Nosocomial Infections: How to Establish Liability

The Supreme Court of Cassation has pronounced a historic sentence marking a turning point in the question of attributing medical liability in cases where nosocomial infections have arisen.

The decision refers to those infections that the patient allegedly contracts within the hospital or other healthcare facilities and establishes that they cannot fall within the objective responsibility of the healthcare facility.

In the past it was not clear how the responsibility of the hospital should be established in similar cases.

With the recent sentence no. 6386 of 3.3.23, the Court of Cassation has finally shed light on these kind of issues, identifying the criteria to be weighed in verifying the existence or otherwise of Healthcare Facilities Liability in the event of actions for damage of this nature.

Therefore, according to the Supreme Court it is necessary to refer to:

  • The Temporal Criteria (i.e. the time interval between discharge and the onset of the pathology),
  • The Topographic Criteria (i.e. whether the infection occurred in the same surgical site as the operation),
  • The Clinical Criteria (i.e. whether or not the appropriate preventive measures based on the specific infection affecting the patient were adopted).

The Supreme Court went on to establish that, starting from the aforementioned criteria, the demonstration of the existence or otherwise of a causal link between the doctors’ work and the onset of the pathology complaint can be provided by the plaintiff even in only probabilistic terms, without the need for absolute certainty.

This new, more balanced approach avoids even objectively attributing responsibility to the health professionals or the medical center solely due to the onset of the infection, and allows for a more correct assessment to be provided, based on the ascertainment of the many variants involved in the issue, on the study of the specific situation under discussion, beginning with the existence or not, albeit in purely probabilistic terms, of the causal link in the story.