Cassation on Monocratic Expert Opinion in Healthcare Liability: Ruling 22442 of 2025 and Article 15 of the Gelli-Bianco Law

The issue of medical liability, with its ethical and legal complexity, sees technical expert opinion as a crucial evidentiary tool. The Supreme Court of Cassation, with ruling no. 22442 of 2025, has intervened to clarify the validity of expert opinions drafted by a single expert in criminal proceedings for healthcare liability, in light of the Gelli-Bianco Law (Law 24/2017). This pronouncement offers essential clarifications for legal practitioners.

The Regulatory Framework: The Gelli-Bianco Law and Collegial Expert Opinion

Law no. 24 of March 8, 2017, known as the Gelli-Bianco Law, amended the regulation of professional healthcare liability. Article 15, paragraph 1, stipulates that, in civil and criminal proceedings for healthcare liability, technical assessments or expert opinions must be entrusted to a panel of consultants (forensic medical examiner and specialists). The intention was to ensure greater completeness and objectivity.

The Cassation Ruling: Analysis of Ruling 22442/2025

Ruling no. 22442 of 2025, issued by the Fourth Criminal Section (President M. A., Rapporteur R. A. L. A.), examined a case (Defendant A. A.) where, despite the Gelli-Bianco Law, an expert opinion had been commissioned from a single expert. The Cassation Court had to determine whether this rendered the expert opinion null and void or inadmissible. Here is the summary principle expressed:

In matters of evidence, the appointment of a single expert, instead of an expert panel, in criminal proceedings concerning healthcare liability, while contrary to the provisions of Article 15, paragraph 1, of Law no. 24 of March 8, 2017, does not result in the nullity of the expert opinion, as it is not expressly provided for, nor is it a cause for its inadmissibility, as such a sanction is imposed only for evidence obtained in violation of a legal prohibition. However, it entails the admission of evidence through methods other than those provided for by law, without affecting the right to defense or the respect for the fundamental principles of the legal system. (In its reasoning, the Court also affirmed that such non-compliance, which may affect the reliability of the expert opinion, justifies the criticism of the reasoning, in the part where it refers to the scientific knowledge introduced by the expert evidence and the conclusions reached by the expert, if they are not clear or adequately explored).

The Cassation Court clarifies that the violation of Article 15, paragraph 1, does not result in nullity (which requires express provision, art. 177 c.p.p.) or inadmissibility (for violation of a legal prohibition, art. 191 c.p.p.). However, non-compliance can affect the "degree of reliability of the expert opinion," allowing the judge's reasoning to be challenged if the conclusions are not "clear or adequately explored." This offers an important protective tool for the defense, shifting the focus to the substantive quality of the assessment.

Practical Implications and Protection of the Right to Defense

Ruling 22442/2025 balances formal rigor with the substance of evidence. The implications are:

• Validity: Expert opinion from a single expert is valid and admissible.
• Quality: Focus on the completeness, clarity, and depth of the report.
• Challenge: The defense can challenge the reasoning if the conclusions are superficial or unclear.
• Role of the Judge: Careful evaluation of the expert opinion, verifying methodological correctness and soundness.

This approach confirms the Court's commitment to due process, opening the door to a substantive review of scientific evidence.

Conclusions

Ruling no. 22442 of 2025 clarifies an important aspect of healthcare liability and criminal proceedings. It reiterates the exhaustive nature of procedural sanctions but, at the same time, reinforces the need for a critical evaluation of scientific evidence. A monocratic expert opinion is not automatically invalidated, but parties are provided with an effective tool to challenge its reliability if it does not meet the standards of clarity and depth. This ensures that the pursuit of procedural truth is anchored in the soundness and completeness of the technical assessment.