Professional Liability: Analysis of Cass. civ., Section III, Order no. 5490 of 2023

The Supreme Court of Cassation, with order no. 5490 of 2023, addressed a complex case concerning professional liability in the healthcare sector, highlighting fundamental legal principles related to the burden of proof and the liability of healthcare facilities. The case involved the death of a patient, C.C., following a Staphylococcus aureus infection contracted during surgery.

Context of the Ruling

The Court of Appeal of Turin had declared the appeal filed by the patient's family inadmissible, confirming the rejection of the claim for damages 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 physicians.

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

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

Legal Principles Involved

The Cassation ruling 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 providers is linked to the obligation to ensure the safety of care.
• It is the facility's burden to prove that the harmful event was caused by external factors not attributable to its conduct.
• The evidence used to exclude liability must be grave, precise, and consistent.

Consequences of the Ruling

The Cassation Court held that the lower court judge had not adequately considered the evidence presented, limiting itself to a superficial assessment of the proofs. The decision to remand the case 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

Ruling no. 5490 of 2023 by the Cassation Court 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 the protection of their rights, in compliance not only with Italian regulations but also with European and international ones.