Assignment

In

Legal Medicine

Submitted to:

Dr. Margaret C. De Guzman

Professor

Submitted by:

Lloyd B. Valiente

JD3
 A.
DOCTRINES
1. Doctrine of Vicarious Negligence or Vicarious Liability
Where a person is not only liable for torts committed by himself, but also for torts
committed by others with whom he has a certain relationship and for whom he is
responsible.

2. Doctrine of Contributory Negligence

The principle of law recognizing that injured persons may have contributed to their
own injury. Under this theory, a defendant may allege that since the defendant and
plaintiff were both negligent, each is in the wrong, and neither should be able to
collect from the other.

3. Doctrine of Apparent Authority

Provides that even if no actual authority has been conferred on an agent, his or her acts,
as long as they are within his or her apparent scope of authority, bind the principal.

4. Captain of the Ship Doctrine

The doctrine imposing liability on a surgeon for the actions of assistants who are under
the surgeon's control but who are employees of the hospital, not the surgeon

5. Doctrine of Assumption of Risk

A common law defense that has been used to pass the responsibility for loss or injury
onto the injured party by asserting that the individual had knowledge and
understanding of the hazards involved in the undertaking and is therefore not entitled
to recovery for the loss. Legal decisions have eroded and narrowed the applicability of
this defense.

6. Doctrine of Last Clear Chance

Provides that where both parties are negligent but the negligent act of one is
appreciably later in point of time than that of the other, or where it is impossible to
determine whose fault or negligence brought about the occurrence of the incident, the
one who had the last clear.
7. Physician-Patient Privilege Communication
Is a legal concept, related to medical confidentiality, that protects communications
between a patient and their doctor from being used against the patient in court. It is a
part of the rules of evidence in many common law jurisdictions. Almost every
jurisdiction that recognizes physician–patient privilege not to testify in court, either by
statute or through case law, limits the privilege to knowledge acquired during the
course of providing medical services. In some jurisdictions, conversations between a
patient and physician may be privileged in both criminal and civil courts.

8. Good Samaritan Act

Is a law which protects any volunteer giving aid to an injured person in an emergency
situation. The Good Samaritan Law offers legal protection in the form of exemption
from lawsuits and liability, acting as a safeguard to those who help another in a real
emergency, life-or-death situation. The law is in place so that bystanders do not feel
reluctant to help out because of the risk of litigation later. This gesture is only
recognized if carried out by a civilian who comes to the aid of an injured or sick
person and not when the person is carrying out their duty as part of their job
description, for example, a health care provider while at work. It is understood that the
person giving the emergency aid owes the injured party a duty of care, that is to say
they will not put the injured or sick person at more risk or exacerbate their injuries
because of their actions or negligence.

9. Doctrine of Double Effect

This doctrine says that if doing something morally good has a morally bad side-effect,
it's ethically OK to do it providing the bad side-effect wasn't intended. This is true
even if you foresaw that the bad effect would probably happen.
 B.
Case Digest
 1. Carillo v. People of the Philippines GR 86890, January 21, 1994
Facts:
Dr. Leandro Carillo, an anesthetist, seeks review of the Decision of the Court of Appeals
dated 28 November 1988, which affirmed his conviction by the Regional Trial Court of the
crime of simple negligence resulting in homicide, for the death of his thirteen (13) year old
patient, Catherine Acosta. At about 10:30 o'clock in the morning of May 31, 1981 of pains in
the lower part of her abdomen. Catherine was then brought to Dr. Elva Pea. Dra. Pea called
for Dr. Emilio Madrid and the latter examined Catherine Acosta. According to Dr. Madrid,
his findings might be appendicitis. Then Dr. Pea told Catherine's parents to bring the child to
the hospital in Baclaran so that the child will be observed. At the Baclaran General Hospital,
a nurse took blood sample form the child. The findings became known at around 3:00
o'clock in the afternoon and the child was scheduled for operation at 5:00 o'clock in the
afternoon. The operation took place at 5:45 p.m. because Dr. Madrid arrived only at that
time. When brought inside the operating room, the child was feeling very well and they did
not subject the child to ECG (electrocardiogram) and X-ray. The appellant Dr. Emilio
Madrid, a surgeon, operated on Catherine. He was assisted by appellant, Dr. Leandro Carillo,
an anesthesiologists. According to the child‟s mother, she "noticed something very
unfamiliar." The three nurses who assisted in the operation were going in and out of the
operating room, they were not carrying anything, but in going out of the operating room,
they were already holding something. It has also been established that the deceased was not
weighed before the administration of anesthesia on her. The operation was finished at 7:00
o'clock in the evening and when the child was brought out from the operating room, she was
observed to be shivering ; her heart beat was not normal; she was asleep and did not wake
up; she was pale; and as if she had difficulty in breathing and Dr. Emilio Madrid suggested
that she placed under oxygen tank; that oxygen was administered to the child when she was
already in the room. Catherine was transferred to her room. Afterwards, her mother noticed
that her heartbeat was not normal. According to the Dr. Madrid, it was due to the lesion of
the child. Few mins after they revived the heartbeat of the child, Dr Madrid and Dr. Carillo
left. At about 15-30 minutes after, the child developed convulsion and stiffening of the body.
The nurse called on Dr dela Pena, which in turn called Dr. Madrid and the cardiologist. The
cardiologist informed the mother that that she suffered from severe infection which went up
to her head. When Catherine remained unconscious until noontime the next day, a
neurologist examined her and she was diagnosed as comatose. 13 Three (3) days later,
Catherine died without regaining consciousness. A case was filed against Dr. Madrid and Dr.
Carillo. The lower court as well as the appellate court rendered them both liable for criminal
negligence. Petitioner contends that the Court of Appeals "completely brushed aside" and
"misapprehended" Catherine's death certificate and biopsy report which allegedly showed
that the cause of death was a ruptured appendix, which led to blood poisoning, rather than
faulty anesthetic treatment; and (2) there was no direct evidence of record showing that
Nubain was administered to Catherine either during the appendectomy procedure or after
such operation.

Issue: WON Dr. Carillo failed to exercise the diligence required by the standards of his
profession.

Held: Yes. Both doctors failed to appreciate the serious condition of their patient whose
adverse physical signs were quite manifest right after surgery. After reviving her heartbeat,
both doctors failed to monitor their patient closely or extend further medical care to her; such
conduct was especially necessary in view of the inadequate, post-operative facilities of the
hospital. the inadequate nature of those facilities did impose a somewhat higher standard of
professional diligence upon the accused surgeon and anesthetist personally than would have
been called for in a modern fully-equipped hospital. There is here a strong implication that
the patient's post-operative condition must have been considered by the two (2) doctors as in
some way related to the anesthetic treatment she had received from the petitioner either
during or after the surgical procedure.
2. DR. VICTORIA L. BATIQUIN and ALLAN BATIQUIN vs. COURT OF APPEALS,
G.R. No. 118231 July 5, 1996

FACTS:
In September 21, 1988 Dr. Batiquin, with the assistance of Dr. Doris Teresita Sy and O.R.
Nurse Arlene Diones and some student nurses performed a simple caesarean section on Mrs.
Villegas at the Negros Oriental Provincial Hospital. after leaving the Hospital Mrs. Villegas
began to suffer abdominal pains and complained of being feverish. The abdominal pains and
fever kept on recurring and bothered Mrs. Villegas no end despite the medications
administered by Dr. Batiquin. When the pains became unbearable and she was rapidly losing
weight she consulted Dr. Ma. Salud Kho at the Holy Child's Hospital in Dumaguete City on
January 20, 1989. Blood test shown that Mrs. Villegas had an infection inside her abdominal
cavity. Thereafter Dr. Kho suggested to Mrs. Villegas to submit to another surgery to which
the latter agreed. When Dr. Kho opened the abdomen of Mrs. Villegas she found a "foreign
body" looked like a piece of a "rubber glove" and which is [sic] also "rubber-drain like". . . .
It could have been a torn section of a surgeon's gloves or could have come from other
sources. And this foreign body was the cause of the infection of the ovaries and consequently
of all the discomfort suffered by Mrs. Villegas after her delivery on September 21, 1988.

ISSUE:
Whether or not a doctor may be held liable for damages for alleged negligence in the
conduct of an operation on the ground of finding a foreign object inside the body of the
patient in a subsequent operation.

HELD:
Yes. 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 happen in 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. In the instant case, all
the requisites for recourse to the doctrine are present. First, the entire proceedings of the
caesarean section were under the exclusive control of Dr. Batiquin. In this light, the private
respondents were bereft of direct evidence as to the actual culprit or the exact cause of the
foreign object finding its way into private respondent Villegas's body, which, needless to
say, does not occur unless through the intersection of negligence. Second, since aside from
the caesarean section, private respondent Villegas underwent no other operation which could
have caused the offending piece of rubber to appear in her uterus. The petitioners, in this
regard, failed to overcome the presumption of negligence arising from resort to the doctrine
of res ipsa loquitur. Dr. Batiquin is therefore liable for negligently leaving behind a piece of
rubber in private respondent Villegas's abdomen and for all the adverse effects.
3. RAMOS vs. COURT OF APPEALS G.R. No. 124354. December 29, 1999.
FACTS:
Erlinda Ramos underwent a surgical procedure to remove stone from her gall bladder
(cholecystectomy). They hired Dr. Hosaka, a surgeon, to conduct the surgery at the De Los
Santos Medical Center (DLSMC). Hosaka assured them that he would find a good
anesthesiologist. But the operation did not go as planned, Dr. Hosaka arrived 3 hours late for
the operation, Dra. Gutierrez, the anesthesiologist “botched” the administration of the
anesthesia causing Erlinda to go into a coma and suffer brain damage. The botched operation
was witnessed by Herminda Cruz, sister in law of Erlinda and Dean of College of Nursing of
Capitol Medical Center. The family of Ramos (petitioners) sued the hospital, the surgeon and
the anesthesiologist for damages. The petitioners showed expert testimony showing that
Erlinda's condition was caused by the anesthesiologist in not exercising reasonable care in
“intubating” Erlinda. Eyewitnesses heard the anesthesiologist saying “Ang hirap ma-intubate
nito, mali yata ang pagkakapasok. O lumalaki ang tiyan.” Diagnostic tests prior to surgery
showed that Erlinda was robust and fit to undergo surgery. The RTC held that the
anesthesiologist ommitted to exercise due care in intubating the patient, the surgeon was
remiss in his obligation to provide a “good anesthesiologist” and for arriving 3 hours late and
the hospital is liable for the negligence of the doctors and for not cancelling the operation
after the surgeon failed to arrive on time. The surgeon, anesthesiologist and the DLSMC
were all held jointly and severally liable for damages to petitioners. The CA reversed the
decision of the Trial Court.
ISSUES:
Whether or not the private respondents were negligent and thereby caused the comatose
condition of Ramos.
HELD:
Yes, private respondents were all negligent and are solidarily liable for the damages. Res
ipsa loquitur – a procedural or evidentiary rule which means “the thing or the transaction
speaks for itself.” It is a maxim for the rule that the fact of the occurrence of an injury, taken
with the surrounding circumstances, may permit an inference or raise a presumption of
negligence, or make out a plaintiff‟s prima facie case, and present a question of fact for
defendant to meet with an explanation, where ordinarily in a medical malpractice case, the
complaining party must present expert testimony to prove that the attending physician was
negligent. This doctrine finds application in this case. On the day of the operation, Erlinda
Ramos already surrendered her person to the private respondents who had complete and
exclusive control over her. Apart from the gallstone problem, she was neurologically sound
and fit. Then, after the procedure, she was comatose and brain damaged.
4. Reyes vs. Sisters of Mercy HospitalG.R No. 130547 (October 3, 2000)A.

Facts
Petitioner, Leah Alesna Reyes, is the wife of the deceased patient, Jorge Reyes. Five days
before the latter‟sdeath, Jorge has been suffering from recurring fever with chills.
The doctors confirmed through the Widal test that Jorge has typhoid fever. However, he did
not respond tothe treatment and died. The cause of his death was “Ventricular Arrythemia
Secondary to Hyperpyrexia and typhoid fever.” Consequently, petitioner filed the instant
case for damages before the Regional Trial Court of Cebu City, which dismissed the case
and was affirmed by theCourt of Appeals.The contention was that Jorge did not die of
typhoid fever. Instead, his death was due tothe wrongful administration of chloromycetin.
They contended that had respondent doctorsexercised due care and diligence, they would not
have recommended and rushed the performanceof the Widal Test, hastily concluded that
Jorge was suffering from typhoid fever, and administered chloromycetin without first
conducting sufficient tests on the patient‟s compatibility with said drug.C.

Issue:
Whether or not Sisters of Mercy Hospital is liable for the death of Jorge Reyes.B.

Held:
No, Sisters of Mercy Hospital is not liable for the death of Jorge Reyes. Reasoning of the
Court There is no showing that the attending physician in this case deviated from the usual
course of treatment with respect to typhoid fever. Jorge was given antibiotic choloromycetin
and some dose of tri globe after compatibility test was made by the doctor and found that no
adversary actions manifested which would necessitate replacement of the medicines. Indeed,
the standard contemplated is not what is actually the average merit among all known
practitioners from
the best to the worst and from the most to the least experienced, but the reasonable average
meritamong the ordinarily good physicians. Here, the doctors did not depart from the
reasonable standard recommended by the experts as they in fact observed the due care
required under the circumstances.
5. Nogales vs. Capitol Medical Center Carpio, J.:G.R. No. 142625, Dec. 19, 2006 | 511
SCRA 204
FACTS:
Corazon Nogales ("Corazon"), who was then 37 years old, was under the exclusive prenatal
care of Dr. Oscar Estrada ("Dr. Estrada") beginning on her fourth month of pregnancy or as
early as December 1975. While Corazon was on her last trimester of pregnancy, Dr. Estrada
noted an increase in her blood pressure and development of leg edema5 indicating
preeclampsia, which is a dangerous complication of pregnancy.
At 6:22 a.m. Dr. Estrada, assisted by Dr. Villaflor, applied low forceps to extract Corazon's
baby. In the process, a 1.0 x 2.5 cm. piece of cervical tissue was allegedly torn. The baby
came out in an apnic, cyanotic, weak and injured condition. Consequently, the baby had to
be intubated and resuscitated by Dr. Enriquez and Dr. Payumo. At 6:27 a.m., Corazon began
to manifest moderate vaginal bleeding which rapidly became profuse. Corazon's blood
pressure dropped from 130/80 to 60/40 within five minutes. There was continuous profuse
vaginal bleeding. The assisting nurse administered hemacel through a gauge 19 needle as a
side drip to the ongoing intravenous injection of dextrose.
On 26 May 1976, Corazon was admitted at 2:30 a.m. at the CMC after the staff nurse noted
the written admission request8 of Dr. Estrada. Upon Corazon's admission at the CMC,
Rogelio Nogales ("Rogelio") executed and signed the "Consent on Admission Agreement”
and “Admission Agreement.” Corazon was then bought to the labor room of the CMC.
At 8:00 a.m., Dr. Noe Espinola ("Dr. Espinola"), head of the Obstetrics Gynecology
Department of the CMC, was apprised of Corazon's condition by telephone. Upon being
informed that Corazon was bleeding profusely, Dr. Espinola ordered immediate
hysterectomy. Rogelio was made to sign a "Consent to Operation." Dr. Rosa Uy ("Dr. Uy"),
who was then a resident physician of CMC, conducted an internal examination of Corazon.
Dr. Uy then called up Dr. Estrada to notify him of her findings. Due to the inclement weather
then, Dr. Espinola, who was fetched from his residence by an ambulance, arrived at the
CMC about an hour later or at 9:00 a.m. He examined the patient and ordered some
resuscitative measures to be administered. Despite Dr.Espinola's efforts, Corazon died at
9:15 a.m. The cause of death was "hemorrhage, postpartum."14 Based on the Doctor's Order
Sheet, around 3:00 a.m., Dr. Estrada ordered for 10 mg.of valium to be administered
immediately by intramuscular injection. Dr. Estrada later ordered the start of intravenous
administration of syntocinon admixed with dextrose,5%, in lactated Ringers' solution, at the
rate of eight to ten micro-drops per minute. According to the Nurse's Observation Notes, Dr.
Joel Enriquez ("Dr. Enriquez"), an anesthesiologist at CMC, was notified at 4:15 a.m. of
Corazon's admission. Subsequently, when asked if he needed the services of an
anesthesiologist, Dr. Estrada refused. Despite Dr. Estrada's refusal, Dr. Enriquez stayed to
observe Corazon‟s condition. At 6:00 a.m., Corazon was transferred to Delivery Room No. 1
of the CMC. At 6:10a.m., Corazon's bag of water ruptured spontaneously. At 6:12 a.m.,
Corazon's cervix was fully dilated. At 6:13 a.m., Corazon started to experience convulsions.
At 6:15 a.m., Dr. Estrada ordered the injection of ten grams of magnesium sulfate. However,
Dr. Ely Villaflor ("Dr. Villaflor"), who was assisting Dr. Estrada, administered only 2.5
grams of magnesium sulphate.
On 14 May 1980, petitioners filed a complaint for damages15 with the Regional
TrialCourt16 of Manila against CMC, Dr. Estrada, Dr. Villaflor, Dr. Uy, Dr. Enriquez,
Dr.Lacson, Dr. Espinola, and a certain Nurse J. Dumlao for the death of Corazon. Petitioners
mainly contended that defendant physicians and CMC personnel were negligent in the
treatment and management of Corazon's condition. Petitioners charged CMC with
negligence in the selection and supervision of defendant physicians and hospital staff.

ISSUE :
W/N CMC should be held liable

Ruling:
YES, The mere fact that a hospital permitted a physician to practice medicine and use its
facilities is not sufficient to render the hospital liable for the negligence of a physician who is
an independent contractor o There is no proof that defendant physician was an employee of
defendant hospital or that the latter
had reason to know that any acts of malpractice would take place •B o r r o w e d S e r v a n t
D o c t r i n e – once the surgeon enters the operating room and takes charge of the
proceedings, the acts or omissions of operating room personnel, and any negligence
associated with such acts or omissions, are imputable to the surgeon.
6. Cantre vs Go
GR No. 160889 April 27, 2007

Facts:

Petitioner Dr. Milagros L. Cantre is a specialist in obstetrics and gynecology at the Dr. Jesus
Delgado memorial Hospital. She was the attending physician of respondent Nora Go, who
was admitted at the said hospital on April 19, 1992. At 1:30am of April 20, 1992, Nora gave
birth to her fourth child, a baby boy. However, at around 3:30am Nora suffered profuse
bleeding insider her womb due to some parts of the placenta were not completely expelled
from her womb after delivery consequently, Nora suffered hypovolemic shock, resulting in a
drop in her blood pressure to 40/0. Petitioner said the assisting resident physician performed
various medical procedures to stop the bleeding and to restore Nora‟s blood pressure. Her
blood pressure was frequently monitored with the use of a sphygmamometer. While
petitioner was massaging Nora‟s uterus for it to contract and stop bleeding, she ordered a
drop light to warm Nora and her baby. Nora remained unconscious until she recovered.
While in the recovery room, her husband, respondent John David Z. Go noticed a fresh
gasping wound 2 1/2″ x 3 1/2″ in the inner portion of her left arm, close to the armpit. He
asked the nurses what caused the injury. He was informed, it was a burn. An investigation
was filed by Nora‟s husband and found out from the petitioner that it was caused by the
blood pressure cuff, however, this was contrary to the findings from a medico-legal report
which stated that it was indeed a burn and that a drop light when placed near a skin for about
10mins could cause such burn. Nora was referred to a plastic surgeon from the hospital and
skin grafting was done on her and scar revision but both still left a mark on Nora‟s arm
compelling the respondent spouse to file a complaint for damages against petitioner.

Issue: Whether or not petitioner is liable for the injury referred by Nora.

Held: Yes. The Hippocratic oath mandates physicians to give primordial consideration to the
well-being of their patients. If a doctor fails to live up to his precept, he is accountable for his
acts. This is notwithstanding, courts face a unique restraint in adjudicating medical
negligence cases because physicians are not guardians of care and they never set out to
intentionally cause injury to their patients. However, intent is immaterial in negligence cases
because where negligence exist and is proven, it automatically gives the injured a right to
reparation for the damage caused.
7. CONCEPCION ILAO-ORETA v. SPOUSES EVA MARIE and BENEDICTO NOEL
RONQUILLO, et al.

Facts:

Respondent spouses Eva Marie Ronquillo and Noel Benedicto Ronquillo had not been
blessed with a child despite several years of marriage. They thus consulted petitioner Dr.
Concepcion Ilao-Oreta, an obstetrician-gynecologist-consultant and chief of the
Reproductive Endocrinology and Infertility Section at the St. Luke„s Medical Center. Dr.
Ilao-Oreta advised Eva Marie to undergo a laparoscopic procedure whereby a laparascope
would be inserted through the patient„s abdominal wall to get a direct view of her internal
reproductive organ in order to determine the real cause of her infertility.The procedure was
scheduled on April 5, 1999 at 2:00 p.m. to be performed by Dr. Ilao-Oreta. Eva Marie,
accompanied by Noel, checked in at the St. Luke„s Medical Center and underwent pre-
operative procedures including the administration of intravenous fluid and enema. However,
Dr. Ilao-Oreta did not arrive at the scheduled time for the procedure and no prior notice of its
cancellation was received. It turned out that the doctor was on a return flight from Hawaii to,
and arrived at 10:00 p.m. of April 5, 1999 in, Manila. The Ronquillo spouses filed a
complaint against Dr. Ilao-Oreta and the St. Luke„s Medical Center for breach of
professional and service contract and for damages before the Regional Trial Court of
Batangas City. They prayed for the award of actual damages including alleged loss of
income of Noel while accompanying his wife to the hospital, moral damages, exemplary
damages, costs of litigation, attorney„s fees, and other available reliefs and remedies. The
RTC decided in favor of Ronquillo spouses and awarded Eva Marie actual damages but ruled
that the failure of the doctor to arrive on time was not intentional. It found no adequate proof
that Noel had been deprived of any job contract while attending to his wife in the hospital.
The spouses appealed to the Court of Appeals and found that Dr. Ilao-Oreta grossly
negligent.

ISSUE:

Whether or not Dr. Ilao-Oreta is guilty of gross negligence for her failure to arrive at the
scheduled time for the procedure

HELD:

It bears noting that when she was scheduling the date of her performance of the procedure,
Dr. Ilao-Oreta had just gotten married and was preparing for her honeymoon, and it is of
common human knowledge that excitement attends its preparations. Her negligence could
then be partly attributed to human frailty which rules out its characterization as gross.

Dr. Ilao-Oreta„s negligence not being gross, Ronquillo spouses are not entitled to recover
moral damages. Neither are the spouses entitled to recover exemplary damages in the
absence of a showing that Dr. Ilao-Oreta acted in a wanton, fraudulent, reckless, oppressive
or malevolent manner, nor to award of attorney„s fees as, contrary to the finding of the CA
that the spouses “were compelled to litigate and incur expenses to protect their interest,” the
records show that they did not exert enough efforts to settle the matter before going to court
8. Lasam vs. Sps. Ramolete G.R. No. 159132 December 8, 2008

Facts:On July 1994, respondent three months pregnant Editha Ramolete was brought to the
Lorma Medical Center (LMC) to vaginal bleeding. A pelvic sonogram was then conducted
on Editha revealing the fetus weak cardiac pulsation. Editha‟s repeat pelvic sonogram
showed that aside from the fetus weak cardiac pulsation, no fetal movement was also
appreciated. Due to persistent and profuse vaginal bleeding, petitioner Dr. Fe Cayao-Lasam
advised Editha to undergo a Dilatation and Curettage Procedure (D&C) or raspa which the
petitioner performed.On September 1994, Editha was brought again to LMC due to vomiting
and severe abdominal pains. One of the attending physician, Dr. Mayo allegedly informed
Editha that there was a dead fetus in her womb. Editha underwent laparotomy where she was
found to have a massive intra-abdominal hemorrhage and a ruptured uterus. Editha had to
undergo a procedure for hysterectomy and as a result, she has no more chance to bear a
child.On November 1994, Editha and her husband Claro Ramolete filed a Complaint for
Gross Negligence and Malpractice against petitioner before the PRC.Respondents alleged
that Editha‟s hysterectomy was caused by petitioners unmitigated negligence and
professional incompetence in conducting the D&C procedure and the petitioners failure to
remove the fetus inside Editha‟s womb. Petitioner denied the allegations of negligence and
incompetenceOn March 1999, Board of Medicine of the PRC exonerated petitioner from the
charges filed against her. Feeling aggrieved, respondents went to the PRC on appeal. On
November 2000, the PRC reversed the findings of the Board and revoked petitioners
authority or license to practice her profession as a physician. Petitioner brought the matter to
the CA but was dismissed on the ground of being improper and premature.

Issue: WON there was medical malpractice in the case?

Held: There was no medical malpractice in the case.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 of 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.From the
testimony of the expert witness and the reasons given by him, it is evident that the D&C
procedure was not the proximate cause of the rupture of Editha‟s uterus. Further in the
testimony, it is clear that the D&C procedure was conducted in accordance with the standard
practice, with the same level of care that any reasonably competent doctor would use to treat
a condition under the same circumstances, and that there was nothing irregular in the way the
petitioner dealt with Editha. Medical malpractice is often brought as a civil action for
damages under Article 2176 of the Civil Code. The defenses in an action for damages,
provided for under Article 2179 of the Civil Code are:

Art. 2179. When the plaintiffs own negligence was the immediate and proximate cause of his
injury, he cannot recover damages. But if his negligence was only contributory, the
immediate and proximate cause of the injury being the defendants lack of due care, the
plaintiff may recover damages, but the courts shall mitigate the damages to be awarded.

It is also undisputed that Editha did not return for a follow-up evaluation, in defiance of the
petitioners advise. Editha omitted the diligence required by the circumstances which could
have avoided the injury. The omission in not returning for a follow-up evaluation played a
substantial part in bringing about Editha‟s own injury. Had Editha returned, petitioner could
have conducted the proper medical tests and procedure necessary to determine Editha‟s
health condition and applied the corresponding treatment which could have prevented the
rupture of Editha‟s uterus. The D&C procedure having been conducted in accordance with
the standard medical practice, it is clear that Editha‟s omission was the proximate cause of
her own injury and not merely a contributory negligence on her part.
9. DR. PEDRO DENNIS CERENO, and DR. SANTOS ZAFE, Petitioners, v. COURT OF
APPEALS, SPOUSES DIOGENES S. OLAVERE and FE R. SERRANO, Respondents.
PEREZ, J.

FACTS: At about 9:15 in the evening of 16 September 1995, Raymond S. Olavere

(Raymond), a victim of a stabbing incident, was rushed to the Bicol Regional Medical Center
(BRMC). Dr. Realuyo, the emergency room resident physician, recommended that Raymond
should undergo blood transfusion. At 10:30 P.M., Raymond was brought inside the operating
room. During that time, the hospital surgeons, Drs. Zafe and Cereno, were busy operating on
gunshot victim Charles Maluluy-on. Assisting them in the said operation was Dr. Rosalina
Tatad (Dr. Tatad), who was the only senior anesthesiologist on duty at BRMC that night.
Just before the operation on Maluluy-on was finished, another emergency case involving
Lilia Aguila, a woman who was giving birth to triplets, was brought to the operating room.
Drs. Zafe and Cereno, in the meantime, proceeded to examine Raymond and they found that
the latters blood pressure was normal and "nothing in him was significant." There being no
other available anesthesiologist to assist them, Drs. Zafe and Cereno decided to defer the
operation on Raymond. At 11:15 P.M., the relatives of Raymond brought the bag of blood to
be used for blood transfusion. Drs. Cereno and Zafe immediately started their operation on
Raymond at around 12:15 A.M. of 17 September 1995. Upon opening of Raymonds thoracic
cavity, they found that 3,200 cc of blood was stocked therein. Dr. Cereno did not
immediately transfuse the blood since the bleeders had to be controlled first. Blood was
finally transfused on Raymond at 1:40 A.M. However, during the operation, Raymond died
due to massive loss of blood. Claiming that there was negligence on the part of those who
attended to their son, the parents of Raymond (herein respondents) filed a complaint for
damages against Drs. Zafe and Cereno. The RTC found Drs. Zafe and Cereno negligent for
not
immediately conducting surgery on Raymond. On appeal, the CA affirmed RTCs findings.

ISSUE: Whether or not Drs. Zafe and Cereno are guilty of gross negligence in the
performance of their duties?

HELD: The petition is granted. CIVIL LAW: medical negligence The type of lawsuit which
has been called medical malpractice or, more appropriately, medical negligence, is that type
of claim which a victim has available to him or her to redress a wrong committed by a
medical professional which has caused bodily harm. In order to successfully pursue such a
claim, a patient must prove that a health care provider, in most cases a physician, either
failed to do something which a reasonably prudent health care provider would have done, or
that he or she did something that a reasonably prudent provider would not have done; and
that the failure or action caused injury to the patient. Given that Dr. Tatad was already
engaged in another urgent operation and that Raymond was not showing any symptom of
suffering from major blood loss requiring an immediate operation, We find it reasonable that
petitioners decided to wait for Dr. Tatad to finish her surgery and not to call the standby
anesthesiologist anymore. There is, after all, no evidence that shows that a prudent surgeon
faced with similar circumstances would decide otherwise. In medical negligence cases, it is
settled that the complainant has the burden of establishing breach of duty on the part of the
doctors or surgeons. It must be proven that such breach of duty has a causal connection to the
resulting death of the patient. Upon opening of his thoracic cavity, it was discovered that
there was gross bleeding inside the body. Thus, the need for petitioners to control first what
was causing the bleeding. Petition is GRANTED. The CA is REVERSED and SET ASIDE.
10. Casumpang v Cortejo G.R. No. 171127
FACTS Mrs. Jesusa Cortejo brought his 11-year old son Edmer to the ER of San Juan de
Dios Hospital because of difficulty in breathing, chest pain, stomach pain and fever. Dr.
Ramoncito Livelo diagnosed Edmer with bronchopneumonia and gave him antibiotic
medication to lessen his fever and to loosen his plegm. By virtue of her Fortune Care card,
Mrs. Corteho was then assigned to Dr. Noel Casumpang, a pediatrician accredited with
Fortune Care. Dr. Casumpang confirmed the initial diagnosis of Bronchopneumonia. Next
day, Edmer vomited phlegm with blood streak. Dr. Ruby Sanga-Miranda, a resident
physician at SJDH came to examine the blood specimen, however, Mrs. Cortejo washed it
away. So she just conducted physical check-up and found out that Edmer‟s symptoms are not
typical of dengue fever. In the afternoon. Edmer vomited blood again. Dr. Miranda then
examined the blood specimen. Suspecting she could be afflicted with dengue, she inserted a
plastic tume in his nose, drained liquid from his stomach with ice cold normal saline
solution, and gave an instruction not to pull out the tube, or give the patient any oral
medication. Blood tests showed that Edmer was suffering from Dengue Hemorrhagic Fever.
Dr. Casumpang then recommended transfer of Edmer to the ICU to which Mrs. Cortejo
consented. However, the ICU was full to Dr. Casumpang suggested transfer hire a private
nurse. Mrs. Cortejo insisted, however, to transfer his son to Makati Medical Center. After the
respondent had signed the waiver, Dr. Casumpang, for the last time, checked Edmer's
condition, found that his blood pressure was stable, and noted that he was "comfortable." By
midnight, Edmer was transferred to MakatiMed via private ambulance. Upon examination of
patient‟s clinical history and lab exam results, attending physician diagnosed Edmer with
Dengue Fever Stage IV that was already in its irreversible stage. Edmer died at 4am with his
death certificate indicating “Hypovolemic Shock/hemorrhagic shock;" "Dengue
Hemorrhagic Fever Stage IV” as cause of death. Cortejo filed an action for damages against
SJDH, Dr. Casumpang and Dr. Miranda before RTC Makati alleging that Edmer‟s death was
caused by the negligent and erroneous diagnosis of the doctors. RTC ruled that doctors were
negligent and also held SJDH solidarily liable for damages, finding that Dr. Casumpang as
consultant is an ostensible agent of SJDH while Dr. Miranda as resident physician is an
employee of SJDH as their qualifications, fitness, and competence are scrutinized and
determined by screening committee of hospital before engaging their services.

University of the Philippines College of Law KS D2021 CA affirmed RTC ruling en toto
finding that SJDH and its attending physicians failed to exercise the minimum medical care,
attention, and treatment expected of an ordinary doctor under like circumstances. CA ruled
that the hospital's liability is based on Article 2180 of the Civil Code. The CA opined that the
control which the hospital exercises over its consultants, the hospital's power to hire and
terminate their services, all fulfill the employer-employee relationship requirement under
Article 2180. It also found that SJDH failed to show that it exercised diligence of a good
father of a family in hiring and supervision of its physician
Issue: WN hospital is solidarity liable with the doctors
(3) injury; and (4) proximate causation

Ruling: YES, but not on the basis of Art 2180 as respondents posits but on the basis of
doctrine of apparent authority or agency by estoppel. There is no employer-employee
relationship because no evidence showing that SJDH exercised any degree of control over
the means, methods of procedure and manner by which the doctors conducted and performed
their medical profession. Petitioning Doctors are mere independent contractors. GENERAL
RULE: hospitals are not liable for the negligence of its independent contractors
EXCEPTION: Doctrine of apparent authority - if the physician or independent contractor
acts as an ostensible agent of the hospital A hospital can be held vicariously liable for the
negligent acts of a physician (or an independent contractor) providing care at the hospital if
the plaintiff can prove these two factors: 1) the hospital's manifestations.
11. DECS and Dir. of Educational Measurement vs. Roberto Rey San Diego and Judge Dizon-
Capulong G.R. No. 89572, December 21, 1989

FACTS: Roberto Rey San Diego, a graduate of the University of the East with a degree of B.S.
Zoology, had taken and flunked 4 National Medical Admission Tests and was applying to take
another test. NMAT Rule provides that a student shall be allowed only three (3) chances to
take the test. After three successive failures, a student shall not be allowed to take the NMAT
for the fourth time. The Regional Trial Court held that the petitioner had been deprived of his
right to pursue a medical education through an arbitrary exercise of the police power.

ISSUE: Whether or not the respondent has been deprived of his right to quality education.

Ruling: The right to quality education is not absolute. The Constitution provides that every
citizen has the right to choose a profession or course of study, subject to fair, reasonable, and
equitable admission and academic requirement. The equal protection requires equality among
equals. There would be unequal protection if some applicants who have passed the tests are
admitted and others who have also qualified are denied entrance. The petition has been granted
and the decision of the respondent court has been reversed.
12. PRC vs De Guzman G.R. No. 144681,

Facts: June 21, 2004Board of Medicine observed that the grades of the seventy-nine
successful examinees from Fatima College who passed the Physician Licensure Examination
were unusually and exceptionally high (Bio Chem and OB- Gyne ). The Board withheld the
registration as physicians of these examinees .The PRC asked the NBI to investigate whether
any anomaly or irregularity marred the February1993 Physician Licensure Examination. The
Board charged respondents with "immorality, dishonest conduct, fraud, and deceit and
recommended that the test results of the Fatima examinees be nullified. RTC ordered the
petitioners to administer the physician‟s oath to Arlene V. De Guzman etal., and enter their
names in the rolls of the PRC. The petitioners then filed a special civil action for certiorari
with the Court of Appeals to set aside the mandatory injunctive writ which was granted but
respondents elevated this to the SC but was denied for failure to show reversible error on the
part of the appellate court. Petitioners then filed a petition for certiorari with TRO which was
granted by the CA.

Issue: WON CA committed a reversible error of law in sustaining the judgment of the trial
court that respondents are entitled to a writ of mandamus

Ruling: Section 2645of the Medical Act of 1959 provides for the administrative and judicial
remedies that respondents herein can avail to question Resolution No. 26 of the Board of
Medicine, namely:(a) appeal the unfavorable judgment to the PRC; (b) should the PRC
ruling still be unfavorable, to elevate the matter on appeal to the Office of the President; and
(c) should they still be unsatisfied, to ask for a review of the case or to bring the case to court
via a special civil action of certiorari. Thus, as a rule, mandamus will not lie when
administrative remedies are still available.46However, the doctrine of exhaustion of
administrative remedies does not apply where, as in this case, a pure question of law is
raised.47On this issue, no reversible error may, thus, be laid at the door of the appellate court
 C.
Opinions to Questions
1. Yes for the reason that life is precious and must be preserved up to the last breath and
the law has long recognized that providing continued life-sustaining treatment to very
sick and critically ill patients may be futile. However in certain jurisprudence ruled
that despite physician or hospital administration arguments that treatment was
appropriate, the courts ruled in favor of the patient's right to refuse treatment and the
patient's surrogate's right to withhold treatment, generally on the condition that there
was clear and convincing evidence that the patient would refuse life-sustaining
treatment if he or she were conscious” but it depends on the circumstances which may
influence the decision of both parties as to whether or not to continue or to stop the
treatment.

2. No even a patient is terminally ill and the chance of surviving would result to
addiction to the treatment it is not to be undertreated for the reason that it is the only
way to prolong the life of the patient.

3. No. the truth hurts or reality bites, but it is the duty of the doctor and the right of the
patient to know the status of his/her illness and it is the duty of the doctor to inform
and advice the patient on how to prolong his/her life.

4. It depends, if it is the only way to prevent it is acceptable to break patients

confidentiality if that would prevent from harming a third party or others however if
there is other alternative or way to prevent it then it is not necessary to break patients
confidentiality.

5. Yes the physician should conduct the operation even if it is against the religion of the
patient because it is the duty of the Physician to prolong the life of a patient regardless
of any violation to the religion of the patient. The duty to preserve humanity is more
important that any kind of religion.

6. Yes the Physician can be compel to perform operation even if it is against the
Physician‟s religion for the reason that it is their sworn duty to conduct operation
when needed in short it is the duty of the physician to conduct operation if they failed
to conduct they will become liable for whatever legal consequences it may produce.
7. No it will become unconstitutional because it is mandated under the constitution ,
Article II, Section 15 declares that “The State shall protect and promote the right to
health of the people and instill health consciousness among them. And a law denying
it would result to that law to be unconstitutional.

8. Yes If that would be the proximate cause of the lung cancer of a certain individual 2nd
or 3rd hand smoking is dangerous to health but it it is really hard to prove in the court
the person who made that smoke.

9. It is not acceptable to compel a person from donating their organs even they are
convicted under death penalty because it is their right and compelling them is a
violation of their right. If they consented it is applicable but if not it is not acceptable.

10. Yes it is possible to use the thumbprint of a corpse if that would serve as an evidence
or as a solution for the attainment of justice.