Una delle attività di estrema importanza svolte dall’Istituto Nazionale della Previdenza Sociale (INPS) consiste nel “recupero crediti”. In particolare, nell’ambito delle prestazioni economiche di malattia, tale attività è principalmente riferita a quelle malattie che sono conseguenza di fatti dolosi o colposi di terzi. Si tratta di patologie estremamente numerose, basti pensare a tutti i casi di incidente stradale in cui è lecito ipotizzare la responsabilità di almeno una delle due parti.
In queste situazioni, l’INPS, sebbene sia tenuto all’erogazione delle prestazioni, ha diritto di ottenere dal terzo responsabile il rimborso della somma corrisposta al soggetto danneggiato a titolo di indennità per la malattia che ne è conseguita. In tale processo, indicato con il termine “surroga”, il medico di controllo ha un ruolo di primo piano.

(1) Responsabile Unità Operativa Complessa INPS Torino 2

The phenomenon of medical error is wide known, and many strategies, such as clinical risk management, have been developed in order to stop it. Among these corrective actions, a greater attention has been paid to nursing malpractice, defined as «all adverse events that arise from purely practical nursing, or the participation of registered nurses in collaborative problem-solving». The solution of the problem of nursing malpractice consists in promoting cultural change. We are ready for this challege, by sharing the results with other health care professionals, respecting the competences and the value of all people, catching up the goal “to defeat the error in medicine”. Trust should be part of the solution: it comes to a measurable factor, which consists in collaborating with courage and speaking out.

(1) Professore a contratto di Infermieristica – Università degli Studi di Roma TorVergata (Sora), di Bari (Taranto) e del Piemonte Orientale (Novara)

To date, only a few case reports have been published on psychiatric disease due to an accident at work. In this article we describe a case of an employee who entered the emergency room after a verbal altercation with superiors and colleagues, complaining about turmoil. The diagnosis of “anxiety crisis” due to accident at work was made (“bullying”), and therefore the insurer (INAIL) justified the 105-day absence which followed this episode. The case was then submitted to a re-evaluation by INAIL itself, that this time judged only the 30 days following the altercation to be related to the accident at work, considering the remaining days to be due to a common disease, not attributable to the traumatic event.
Here we discuss the peculiar features of this case: the nature of the illness diagnosed, the kind of onset, and the management of the injury by the health care authority (INAIL).

(1) Dipartimento di Sanità Pubblica e Neuroscienze, Università degli Studi di Pavia – University consortium for the study of adaptive disorder and headache (UCADH), IRCCS Fondazione “C. Mondino”, Pavia
(2) Dipartimento di Sanità Pubblica e Neuroscienze, Università degli Studi di Pavia – U.O. Medicina Ambientale e Medicina Occupazionale, IRCCS Fondazione Salvatore Maugeri, Pavia

Medically assisted procreation is a challenging result in medical research. Since the first baby born after in vitro fecundation in 1978, technology has greatly grown: but at the same time also legal, moral and ethical questions have arisen. Different European countries have established different rules: here we analyse, in particular, the Law 40/04, which in Italy still regulates the matter, with all its implications and consequences. The topic is really complicated, and in Italy the legislator has decided to write restrictive measures, sometimes presenting lacks and contradictions. More recently guidelines and judgements have tried to fill these legislative gaps.

(1) Ricercatore universitario confermato; Docente di Medicina Legale nelle Facoltà Mediche dell’Università “Sapienza” di Roma
(2) Avvocato del Foro di Roma. Dottore di ricerca in Medicina Legale e Scienze Forensi

In Italy the “medico di controllo” is the physician checking diagnosis, prognosis and fitness for the job of an ill worker absent from work, whose disease is certified by the general practitioner. Unfortunately, this control is too often limited to assessing the presence of the worker at home. This article describes in detail the responsibilities of this class of physicians, analysing the actions to be done in the light of case law and INPS policies, such as the possibility for the workers to contest the judgement of the physician, the VMC/REF form to fill, the actions to do in case the worker is away from home, etc.

(1) Coordinatore medico legale regionale INPS