Medical malpractice law and tort reform are contentious issues in the United States. A vast empirical literature assesses the effectiveness and costs of current U.S. medical malpractice law. It is difficult to make worldwide inference from U.S. studies given the particularities of their healthcare delivery and legal system. In this paper we focus on Italy as an example of a civil law jurisdiction. Italian medical malpractice law is essentially judge-made law. However, its effectiveness is likely to be curtailed by excessive delays in litigation. Several reforms have been enacted since the late 1980s to correct this situation. By making use of the decisions of the Italian Court of Cassation (which have shaped medical malpractice law) from 1970 to 2009, we show that these reforms had no general statistically significant impact on delays. Recent reduction of delays does not seem to be related to legal reforms.