Cassation Court on Collegial Expert Opinions in Medical Liability: Ruling No. 15594 of 2025 and Article 15 of the Gelli-Bianco Law

In the complex and delicate field of healthcare liability, the role of the court-appointed expert opinion (CTU) is of paramount importance. It is through the impartial analysis of experts that a judge can ascertain the correctness of medical practice and any causal link to the damage suffered by the patient. A recent ruling by the Supreme Court of Cassation, ruling No. 15594 of June 11, 2025, provides essential clarification on the application of Article 15 of the Gelli-Bianco Law (Law No. 24 of 2017), concerning the collegiality of CTUs in medical liability proceedings. This decision, which saw parties Q. (C. F.) and A. (C. M. G.) in opposition, quashed and remanded a previous ruling by the Court of Appeal of Venice, outlining a clear path for Italian courts.

Regulatory Context: The Gelli-Bianco Law and Collegiality of CTUs

Law No. 24 of 2017, known as the Gelli-Bianco Law, introduced significant changes in healthcare liability, aiming to balance patient protection with the protection of healthcare professionals. One of the most innovative aspects is contained in Article 15, which establishes specific requirements for the appointment of court-appointed technical consultants and experts in healthcare liability proceedings. In particular, the provision stipulates that the assignment should be entrusted to a panel of consultants, composed of a forensic physician and one or more specialists in the discipline relevant to the case. This collegiality aims to ensure a more complete and in-depth assessment, reducing the risk of errors or bias.

This provision is part of a procedural framework that often includes, before the merits judgment, a preliminary technical assessment for the purpose of dispute resolution, governed by Article 696-bis of the Code of Civil Procedure. The central issue that arose before the Cassation Court concerned the applicability of Article 15 of the Gelli-Bianco Law to merits proceedings initiated after its entry into force, in cases where the preliminary technical assessment had been carried out previously, according to the prior rules and without the collegiality requirement.

Ruling 15594/2025: A Crucial Clarification

The ruling of the Court of Cassation No. 15594 of June 11, 2025, addresses precisely this delicate issue, establishing a legal principle of considerable impact. The Court reiterated the application of the tempus regit actum principle, according to which the applicable law is that in force at the time the procedural act is performed. This means that Article 15 of the Gelli-Bianco Law applies to all merits proceedings initiated after its entry into force.

Article 15 of Law No. 24 of 2017 (concerning the requirements to be observed for the "appointment of court-appointed technical consultants and experts in healthcare liability proceedings") is applicable, based on the principle of tempus regit actum, to all merits proceedings initiated after its entry into force. Therefore, even if, prior to such entry into force, the preliminary technical assessment for the purpose of dispute resolution pursuant to Article 696-bis of the Code of Civil Procedure was carried out according to the previously applicable rules and without observing the collegiality requirement for the assignment, the merits judge – while upholding the regularity of the assessment and its acquisition – has the obligation to implement the principle of collegiality referred to in the aforementioned Article 15, by renewing it and entrusting the relevant assignment to a panel of consultants possessing the requirements requested by the aforementioned provision.

This legal maxim clarifies a fundamental point: even if a preliminary technical assessment (ATP) was conducted in accordance with the rules in force before the Gelli-Bianco Law came into effect and without the collegiality mandated by Article 15, and its inclusion in the merits proceedings is considered regular, the merits judge is still obligated to implement the principle of collegiality. This translates into the necessity of renewing the technical assessment, entrusting the assignment to a panel of consultants who meet the requirements established by Article 15. In other words, the validity of the ATP does not exempt the judge, in the subsequent merits proceedings, from ensuring that the technical evaluation is conducted according to the new collegiality standards, if the proceedings were initiated after the law came into effect.

Practical Implications of the Ruling

The consequences of this ruling are significant for all parties involved in healthcare liability litigation:

• For Judges: It is a clear warning about the obligation to rigorously apply Article 15 of Law No. 24/2017, even in the presence of a prior non-collegial ATP. The renewal of the CTU becomes a necessary step for the proper management of the proceedings.
• For Lawyers: It requires a deep understanding of transitional rules and careful evaluation of the procedural stage. It will be crucial to request the renewal of the CTU in a collegial form if the merits proceedings began after 2017 and the ATP did not comply with this requirement.
• For Patients: It offers a greater guarantee of impartiality and accuracy in the assessment of damages, as the collegiality of the CTU is designed to ensure a broader and multidisciplinary view.
• For Healthcare Professionals: Even for healthcare professionals, a collegial CTU represents a greater guarantee, as the assessment will be the result of a comparison between different expertise, reducing the risk of hasty or biased judgments.

The principle of tempus regit actum, invoked by the Cassation Court, is based on Article 11 of the Preliminary Provisions to the Civil Code, which governs the effectiveness of law over time. This ruling, also referencing previous decisions (such as No. 13038 of 2024 and No. 13060 of 2024), consolidates the jurisprudential trend aimed at strengthening procedural guarantees in the sensitive sector of medical liability.

Conclusions

Ruling No. 15594 of 2025 by the Court of Cassation represents a firm point in the interpretation of Article 15 of the Gelli-Bianco Law. By reiterating the obligation of collegiality for court-appointed expert opinions in healthcare liability proceedings, even when a prior non-collegial preliminary technical assessment has been duly acquired, the Supreme Court ensures that the principles of completeness and impartiality remain at the center of judicial evaluation. This ruling is essential for ensuring fairer and more transparent justice, offering greater legal certainty and contributing to better protection for both patients and healthcare professionals. For our Law Firm, staying updated on such jurisprudential developments is essential to offer our clients the best possible strategy and legal representation.