SN by order of 25.6.2026, I CSK 467/26, Legalis, refused to accept a cassation complaint for examination. The applicant considered the grounds for the adoption of the cassation action to be heard in a substantive legal question relating to the answer to the question whether, pursuant to Article 278(1) of the NPC, the ruling court should, in cases where the evidence obtained so far from the opinions of the judicial experts does not licence the formulation of clear and comprehensive conclusions, let evidence from the opinion of the next expert.
The second of the questions raised afraid whether, in the light of Article 278(1) of the KPC in the mention to Article 233(1) of the KPC, the court, erstwhile carrying out a comprehensive assessment of the evidence collected, could be regarded as the ‘highest expert’ in the case, and, therefore, erstwhile examining the opinions of experts with different views and conclusions, it should accept the findings of an expert who pointed to errors in the medical procedures carried out, even though he was not a specialist in the fundamental field of the case, i.e. chest surgery.
Status of the case
The plaintiff was a patient of the suspect hospital. She had advanced obstructive changes, deformation of the bone structures of the chest, cardiac displacement to the right, abnormal pulmonary anatomy – emphysema and over-aeration of the right lung, and reduced volumetric and importantly pressed by the left lung ribs – as well as idiopathic BOOP interstitial inflammation. Following chest deformation and lung underdevelopment, the spirometric parameters of the plaintiffs were importantly reduced. However, it was found in the case that the simplification of these indicators did not constitute a contraindications to the procedure but was associated with an additional hazard of respiratory complications.
Prior to the operation, the plaintiff was informed of its course and of possible consequences and typical complications. She was besides informed about the anticipation of utilizing artificial ventilation with a respirator, the usage of additional drugs and medical activities, as well as the hazard of excessive bleeding, diaphragm palsy, paralysis or paralysis of the vocal cord, Horner syndrome, impaired wound healing, inflammation of the pleural or mediastinal cavity and hematomas in the wound area. The plaintiff signed a message indicating that there were no additional questions and that she was full informed of the operational risks and possible complications.
The procedure was carried out on 21.11.2013. The plaintiff then developed a wellness disorder caused by postoperative complications. Their treatment active prolonged hospitalization and patient suffering. Finally, the plaintiff left the infirmary on 31.1.2014. She then appeared against the infirmary with a lawsuit.
Position of the Universal Court
The appeal court dismissed the plaintiff's request, considering that it had given informed consent to the operation and had been full informed of the risks involved. The Court besides considered that there was no reason to believe that informing the plaintiff of the hazard of a uncommon complication would lead to her refusing to accept the operation.
The Court besides concluded that there was no medical mistake in the case and that the plaintiff’s wellness disorder was a consequence of operational complications. Treatment was followed by medical procedures. There was so no basis for attributing work to the infirmary for the uncommon consequences of the operation.
In the course of the proceedings, evidence from the expert opinion of a forensic surgeon – a specialist in thoracosurgery – was taken and the opinions of a national consultant in thoracosurgery were used. On the basis of these, it was established that no diagnostic, therapeutic or organisational errors were made in the treatment of the plaintiff, resulting in prolonged treatment or wellness damage. However, the infection revealed in the plaintiff was associated with endogenous flora or secondary endogenous flora.
SN considerations
The SN based its deliberations on 3 levels: the relevance of the legal issue presented, legal and medical issues and the appropriateness of allowing evidence from the opinion of the next expert.
He pointed out that referring to an crucial legal issue requires the formulation of a problem of an abstract nature, not yet settled in the case law and requiring a thorough interpretation. The applicant should besides supply an argument, including a mention to the caselaw, which would justify the anticipation of divergent legal assessments erstwhile applying certain provisions. The importance of the issue should be reflected in both the importance of the explanation problem and its relation with the case being identified.
The NS cites the position established in the caselaw that the court is not obliged to accept evidence from the opinion of another expert whenever the organization considers the present opinion to be unfavourable and expects that another opinion will let it to show a favourable thesis. The request to appoint another expert should arise from the nonsubjective circumstances of the case, not only from the dissatisfaction of the organization with the conclusions already drawn up (cf. judgement of 15.2.1974, II CR 817/73, Legalis; judgement of 18.2.1974, II CR 5/74, Legalis; judgement of 5.11.1974, I CR 562/74, Legalis; judgement of 27.6.2001, II UKN 446/00, Legalis and judgement of 29.11.2016, II PK 242/15, Legalis).
In the justification of this provision, the ultimate Court besides cited a number of crucial jurisdictional positions applicable for the designation of medical matters.
Firstly, he pointed to the separate legal basis for redress claims. 1 of them may be based in Article 4(1) of the Act of 6.11.2008 on Patient Rights and Patient Rights Ombudsman (i.e. OJ of 2024 item 581) and concern a violation of the patient's right to information, regardless of the final result of the procedure. The second may, on the another hand, be based on Article 445(1) in Article 444(1) of the CCC and concern the faulty origin of bodily injury or wellness disorder following defective treatment. These claims are of a separate nature and relate to various unlawful events.
Secondly, SN recalled that there are besides complications peculiarly dangerous to the patient's wellness or life as regards the foreseeable consequences of the surgery. You should be informed of these, even if rare. However, this does not require that all possible, even very serious, consequences of the procedure be reported, regardless of the kind of procedure and the likelihood of them occurring. The scope of the information work depends on the nature and intent of the procedure, including whether it is taken with absolute, comparative or cosmetic indications. In the event of an absolute procedure, the doctor should explain to the patient in peculiar its purpose, nature and usual consequences.
Thirdly, it is not possible to inform the patient of all the consequences of the procedure which cannot be predicted or which are exceptional.
Comment
Medical disputes are complex. In most of them, evidence from the expert's opinion is essential due to the request to usage peculiar messages. The complexity of the case, the difficulty of uncovering an expert with the right expertise and the time essential to draw up an opinion are factors affecting the dimension of proceedings.
It is so appropriate to approve the position of the SN regarding the admission of further evidence from the opinions of judicial experts. The specified fact that the organization disagrees with the content of the present opinion or considers it to be detrimental to its procedural position cannot automatically lead to the request to appoint another expert. The request for specified evidence should be based on nonsubjective circumstances of the case, in peculiar ambiguity, incompleteness or contradiction of views which cannot be otherwise removed.
SN considerations stay in line with the erstwhile guidance of the case law relating to both the work to inform a doctor and to separate between the grounds of work for violation of patient rights and for bodily injury or disorder due to defective treatment.
The content of the questions raised by the complainant besides justifies the conclusion of the SN that there was no applicable legal issue within the meaning of the provisions governing the adoption of the cassation action for examination. The questions were, to a large extent, intended to challenge the way evidence was assessed in a peculiar case and the results of expert opinions carried out, not to resolve a fresh abstract legal problem requiring the ultimate Court to speak.
Order of 25.6.2026, I CSK 467/26, Legalis
