31.

Solidum vs People of the Philippines

GR No. 192123 March 10, 2014

FACTS: Gerald Albert Gercayo was born on June 2, 1992 with an imperforate anus. Two days
after his birth, Gerald underwent colostomy, a surgical procedure to bring one end of the large
intestine out through the abdominal walls, enabling him to excrete through a colostomy bag
attached to the side of his body. On May 17, 1995, Gerald was admitted at the Ospital ng
Maynila for a pull-through operation. Dr. Leandro Resurreccionheaded the surgical team, and
was assisted by Dr. Joselito Lucerio, Dr.Donatella Valeria and Dr. Joseph Tibio. The
anesthesiologist included Drs. Abella, Razon and Solidum. During the operation, Gerald
experienced bradycardia and went into a coma. His coma lasted for two weeks , but he
regained consciousness only after a month. He could no longer see, hear, or move. A complaint
for reckless imprudence resulting in serious physical injuries were filed by Geralds parents
against the team of doctors alleging that there was failure in monitoring the anesthesia
administered to Gerald.

ISSUES: Whether or not petitioner is liable for medical negligence.

Whether or not res ipsa liquitor can be resorted to in medical negligence cases.

RULING: No. Negligence is defined as the failure to observe for the protection of the interests of
another person that degree of care, precaution, and vigilance that the circumstances justly
demand, whereby such other person suffers injury. Reckless imprudence, on the other hand,
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 to perform or
failing to perform such act.

The negligence must be the proximate cause of the injury. For, negligence no matter in what it
consists, cannot create a right of action unless it is the proximate cause of the injury complained
of. And the proximate cause of an injury is that cause, which, in natural and continuous
sequence and unbroken by any efficient intervening cause, produces the injury, and without
which the result would not have occurred.
An action upon medical negligence whether criminal, civil or administrative calls for the
plaintiff to prove by competent evidence each of the following four elements namely: a.) the duty
owed by the physician to the patient, as created by the physician-patient relationship, to act in
accordance with the specific norms or standards established by his profession; b.) the breach of
the duty by the physicians failing to act in accordance with the applicable standard of care; c.)
the causation, is, there must be a reasonably close and casual connection between the
negligent act or omission and the resulting injury; and d.) the damages suffered by the patient.
In the medical profession, specific norms on standard of care to protect the patient against
unreasonable risk, commonly referred to as standards of care, set the duty of the physician in
respect of the patient. The standard of care is an objective standard which conduct of a
physician sued for negligence or malpractice may be measured, and it does not depend
therefore, on any individuals physicians own knowledge either. In attempting to fix a standard
by which a court may determine whether the physician has properly performed the requisite
duty toward the patient, expert medical testimony from both plaintiff and defense experts is
required.

The doctrine of res ipsa liquitor means that where the thing which causes injury is shown to be
under the management of the defendant, and the accident is such as in ordinary course of
things does not happen if those who have management use proper care, it affords reasonable
evidence, in the absence of an explanation by defendant that the accident arose from want of
care.
Nevertheless, despite the fact that the scope of res ipsa liquitor has been measurably enlarged,
it does not automatically apply to all cases of medical negligence as to mechanically shift the
burden of proof to the defendant to show that he is not guilty of the ascribed negligence. Res
ipsa liquitor is not a rigid or ordinary doctrine to be perfunctorily used but a rule to be cautiously
applied, depending upon the circumstances of each case. It is generally restricted to situations
in malpractice cases where a layman is able to say, as a matter of common knowledge and
observation, that the consequences of professional care were not as such as would ordinarily
have followed if due care had been exercised. A distinction must be made between the failure to
secure results, and the occurrence of something more unusual and not ordinarily found if the
service or treatment rendered followed the usual procedure of those skilled in that particular
practice. It must be conceded that the doctrine of res ipsa liquitor 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 why any particular scientific treatment did not produce the desired
results. Thus, res ipsa liquitor is not available in a malpractice suit if the only showing is that the
desired result of an operation or treatment was not accomplished. The real question, therefore,
is whether or not in the process of the operation any extraordinary incident or unusual event
outside the routine performance occurred which is beyond the regular scope of customary
professional activity in such operations, which if unexplained would themselves reasonably
speak to the average man as the negligent case or causes of the untoward consequence. If
there was such extraneous intervention, the doctrine of res ipsa liquitor may be utilized and the
dependent is called upon to explain the matter, by evidence of exculpation, if he could.

31. MARITER MENDOZA vs. ADRIANO CASUMPANG (G.R. No. 197987)

FACTS:
On February 13, 1993 Josephine Casumpang underwent a hysterectomy and myomectomy
under the care and Supervision of Dr. Mariter Mendoza at Iloilo Doctors Hospital, after the
operation Josephine experienced recurring fever , nausea, and vomiting. Three months after
while taking a shower she felt something protruding in her genitals, which was later found out to
be a rolled gauze left inside her cervix. Which was the reason she filed a suit against , Dr.
Mendoza for medical negligence and damages.

ISSUE:
Whether or not Dr. Mariter Mendoza is guilty of medical negligence

RULING:
YES, An operation requiring the placing of sponges in the incision is not complete until the
sponges are properly removed, and it is settled that the leaving of sponges or other foreign
substances in the wound after the incision has been closed is at least prima facie negligence by
the operating surgeon. To put it simply, such act is considered so inconsistent with due care as
to raise an inference of negligence. There are even legions of authorities to the effect that such
act is negligence per se.
32. Jarcia vs People of the Philippines
GR No. 187926 February 15, 2012

FACTS:
Belinda Santiago lodged a complaint with the National Bureau of Investigation (NBI) against the
petitioners, Dr. Emanuel Jarcia and Dr. Marilou Bastan, for their alleged neglect of professional
duty which caused her son, Roy Alfonso Santiago, to suffer physical injuries. Upon
investigation, the NBI found that Roy Jr. was hit by a taxicab; that he was rushed to the Manila
Doctors Hospital for an emergency medical treatment; that an X-ray of the victims ankle was
ordered; that the X-ray result showed no fracture as read by Dr. Jarcia; that Dr. Bastan entered
the emergency room and, after conducting her own examination of the victim, informed Mrs.
Santiago that since it was only the ankle that was hit there was no need to examine the upper
leg; that 11 days later, Roy developed fever, swelling of the right leg and misalignment of the
right foot; that Mrs. Santiago brought him back to the hospital; and that the x-ray revealed a right
mid-tibial fracture and a linear hairline fracture in the shaft of the bone. A complaint for reckless
imprudence resulting physical injuries was filed against the petitioners for the alleged
misconduct in the handling of the illness of Roy.

ISSUE:
Whether or not the petitioners failed to exercise the degree of care expected of them as doctors
and are liable for negligence to the private respondent
.
RULING:
Yes. The doctrine of res ipsa liquitor as a rule of evidence is unusual to the law of negligence
which recognizes that prima facie negligencce 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 duty. The doctrine can be invoked when and only when, under the
circumstances involved, direct evidence is absolute and not readily available.
The requisites for the application of the doctrine of res ipsa liquitor 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.
Negligence is defined as the failure to observe for the protection of the interests 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.
In failing to perform an extensive medical examination to determine the extent of Roys injuries,
Dr. Jarcia and Dr. Bastan were remiss of their duties as members of the medical profession.
Assuming for the sake of argument that they did not have the capacity to make such thorough
evaluation at that stage they should have referred the patient to another doctor with sufficient
training and experience instead of assuring him and his mother that everything was all right.