Health Liability and Causation: Commentary on Order No. 17171 of 2024

The judgment No. 17171 of June 21, 2024, by the Court of Cassation offers an important reflection on the issue of health liability, particularly regarding the causal link and the concept of unreasonable risk. In this article, we will analyze the key points of this order, seeking to make its content and legal implications understandable.

Context of the Judgment

The dispute concerns a claim for damages by a patient, D. (M. D.), against A. (C. P.). The specific case focuses on the delayed diagnosis of two benign neoplasms, which, although distinct, raise questions about the liability of the healthcare professionals involved. The order of the Court of Cassation addresses the issue of causation, referring to the theory of the purpose of the violated rule.

CAUSATION (LINK OF) Theory of the purpose of the violated rule - Prerequisites and scope - Factual circumstances regarding health liability. When the tort is constituted by the violation of rules aimed at avoiding the creation of an unreasonable risk, liability extends only to those harmful events that represent the concretization of the aforementioned risk. (In the present case, relating to the claim for damages to health resulting from the delayed diagnosis of two benign neoplasms, entirely independent of each other, the Supreme Court confirmed the lower court's judgment which had excluded that the onset of the second could be causally correlated to the actions of the healthcare professionals, as the rule of the art violated was intended solely to avert the concretization of the risk relating to the manifestation of the first pathology, being based on its specific clinical picture, different from that which would have required instrumental investigations aimed at identifying the other).

Analysis of the Headnote

The headnote expressed by the Court clarifies that, in the presence of a violation of rules intended to prevent unreasonable risks, the healthcare professional's liability is limited to harmful events that concretize the specific risk. This means that if the violation of the rules aims at preventing a certain type of damage, liability cannot be automatically extended to unrelated events.

In the case at hand, the Court confirmed that the onset of the second neoplasm was not causally linked to the actions of the healthcare professionals, as the violation of the rule of the art concerned only the first pathology. Therefore, it is essential that health liability be assessed with reference to the specific clinical context and the risks foreseen by current regulations.

Implications for Health Liability

This order highlights some crucial points for legal practice in the healthcare sector:

• The need for a thorough analysis of the causal link between the tort and the damage suffered by the patient.
• The recognition that liability is limited to events that represent a concrete manifestation of the risk foreseen by the violated rule.
• The importance of the correct application of the rules of forensic medicine and good clinical practices in determining the liability of professionals in the sector.

Conclusions

In summary, order No. 17171 of 2024 represents an important clarification on health liability, establishing clear limits in relation to the causal link and the concept of unreasonable risk. This offers valuable guidance for professionals in the legal and healthcare sectors, emphasizing the importance of a precise and contextualized assessment of liability situations. Knowing and understanding these principles is fundamental to ensuring adequate protection of patients' rights and the correct application of justice.