The case of Domenico, the young heart-transplant patient who died after surgery at Naples' Monaldi hospital, has returned before the Tribunale del Riesame for a hearing on the professional suspension imposed on cardiac surgeon Guido Oppido. The defense has asked for the measure to be revoked.

According to reporting by Il Mattino, Oppido's lawyers argue that the removal of Domenico's native heart was not performed before the organ intended for transplant was available in the operating room. That timing question is central to the precautionary proceedings against the surgeon.

The defense reconstruction: 14:26 and 14:34

The defense reconstruction is based on analysis of a screenshot taken from a video found on the mobile phone of an operating-room nurse.

The lawyers argue that:

  • at 14:26, the transport box containing the heart arriving from Bolzano was already inside the operating room;
  • at 14:34, Domenico's own heart was still beating on the operating table.

On that basis, the defense maintains that Oppido operated only when the box was in the room, and presents the video material as evidence that would clear him on the contested sequence of the explant.

The sources acquired do not provide an independent verification of the screenshot or of the full video, and the defense timeline has not been reported as judicially confirmed. The outcome of the Riesame hearing is still awaited.

A damaged organ, ECMO and the Berlin Heart question

The sources agree on one difficult background point: the heart arriving from Bolzano was reported as damaged during transport, and after the transplant the team resorted to ECMO extracorporeal support.

A court-appointed expert assessment, ordered by the investigating judge, then raised a second, post-operative issue. According to the summaries reported by Il Messaggero and la Repubblica, the expert opinion indicated that a Berlin Heart device could have preserved organ function and kept open the possibility of a re-transplant for Domenico, as an alternative to ECMO.

The parties interpret that assessment in opposite ways. The family considers it compatible with responsibility in the subsequent management of the patient, while Oppido's defenders argue that the surgical conduct itself deserves no criticism.

A video presenting the defense position also states that Oppido was not informed of the damage to the donor heart.

What the family contests

Domenico's parents, represented by lawyer Francesco Petruzzi, ask the judiciary to examine whether the facts could amount to voluntary homicide by omission, linking that legal question to the alleged failure to switch from ECMO to the Berlin Heart.

The family also disputes the documentary reconstruction concerning the evaluation of the Berlin Heart and its subsequent non-use. Criminal responsibility and any alleged falsification of the clinical record remain under investigation and have not been finally decided.

What is at stake at the Riesame

For readers following a complex precautionary case, two distinctions matter.

First, the Riesame is not deciding final guilt or innocence. It is reviewing whether the professional suspension against Oppido should remain in place while investigations and expert disputes continue. The defense request for revocation therefore focuses on the seriousness of the indications and the need for a precautionary measure, not on a final verdict.

Second, the case now has two separate contested levels: the timing of the surgery in the operating room, and the post-operative choices after the transplant. The video screenshot addresses the first level. The Berlin Heart versus ECMO dispute, and the documentary questions raised by the family, concern the second. A finding on one would not automatically resolve the other.

What remains open, on the basis of the sources available, includes the judicial validation of the defense timetable, the allocation of responsibility for the damage to the organ during transport, the post-operative management, and the final decision of the Riesame.