Court of Cassation, criminal division, judgment 670 of 22 June 2017. The firm acted for one of the civil parties.
What the case was about
A private clinic in Milan, operating within the Italian national health service, was found to have subjected patients to invasive surgery they did not need. The proceedings lasted nine years and ended four life sentences; they also decided the compensation owed by the hospital bodies to the people who had been operated on.
The mechanism at the centre of the case was financial. Italian hospitals are reimbursed by the region under Diagnosis Related Groups — a system imported from the United States, where it sits alongside an insurer that approves the treatment in advance. In a public-health system without that prior control, reimbursement by itemised claim created an incentive that worked in the wrong direction: the more expensive the operation, the more it paid, and the more expensive operations were also the more invasive ones.
Why it matters
Criminal proceedings in Italy can decide the civil compensation owed to the victim, if the victim joins as a parte civile — a civil party within the criminal case. It is a procedural route that has no exact equivalent in common-law systems, and foreign clients rarely know it exists. It avoids running a separate civil action years later, with the evidence already dispersed.
The case also shows what the defence of a patient actually requires. It is not enough to show that an operation went badly; here the work consisted in reconstructing the funding rules of an entire health system, and in demonstrating that the decision to operate had been taken for reasons that had nothing to do with the patient in front of the surgeon.
If this is your situation
Medical liability claims in Italy turn on causation and on the technical evidence that establishes it. The useful step is almost always the earliest one: securing the clinical records and obtaining an independent medical opinion before anything is conceded or settled.