Medical negligence claims in Malta are not regulated by a specific statutory framework. Instead, Maltese courts rely on the general provisions on damages contained in the Civil Code, Chapter 16 of the Laws of Malta.
Medical Negligence Claims in Malta
In a recent judgement regarding alleged damage caused because of breast augmentation surgery an extensive explanation was given on how tortious liability is considered due to a medical intervention.
In the case, the patient (the “plaintiff”) instituted proceedings against her plastic surgeon and his medical team, alleging damages arising from breast augmentation surgery. The plaintiff claimed that the breast implants had been inserted incorrectly, no adequate follow-up care was provided, and the procedure failed to meet accepted professional standards. She later consulted another medical practitioner to remove the implants.
The surgeon and his medical team (the “respondents”) denied all allegations of malpractice. They maintained that the surgery had been carried out according to established medical standards. Moreover, they argued that the implants were inserted correctly, with no visible scarring from any incisions. The respondents also stated that post-operative care had been duly provided by a qualified medical team and that the surgeon had personally examined the patient more than once after the operation.
The Legal Basis for Medical Tortious Liability in Malta
In its judgment, the Court referred to Article 1125 of the Civil Code, which provides:
“Where any person fails to discharge an obligation which he has contracted, he shall be liable in damages.”
Based on this provision and previous Maltese case law, the Court reiterated that, in medical negligence cases, the plaintiff must prove the following:
- The existence of a contractual relationship between the parties;
- That actual damage was sustained; and
- A causal link between the medical intervention and the alleged damage.
Accordingly, a patient alleging medical negligence must establish that the medical practitioner owed a contractual obligation, that damage was suffered, and that such damage resulted directly from the medical intervention.
The Court further confirmed that the burden of proof only shifts to the medical practitioner once fault has first been proven by the patient. At that stage, the practitioner must then prove that the procedure was performed according to accepted medical practices and standards.
No Guarantee of a Specific Medical Result
The Court also reaffirmed an important principle of Maltese medical law: a medical practitioner cannot guarantee a specific result. Liability does not arise merely because the desired outcome is not achieved. Instead, the practitioner’s conduct is assessed according to whether they acted prudently, diligently, and in line with accepted standards of medical practice.
Why the Plaintiff’s Claim Failed
Firstly, the Court noted that although that the plaintiff did not bring any proof of a contractual relationship the respondent’s had renounced to the necessity of this requisite. In fact, the respondent’s confirmed that there was a contractual relationship between the patient and the surgeon and his medial team.
Secondly, the Court found that the plaintiff did not prove any damage. The surgeon she allegedly engaged to remove the implants never testified. Nor was a court appointed expert requested despite the technical nature of the allegations.
Thirdly, the plaintiff also failed to provide evidence showing that the surgeon or medical team acted negligently.
Why the Respondents Plea Succeeded
By contrast, the respondents presented the patient’s medical records together with photographic evidence taken before and after the surgery. After examining this evidence and hearing their testimonies, the Court found no indication that the operation had been improperly performed or that the post-operative care provided was deficient.
Court Decision
The Court ultimately held that the surgeon and his medical team were not liable for the damages allegedly sustained by the patient.
The surgeon and his medical team were represented by Dr Jeannine Giglio and Dr Michaela Giglio.