DR. RUBI LI VS. SPS. REYNALDO & LINA SOLIMANG.R. NO.
165279En Banc, June 7, 2011Justice Villarama
FACTS:
On February 21, 1994, respondent spouses filed a damage suit
against herein petitioner charging her with negligence and
disregard of their 11-year old daughter, Angelica Solimans safety,
health, and welfare by her careless administration of the
chemotherapy drugs, failure to observe the essential precaution in
detecting early the symptoms of fatal blood platelet decrease and
stopping early on the chemotherapy, which bleeding led to
hypovolemic shock that caused Angelicas untimely demise. Angelica
was suffering from osteosarcoma, a high-grade (highly malignant)
cancer of the bone which usually afflicts teenage children.
On September 5, 1997, the RTC of Legazpi City, Branch 8,
dismissed the complaint holding that petitioner was not liable for
damages as she observed the best known procedures and employed her
highest skill and knowledge in the administration of chemotherapy
drugs on Angelica but despite all efforts said patient died.
On appeal, the CA, while concurring with the trial courts
finding that there was no negligence in the administration of
chemotherapy treatment to Angelica, found that petitioner as her
attending physician failed to fully explain to the respondents all
the known side effects of chemotherapy which gravely affected their
child. Thus, the appeal was granted and the trial courts decision
was modified and entitled the respondents to their claim for
damages. Hence, this petition.
ISSUE:
WON the petitioner can be held liable for failure to fully
disclose serious side effects to the parents of the child patient
who died while undergoing chemotherapy, despite the absence of
finding that petitioner was negligent in administering the said
treatment.
RULING OF THE COURT:
The petition for review on certiorari is granted. The CA
Decision is set aside and the trial courts decision is reinstated
and upheld.
HELD:
There are four essential elements a plaintiff must prove in a
malpractice action based upon the doctrine of informed consent: 1)
the physician had a duty to disclose material risks; 2) he failed
to disclose or inadequately disclosed those risks; 3) as a direct
and proximate result of the failure to disclose, the patient
consented to treatment she otherwise would not have consented to;
and 4) plaintiff was injured by the proposed treatment. The
gravamen in an informed consent case requires the plaintiff to
point to significant undisclosed information relating to the
treatment which would have altered her decision to undergo it.
The element of ethical duty to disclose material risks in the
proposed medical treatment cannot thus be reduced to one simplistic
formula applicable in all instances. Further, it a medical
malpractice action based on lack of informed consent, the plaintiff
must prove both the duty and the breach of that duty through expert
testimony. Such expert testimony must show the customary standard
of care of physicians in the same practice as that of the defendant
doctor.
In this case, the testimony of the doctors presented as
witnesses does not qualify as expert testimony to establish the
standard of care in obtaining consent for chemotherapy treatment.
In the absence of expert testimony in this regard, the Court feels
hesitant in defining the scope of mandatory disclosure in cases of
malpractice based on lack of informed consent, much less set a
standard of disclosure that, even in foreign jurisdiction, has been
noted to be an evolving one.
PROFESSIONAL SERVICES, INC. VS. NATIVIDAD & ENRIQUE
AGANAG.R. NO. 126297First Division, January 31, 2007Justice
Sandoval-Gutierrez
FACTS:
The case stemmed from a complaint for damages filed at the RTC
Branch 96, Quezon City by respondents-spouses Agana against herein
petitioner, Professional Services Inc., owner of Medical City
Hospital, together with Dr. Miguel Ampil and Dr. Juan Fuentes, who
performed an anterior resection surgery and hysterectomy operation
on Natividad, respectively. Respondents alleged that the two
doctors are liable for negligence for leaving two pieces of gauze
inside Natividads body, and malpractice for concealing their acts
of negligence. Apparently, Natividad was diagnosed to have
malignancy in her sigmoid area and it had spread on her left ovary,
necessitating the removal of certain portions of it.
On March 17, 1993, the trial court rendered its Decision in
favour of the spouses Agana. However, on appeal, the CA dismissed
the case against Dr. Fuentes for lack of evidence and pronouncing
Dr. Ampil as the sole liable for the damages caused by negligence
and malpractice. Hence, this petition.
ISSUES:
1. WON the CA erred in holding Dr. Ampil liable for negligence
and malpractice.2. WON the CA erred in absolving Dr. Fuentes of any
liability.3. WON the PSI may be held solidarily liable for the
negligence of Dr. Ampil.
RULING OF THE COURT:
Petition denied. The CA Decision is affirmed with costs against
PSI and Dr. Miguel Ampil.
HELD:
1. This is a clear case of medical malpractice or more
appropriately, medical negligence. To successfully pursue this kind
of case, a patient must prove that a health care provided either
failed to do something which a reasonably prudent health care
provider would have done, or that he did something that a
reasonably prudent provider would not have done, and that failure
or action caused injury to patient. Simply put, the elements are
duty, breach, injury and proximate causation. Dr. Ampil, as the
lead surgeon, had the duty to remove all foreign objects, such as
gauzes, from Natividads body before closure of the incision. When
he failed to do so, it was his duty to inform Natividad about it.
Dr. Ampil breached both duties. Such breach caused injury to
Natividad, necessitating her further examination by American
doctors and another surgery. That Dr. Ampils negligence is the
proximate cause of Natividads injury could be traced from his act
of closing the incision despite the information given by the
attending nurses that two pieces of gauze were still missing. That
they were later on extracted from Natividads vagina established the
causal link between Dr. Ampils negligence and the injury. And what
further aggravated such injury was his deliberate concealment of
the missing gauzes from the knowledge of Natividad and her
family.
2. Under the Captain of the Ship rule, the operating surgeon is
the person in complete charge of the surgery room and all personnel
connected with the operation. Their duty is to obey his orders. As
stated before, Dr. Ampil was the lead surgeon. In other words, he
was the Captain of the Ship. That he discharged such role is
evident from his following conduct: 1) calling Dr. Fuente to
perform a hysterectomy; 2) examining the work of Dr. Fuentes and
finding it in order; 3) granting Dr. Fuentes permission to leave;
and 4) ordering the closure of the incision. To our mind, it was
this act of ordering the closure of the incision notwithstanding
the two pieces of gauze remained unaccounted for, that caused
injury to Natividads body. Clearly, the control and management of
the thing which caused the injury was in the hands of Dr. Ampil,
not Dr. Fuentes.
In this jurisdiction, res ipsa loquitur is not a rule of
substantive law, hence, does not per se create or constitute an
independent or separate ground of liability, being a mere
evidentiary rule. In other words, mere invocation and application
of the doctrine does not dispense with the requirement of proof of
negligence. Here, the negligence was proven to have been committed
by Dr. Ampil and not by Dr. Fuentes.
3. Principle of Apparent Authority in cases where it can be
shown that a hospital, by its actions, has held out a particular
physician as its agent and/or employee and that a patient has
accepted treatment from that physician in the reasonable belief
that it is being rendered in behalf of the hospital, then the
hospital will be liable for the physicians negligence.
Concept of an Agency by Estoppel the hospital is now stopped
from passing all the blame to the physicians whose names it proudly
paraded in the public directory leading the public to believe that
it vouched for their skill and competence. X x x Corporate entities
like PSI are capable of acting only through other individuals, such
as physicians. If these accredited physicians do their job well,
the hospital succeeds in its mission of offering quality medical
services and thus profits financially. Logicially, where negligence
mars the quality of its services, the hospital should not be
allowed to escape liability for the acts of its ostensible
agents.
Corporate Negligence or Corporate Responsibility clearly, the
hospital failed to exercise their duties such as 1) the use of
reasonable care in the maintenance of safe and adequate facilities
and equipments; 2) the selection and retention of competent
physicians; 3) the overseeing or supervision of all persons who
practice medicine within its walls; and 4) the formulation,
adoption and enforcement of adequate rules and policies that ensure
quality care for its patients.
DR. NINEVETCH CRUZ VS. CAG.R. NO. 122445Third Division, November
18, 1997Justice Francisco
FACTS:
The case stemmed from a medical malpractice suit filed with the
MTCC of San Pablo City charging herein petitioner and one Dr. Lina
Ercillo with reckless imprudence and negligence resulting to
homicide of one Lydia Umali. The inferior court acquitted Dr. Lina
Ercillo for insufficiency of evidence, while held the petitioner
sole responsible for the death of the victim, found her guilty
under Art. 365 of the RPC and was sentenced to suffer the penalty
of 2 months and 1 day of arresto mayor with costs. The RTC, on
appeal, affirmed in toto the MTCCs decision, which prompted the
petitioner to file a petition for review with the CA but to no
avail. Hence, this petition.
ISSUE:
WON petitioners conviction of the crime reckless imprudence
resulting to homicide arising from an alleged medical malpractice,
is supported by the evidence on record.
RULING:
Petitioner was acquitted but is ordered to pay the heirs civil
liability and damages.
HELD:
x x x The deference of courts to the expert opinion of qualified
physicians stems from its realization that the latter possess
unusual technical skills which laymen in most instances are
incapable of intelligently evaluating. Expert testimony should have
been offered to prove that the circumstances cited by the courts
below are constitutive of conduct falling below the standard of
care employed by other physicians in good standing when performing
the same operation. It must be remembers that when the
qualifications of a physician are admitted, as in the instant case,
there is an inevitable presumption that in proper cases he takes
the necessary precaution and employs the best of his knowledge and
skill in attending to his clients, unless the contrary is
sufficiently established. This presumption is rebuttable by expert
opinion which is so sadly lacking in the case at bench.
In litigations involving medical negligence, the plaintiff has
the burden of establishing appellants negligence and for a
reasonable conclusion of negligence, there must be proof of breach
of duty on the part of the surgeon as well as a casual connection
of such breach and the resulting death of his patient.SPS.
FREDELICTO FLORES VS. SPS. DOMINADOR PINEDAG.R. NO. 158996Second
Division, November 14, 2008Justice Brion
FACTS:
This petition involves a medical negligence case that stemmed
from the RTC of Nueva Ecija, Branch 37 against herein petitioners,
Dr. Fredelicto Flores and Felicisima Flores. The victim, Teresita
Pineda, sought the medical help of Dr. Fredelicto as she was
complaining general body weakness, loss of appetite, frequent
urination and thirst, and on-and-off vaginal bleeding. On April 28,
1987, Teresita went to Dr. Fredelictos clinic at UDMC and after
conducting a routine check-up, he prepared the patient for an on
call D&C operation together with his wife, Dr. Felicisima
Flores. A day after the operation, Teresita was subjected to an
ultrasound examination and the results yielded an enlarged uterus
and myoma uteri. Teresitas condition had worsened and she was
rushed to the ICU. Further tests confirmed that she was suffering
from Diabetes Mellitus Type II. Insulin was administered on
Teresita but the medication might have arrived too late. Due to
complications induced by diabetes, Teresita died in the morning of
May 6, 1987.
The trial court ruled in favour of Teresitas family. The CA
affirmed the judgment, but modified the amount of damages awarded.
Hence, this recourse.
ISSUE:
WON the trial court and the CA were correct in holding
petitioners liable for medical negligence.
RULING:
The trial court and the CA Decision were affirmed, likewise the
amount of damages awarded.
HELD:
A medical negligence case is a type of claim to redress a wrong
committed by a medical professional, that has caused bodily harm to
or the death of a patient. There are four elements involved in a
medical negligence case, namely: duty, breach, injury and proximate
causation.
Duty refers to the standard of behaviour which imposes
restrictions on ones conduct. The standard in turn refers to the
amount of competence associated with the proper discharge of the
profession. A physician is expected to use at least the same level
of care that any other reasonably competent doctor would use under
the same circumstances. Breach of duty occurs when the physician
fails to comply with these professional standards. If injury
results to the patient as a result of this breach, the physician is
answerable for negligence.
As in any civil action, the burden to prove the existence of the
necessary elements rests with the plaintiff. To successfully pursue
a claim, the plaintiff must prove by preponderance of evidence
that, one, the physician either failed to do something which a
reasonably prudent health care provider would have done, or that he
did something that a reasonably prudent provider would not have
done; and two, the failure or action caused injury to patient.
Expert testimony is therefore essential since the factual issue of
whether a physician or surgeon has exercised the requisite degree
of skill and care in the treatment of his patient is generally a
matter of expert opinion.
DR. FERNANDO SOLIDUM VS. PEOPLEG.R. NO. 192123First Division,
March 10, 2014Justice Bersamin
FACTS:
The case stemmed from a complaint for reckless imprudence
resulting in serious physical injuries filed with the RTC Manila by
Ma. Luz Gercayo, mother of the patient Gerald Albert Gercayo,
against the attending physicians of the Ospital ng Maynila who
conducted a pull through operation (an operation for anal opening)
to the 3-year old baby boy Gerald who was born with an imperforate
anus. However, upon a finding of probable cause, the City
Prosecutors Office filed an information solely against herein
petitioner, Dr. Solidum, being then the anesthesiologist tasked to
administer the anesthesia on the patient. During the operation,
Gerald allegedly experienced bradycardia and went into a coma for
two weeks and after regaining consciousness, he could no longer
see, hear or move.
On July 19, 2004, the RTC rendered its judgment finding Dr.
Solidum guilty beyond reasonable doubt of the crime charged. On
appeal, the CA affirmed the conviction of the petitioner. Hence,
this petition.
ISSUES:
1.WON the doctrine of res ipsa loquitur was applicable
herein.2.WON Dr. Soliman was liable for criminal negligence.
RULING OF THE COURT:
The Court grants the petition for review on certiorari, reversed
and set aside the decision of the trial court and the CA and
acquitted Dr. Solidum.
HELD:
1.It must be conceded that the doctrine of res ipsa loquitur can
have no application in a suit against a physician or surgeon which
involves the merits of a diagnosis or of a scientific treatment.
The physician or surgeon is not required at his peril to explain
why any particular diagnosis was not correct, or any particular
scientific treatment did not produce the desired result. Thus, res
ipsa loquitur is not available in a malpractice suit if the only
showing is that the desired result of an operation or treatment was
not accomplished.
In order to allow resort to the doctrine, therefore, the
following essential requisites must first be satisfied, to wit: 1)
the accident was of a kind that does not ordinarily occur unless
someone is negligent; 2) the instrumentality or agency that caused
the injury was under the exclusive control of the person charged;
and 3) the injury suffered must not have been due to any voluntary
action or contribution of the person injured.
The Court considers the application here of the doctrine of res
ipsa loquitur inappropriate. Although the second and third elements
were present, the first element was undeniably wanting. Hypoxia
would not ordinarily occur in the process of a pull-through
operation, or during the administration of anesthesia to the
patient, but such fact alone did not prove that the negligence of
any of his attending physicians, including the anesthesiologists,
had caused the injury.
2.The prosecution did not prove the elements of reckless
imprudence beyond reasonable doubt because the circumstances cited
by the CA were insufficient to establish that Dr. Solidum had been
guilty of inexcusable lack of precaution in monitoring the
administration of the anesthetic agent to Gerald. xxx In
litigations involving medical negligence, the plaintiff has the
burden of establishing appellants negligence and for a reasonable
conclusion of negligence, there must be proof of breach of duty on
the part of the surgeon as well as a causal connection of such
breach and the resulting death of his patient.
FE CAYAO-LASAM VS. SPS. CLARO & EDITHA RAMOLETEG.R. NO.
159132Third Division, December 18, 2008Justice Austria-Martinez
FACTS:
Respondent Editha Ramolete was three months pregnant when she
was brought to the Lorma Medical Center due to vaginal bleeding.
Upon conduct of a pelvic sonogram, a fetus weak cardiac pulsation
was revealed and no fetal movement was appreciated, coupled with
persistent and profuse vaginal bleeding, thus petitioner advised
Editha to undergo a dilatation and curettage procedure (raspa).
On September 16, 1994, barely two months after, Editha was once
again brought to LMC as she was suffering from vomiting and severe
abdominal pains. It was found out by the doctors that there was a
dead fetus in her womb and to have a massive intra-abdominal
hemorrhage and ruptured uterus. She underwent a procedure for
hysterectomy, as a result of which she can no longer bear a child.
This prompted Editha and her husband Claro to file a complaint for
gross negligence and malpractice against petitioner before the
PRC.
On March 4, 1999, the Board of Medicine of the PRC rendered a
Decision exonerating petitioner from the charges filed against her.
However, on appeal, the PRC reversed the findings of the Board and
revoked petitioners authority or license to practice her profession
as a physician.
Petitioner elevated the matter to the CA for review under Rule
43 but the same was dismissed for being improper and premature.
Hence, this petition.
ISSUE:
WON petitioner is liable for gross negligence and
malpractice.
RULING OF THE COURT:
The SC granted the petition and affirmed the Decision of the
Board of Medicine exonerating the petitioner from charges against
her.
HELD:
Medical malpractice is a particular form of negligence which
consists in the failure of a physician or surgeon to apply to his
practice of medicine that degree fo care and skill which is
ordinarily employed by the profession generally, under similar
conditions, and in like surrounding circumstances. In order to
successfully pursue such a claim, a patient must prove that the
physician or surgeon either failed to do something which a
reasonably prudent physician or surgeon would not have done, and
that the failure or action caused injury to the patient. There are
four elements involved in medical negligence cases: duty, breach,
injury, and proximate causation.
A physician-patient relationship was created when Editha
employed the services of the petitioner. As Edithas physician,
petitioner was duty-bound to use at least the same level of care
that any reasonably competent doctor would use to treat a condition
under the same circumstances. The breach of these professional
duties of skill and care, or their improper performance by a
physician surgeon, whereby the patient is injured in body or in
health, constitutes actionable malpractice. As to this aspect of
medical malpractice, the determination of the reasonable level of
care and the breach thereof, expert testimony is essential.
Further, inasmuch as the causes of the injuries involved in
malpractice actions are determinable only in the light of
scientific knowledge, it has been recognized that expert testimony
is usually necessary to support the conclusion as to causation.
In the present case, respondents did not present any expert
testimony to support their claim that petitioner failed to do
something which a reasonably prudent physician or surgeon would
have done.
ROGELIO NOGALES, et al. VS. CAPITOL MEDICAL CENTER, et al.G.R.
NO. 142625Third Division, December 19, 2006Justice Carpio
FACTS:
On May 14, 1980 petitioners filed a complaint for damages with
the RTC of Manila against herein respondents for the death of
Corazon Nogales. Petitioners contended that respondents were
negligent in the treatment and management of Corazons condition.
Corazon died due to hemorrhage, post partum.
The trial court rendered judgment on November 22, 1993 finding
Dr. Oscar Estrada solely liable for damages holding that the victim
was under his pre-natal care, apparently, his fault began from his
incorrect and inadequate management and lack of treatment of the
pre-eclamptic condition of his patient. Petitioners appealed the
trial courts decision claiming that the remaining respondents
should be held equally liable for negligence. However, the CA
affirmed the lower courts decision. Hence, this petition.
ISSUE:
WON Capitol Medical Center is vicariously liable for the
negligence of Dr. Estrada.
RULING OF THE COURT:
The SC partly grants the petition. It found respondent CMC
vicariously liable for the negligence of Dr. Oscar Estrada.
HELD:
In general, a hospital is not liable for the negligence of an
independent contractor-physician. There is, however, an exception
to his principle. The hospital may be liable if the physician is
the ostensible agent of the hospital. This exception is also known
as the doctrine of apparent authority.
The doctrine of apparent authority essentially involves two
factors to determine the liability of an independent
contractor-physician. The first factor focuses on the hospitals
manifestations and is sometimes described as an inquiry whether the
hospital acted in a manner which would lead a reasonable person to
conclude that the individual who was alleged to be negligent was an
employee or agent of the hospital. In this regard, the hospital
need not make express representations to the patient that the
treating physician is an employee of the hospital; rather a
representation may be general and implied. The doctrine of apparent
authority is a species of the doctrine of estoppels. Article 1431
of the Civil Code provides that through estoppels, an admission or
representation is rendered conclusive upon the person making it,
and cannot be denied or disproved as against the person relying
thereon. Estoppel rests on this rule: Whenever a party has, by his
own declaration, act or omission, intentionally and deliberately
led another to believe a particular thing true, and to act upon
such belief, he cannot, in any litigation arising out of such
declaration, act or omission, be permitted to falsify it.
In the instant case, CMC impliedly held out Dr. Estrada as a
member of its medical staff. Through CMCs acts, CMC clothed Dr.
Estrada with apparent authority thereby leading the Spouses Nogales
to believe that Dr. Estrada was an employee or agent of CMC. CMC
cannot now repudiate such authority.
DR. MILAGROS CANTRE VS. SPS. JOHN DAVID & NORA GOG.R. NO.
160889Second Division, April 27, 2007Justice Quisumbing
FACTS:
On April 20, 1992, respondent Nora Go gave birth to her fourth
child. However, two hours after giving delivery, she suffered
profuse bleeding inside her womb due to some parts of the placenta
which were not completely expelled from her womb. Consequently,
Nora suffered hypovolemic shock resulting in a drop in her blood
pressure to 40 over 0. After recovery, Noras husband noticed a
fresh gaping would 2 by 3 inches in the inner portion of her left
arm. When asked, the nurses informed him that it was a burn, but
petitioner Dr. Cantre said the blood pressure cuff caused the
injury. The spouses went to the NBI for a physical examination of
Noras injury to which the medico legal testified to be a burn and
not a wound caused by a blood pressure cuff. Noras injury was
referred to a plastic surgeon, unfortunately, her arm would never
be the same as it bore unsightly mark and the pain therein remains.
Thus, on June 21,1993, respondent spouses filed a complaint for
damages against petitioner where the trial court ruled in their
favor. On appeal, the CA affirmed the decision of the lower court.
Hence, this petition.
ISSUE:
1. WON the questioned additional exhibits are admissible in
evidence.2. WON petition is liable for the injury suffered by
respondent Nora Go.3. WON the appellate court committed grave abuse
of discretion in its assailed issuances.
RULING OF THE COURT:
The petition is denied. The Decision of the trial court and the
CA are both affirmed.
HELD:
1. The exhibits are admissible in evidence since it consist
mostly of Noras medical records which were produced by the hospital
during trial pursuant to a subpoena duces tecum. Petitioners
counsel admitted the existence of the same when they were formally
offered for admission by the trial court. In any case, given the
particular circumstances of this case, a ruling on the negligence
of petitioner may be made based on the res ipsa loquitur doctrine
even in the absence of such additional exhibits.2. Petitioners
defense that Noras wound was caused not by the droplight but by the
constant taking of her blood pressure, even if the latter was
necessary given her condition, does not absolve her from liability.
As testified to by the medico-legal officer, Dr. Arizala, Jr., the
medical practice is to deflate the blood pressure cuff immediately
after each use. Otherwise, the inflated band can cause injury to
the patient similar to what could have happened in this case. Thus,
if Noras wound was caused by the blood pressure cuff, then the
taking of Noras blood pressure must have been done so negligently
as to have inflicted a gaping would on her arm, for which
petitioner cannot escape liability under the captain of the ship
doctrine. Further, petitioners argument that the failed plastic
surgery was not intended as a cosmetic procedure, but rather as a
measure to prevent complication does not help her case. It does not
negate negligence on her part. Based on the foregoing, the
presumption that petitioner was negligent in the exercise of her
profession stands unrebutted.
3. Considering the specific circumstances in the instant case,
the Court find no grave abuse of discretion in the assailed
decision and resolution of the CA.
ROGELIO RAMOS, ET AL. VS. CAG.R. NO. 124354First Division, April
11, 2002Justice Kapunan
FACTS:
Sometime in 1985, petitioner Erlinda Ramos, after seeking
professional medical help, was advised to undergo an operation for
the removal of a stone in her gall bladder (cholecystectomy). She
was referred to Dr. Hosaka, a surgeon, who agreed to perform the
operation on her. The operation was scheduled for June 17, 1985 at
9AM at Delos Santos Medical Center. On the day of the operation,
Dr. Hosaka arrived late and it was disclosed by Herminda Cruz,
sister-in-law of the patient, that the latter was intubated and
that the operation was not going well. The patient then was brought
to the ICU and was revealed to be suffering from bronchospasm.
Erlinda stayed in the ICU for a month and since the ill-fated
operation, she remained in comatose condition until she died on
August 3, 1999.
Thus, petitioners filed with the RTC of Quezon City a civil case
for damages against herein private respondents. After due trial,
the trial court rendered judgment in favor of petitioners holding
private respondents guilty of negligence in the performance of
their duties to Erlinda. On appeal, the CA reversed the trial
courts decision.
However, upon petition for review on certiorari, the Highest
Tribunal affirmed and modified the trial courts decision, thus
prompted the private respondents to file their motion for
reconsideration.
ISSUES:
1. WON Dr. Orlino Hosaka is liable for negligence.2. WON Dr.
Perfecta Gutierrez is liable for negligence.3. WON the DSMC is
liable for any act of negligence committed by their visiting
consultant surgeon and anesthesiologist.
RULING:
The assailed Decision is again modified. Private respondent DSMC
was absolved from liability, while Dr. Hosaka and Dr. Gutierrez
were declared to be solidarily liable for the injury suffered by
Erlina Ramos and were ordered to pay damages.
HELD:
1. Dr. Hosaka cannot claim that he was entirely blameless of
what happened to Erlinda. His conduct clearly constituted a breach
of his professional duties to Erlinda. Dr. Hosaka was remiss in his
duty of attending to petitioner Erlinda promptly, for he arrived
more than three hours late for the scheduled operation. The
unreasonable delay in Erlindas scheduled operation subjected her to
continued starvation and consequently, to the risk of acidosis, or
the condition of decreased alkalinity of the blood and tissues,
marked by sickly sweet breath, headache, nausea and vomiting, and
visual disturbances. The long period that Dr. Hosaka made Erlinda
wait for him certainly aggravated the anxiety that she must have
been feeling at the time. It could be safely said that her anxiety
adversely affected the administration of anesthesia on her. As
explained by Dr. Camagay, the patients anxiety usually causes the
outpouring of adrenaline which in turn results in high blood
pressure or disturbances in the heart rhythm.
2.Dr. Gutierrezs claim of lack of negligence on her part is
belied by the records of the case. It has been sufficiently
established that she failed to exercise the standards of care in
the administration of anesthesia on a patient. The injury incurred
by petitioner Erlinda does not normally happen absent any
negligence in the administration of anesthesia and in the use of an
endotracheal tube. As was noted in our Decision, the instruments
used in the administration of anesthesia including the endotracheal
tube, were all under the exclusive control of private respondents
Dr. Gutierrez and Dr. Hosaka.
2. After a careful consideration of the arguments raised by
DLSMC, the Court finds that respondent hospitals position on this
issue is meritorious. There is no employer-employee relationship
between the hospital and Drs. Hosaka and Gutierrez which would hold
the former solidarily liable for the injury suffered by petitioner
Erlinda under Art. 2180 of the Civil Code.
DR. EMMANUEL JARCIA, JR., ET AL. VS. PEOPLEG.R. NO. 187926Third
Division, February 15, 2012Justice Mendoza
FACTS:
Belinda Santiago lodged a complaint with the NBI against herein
petitioners for their alleged neglect of professional duty which
caused her son, Roy Alfonso Santiago, to suffer serious physical
injuries. Upon investigation, the NBI found that Roy was hit by a
taxicab; that he was rushed to Manila Doctors Hospital for an
emergency medical treatment; that an Xray of the victims ankle was
ordered and showed no fracture as read by Dr. Jarcia; that Dr.
Bastan informed her that since it was only the ankle that was hit,
there was no need to examine the upper leg; that eleven days later,
Roy developed fever, swelling of the right leg and misalignment of
the right foot. When Belinda brought Roy back to the hospital, it
was revealed on the X-ray that a right mid-tibial fracture and a
linear hairline fracture in the shaft of the bone.
After due trial, the RTC found the petitioners guilty beyond
reasonable doubt of the crime of Simple Imprudence Resulting to
Serious Physical Injuries. On appeal, the CA affirmed the decision
of the lower court. Hence, this petition.
ISSUES:
1. WON the doctrine of res ipsa loquitur is applicable in this
case.2. WON the petitioners are liable for criminal negligence.
RULING OF THE COURT:
The petition is partly granted. The Decision of the CA and the
trial court is reversed and set aside. The petitioners are
acquitted of the crime charged but were declared civilly liable to
the private complainants. The CA erred in applying the doctrine of
res ipsa loquitur in this particular case.
HELD:
1. This doctrine of res ipsa loquitur (the thing speaks for
itself) means where the thing which causes injury is shown to be
under the management of the defendant, and the accident is such as
in the ordinary course of things does not happened if those who
have the management use proper care, it affords reasonable
evidence, in the absence of an explanation by the defendant, that
the accident arose from want of care.
The doctrine of res ipsa loquitur, as a rule of evidence is
unusual to the law of negligence which recognizes that prima facie
negligence may be established without direct proof and furnishes a
substitute for specific proof of negligence. The doctrine, however,
is not a rule of substantive law, but merely a mode of proof or a
mere procedural convenience. The rule, when applicable to the facts
and circumstances of a given case, is not meant to and does not
dispense with the requirement of proof of culpable negligence on
the party charged. It merely determines and regulates what shall be
prima facie evidence thereof and helps the plaintiff in proving a
breach of the duty. The doctrine can be invoked when and only when,
under the circumstances involved, direct evidence is absent and not
readily available.
The requisites for the application of the doctrine of res ipsa
loquitur are 1) the accident was of a kind which does not
ordinarily occur unless someone is negligent; 2) the
instrumentality or agency which caused the injury was under the
exclusive control of the person in charge; and 3) the injury
suffered must not have been due to any voluntary action or
contribution of the person injured.
In this case, the circumstances that caused patient Roys injury
and the series of tests that were supposed to be undergone by him
to determine the extent of the injury suffered were not under the
exclusive control of Drs. Jarcia and Bastan. It was established
that they are mere residents of the Manila Doctors Hospital at that
time who attended to the victim at the emergency room.
2. The totality of the evidence on record clearly points to the
negligence of the petitioners. At the risk of being repetitious,
the Court, however, is not satisfied that Dr. Jarcia and Dr. Batan
are criminally negligent in this case.
Negligence is defined as the failure to observe for the
protection of the interest of another person that degree of care,
precaution, and vigilance which the circumstances justly demand,
whereby such other person suffers injury. Reckless imprudence
consists of voluntarily doing or failing to do, without malice, an
act from which material damage results by reason of an inexcusable
lack of precaution on the part of the person performing or failing
to perform such act. The elements of simple negligence are: 1) that
there is lack of precaution on the part of the offender; and 2)
that the damage impending to be caused is not immediate or the
danger is not clearly manifest.
In this case, the Court is not convinced with moral certainty
that the petitioners are guilty of reckless imprudence or simple
negligence. The elements thereof were not proved by the prosecution
beyond reasonable doubt.
