Professional Liability in Healthcare: Commentary on Judgment Cass. civ., Section III, No. 5922 of 2024

The recent order of the Court of Cassation, Third Civil Section, No. 5922 of 2024, offers important insights into professional liability in healthcare. In this case, A.A. sued the Local Health Authority of Turin following a surgical procedure that resulted in significant damages, alleging that the anesthetist had acted unskillfully. However, the Court rejected the claim for compensation, emphasizing the need to prove the causal link between the doctor's conduct and the damage suffered.

Legal Context and Principles of Medical Liability

In Italian law, medical liability is typically classified as contractual liability, as established by consolidated case law. In particular, the Court clarified that while the patient must demonstrate the causal link between the doctor's conduct and the damage, it is up to the healthcare facility to prove the exact fulfillment of its obligations. This principle is crucial, as it establishes a division of the burden of proof that can significantly influence the outcome of a case.

The Court recognized that the causal link is not a mere factual circumstance but must be ascertained through inferential and evidentiary reasoning.

Critical Issues in the Lower Court's Judgment

The Court of Appeal of Turin held that A.A. had not provided sufficient evidence to demonstrate the anesthetist's lack of skill. However, the Court of Cassation highlighted that the lower court had confused two fundamental elements: the fact of non-performance and the causal link. A.A.'s defense did not need to prove the doctor's lack of skill, but only the link between the doctor's actions and the damages sustained. Furthermore, it emerged that the reasoning of the judgment was contradictory and that the Court had not taken into account documentary evidence in favor of the appellant.

Conclusions

Judgment No. 5922 of 2024 represents an important step forward in clarifying the dynamics of medical liability, emphasizing the importance of a correct allocation of the burden of proof. This case highlights how evidentiary evidence must be evaluated as a whole and how fundamental it is for patients to be adequately supported in demonstrating their rights.