Artigo de revisão
THE TECNICAL ASSISTANT IN CIVIL ACTIONS FOR ALLEGED MEDICAL ERROR
Como citar: Netto JN, Campos RADC, Fujita RR. O assistente técnico nas ações cíveis por suposto erro médico. Persp Med Legal Pericia Med. Vol. 10, 2025; 250945.
https://dx.doi.org/10.47005/250945Aceito em 26/11/2025
The authors report no conflict of interest.
THE TECNICAL ASSISTANT IN CIVIL ACTIONS FOR ALLEGED MEDICAL ERROR
Resumo
RESUMO INTRODUÇÃO: Tem-se poucos estudos referente a esse tema, sendo as publicações mais voltadas à medicina legal, faltando enfoque voltados às demais áreas de conhecimento (1). Faz-se necessária a produção de dados quanto ao tema devido ao grande aumento da judicialização da medicina no Brasil. MÉTODO: Busca nos trabalhos científicos, teses e dissertações no Direito e na Medicina, da melhor definição do que é o assistente técnico, fazendo sua correlação com os Códigos de Processo Civil de 1923, 1973 e 2015. RESULTADOS: A prova técnica médica em casos de suposta má prática é importante na tomada da decisão pelo julgador, sendo o laudo pericial relevante (14,15), assim como o parecer técnico (do assistente técnico) o qual também pode ser utilizado na formação do convencimento pelo juízo CONCLUSÃO: O assistente técnico é o auxiliar da parte no processo médico, devendo fiscalizar e assessorar o trabalho pericial, visando trazer à luz a veracidade dos fatos debatidos em discussão técnica. PALAVRAS-CHAVE: Prova pericial, Assistente Médico, Medicina Legal, Contraditório, Legislação Médica, Jurisprudência Médica.
Palavras Chave: Prova pericial, Assistente Médico, Medicina Legal, Contraditório, Legislação Médica, Jurisprudência Médica.
Abstract
ABSTRACT INTRODUCTION: There are few studies on this subject, with publications more focused on forensic medicine, lacking focus on other areas of knowledge (1). It is necessary to produce data on the subject due to the great increase in the judicialization of medicine in Brazil. METHOD: Search in scientific works, theses and dissertations in Law and Medicine, the best definition of what a technical assistant is, making its correlation with the Codes of Civil Procedure of 1923, 1973 and 2015. RESULTS: Medical technical evidence in cases of alleged malpractice is important for decision-making by the judge, with the relevant expert report (14,15), as well as the technical opinion (from the technical assistant) which can also be used in the formation of the conviction by the court. CONCLUSION: The technical assistant is the auxiliary of the party in the medical process, and must supervise and advise the expert work, aiming to bring to light the veracity of the facts discussed in the technical discussion. KEYWORDS: Expert Testimony, Doctor Assistant, Legal Medicine, Contradictory, Medical Legislation, Medical Jurisprudence.
Keywords (MeSH): Expert Testimony, Doctor Assistant, Legal Medicine, Contradictory, Medical Legislation, Medical Jurisprudence.
Introduction
Regarding the topic of medical expertise, publications focus more on the topic of legal medicine, with few scientific studies focusing on other medical specialties1, with the aim of evaluating the real importance of the technical assistant in civil proceedings for alleged medical error.
There is a lack of data on the subject, due to the growth in the judicialization of medicine, there has been a significant increase in legal demands in Brazil2,3, where the doctor is faced with a lawsuit simply because the patient is dissatisfied with the result of the procedure or the information previously obtained, being data are totally subjective.
In the Brazilian legal system, the rule is subjective civil liability, while objective liability is residual, applicable only in cases provided for by law. Due to the evolution of society, there are different understandings in different areas. Therefore, it is necessary to analyze the doctor’s subjective responsibility, which is an obligation of means and not of result. This considers the obligation to practice the profession ethically, take due care and the risk inherent to the profession, as it deals with human beings4 (KFOURI NETO, 2013).
Although the Regional Medicine Councils (CRM) do not require the doctor to be a specialist to work in any branch of Medicine, according to the CFM Opinion n. 17/20045, it is important to always work in your area of specialization, being qualified by CREMESP and it is prudent to also be qualified by the company representing this specialty; even so, he will be subject to respond to ethical-professional processes and suffer appropriate punishments when negligence, incompetence or imprudence are proven, in accordance with Art. 1º of the Code of Medical Ethics (CEM)6.
In the historical context, Brazil had three Civil Procedural Codes, one in 1939, another in 1973 and, most recently in 2015 7,8.
The 1939 code provided for in its article 129 the appointment of the expert by the judge, and in article 132 the appointment of a technical assistant by the parties, who would monitor the expert’s work and be able to challenge their conclusions, in addition to allowing the same means of investigation of the expert to the assistants in its single paragraph7.
According to Decree-Law No. 4,565 of 1942, if the parties agree and indicate the same name as expert, before the judge’s order, this expert will be appointed. If there is no indication from the parties, the judge will make the choice, thus prevailing if the parties do not indicate another expert within 48 hours9.
According to Decree-Law no. 8,570 of 1946 in articles 129 and 132, the examination may be carried out by a single expert, if there is disagreement between the parties, each party could nominate their expert and the judge may nominate a third expert to choose one of the reports presented, as the experts appointed by the parties tended towards the side that indicated it. If indicated by only one of the parties, the other may agree or indicate its expert within 24 hours of being notified, as per sole paragraph10.
Establishes the Code of Civil Procedure (CPC) by Law No. 5,869 of 1973 in article 421 §1º that the judge will appoint the expert opening a deadline for appointment a technical assistant and present questions; and in article 429 that to perform the function, both experts and technical assistants can use all necessary means11.
The civil procedural text underwent important modifications after approximately 20 years of its creation in 1973, to simplify the process in relation to expert evidence through Law 8455 in 1992, where we have in article 421 that the judge will appoint the expert, setting a deadline for delivering the report12.
And by Law No. 13,105 of 2015 in article 465 where the judge will appoint the expert and he must be specialized in the object of the expertise, setting a deadline for delivery of the report, opening deadline for the parties to nominate a technical assistant and present questions. Fitting here article 466 § 1 and 2, where technical assistants are trusted by the party and have no impediments or suspensions in addition to ensuring monitoring of steps with prior communication. And article 471 § 1 and 2 about the indication of the technical assistant and setting a deadline for delivering technical opinion8.
After this brief historical report, we will pay attention to the study of the technical assistant, a priori, according to article 156 of CPC8, expertise is requested when the proof depends on specific technical knowledge, experts are appointed by the judges and technical assistants are hired and appointed by the parties.
In discussions about health care in search of compensation, in Civil Law, there is medical expert evidence. It is the expert’s role to clarify the situation in discussion, with substantiated conclusions after its technical evaluation13. The main means of proof in actions involving medical malpractice is medical expertise. The expert report has great influence on the decision whether or not the actions should be taken14.
It must be discussed whether the doctor, without fault, would be responsible for an act inherent to the human being that does not arise from medical activity, such as illness or death. Is the objective responsibility of the doctor equal to the fight against human nature, given that the profession has a risk because it is the most precious asset of human beings: life4 (KFOURI NETO, 2013).
The parties must be informed of the day and time of the examination in accordance with Law 10,358 of 2001 article 431-A15, and it is their obligation to inform their technical assistant so that they can participate in the examination and contribute to clarifying the facts, through the preparation of their technical opinion, with deadline for delivery.
The expert clarifies the facts for the court, based on scientific knowledge, to convince the judge and justice13.
Material and Method
Search for the best definition of what a technical assistant is. Search for articles, theses and dissertations in Law and Medicine, correlating them with the Civil Procedure Codes of 1923, 1973 and 2015.
Approved by the UNIFESP Research Ethics Committee, under number 114889/2021 and approval of the Brasil CAAE platform:52278721.6.0000.5505.
Results
Medical expertise is fundamental to understanding the judgment, with technical evidence based on medical knowledge in cases of alleged medical malpractice being important in the judge’s decision-making. The relevance of the expert report to the outcome of the case is well known; the judge may or may not agree with the content of the expert report, but, in most cases, the judge considers the expert report14.
Most publications refer to medicines16 and legal medicine, which may be related to the fact that the latter is taught in colleges1.
It is up to the expert to clarify for the court, through his specialized knowledge, about the health care provided by the doctor in the case under discussion, contributing for making a judicial decision13.
Criminal Law articles highlight the importance of expertise as evidence, exalting the importance of the technical assistant as an important evolution in the accused’s participation in the production of evidence17.
| ARTICLE, BOOK | SUBJECT
|
YEAR |
| Medical expertise in scientific literature | Medical expertise | 2016 |
| Judicialization of health in Brazil: profile of demands, causes and proposed solutions | Judicialization of medicine | 2019 |
| Complaints for medical error in Goiás | Medical error | 2009 |
| Preparation of the expert medical practice assessment report within the scope of Civil Law | Preparation of the expert report | 2018 |
| The importance of the medical expert report in forming the understanding of judgment: analysis of cases of alleged medical malpractice in general surgery | Importance of the expert report | 2012 |
| The Judicialization of health in public and private health systems: a systematic review | Judicialization of health | 2020 |
| The role of the technical assistant in criminal proceedings: legislative and doctrinal issues | Technical assistant | 2017 |
| Doctor’s civil liability | Subjective liability | 2013 |
| Judicial medical expertise | Expert | 1982 |
Table1. Articles and books used in this work
| LEGISLAÇÃO / NORMAS | ASSUNTO | ANO |
| CFM Opinion No. 17/2004 | Qualification to exercise expert activity | 2004 |
| CFM Resolution No. 2,217 | Code of Medical Ethics | 2018 |
| Law No. 1,608 | Code of Civil Procedure of 1939 | 1939 |
| Law No. 5,869 | Code of Civil Procedure of 1973 | 1973 |
| Law No. 13,105 | Code of Civil Procedure of 2015 | 2015 |
| Decree-Law No. 4,565 | Amends and rectifies provisions of the Civil Procedure Code | 1942 |
| Decree-Law No. 8,570 | From the new wording to provisions of the Civil Procedure Code | 1946 |
| Law No. 8,455 | Code of Civil Procedure, referring to expert evidence | 1992 |
| Law No. 10,358 | Code of Civil Procedure, relating to the knowledge process | 2001 |
Table 2. Legislation and standards used in this work
Discussion
The technical assistant does not have the premise of impartiality, he is hired by the party and interests of his contractor, however, he must always act in accordance with the truth and professional ethics. Being the party’s consultant, technically guiding the contractor’s team and participating in the entire technical process with the expert, supervising and advising the expert’s work.
Second Hermes Rodrigues de Alcântara:
Expert (peritus) is any individual with unblemished and respectable knowledge of morals, specialized in certain trades, arts or sciences, capable of leading anyone to the truth, when asked to do so. Being a poet is not for everyone, being an expert means having imagination, editorial inspiration, language skills and research spirit, who sees in each case not a boring routine, but a possibility of rediscovery or, until new discoveries18.
The expert impartially evaluates and prepares technical reports that serve as evidence for the judge, using his specialized knowledge to provide clarifications during the hearings, when necessary. The technical assistant, hired by the party, offers technical support, critically analyzes the expert report, prepares an opinion helping to construct arguments and strategies, and can testify at hearings to support the party that hired him. Together, they ensure a complete and fair analysis of medical issues in the judicial sphere.
The technical assistant must technically guide his client and team of lawyers, through specific knowledge, so that the most assertive decision can be made during the process.
The technical assistant’s work begins in the initial or in the dispute (depending on who represents it), as it will bring all the technical basis, forming logical reasoning from the beginning of the dispute, bringing consistency and continuity when formulating and presenting the questions, monitoring the expertise and producing the technical opinion.
The importance of medical expertise as evidence in civil proceedings in the health sector is well known. It is worth talking about the daily registration of newly graduated doctors or not to be court experts, but without the necessary training and/or understanding to do so17, this fact makes the hiring of a qualified technical assistant even more important.
Thus, the technical assistant monitors all expert acts to agree, disagree, challenge, criticize, complement the expert report, according to his specific technical arguments in the technical opinion, through his free action the judge analyzes all documents in the case and substantiates his decision, which can be based on this opinion. Thus, there has been a high level of technical discussion in the process to bring to light the veracity of the facts and clarify the matter being debated by the court.
The important role of the technical assistant in judicial medical proceedings stands out. According to article 436 of the 1973 CPC, the judge is not restricted to the expert report and can use other elements to reach his conclusion, and articles 371 and 479 of the CPC 2015, the judge will be able to use in his decision the evidence contained in the case, regardless of who produced it, that is, he can consider the technical opinion presented by the party as evidence in the action and make his decision, indicating in the sentence the reasons that led him to do so. to this conclusion8.
Conclusion
The technical assistant in judicial medical proceedings is the party’s assistant, he is the expert hired by the party and must technically guide his client and the team of lawyers, and it is ideal to start technical work early, always acting with truth and professional ethics and participating in the entire technical process with the expert, supervising and advising the expert’s work. The judge may use the technical opinion, objection or criticism from the technical assistant to base his decisions in the sentence, making the importance of this in the process clear.
References
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