The hypothesis of medical liability arising from healthcare-associated infections features important profiles of complexity, in terms of both ascertaining the causal link and assessing the individual resulting harm. The Italian jurisprudence has repeatedly ruled on the need for healthcare facilities to produce evidence confirming the non-failure to comply with the rules of prevention, until a recent ruling by the Court of Cassation which provided an actual checklist indicating necessary exonerating proof and identifying the staff that directly assumes the responsibility for the infection.