Gianpaolo Ronconi 11*, Cristina Nigito1, Fabio De Giorgio2, Paola E. Ferrara1

1. Physical Medicine and Rehabilitation Unite, Teaching Hospital Foundation “Agostino Gemelli” IRCCS, Catholic University of Sacred Heart, Rome, Italy; 2. Public Health Institute, Legal Medicine Section, Teaching Hospital Foundation “Agostino Gemelli”, Catholic University of Sacred Heart, Rome, Italy.

Key wordsDry Needling, Rehabilitation, Legal Medicine.
SummaryIn an our previous article, we described a case of a professional swimmer who presented a pneumothorax after treatment with dry needling (DN), performed by a physiotherapist.
Although only few cases of serious adverse events after this treatment are reported in literature, the description of this case seemed to us of considerable interest to underline and discuss the medical-legal and ethical aspects related to competencies and responsibilities of medical doctors and physiotherapists performing the procedure.
The doctor-patient relationship, in this case, has failed because the patient has not received a correct diagnosis and adequate rehabilitation treatment according to international guidelines.
In Italy a specialist medical doctor’s prescription is required as a guide in the rehabilitation program performed by the physiotherapist after a clear and official diagnosis.
The Italian Council of Health in the session of 13 June 2017, established that the practice of DN is a doc- tor’s exclusive competence due to the invasive characteristics and potential complications of this technique.

Current statement about Dry Needling practice in Italy after the opinion of the Italian Superior Health Council: practical implications for the safeguard of the patients in a case of malpractice

Parole chiaveDry needling, Riabilitazione, Medicina legale.
RiassuntoIn un nostro precedente articolo abbiamo descritto un caso di un nuotatore professionista che ha presentato esiti di uno pneumotorace dopo trattamento con tecnica dry needling (DN), praticato da un fisioterapista.
Sebbene in letteratura siano riconosciuti solo pochi casi di eventi avversi gravi, conseguenti a questo trattamento, la descrizione di questo caso ci è sembrata di notevole interesse per sottolineare e discutere gli aspetti medico-legali ed etici relativi alle competenze e alle responsabilità dei medici e dei fisioterapisti che eseguono la procedura.
La relazione medico-paziente, in questo caso è venuta a mancare, in quanto il paziente non ha ricevuto una corretta diagnosi e un adeguato trattamento riabilitativo secondo le linee guida internazionali.