Speaking for itself

A LAW EACH DAY (KEEPS TROUBLE AWAY) - Jose C. Sison (The

Philippine Star)

This is a novel case about medical malpractice or the liability of a surgeon,

anesthesio logist and a hospital for damages due to the negligence in the
performance of their duties to a patient. In this case, the court likewise
explains the doctrine of Res Ipsa Loquitur which means the “thing or
transaction speaks for itself,” and when it can be used in determining
whether negligence really exists.

This case involves Marta, a 47-year-old robust woman married to Ramon, a

telecommunications executive, with three sons, Romy, Ray and Randy. She
is as normal as any other woman except for some discomforts that
interfered with her normal ways. So she sought professional advice and
was told to undergo an operation for the removal of a stone in her gall
bladder. After a series of examinations which included blood and urine
tests, she was found fit for surgery and was scheduled for operation.

On the day of the surgery, she went to the hospital and placed herself
under the care, custody and control of Dr. Losada, the surgeon who will
operate on her, and Dr. Cruz, the anesthesiologist recommended by Dr.
Losada who will administer the anesthesia on her. On that day, Marta was
neurologically sound, and except for a few minor discomforts, was
physically fit in mind and body. However Dr. Losada was late for about
three hours and during the administration of the anesthesia prior to the
actual surgery, she suffered irreparable damage to her brain as a result of
lack of oxygen for four to five minutes and was thus confined at the
intensive care unit (ICU). She remained in the hospital for about four
months during which Ramon had to spend P8,000 a month. And when she
was discharged she still needed constant medical attention as she was
diagnosed to be suffering from brain damage.

So a complaint for damages was filed before the Regional Trial Court
(RTC) by Marta and Ramon and their children against Dr. Losada, Dr. Cruz
and the hospital, alleging negligence in the treatment and care of Marta.
Ramon and her sister Caridad who was dean of the college of nursing in
another hospital and who was present during the surgical operation
testified, to prove their complaint. Drs. Lozada, Cruz and the hospital
denied the charge and claimed that Marta’s brain damage was due to her
allergic reaction to the anesthetic agent.

After trial the RTC rendered judgment in favor of Ramon and Marta ruling
that Dr. Losada, Dr. Cruz and the hospital are guilty of negligence in the
performance of their duty to Marta. So Drs Lozada, Cruz and the hospital
was ordered to pay the actual, moral, exemplary damages and attorney’s
fees totaling P1,732,000. On appeal, the Court of Appeals (CA), reversed
the decision of the RTC and dismissed the complaint. The CA even ordered
Ramon et.al. to pay the unpaid hospital bills.

The Supreme Court however reversed the CA decision. The SC said that
although generally, expert medical testimony is relied upon in malpractice
suits to prove that a physician has done a negligent act or that he deviated
from the standard medical procedure, such expert testimony applies only to
such matters clearly within the domain of medical science and not to
matters that are within the common knowledge of mankind which may be
testified to by anyone familiar with the facts. In this case the doctrine of Res
Ipsa Loquitur may be used because the injury itself provides the proof of
negligence. Under this doctrine, where common knowledge and experience
teach that a resulting injury would not have occurred to the patient if due
care had been exercised an inference of negligence may be drawn. Here,
the defendants were unable to disprove the presumption of negligence on
their part in the care of Marta and their negligence was the cause of her
piteous condition, based on said doctrine. So Dr. Cruz is negligent in the
anesthesia phase as she failed to properly place the tube on the patient as
testified by Caridad, the nurse- sister-in-law of Marta. In fact, the
defendants themselves admitted that the first intubation was a failure thus
necessitating another anesthesiologist. Dr. Losada is also negligent
because of his failure to determine whether his anesthesiologist Dr. Cruz,
properly intubated the patient. Besides he was also three hours late for the
operation. The hospital is also liable here because it did not exercise the
diligence of a good father of a family in the hiring and supervision of the
doctors and consultant staff with whom it has employer-employee
relationship, since it has control in their hiring and firing. So Ramon and
Marta and their children should be awarded actual, moral temperate
damages and attorney’s fees totaling P5,402,000.(Ramos etc. vs Court of
Appeals et al., G.R. 124354, December 29, 1999).