Alano vs Magud-Logmao

GR No. 1755540 April 7, 2014

Facts: At around 9:50pm of March 1, 1988, Arnelito Logmao then 18 y/o, was brought to the
East Avenue Medical Center (EAMC) in Quezon City by two sidewalk vendors, who allegedly
saw the former fall from the overpass near the Farmers Market in Cubao, Quezon City. The
patients data sheet identified the patient as Angelito Lugmoso of Boni Ave., Mandaluyong.
However, the clinical abstract prepared by Dr. Paterno F. Cabrera, the surgical resident on-duty at
the emergency room of EAMC, stated the patient is Angelito Logmao. Dr. Cabrera reported that
Logmao was drowsy with alcoholic breath, was conscious and coherent; that the skull x-ray
showed no fracture; that at around 4:30am of March 2, 1988, Logmao developed generalized
seizures and was managed by the neuro-surgeon resident on-duty; that the condition of Logmao
progressively deteriorated and he was intubated and ambu-bagging support was provided; that
admission to the ICU and mechanical ventilation support became necessary, but there was no
vacancy at the ICU and all the ventilation units were being used by other patients; that a resident
physician of NKTI, who was rotating at EAMC, suggested that Logmao be transferred to NKTI;
and that after arrangements were made, Logamo was transferred to NKTI at 10:10am. At the
NKTI, the name Angelito Logmao was recorded as Angelito Lugmoso. Lugmoso was
immediately attended to and given the necessary medical treatment. As Lugmoso had no
relatives around, Jennifer Misa, transplant coordinator was asked to locate his family by enlisting
police and media assistance. Dr. Enrique Ona, chairman of the Department of Surgery, observed
that severity of the brain injury of Lugmoso manifested symptoms of brain death. He requested
the laboratory section to conduct tissue typing and tissue cross-matching examination, so that
should Lugmoso expire despite the necessary care and medical management and he would be
found to be a suitable organ donor and his family would consent to organ donation, the organs
thus donated could be detached and transplanted promptly to any compatible beneficiary. The
identity of Lugmoso was verified by Misa from EAMC and she was furnished the patients data
sheet. She then contacted several radio and television stations to request for air time for the
purpose of locating the family of Angelito Lugmoso of Boni Ave., Mandaluyong who was
confined at NKTI with severe head injury after allegedly falling from the Cubao overpass, as
well as police station no. 5 Eastern Police District. Lugmoso was pronounced brain dead on
March 3, 1988 7:00am. Two hours later, Dr. Ona was informed that EEG recording exhibited a
flat tracing thereby confirming his brain death. He was found to be a suitable donor of the heart,
kidneys, pancreas, and liver, and after the extensive search, no relatives were found. Dr. Ona then
requested the removal of the specific organs of Lugmoso from the herein petitioners, Dr. Alano,
the director of NKTI who thereafter issued a memorandum stating that only after the
requirements of RA 349 as amended by PD 856 was complied, they can remove the specified
organs of Lugmoso. Lugmosos remains was brought at La Funeraria Oro. A press release made
by NKTI announcing a double organ transplant led to the findings of the relatives of Lugmoso.
Issue: Whether or not the removal of Lugmosos organs were valid.

Held: Yes. The internal organs of the deceased were removed only after he had been declared
brain dead; thus the emotional pain suffered by respondent due to the death of her son cannot be
in any way be attributed to petitioner. Neither can the court find evidence or second to show that
respondents emotional suffering at the sight of the pitful state in which she found her sons
lifeless body be categorically attributed to petitioners conduct.
Thus, there can be no cavil that petitioners employed reasonable means to disseminate
notifications intended to reach the relatives of the deceased. The only question that remains
pertains to the sufficiency of time allotted for notices to reach the relatives of the deceased.
If respondent failed to immediately receive notice of her sons death because the notices did not
properly state the name or identity of the deceased, fault cannot be laid at petitioners door. The
trial and appellate courts found that it was the EAMC, who recorded the wrong information
regarding the deceaseds identity to NKTI. The NKTI could not have obtained the information
about his name from the patient, because as found by the lower courts, the deceased was already
unconscious by the time he was brought to NKTI.
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 Noras blood pressure. Her blood pressure was
frequently monitored with the use of a sphygmamometer. While petitioner was massaging Noras
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 Noras 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 Noras
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.
In cases, involving medical negligence, the doctrine of res ipsa liquitor allows the mere
existence of an injury to justify a presumption of negligence on the part of the person who
controls the instrument causing the injury, provided that the following requisites concur:
1. The accident is of a kind which ordinarily does not occur in the absence of someones
negligence;
2. It is caused by an instrumentality within the exclusive control of the defendant or
defendants;
3. The possibility of contributing conduct which would make the plaintiff responsible is
eliminated.
All of these three requisites were present in the case at bar.
Under the the captain of the ship doctrine, the surgeon in charge of the operation is liable for the
negligence of his assistants during the time when those are under the surgeons control.
Cayao-Lasam vs Spouses Ramolete
GR No. 159132 December 18, 2002
Facts: On July 28, 1994, respondent 3 months pregnant Editha Ramolete was brought to Lorma
Medical Center (LMC) in San Fernando, La Union due to vaginal bleeding upon advise of
petitioner related via telephone, Editha was admitted to the LMC on the same day. A pelvic
sonogram was then conducted on Editha revealing the fetus weak cardiac pulsation. The
following day, Editha 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 advised her to undergo a D&C procedure. She was discharged the following
day. On September 16, 1994, Editha was once gain brought at the LMC, as she was suffering
from vomiting ans severe abdominal pains. Editha was attended by Drs. Dela Cruz, Mayo and
Komiya. Dr. Mayo allegedly informed Editha that there was a dead fetus in the latters womb,
after Editha went laparectomy, she was found to have massive intra abdominal hemorrhage and
ruptured uterus. Thus, she had to go hysterectomy and as a result no more chance to bear a child.
Issue: Whether or not petitioner is liable for medical malpractice.

Held: No. 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 cause..
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 patients 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, in as much 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 suspect the
conclusion as to causation.
It is undisputed that Editha did not return for follow-up evaluation, in defiance of the petitioners
advice. This is as found out is the proximate cause of the injury she sustained.
CERENO vs. COURT OF APPEALS
G.R. No. 167366 September 26, 2012
FACTS: At about 9:15 in the evening, Raymond S. Olavere (Raymond), a victim of a stabbing
incident, was rushed to the emergency room of the Bicol Regional Medical Center (BRMC).
The emergency room resident physician recommended that the patient undergo "emergency
exploratory laparotomy and requested the parents of Raymond to procure 500 cc of type "O"
blood needed for the operation.
At 10:30 P.M., Raymond was wheeled inside the operating room. During that time, the hospital
surgeons, herein petitioners, were conducting an operation on a gunshot victim. Assisting them
was the only senior anaesthesiologist on duty at BRMC that night, Dr. Tatad.
By the time the surgery finished, there was another emergency involving the birth of triplets to
which Dr. Tatad started working on. There being no other available anaesthesiologist to assist the
petitioners, they decided to defer the operation on Raymond
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."
At 11:15 P.M., the blood arrived. At around 12:15 A.M., the petitioners started operating on
Raymond and upon opening of

Raymonds thoracic cavity, they found that 3,200 cc of blood was stocked therein. The blood was
evacuated and petitioners found a puncture at the inferior pole of the left lung. Dr. Cereno did not
immediately transfuse blood because he had to control the bleeders first.
Blood was transfused on Raymond at 1:40 A.M. At 1:45 A.M., Raymond suffered a cardiac
arrest. The operation ended at 1:50 A.M. and Raymond was pronounced dead at 2:30 A.M.
Raymonds death certificate5 indicated that the immediate cause of death was "hypovolemic
shock" or the cessation of the functions of the organs of the body due to loss of blood.
ISSUE: Whether or not petitioners were guilty of medical malpractice.
HELD: No.
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.22
A Verdict in malpractice action cannot be based on speculation or conjecture. Causation must be
proven within a reasonable medical probability based upon competent expert testimony.
The parents of Raymond failed in this respect. Their cause stands on the mere assumption that
Raymonds life would have been saved had petitioner surgeons immediately operated on him;
had the blood been cross-matched immediately and had the blood been transfused immediately.
There is nothing in the testimony of Dr. Tatad, or in any evidence on the record for that matter,
which shows that the petitioners were aware of the "BRMC protocol" that the hospital keeps a
standby anesthesiologist available on call.
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,
petitioners deciding to wait for Dr. Tatad to finish her surgery and not to call the standby
anesthesiologist anymore was reasonable. There is no evidence that shows that a prudent surgeon
faced with similar circumstances would decide otherwise.
As to the failure of Dr. Cereno to transfuse blood immediately, his testimony was not rebutted
that there was a need first to control the bleeders otherwise the blood transfused will be lost just
the same.
Dela Torre vs Imbuido
GR No. 192973 September 29, 2014
Facts: At around 3:00pm of February 3, 1992, Carmen was brought to Divine Spirit General
Hospitals operating room for her caesarian section operation, which was to be performed by Dr.
Nestor. By 5:30pm, of the same day, Pedrito was informed by his wifes delivery of a baby boy.
In the early morning of February 4, 1992, Carmen experienced abdominal pains and difficulty in
urinating. She was diagnosed to be suffering from urinary tract infection (UTI), and was
prescribed medication by Dr. Norma. On February 10, 1992, Pedrito noticed that Carmens

stomach was getting bigger, but Dr. Norma dismissed the patients condition as mere fratulence.
When Carmens stomach still grow bigger despite medications, Dr. Norma advised Pedrito of the
possibility of a second operation on Carmen. Dr. Norma, however, provided no details on its
purpose and the doctor who would perform it. At around 3:00pm on February 12, 1992 Carmen
had her second operation. Later in the evening, Dr. Norma informed Pedrito that everything was
going on fine with his wife. The condition of Carmen, however, did not improve. It instead
worsened that on February 13, 1992, she vomited dark red blood. At 9:30pm of the same day,
Carmen died. Per her death certificate upon information provided by the hospital, the immediate
cause of Carmens death was cardio-respiratory arrest secondary to cerebro vascular accident,
hypertension and chronic nephritis induced by pregnancy. An autopsy report prepared by Dr.
Partilano, medico-legal officer designate of Olongapo City, however, provided that the cause of
Carmens death was shock due to peritonitis severe with multiple intestinal adhesions; status post
caesarian section and exploratory laparotomy. Pedrito claimed in his complaint that the
respondents failed to exercise the degree of diligence required of them as members of the
medical profession, and were negligent for practicing surgery on Carmen in the most unskilled,
ignorant, and cruel manner.
Issue: Whether or not respondents were liable for medical malpractice that resulted to Carmens
death.
Held: No. 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, or his or her family as in this case, must prove that healthcare 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 failure or action caused injury to the patient.
Four essential elements must be established namely: 1.) duty; 2.) breach; 3.) injury and 4.)
proximate causation. All four elements must be present in order to find the physician negligent
and thus, liable for damages.
For the trial court to give weight to Dr. Partilanos report, it was necessary to show first Dr.
Partilanos specialization and competence to testify on the degree of care, skill and diligence
needed for the treatment of Carmens case. Considering that it was not duly established that Dr.
Partilano practiced and was an expert on the fields that involved Carmens condition, he could
not have accurately identified the said degree of care, skill and diligence and the medical
procedure, that should have been applied.