Dr.

Alano vs Logmao

FACTS:

Logmao, 18, was brought to the East Avenue Medical Center in Quezon City after falling from an overpass near
Farmers Market in Cubao at 9:50 p.m. on March 1, 1988.

The patients name, however, was erroneously listed at the hospital as Angelito Lugmoso of Boni Avenue,
Mandaluyong City.

Early the next day, Logmao suffered seizures and progressively deteriorated. He was transferred unconscious to the
NKTI (NATIONAL KIDNEY AND TRANSPLANT INSTITUTE).

At the NKTI, Ona (Enrique T. Ona) noted the severity of Logmaos injuries and recommended that he be made an
organ donor should he expire. A transplant coordinator then contacted the police and media to find Logmaos family
in Mandaluyong.

Due to the error in his recorded name, Logmaos family could not be located. The victim was pronounced brain dead
at 9:10 a.m. on March 3 due to craniocerebral injury. Ona requested Alano (NKTI head) to authorize the removal of
Logmaos organs for transplantation.

Alano issued a memorandum approving Onas request, provided reasonable efforts had been made to contact
Logmaos relatives. Under the laws on transplants, namely, Republic Act No. 349 and Presidential Decree No. 856,
hospital authorities may authorize organ transplants if the donor had no next of kin.

Since no relatives came forward to claim Logmaos body, the NKTI went ahead with the organ harvesting and
transplant. Two patients benefited from Logmaos organs.

When Logmaos mother (Zenaida Logmao) discovered the whereabouts of his dead son, she sued Alano for ordering
her sons internal organs harvested and transplanted without permission

ISSUE: Whether or not Alano was is negligent in authorizing the harvesting and transplant of Logmaos internal
organs.

HELD:

Dr. Filoteo Alano, was not negligent in authorizing the institutes surgeons led by Dr. Enrique Ona, now the health
secretary, to remove the kidneys, pancreas, liver and heart of Arnelito Logmao after he was declared brain dead.

The justices also dismissed the award for damages worth P550,000 that the Court of Appeals had given in 2006 to
Logmaos mother Zenaida, who had claimed that there was a conspiracy to harvest her sons organs while he was
still alive and that his true identity was deliberately concealed.

Complainant failed to substantiate her claims, adding, [T]here can be no cavil that petitioner employed reasonable
means to disseminate notifications intended to reach the relatives of the deceased.

They failed to present any expert witness to prove that given the medical technology and knowledge at that time in
the 1980's, the doctors could or should have waited longer before harvesting the internal organs for transplantation.

Finding petitioner liable for damages is improper. It should be emphasized that 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 in any way be attributed to petitioner. Neither can the Court find evidence on record to
show that respondent's emotional suffering at the sight of the pitiful state in which she found her son's lifeless body
be categorically attributed to petitioner's conduct.
 REPUBLIC ACT NO. 349

REPUBLIC ACT NO. 349 - AN ACT TO LEGALIZE PERMISSIONS TO USE HUMAN ORGANS OR ANY
PORTION OR PORTIONS OF THE HUMAN BODY FOR MEDICAL, SURGICAL, OR SCIENTIFIC PURPOSES,
UNDER CERTAIN CONDITIONS

Section 1. A person may validly grant to a licensed physician, surgeon, known scientist, or any medical or
scientific institution, authority to detach at any time after the grantor's death any organ, part or parts of his body and
to utilize the same for medical, surgical or scientific purposes.

Similar authority may also be granted for the utilization for medical, surgical, or scientific purposes, of any organ,
part or parts of the body which, for a legitimate reason, would be detached from the body of the grantor.

Sec. 2. The authorization referred in section one of this Act must; be (1)in writing; (2) specify the person or
institution granted the authorization, (3)the organ, part or parts to be detached, (4)the use or uses of the
organ, (5)part or parts are to be employed; and (6)signed by the grantor and two disinterested witnesses.

If the grantor is a minor or an incompetent person, the authorization may be executed by his guardian with the
approval of court; in default thereof, by the legitimate father or mother, in order, named. Married women may grant
the authority referred to in section one of this Act, without the consent of the husband.

A copy of every such authorization must be furnished the Secretary of Health.

Sec. 3. An authorization granted in accordance with the provisions of this Act shall be bind the executors,
administrators and successors of the deceased and all members of his family.

Sec. 4. Any law or regulation inconsistent with this Act are hereby repealed.

Sec. 5. This Act shall take effect upon its approval.

Jarcia v. People
(February 15, 2012)
Ponente
: Mendoza, J.
FACTS:
Private complainant Belinda Santiago lodged a complaint with the National Bureau of Investigation against the
petitioners, Dr. Emmanuel Jarcia, Jr. and Dr. Marilou Bastan, 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 Jr. was hit by a taxicab; that he was rushed to the Manila DoctorsHospital
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. despite Mrs. Santiago's protest the doctors did not examine the upper portion of the leg of Roy. that eleven
(11) days later, Roy Jr. 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.
After trial and applying the doctrine of res ipsa loquitor the RTC found petitioners to be guilty of simple negligence. The
decision was affirmed in toto by the CA.

ISSUES:
(1) Whether or not res ipsa loquitor is applicable in this case
.(2) Whether or not the petitioner physicians are negligent, hence liable for damages.
HELD:
As to the first issue:
This doctrine of res ipsa loquitur 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 happen 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 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 incharge; and

(3) the injury suffered must not have been due to any voluntary action or contribution of the person injured.

However, 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. Ergo, the doctrine can be invoked when and only when, under the circumstances involved, direct evidence
is absent and not readily available.Relative to the case, res ipsa loquitor does not apply since the circumstances that
caused patient Roy Jr.s 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.While
it may be true that the circumstances pointed out by the courts below seem doubtless to constitute reckless imprudence
on the part of the petitioners, this conclusion is still best achieved, not through the scholarly assumptions of a layman
like the patients mother, but by the unquestionable knowledge of expert witness/es. As to whether the petitioners have
exercised the requisite degree of skill and care in treating patient Roy, Jr. is generally a matter of expert opinion.

As to the second issue: Petitioners were negligent in their obligation. It was proven that a thorough examination was not
performed on Roy Jr since as residents on duty at the emergency room, Dr. Jarcia and Dr. Bastan were expected to know the
medical protocol in treating leg fractures and in attending to victims of car accidents. Thus, simple negligence is resent if: (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. Dr. Jarcia and Dr. Bastan, explained the court, cannot pass on the liability to the taxi driver who hit
the victim. It may be true that the actual, direct, immediate, and proximate cause of the injury (fracture of the leg bone or tibia)
of Roy Jr. was the vehicular accident when he was hit by a taxi. The petitioners, however, cannot simply invoke such fact alone
to excuse themselves from any liability. If this would be so, doctors would have a ready defense should they fail to do their job in
attending to victims of hit-and-run, maltreatment, and other crimes of violence in which the actual, direct, immediate, and
proximate cause of the injury is indubitably the act of the perpetrator/s. In failing to perform an extensive medical examination
to determine the extent of Roy Jr.s 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. Moreover, the contention of petitioners that they cannot be held liable since Roy is
not their patient, since they are not the attending physicians but merely requested by the ER does not hold water. Physician-
patient relationship exists when a patient engages the services of a physician, a physician-patient relationship is generated. And
in accepting a case, the physician, for all intents and purposes, represents that he has the needed training and skill possessed by
physicians and surgeons practicing in the same field; and that he will employ such training, care, and skill in the treatment of the
patient. Thus, in treating his patient, a physician is under a duty to exercise that degree of care, skill and diligence which physicians
in the same general neighborhood and in the same general line of practice ordinarily possess and exercise in like cases. Stated
otherwise, the physician has the obligation to use at least the same level of care that any other reasonably competent physician
would use to treat the condition under similar circumstances. There is a physician-patient relationship in this case since the
petitioner obliged themselves and examined the victim, and later assured the mother that everything was fine and that they
could go home. Their assurance that everything is fine deprived the victim of seeking medical help. Petitioners were absolved in
the criminal charge for the reason that a reasonable doubt existed but the are liable for damages. There is no direct evidence
proving that it was their negligence that caused the suffering of Roy.
RAMOS vs. COURT OF APPEALS
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.

RATIO:

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 plaintiffs 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 damagedres ipsa loquitur!the thing speaks for itself!

Negligence Private respondents were not able to disprove the presumption of negligence on their part in the care of Erlinda
and their negligence was the proximate cause of her condition. One need not be an anesthesiologist in order to tell whether or
not the intubation was a success. [res ipsa loquitur applies here]. The Supreme Court also found that the anesthesiologist only
saw Erlinda for the first time on the day of the operation which indicates unfamiliarity with the patient and which is an act of
negligence and irresponsibility.
The head surgeon, Dr. Hosaka was also negligent. He failed to exercise the proper authority as the captain of the ship in
determining if the anesthesiologist observed the proper protocols. Also, because he was late, he did not have time to confer with
the anesthesiologist regarding the anesthesia delivery.

The hospital failed to adduce evidence showing that it exercised the diligence of a good father of the family in hiring and
supervision of its doctors (Art. 2180). The hospital was negligent since they are the one in control of the hiring and firing of their
consultants. While these consultants are not employees, hospitals still exert significant controls on the selection and
termination of doctors who work there which is one of the hallmarks of an employer-employee reationship. Thus, the hospital
was allocated a share in the liability.

Damages temperate damages can and should be awarded on top of actual or compensatory damages in instances where the
injury is chronic and continuing.