Medical liability: after 14 years, the Supreme Court of Cassation brought a civil negligence case centring on a ‘Contour Transtar’ procedure to a close 4 August 2026 – Posted in: News

The Supreme Court of Cassation has dismissed, by order no. 3904/2026 of the Third Civil Division, the appeals lodged by a surgeon and a well‑known Rome clinic, thereby making final the judgment on the merits by which the Court of Appeal of Rome had held them jointly and severally liable to compensate the damages arising from a surgical operation that had caused extremely serious disabling consequences to a patient.
The patient, in the presence of a diagnosis recorded in the medical chart of rectal prolapse and haemorrhoidal mucus, underwent in 2009 a rectal resection performed using a then innovative technique known as the “Contour Transtar” procedure, which entails the use of a mechanical “cut‑and‑staple” device. However, instead of resolving the diagnosed condition, the operation led to a drastic deterioration in her state of health, with the onset of severe complications, including faecal incontinence.
Although the court‑appointed expert report had considered the surgeon’s conduct to be entirely correct from a technical standpoint, both the Court of First Instance and the Court of Appeal of Rome, relying on the extensive medical documentation produced by the claimants, duly departed from that opinion, finding that the operation, albeit technically correct in its execution, had been inappropriate, as it was carried out based on an erroneous diagnosis and, above all, without an adequate reconstruction of the actual pathology from which the patient was suffering.
Having rejected all seven grounds of appeal put forward by the appellants, the Supreme Court of Cassation upheld the adequacy of the reasoning of the Court of Appeal, holding that, through such reasoning, the conclusions of the court‑appointed expert had been reasonably disregarded, and other items of evidence had been relied upon, including the assessments of the parties’ own experts, in accordance with the principle iudex peritus peritorum.
At all stages of the proceedings, Attorney Augusto Vacca, founder of AV & Partners, represented the patient and her family members.