure, analyzing the profiles of liability of the healthcare professionals and the issue of the loss of therapeutic chances. The ruling provides significant insights regarding the causal link and the burden of proof in the medical-legal field.

The Context of the Ruling

The case concerned the request for damages from the heirs of V.M., who died after undergoing surgery to remove a tumor. The Court of Appeal of Milan had initially rejected the claim for damages, excluding a causal link between the surgery and the death. The appellants contested this decision, highlighting the incorrect application of the principle of medical contractual liability and the lack of proper consideration of the causal link.

The Court of Cassation reiterated the importance of proving the causal link between the conduct of healthcare professionals and the damage suffered by the patient, paying particular attention to the loss of therapeutic chances.

Analysis of the Grounds for the Appeal

The appeal was articulated in four grounds, including the violation of the principles of medical liability and the issue of informed consent. The Court deemed some grounds inadmissible, emphasizing that the causal link between the surgery and the death could not be proven with certainty. In particular, the grounds related to the loss of chance were analyzed in light of scientific evidence and the technical consultancy, which established that even a timely intervention would not have guaranteed the patient's survival.

The Consequences of the Ruling

The ruling of the Cassation highlights how health care liability must be assessed not only in terms of non-performance but also with respect to the concrete possibility of an improved outcome. In this case, the Court excluded the compensability of the loss of chance, emphasizing that the possibility of survival was not appreciable in statistical terms. This approach further clarifies the concept of loss of chance, establishing that a concrete proof of the possibility of a better outcome is necessary for its compensability.

  • Importance of technical consultancy in assessing the causal link.
  • Need for concrete evidence for loss of chance.
  • Clarity on patients' rights and informed consent.

Conclusions

In conclusion, the ruling No. 28993 of 2019 offers a clear and articulated view of health care liability, outlining the criteria for establishing the causal link and assessing the loss of chance. It represents an important reference point for legal professionals and patients, emphasizing the importance of transparency and proper information in the doctor-patient relationship.

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