If no legal right has been violated, there can be

no application of a legal remedy, and the writ

of mandamus is a legal remedy for a legal right.
There must be a well-defined, clear and certain
legal right to the thing demanded. It is long
established rule that a license to practice
medicine is a privilege or franchise granted by
the government.

Practice of Medicine!

Professional Regulation Commission (PRC) vs. De

Guzman



Accordingly, Section 20 of Rep. Act No. 2382, as
amended should be read in conjunction with the
other provisions of the Act. Thus, to determine
whether the petitioners had the ministerial
obligation to administer the Hippocratic Oath to
respondents and register them as physicians,
recourse must be had to the entirety of the Medical
Act of 1959.

The surrounding circumstances in this case call for
serious inquiry concerning the satisfactory
compliance with the Board requirements by the
respondents. The unusually high scores in the two
most difficult subjects was phenomenal, according
to Fr. Nebres, the consultant of PRC on the matter,
and raised grave doubts about the integrity, if not
validity, of the tests. These doubts have to be
appropriately resolved.

Under the second paragraph of Section 22, the
Board is vested with the power to conduct
administrative investigations and disapprove
applications for examination or registration

Practice of Medicine Section 8 of Rep. Act No.
2382 prescribes, among others, that a person who
aspires to practice medicine in the Philippines,
must have satisfactorily passed the corresponding
Board Examination. Section 22, in turn, provides
that the oath may only be administered to
physicians who qualified in the examinations. The
operative word here is satisfactorily, defined as
sufficient to meet a condition or obligation or
capable of dispelling doubt or ignorance.
Gleaned from Board Resolution No. 26, the
licensing authority apparently did not find that the
respondents satisfactorily passed the licensure
examinations. The Board instead sought to nullify
the examination results obtained by the
respondents.

Mandamus is a command issuing from a court of
competent jurisdiction, in the name of the state or
the sovereign, directed to some inferior court,
tribunal, or board, or to some corporation or person
requiring the performance of a particular duty
therein specified, which duty results from the
official station of the party to whom the writ is
directed, or from operation of law.

Verily, to be granted the privilege to practice

medicine, the applicant must show that he
possesses all the qualifications and none of the
disqualificationswithout a definite showing that
the aforesaid requirements and conditions have
been satisfactorily met, the courts may not grant the
writ of mandamus to secure said privilege without
thwarting the legislative will.

Department of Education, Culture and Sports vs.
San Diego


The issue raised is the academic preparation of the
applicant. This may be gauged at least initially by
the admission test and, indeed with more reliability,
by the three-flunk rule. The latter cannot be
regarded any less valid than the former in the
regulation of the medical profession. Police power
is validly exercised if (a) the interests of the public
generally, as distinguished from those of a
particular class, require the interference of the
State, and (b) the means employed are reasonably
necessary to the attainment of the object sought to
be accomplished and not unduly oppressive upon
individuals.

It is the right and indeed the responsibility of the
State to insure that the medical profession is not
infiltrated by incompetents to whom patients may
unwarily entrust their lives and health. The method
employed by the challenged regulation is not
irrelevant to the purpose of the law nor is it
arbitrary or oppressive. The three-flunk rule is
intended to insulate the medical schools and
ultimately the medical profession from the
intrusion of those not qualified to be doctors.

While every person is entitled to aspire to be a
doctor, he does not have a constitutional right
to be a doctor.

The contention that the challenged rule violates the
equal protection clause is not well-taken. A law
does not have to operate with equal force on all
persons or things to be conformable to Article III,
Section 1 of the Constitution. There can be no

question that a substantial distinction exists

between medical students and other students who
are not subjected to the NMAT and the three-flunk
rule. The medical profession directly affects the
very lives of the people, unlike other careers which,
for this reason, do not require more vigilant
regulation. The accountant, for example, while
belonging to an equally respectable profession,
does not hold the same delicate responsibility as
that of the physician and so need not be similarly
treated. There would be unequal protection if some
applicants who have passed the tests are admitted
and others who have also qualified are denied
entrance. In other words, what the equal protection
requires is equality among equals.

Doris Sy, Dr. Batiquin's assistant during the

operation on private respondent Villegas. But the
trial court failed to recognize that the assertions of
Drs. Batiquin and Sy were denials or negative
testimonies. Well-settled is the rule that positive
testimony is stronger than negative testimony.

Ramos vs. Court of Appeals



Medical Negligence!
Batiquin vs. Court of Appeals



The petitioners emphasize that the private
respondents never reconciled Dr. Khos testimony
with Dr. Batiquin's claim on the witness stand that
when Dr. Batiquin confronted Dr. Kho about the
foreign body, the latter said that there was a piece
of rubber but that she threw it away. Although
hearsay, Dr. Batiquin's claim was not objected to,
and hence, the same is admissible but it carries no
probative value. Nevertheless, assuming otherwise,
Dr. Batiquin's statement cannot belie the fact that
Dr. Kho found a piece of rubber near private
respondent Villega's uterus. And even if we were to
doubt Dr. Kho as to what she did to the piece of
rubber, i.e., whether she threw it away or sent it to
Cebu City, we are not justified in distrusting her as
to her recovery of a piece of rubber from private
respondent Villega's abdomen. On this score, it is
perfectly reasonable to believe the testimony of a
witness with respect to some facts and disbelieve
his testimony with respect to other facts. And it has
been aptly said that even when a witness is found to
have deliberately falsified in some material
particulars, it is not required that the whole of his
uncorroborated testimony be rejected, but such
portions thereof deemed worthy of belief may be
credited.

It is here worth noting that the trial court paid heed
to the following portions of Dr. Batiquin's
testimony: that no rubber drain was used in the
operation, and that there was neither any tear on Dr.
Batiquin's gloves after the operation nor blood
smears on her hands upon removing her gloves.
Moreover, the trial court pointed out that the
absence of a rubber drain was corroborated by Dr.

The conduct of a preanesthetic/preoperative

evaluation prior to an operation, whether elective or
emergency, cannot be dispensed with. Such
evaluation is necessary for the formulation of a
plan of anesthesia care suited to the needs of the
patient concerned. Pre-evaluation for anesthesia
involves taking the patient's medical history,
reviewing his current drug therapy, conducting
physical examination, interpreting laboratory data,
and determining the appropriate prescription of
preoperative medications as necessary to the
conduct of anesthesia. Physical examination of the
patient entails not only evaluating the patient's
central nervous system, cardiovascular system and
lungs but also the upper airway. Examination of the
upper airway would in turn include an analysis of
the patient's cervical spine mobility,
temporomandibular mobility, prominent central
incisors, deceased or artificial teeth, ability to
visualize uvula and the thyromental distance.

Expert Testimony A pulmonologist could not
be considered an authority on anesthesia
practice and procedure and their complications

The Court has reservations on giving evidentiary
weight to the entries purportedly contained in Dr.
Gutierrez' synopsis. It is significant to note that the
said record prepared by Dr. Gutierrez was made
only after Erlinda was taken out of the operating
room. The standard practice in anesthesia is that
every single act that the anesthesiologist performs
must be recorded. In Dr. Gutierrez' case, she could
not account for at least ten (10) minutes of what
happened during the administration of anesthesia
on Erlinda.

Dr. Hosaka's irresponsible conduct of arriving very
late for the scheduled operation of petitioner
Erlinda is violative, not only of his duty as a
physician to serve the interest of his patients with
the greatest solicitude, giving them always his best
talent and skill, but also of Article 19 of the Civil
Code which requires a person, in the performance
of his duties, to act with justice and give everyone
his due.

It has been consistently held that in determining

whether an employer- employee relationship exists
between the parties, the following elements must be
present: (1) selection and engagement of services;
(2) payment of wages; (3) the power to hire and
fire; and (4) the power to control not only the end to
be achieved, but the means to be used in reaching
such an end.

DLSMC maintains that first, a hospital does not
hire or engage the services of a consultant, but
rather, accredits the latter and grants him or her
the privilege of maintaining a clinic and/or
admitting patients in the hospital upon a
showing by the consultant that he or she
possesses the necessary qualifications, such as
accreditation by the appropriate board
(diplomate), evidence of fellowship and
references. Second, it is not the hospital but the
patient who pays the consultant's fee for
services rendered by the latter. Third, a hospital
does not dismiss a consultant; instead, the latter
may lose his or her accreditation or privileges
granted by the hospital. Lastly, DLSMC argues
that when a doctor refers a patient for
admission in a hospital, it is the doctor who
prescribes the treatment to be given to said
patient. The hospital's obligation is limited to
providing the patient with the preferred room
accommodation, the nutritional diet and
medications prescribed by the doctor, the
equipment and facilities necessary for the
treatment of the patient, as well as the services
of the hospital staff who perform the ministerial
tasks of ensuring that the doctor's orders are
carried out strictly. After a careful
consideration of the arguments raised by
DLSMC, the Court finds that respondent
hospital's position on this issue is meritorious.
There is no employer-employee relationship
between DLSMC and Drs. Gutierrez and
Hosaka which would hold DLSMC solidarity
liable for the injury suffered by petitioner
Erlinda under Article 2180 of the Civil Code.

Neither is there any showing that it is DLSMC
which pays any of its consultants for medical
services rendered by the latter to their
respective patients. Moreover, the contract
between the consultant in respondent hospital
and his patient is separate and distinct from the
contract between respondent hospital and said
patient. The first has for its object the rendition
of medical services by the consultant to the
patient, while the second concerns the
provision by the hospital of facilities and

services by its staff such as nurses and

laboratory personnel necessary for the proper
treatment of the patient.

Nogales vs. Capitol Medical Center



In general, a hospital is not liable for the negligence
of an independent contractor-physician. There is,
however, an exception to this principle. The
hospital may be liable if the physician is the
ostensible agent of the hospital. This exception is
also known as the doctrine of apparent authority.

Under the doctrine of apparent authority a hospital
can be held vicariously liable for the negligent acts
of a physician providing care at the hospital,
regardless of whether the physician is an
independent contractor, unless the patient knows, or
should have known, that the physician is an
independent contractor. The elements of the action
have been set out as follows:

(1) the hospital, or its agent, acted in a manner that
would lead a reasonable person to conclude
that the individual who was alleged to be
negligent was an employee or agent of the
hospital;

(2) where the acts of the agent create the
appearance of authority, the plaintiff must also
prove that the hospital had knowledge of and
acquiesced in them; and

(3) the plaintiff acted in reliance upon the conduct
of the hospital or its agent, consistent with
ordinary care and prudence. The element of
holding out on the part of the hospital does
not require an express representation by the
hospital that the person alleged to be negligent
is an employee. Rather, the element is satisfied
if the hospital holds itself out as a provider of
emergency room care without informing the
patient that the care is provided by independent
contractors. The element of justifiable reliance
on the part

Estoppel rests on this rule: Whenever a party has,
by his own declaration, act, or omission,
intentionally and deliberately led another to believe
a particular thing true, and to act upon such belief,
he cannot, in any litigation arising out of such
declaration, act or omission, be permitted to falsify
it

The Court cannot close its eyes to the reality
that hospitals, such as CMC, are in the business
of treatment. The conception that the hospital
does not undertake to treat the patient, does not

undertake to act through its doctors and nurses,

but undertakes instead simply to procure them
to act upon their own responsibility, no longer
reflects the fact. Present day hospitals, as their
manner of operation plainly demonstrates, do
far more than furnish facilities for treatment.
They regularly employ on a salary basis a large
staff of physicians, nurses and interns [sic], as
well as administrative and manual workers, and
they charge patients for medical care and
treatment, collecting for such services, if
necessary, by legal action. Certainly, the person
who avails himself of hospital facilities expects
that the hospital will attempt to cure him, not
that its nurses or other employees will act on
their own responsibility.

Captain of the Ship Doctrine the doctrine holds

the surgeon in charge of an operation liable for the
negligence of his assistants during the time when
those assistants are under the surgeon's control.

It can be logically inferred that petitioner, the
senior consultant in charge during the delivery
of Nora's baby, exercised control over the
assistants assigned to both the use of the
droplight and the taking of Nora's blood
pressure. Hence, the use of the droplight and
the blood pressure cuff is also within
petitioner's exclusive control.

Unconvincing is CMC's argument that petitioners

are estopped from claiming damages based on the
Consent on Admission and Consent to Operation.
Both release forms consist of two parts. The first
part gave CMC permission to administer to
Corazon any form of recognized medical treatment
which the CMC medical staff deemed advisable.
The second part of the documents, which may
properly be described as the releasing part, releases
CMC and its employees from any and all claims
arising from or by reason of the treatment and
operation. The documents do not expressly release
CMC from liability for injury to Corazon due to
negligence during her treatment or operation.
Neither do the consent forms expressly exempt
CMC from liability for Corazon's death due to
negligence during such treatment or operation.
Such release forms, being in the nature of contracts
of adhesion, are construed strictly against hospitals.
Besides, a blanket release in favor of hospitals
from any and all claims, which includes claims
due to bad faith or gross negligence, would be
contrary to public policy and thus void.

Cayao-Lasam vs. Ramolete



Cantre vs. Go



In cases involving medical negligence, the doctrine
of res ipsa loquitur 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:

The principle of double jeopardy finds no
application in administrative cases. Double
jeopardy attaches only:

(1) upon a valid indictment;

(2) before a competent court;

(3) after arraignment;

(4) when a valid plea has been entered; and

(5) when the defendant was acquitted or
convicted, or the case was dismissed or
otherwise terminated without the express
consent of the accused.

These elements were not present in the
proceedings before the Board of Medicine,
as the proceedings involved in the instant
case were administrative and not criminal
in nature. The Court has already held that
double jeopardy does not lie in
administrative cases.

Even simple negligence is not subject to blanket

release in favor of establishments like hospitals but
may only mitigate liability depending on the
circumstances.



1. The accident is of a kind which ordinarily

does not occur in the absence of someone's
negligence;

2. It is caused by an instrumentality within the
exclusive control of the defendant or
defendants; and

3. The possibility of contributing conduct
which would make the plaintiff responsible
is eliminated.

Section 35 of the Rules and Regulations Governing

the Regulation and Practice of Professionals

Sec. 35. The complainant/respondent may
appeal the order, the resolution or the decision
of the Board within thirty (30) days from
receipt thereof to the Commission whose
decision shall be final and executory.
Interlocutory order shall not be appealable to
the Commission.

Sec. 1. Appeal; Period Non-Extendible.The

decision, order or resolution of the Board shall
be final and executory after the lapse of fifteen
(15) days from receipt of the decision, order or
resolution without an appeal being perfected or
taken by either the respondent or the
complainant. A party aggrieved by the decision,
order or resolution may file a notice of appeal
from the decision, order or resolution of the
Board to the Commission within fifteen (15)
days from receipt

of the person injured, which, concurring with

the defendant's negligence, is the proximate
cause of the injury.

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.

Again, based on the evidence presented in the

present case under review, in which no
negligence can be attributed to the petitioner,
the immediate cause of the accident resulting in
Editha's injury was her own omission when she
did not return for a follow-up check up, in
defiance of petitioner's orders. The immediate
cause of Editha's injury was her own act; thus,
she cannot recover damages from the injury.
Doctors are protected by a special rule of law,
they are not guarantors of care and they are not
insurers against mishaps or unusual
consequences.

When a patient engages the services of a

physician, a physician-patient relationship is
generated; In treating his patient, a physician is
under a duty to the former 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,
which standard level of care, skill and diligence
is a matter best addressed by expert medical
testimony, because the standard of care in a
medical malpractice case is a matter peculiarly
within the knowledge of experts in the field.

Medical malpractice, in our jurisdiction, 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 plaintiff's 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
defendant's lack of due care, the plaintiff may
recover damages, but the courts shall mitigate the
damages to be awarded.

Contributory negligence is the act or omission
amounting to want of ordinary care on the part

A physician-patient relationship was created when

Editha employed the services of the petitioner. As
Editha's 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 patient is 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, inasmuch 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 support the conclusion as to causation.

Lucas vs. Tuao



Petitioners' position, in sum, is that Peter's
glaucoma is the direct result of Dr. Tuao's
negligence in his improper administration of the
drug Maxitrol; thus, [the latter] should be liable
for all the damages suffered and to be suffered by
petitioners. Clearly, the present controversy is a
classic illustration of a medical negligence case
against a physician based on the latter's
professional negligence. In this type of suit, the
patient or his heirs, in order to prevail, is required
to prove by preponderance of evidence that the
physician failed to exercise that degree of skill,
care, and learning possessed by other persons in the
same profession; and that as a proximate result of
such failure, the patient or his heirs suffered
damages.

preponderance of evidence refers to evidence

which is of greater weight or more convincing
than that which is offered in opposition to itin
the last analysis, it means probability of truth, it
is evidence which is more convincing to the
court as worthy of belief than that which is
offered in opposition thereto.

medical and surgical treatment. Within that

reality, three legal relationships crisscross:

Best Evidence Expert Witnesses; Medical

negligence cases are best proved by opinions of
expert witnesses belonging in the same general
neighborhood and in the same general line of
practice as defendant physician or surgeon

Where an employment relationship exists the

hospital may be held vicariously liable under
Article 2176 in relation to Article 2180 of the Civil
Code or the principle of respondeat superior.

If no standard is established through expert

medical witnesses, then courts have no
standard by which to gauge the basic issue of
breach thereof by the physician or surgeon

When no employment relationship exists but it is

shown that the hospital holds out to the patient that
the doctor is its agent the hospital may still be
vicariously liable under Article 2176 in relation to
Article 1431 and Article 1869 of the Civil Code or
the principle of apparent authority.

The mere fact that the patient does not get well or
that a bad result occurs does not in itself indicate
failure to exercise due care.

Even if we are to assume that Dr. Tuao committed
negligent acts in his treatment of Peter's condition,
the causal connection between Dr. Tuao's
supposed negligence and Peter's injury still needed
to be established. The critical and clinching factor
in a medical negligence case is proof of the causal
connection between the negligence which the
evidence established and the plaintiff's injuries.

In the case, there was insufficient evidence that PSI

exercised the power of control or wielded such
power over the means and the details of the specific
process by which Dr. Ampil applied his skills in the
treatment of Natividad. Consequently, PSI cannot
be held vicariously liable for the negligence of Dr.
Ampil under the principle of respondeat superior.
(No ER-EE rel)

In Open-angle glaucoma, which is

characterized by an almost complete absence of
symptoms and a chronic, insidious course,
halos around lights and blurring of vision do
not occur unless there has been a sudden
increase in the intraocular vision

HOWEVER, there is ample evidence that the

hospital (PSI) held out to the patient (Natividad)
that the doctor (Dr. Ampil) was its agent. Present
are the two factors that determine apparent
authority: first, the hospital's implied manifestation
to the patient which led the latter to conclude that
the doctor was the hospital's agent; and second, the
patients reliance upon the conduct of the hospital
and the doctor, consistent with ordinary care and
prudence.

Professional Services, Inc. vs. Court of Appeals



Corporate Negligence; Ostensible Agency
Court holds that Professional Services, Inc. (PSI) is
liable to the Aganas not under the principle of
respondent superior for lack of evidence of an
employment relationship with Dr. Ampil but under
the principle of ostensible agency for the
negligence of Dr. Ampil and pro hac vice under the
principle of corporate negligence for its failure to
perform its duties as a hospital.

While in theory a hospital as a juridical entity
cannot practice medicine, in reality it utilizes
doctors, surgeons and medical practitioners in
the conduct of its business of facilitating

(1) between the hospital and the doctor

practicing within its premises;

(2) between the hospital and the patient being
treated or examined within its premises and

(3) between the patient and the doctor. The
exact nature of each relationship
determines the basis and extent of the
liability of the hospital for the negligence
of the doctor.



Li vs. Soliman



Informed consent evolved into a general principle
of law that a physician has a duty to disclose what a
reasonably prudent physician in the medical
community in the exercise of reasonable care
would disclose to his patient as to whatever grave
risks of injury might be incurred from a proposed
course of treatment, so that a patient, exercising
ordinary care for his own welfare, and faced with a
choice of undergoing the proposed treatment, or

alternative treatment, or none at all, may

intelligently exercise his judgment by reasonably
balancing the probable risks against the probable
benefits.

Examining the evidence on record, we hold that
there was adequate disclosure of material risks
inherent in the chemotherapy procedure
performed with the consent of Angelicas
parents. Respondents could not have been
unaware in the course of initial treatment and
amputation of Angelicas lower extremity, that
her immune system was already weak on
account of the malignant tumor in her knee.
When petitioner informed the respondents
beforehand of the side effects of chemotherapy
which includes lowered counts of white and red
blood cells, decrease in blood platelets,
possible kidney or heart damage and skin
darkening, there is reasonable expectation on
the part of the doctor that the respondents
understood very well that the severity of these
side effects will not be the same for all patients
undergoing the procedure. In other words, by
the nature of the disease itself, each patients
reaction to the chemical agents even with pretreatment laboratory tests cannot be precisely
determined by the physician. That
deathcanpossibly result from complications of
the treatment or the underlying cancer itself,
immediately or sometime after the
administration of chemotherapy drugs, is a risk
that cannot be ruled out, as with most other
major medical procedures,butsuch conclusion
can be reasonably drawn from the general side
effects of chemotherapy already disclosed.

Proficiency in diagnosis and therapy is not the full
measure of a physician's responsibility; The
physician is not expected to give the patient a short
medical education, the disclosure rule only requires
of him a reasonable explanation, which means
generally informing the patient in nontechnical
terms as to what is at stake, the therapy alternatives
open to him, the goals expectably to be achieved,
and the risks that may ensure from particular
treatment or no treatment.

!
Dissenting

Two standards by which courts determine what
constitutes adequate disclosure of associated risks
and side effects of a proposed treatment: the

physician standard, and the patient standard of

materiality

physician standard, a doctor is obligated to
disclose that information which a reasonable
doctor in the same field of expertise would
have disclosed to his or her patient.

patient standard of materiality, a doctor is
obligated to disclose that information which a
reasonable patient would deem material in
deciding whether to proceed with a proposed
treatment.

Cereno vs. Court of Appeals



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,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.

First, 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. Evidence to the
effect that petitioners knew of the "BRMC
protocol" is essential, especially in view of the
contrary assertion of the petitioners that the matter
of assigning anesthesiologists rests within the full
discretion of the BRMC Anesthesiology
Department. Without any prior knowledge of the
"BRMC protocol," We find that it is quite
reasonable for the petitioners to assume that matters
regarding the administration of anesthesia and the
assignment of anesthesiologists are concerns of the
Anesthesiology Department, while matters
pertaining to the surgery itself fall under the
concern of the surgeons. Certainly, court cannot
hold petitioners accountable for not complying with
something that they, in the first place, do not know.

Even assuming ex gratia argumentithat there is

such "BRMC protocol" and that petitioners knew
about it, from the testimony of Dr.Tatad herself, it
is clear that the matter of requesting for a standby
anaesthesiologist is not within the full discretion of
petitioners.

Second, the alleged delay in the cross-matching of

the blood, if there was any, cannot be attributed as
the fault of the petitioners. The petitioners were
never shown to be responsible for such delay. It is
highly unreasonable and the height of injustice if
petitioners were to be sanctioned for lapses in
procedure that does not fall within their duties and
beyond their control.

Lastly, Dr.Cereno, in his unchallenged testimony,

aptly explained the apparent delay in the
transfusion of blood on Raymond before and during
the operation.It was noted that Raymond, who was
a victim of a stabbing incident, had multiple
wounds when brought to the hospital. 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. Despite the situation that
evening i.e. numerous patients being brought to the
hospital for emergency treatment considering that it
was the height of the Peafrancia Fiesta, it was
evident that petitioners exerted earnest efforts to
save the life of Raymond.Also they have look for
some other lesions. It does not mean that when they
slice the chest they will see the lesions
immediately.

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.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. Aside from their
failure to prove negligence on the part of the
petitioners, they also failed to prove that it was
petitioners fault that caused the injury.

Doctors are protected by a special law. They are not

guarantors of care. They do not even warrant a
good result. They are not insurers against mishaps
or unusual consequences. Furthermore, they are not
liable for honest mistake of judgment.

!
!
!
!

Jarcia vs. People



Res Ipsa Loquitor; The 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 elements of simple negligence are: (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.

In this case, the Court is not convinced with

moral certainty that the petitioners are guilty of
reckless imprudence or simple negligence. The
elements thereof were not proved by the
prosecution beyond reasonable doubt.

The testimony of Dr. Cirilo R. Tacata (Dr.

Tacata), a specialist in pediatric orthopedic,
although pointing to some medical procedures
that could have been done by Dr. Jarcia and Dr.
Bastan, as physicians on duty, was not clear as
to whether the injuries suffered by patient Roy
Jr. were indeed aggravated by the petitioners
judgment call and their diagnosis or
appreciation of the condition of the victim at
the time they assessed him.

It can be gleaned from the testimony of Dr.

Tacata that a thorough examination was not
performed on Roy Jr. 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. There was, however,
no precise evidence and scientific explanation
pointing to the fact that the delay in the
application of the cast to the patients fractured
leg because of failure to immediately diagnose
the specific injury of the patient, prolonged the
pain of the child or aggravated his condition or
even caused further complications. Any person
may opine that had patient Roy Jr. been treated
properly and given the extensive X-ray
examination, the extent and severity of the
injury, spiral fracture of the mid-tibial part or
the bigger bone of the leg, could have been
detected early on and the prolonged pain and
suffering of Roy Jr. could have been prevented.
But still, that opinion, even how logical it may

seem would not, and could not, be enough basis

to hold one criminally liable; thus, a reasonable
doubt as to the petitioners guilt.

Although the Court sympathizes with the plight of

the mother and the child in this case, the Court is
bound by the dictates of justice which hold
inviolable the right of the accused to be presumed
innocent until proven guilty beyond reasonable
doubt. The Court, nevertheless, finds the petitioners
civilly liable for their failure to sufficiently attend
to Roy Jr.s medical needs when the latter was
rushed to the ER, for while a criminal conviction
requires proof beyond reasonable doubt, only a
preponderance of evidence is required to establish
civil liability. Taken into account also was the fact
that there was no bad faith on their part

!
!
!
!
!
!
!
!
!
!
!

!
!

!
!