Healthcare Liability and the Burden of Proof: Commentary on Cass. civ., Section III, Order no. 12585 of 2024

The Court of Cassation, with Order no. 12585 of 2024, addresses a case of particular relevance in healthcare liability, examining the delicate issue of the burden of proof in cases of medical malpractice. In this article, we will explore the details of the ruling and its implications within the context of Italian civil law.

The Case Under Review

The case concerns the compensation claim filed by A.A. and B.B. against the ASL n. 2 Lanciano Vasto Chieti following the death of their newborn children, C.C. and E.E., due to infections contracted in hospital. Specifically, the Court of Chieti had partially granted the claim, recognizing the healthcare facility's liability for the death of C.C., while the ASL's appeal was upheld for E.E.

The peculiarity of the situation justifies the compensation of costs for the present stage, considering that the ward was found to be infected and that there had been other infant deaths.

The Court of Cassation's Reasoning

The Court of Cassation rejected the appeal filed by the parents, highlighting several critical points. Firstly, the Court emphasized that the ASL, in its appeal, had specifically contested the presence of infected catheters and tubes. The appellants failed to prove that these devices were sterile, which led to a finding of inadmissibility of their arguments.

Secondly, it emerged that the appellate judge had made a distinction between the cases of C.C. and E.E. based on scientific data. The latter was not adequately contested by the appellants, who failed to demonstrate a causal link between the health conditions and the deaths.

Implications for the Right to Health

This ruling sheds light on some fundamental issues concerning the right to health and the liability of healthcare facilities. The parents found themselves in a difficult position, as the burden of proving the ASL's incorrect conduct fell upon them. Italian law, particularly Article 2697 of the Civil Code, establishes that whoever wishes to assert a right must prove the facts that constitute its basis.

• The contractual liability of the ASL requires proof of non-performance by the facility.
• The "more likely than not" principle could be applied in similar situations, but the burden of proving liability remains with the plaintiff.
• The importance of medical documentation and its integrity in demonstrating any negligence.

Conclusions

In conclusion, the ruling of the Court of Cassation no. 12585 of 2024 offers significant insights into understanding the dynamics of healthcare liability in Italy. It underscores the importance of the burden of proof and the difficulties citizens face in pursuing their rights in complex contexts such as healthcare. The decision highlights the need for greater attention to evidence management in the medico-legal field to ensure an adequate level of protection for patients and their families.