9/8/2016

G.R. No. 142625

TodayisThursday,September08,2016

RepublicofthePhilippines
SUPREMECOURT
Manila
THIRDDIVISION
G.R.No.142625December19,2006
ROGELIOP.NOGALES,forhimselfandonbehalfoftheminors,ROGERANTHONY,ANGELICA,NANCY,
andMICHAELCHRISTOPHER,allsurnamedNOGALES,petitioners,
vs.
CAPITOLMEDICALCENTER,DR.OSCARESTRADA,DR.ELYVILLAFLOR,DR.ROSAUY,DR.JOEL
ENRIQUEZ,DR.PERPETUALACSON,DR.NOEESPINOLA,andNURSEJ.DUMLAO,respondents.

DECISION

CARPIO,J.:
TheCase
This petition for review1 assails the 6 February 1998 Decision2 and 21 March 2000 Resolution3 of the Court of
AppealsinCAG.R.CVNo.45641.TheCourtofAppealsaffirmedintotothe22November1993Decision4 of the
RegionalTrialCourtofManila,Branch33,findingDr.OscarEstradasolelyliablefordamagesforthedeathofhis
patient,CorazonNogales,whileabsolvingtheremainingrespondentsofanyliability.TheCourtofAppealsdenied
petitioners'motionforreconsideration.
TheFacts
Pregnantwithherfourthchild,CorazonNogales("Corazon"),whowasthen37yearsold,wasundertheexclusive
prenatal care of Dr. Oscar Estrada ("Dr. Estrada") beginning on her fourth month of pregnancy or as early as
December1975.WhileCorazonwasonherlasttrimesterofpregnancy,Dr.Estradanotedanincreaseinherblood
pressure and development of leg edema5 indicating preeclampsia,6 which is a dangerous complication of
pregnancy.7
Aroundmidnightof25May1976,CorazonstartedtoexperiencemildlaborpainspromptingCorazonandRogelio
Nogales ("Spouses Nogales") to see Dr. Estrada at his home. After examining Corazon, Dr. Estrada advised her
immediateadmissiontotheCapitolMedicalCenter("CMC").
On26May1976,Corazonwasadmittedat2:30a.m.attheCMCafterthestaffnursenotedthewrittenadmission
request8ofDr.Estrada.UponCorazon'sadmissionattheCMC,RogelioNogales("Rogelio")executedandsigned
the"ConsentonAdmissionandAgreement"9and"AdmissionAgreement."10Corazonwasthenbroughttothelabor
roomoftheCMC.
Dr.RosaUy("Dr.Uy"),whowasthenaresidentphysicianofCMC,conductedaninternalexaminationofCorazon.
Dr.UythencalledupDr.Estradatonotifyhimofherfindings.
BasedontheDoctor'sOrderSheet,11around3:00a.m.,Dr.Estradaorderedfor10mg.ofvaliumtobeadministered
immediately by intramuscular injection. Dr. Estrada later ordered the start of intravenous administration of
syntocinon admixed with dextrose, 5%, in lactated Ringers' solution, at the rate of eight to ten microdrops per
minute.
AccordingtotheNurse'sObservationNotes,12Dr.JoelEnriquez("Dr.Enriquez"),ananesthesiologistatCMC,was
notified at 4:15 a.m. of Corazon's admission. Subsequently, when asked if he needed the services of an
http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

1/12

9/8/2016

G.R. No. 142625

anesthesiologist, Dr. Estrada refused. Despite Dr. Estrada's refusal, Dr. Enriquez stayed to observe Corazon's
condition.
At6:00a.m.,CorazonwastransferredtoDeliveryRoomNo.1oftheCMC.At6:10a.m.,Corazon'sbagofwater
ruptured spontaneously. At 6:12 a.m., Corazon's cervix was fully dilated. At 6:13 a.m., Corazon started to
experienceconvulsions.
At6:15a.m.,Dr.Estradaorderedtheinjectionoftengramsofmagnesiumsulfate.However,Dr.ElyVillaflor("Dr.
Villaflor"),whowasassistingDr.Estrada,administeredonly2.5gramsofmagnesiumsulfate.
At6:22a.m.,Dr.Estrada,assistedbyDr.Villaflor,appliedlowforcepstoextractCorazon'sbaby.Intheprocess,a
1.0x2.5cm.pieceofcervicaltissuewasallegedlytorn.Thebabycameoutinanapnic,cyanotic,weakandinjured
condition.Consequently,thebabyhadtobeintubatedandresuscitatedbyDr.EnriquezandDr.Payumo.
At6:27a.m.,Corazonbegantomanifestmoderatevaginalbleedingwhichrapidlybecameprofuse.Corazon'sblood
pressure dropped from 130/80 to 60/40 within five minutes. There was continuous profuse vaginal bleeding. The
assistingnurseadministeredhemacelthroughagauge19needleasasidedriptotheongoingintravenousinjection
ofdextrose.
At 7:45 a.m., Dr. Estrada ordered blood typing and cross matching with bottled blood. It took approximately 30
minutesfortheCMClaboratory,headedbyDr.PerpetuaLacson("Dr.Lacson"),tocomplywithDr.Estrada'sorder
anddelivertheblood.
At 8:00 a.m., Dr. Noe Espinola ("Dr. Espinola"), head of the ObstetricsGynecology Department of the CMC, was
apprised of Corazon's condition by telephone. Upon being informed that Corazon was bleeding profusely, Dr.
Espinolaorderedimmediatehysterectomy.Rogeliowasmadetosigna"ConsenttoOperation."13
Duetotheinclementweatherthen,Dr.Espinola,whowasfetchedfromhisresidencebyanambulance,arrivedat
theCMCaboutanhourlaterorat9:00a.m.Heexaminedthepatientandorderedsomeresuscitativemeasuresto
be administered. Despite Dr. Espinola's efforts, Corazon died at 9:15 a.m. The cause of death was "hemorrhage,
postpartum."14
On14May1980,petitionersfiledacomplaintfordamages15withtheRegionalTrialCourt16ofManilaagainstCMC,
Dr.Estrada,Dr.Villaflor,Dr.Uy,Dr.Enriquez,Dr.Lacson,Dr.Espinola,andacertainNurseJ.Dumlaoforthedeath
of Corazon. Petitioners mainly contended that defendant physicians and CMC personnel were negligent in the
treatmentandmanagementofCorazon'scondition.PetitionerschargedCMCwithnegligenceintheselectionand
supervisionofdefendantphysiciansandhospitalstaff.
Forfailingtofiletheiranswertothecomplaintdespiteserviceofsummons,thetrialcourtdeclaredDr.Estrada,Dr.
Enriquez, and Nurse Dumlao in default.17 CMC, Dr. Villaflor, Dr. Uy, Dr. Espinola, and Dr. Lacson filed their
respectiveanswersdenyingandopposingtheallegationsinthecomplaint.Subsequently,trialensued.
Aftermorethan11yearsoftrial,thetrialcourtrenderedjudgmenton22November1993findingDr.Estradasolely
liablefordamages.Thetrialcourtruledasfollows:
The victim was under his prenatal care, apparently, his fault began from his incorrect and inadequate
management and lack of treatment of the preeclamptic condition of his patient. It is not disputed that he
misappliedtheforcepsincausingthedeliverybecauseitresultedinalargecervicaltearwhichhadcaused
theprofusebleedingwhichhealsofailedtocontrolwiththeapplicationofinadequateinjectionofmagnesium
sulfate by his assistant Dra. Ely Villaflor. Dr. Estrada even failed to notice the erroneous administration by
nurseDumlaoofhemacelbywayofsidedrip,insteadofdirectintravenousinjection,andhisfailuretoconsult
aseniorobstetricianatanearlystageoftheproblem.
OntheparthoweverofDra.ElyVillaflor,Dra.RosaUy,Dr.JoelEnriquez,Dr.Lacson,Dr.Espinola,nurseJ.
DumlaoandCMC,theCourtfindsnolegaljustificationtofindthemcivillyliable.
On the part of Dra. Ely Villaflor, she was only taking orders from Dr. Estrada, the principal physician of
CorazonNogales.Shecanonlymakesuggestionsinthemannerthepatientmaybetreatedbutshecannot
imposeherwillastodosowouldbetosubstitutehergoodjudgmenttothatofDr.Estrada.Ifshefailedto
correctly diagnose the true cause of the bleeding which in this case appears to be a cervical laceration, it
cannotbesafelyconcludedbytheCourtthatDra.Villaflorhadthecorrectdiagnosisandshefailedtoinform
Dr. Estrada. No evidence was introduced to show that indeed Dra. Villaflor had discovered that there was
lacerationatthecervicalareaofthepatient'sinternalorgan.
OnthepartofnurseDumlao,thereisnoshowingthatwhensheadministeredthehemacelasasidedrip,she
diditonherown.Ifthecorrectprocedurewasdirectlythrutheveins,itcouldonlybebecausethiswaswhat
wasprobablytheordersofDr.Estrada.
http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

2/12

9/8/2016

G.R. No. 142625

While the evidence of the plaintiffs shows that Dr. Noe Espinola, who was the Chief of the Department of
ObstetricsandGynecologywhoattendedtothepatientMrs.Nogales,itwasonlyat9:00a.m.Thathewas
abletoreachthehospitalbecauseoftyphoonDidang(Exhibit2).Whilehewasabletogiveprescriptioninthe
manner Corazon Nogales may be treated, the prescription was based on the information given to him by
phoneandheactedonthebasisoffactsaspresentedtohim,believingingoodfaiththatsuchisthecorrect
remedy. He was not with Dr. Estrada when the patient was brought to the hospital at 2:30 o'clock a.m. So,
whatevererrorsthatDr.Estradacommittedonthepatientbefore9:00o'clocka.m.arecertainlytheerrorsof
Dr.EstradaandcannotbethemistakeofDr.NoeEspinola.Hisfailuretocometothehospitalontimewas
duetofortuitousevent.
OnthepartofDr.JoelEnriquez,whilehewaspresentinthedeliveryroom,itisnotincumbentuponhimto
calltheattentionofDr.Estrada,Dra.VillaflorandalsoofNurseDumlaoontheallegederrorscommittedby
them. Besides, as anesthesiologist, he has no authority to control the actuations of Dr. Estrada and Dra.
Villaflor. For the Court to assume that there were errors being committed in the presence of Dr. Enriquez
wouldbetodwellonconjecturesandspeculations.
On the civil liability of Dr. Perpetua Lacson, [s]he is a hematologist and incharge of the blood bank of the
CMC.TheCourtcannotacceptthetheoryoftheplaintiffsthattherewasdelayindeliveringthebloodneeded
bythepatient.Itwastestified,thatinorderthatthisbloodwillbemadeavailable,alaboratorytesthastobe
conductedtodeterminethetypeofblood,crossmatchingandothermattersconsistentwithmedicalscience
so,thelapseof30minutesmaybeconsideredareasonabletimetodoallofthesethings,andnotadelayas
theplaintiffswouldwanttheCourttobelieve.
Admittedly,Dra.RosaUyisaresidentphysicianoftheCapitolMedicalCenter.Shewassuedbecauseofher
allegedfailuretonoticetheincompetenceandnegligenceofDr.Estrada.However,thereisnoevidenceto
supportsuchtheory.NoevidencewasadducedtoshowthatDra.RosaUyasaresidentphysicianofCapitol
Medical Center, had knowledge of the mismanagement of the patient Corazon Nogales, and that
notwithstandingsuchknowledge,shetoleratedthesametohappen.
Inthepretrialorder,plaintiffsandCMCagreedthatdefendantCMCdidnothaveanyhandorparticipationin
the selection or hiring of Dr. Estrada or his assistant Dra. Ely Villaflor as attending physician[s] of the
deceased.Inotherwords,thetwo(2)doctorswerenotemployeesofthehospitalandthereforethehospital
didnothavecontrolovertheirprofessionalconduct.WhenMrs.Nogaleswasbroughttothehospital,itwas
an emergency case and defendant CMC had no choice but to admit her. Such being the case, there is
thereforenolegalgroundtoapplytheprovisionsofArticle2176and2180oftheNewCivilCodereferringto
thevicariousliabilityofanemployerforthenegligenceofitsemployees.Ifeverinthiscasethereisfaultor
negligenceinthetreatmentofthedeceasedonthepartoftheattendingphysicianswhowereemployedby
thefamilyofthedeceased,suchcivilliabilityshouldbebornebytheattendingphysiciansundertheprinciple
of"respondeatsuperior".
WHEREFORE,premisesconsidered,judgmentisherebyrenderedfindingdefendantDr.EstradaofNumber
13 Pitimini St. San Francisco del Monte, Quezon City civilly liable to pay plaintiffs: 1) By way of actual
damages in the amount of P105,000.00 2) By way of moral damages in the amount of P700,000.00 3)
Attorney'sfeesintheamountofP100,000.00andtopaythecostsofsuit.
Forfailureoftheplaintiffstoadduceevidencetosupportits[sic]allegationsagainsttheotherdefendants,the
complaintisherebyordereddismissed.WhiletheCourtlookswithdisfavorthefilingofthepresentcomplaint
againsttheotherdefendantsbythehereinplaintiffs,asinawayithascausedthempersonalinconvenience
and slight damage on their name and reputation, the Court cannot accepts [sic] however, the theory of the
remainingdefendantsthatplaintiffsweremotivatedinbadfaithinthefilingofthiscomplaint.Forthisreason
defendants'counterclaimsareherebyordereddismissed.
SOORDERED.18
Petitioners appealed the trial court's decision. Petitioners claimed that aside from Dr. Estrada, the remaining
respondents should be held equally liable for negligence. Petitioners pointed out the extent of each respondent's
allegedliability.
On 6 February 1998, the Court of Appeals affirmed the decision of the trial court.19 Petitioners filed a motion for
reconsiderationwhichtheCourtofAppealsdeniedinitsResolutionof21March2000.20
Hence,thispetition.
Meanwhile, petitioners filed a Manifestation dated 12 April 200221 stating that respondents Dr. Estrada, Dr.
Enriquez,Dr.Villaflor,andNurseDumlao"neednolongerbenotifiedofthepetitionbecausetheyareabsolutelynot
http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

3/12

9/8/2016

G.R. No. 142625

involved in the issue raised before the [Court], regarding the liability of [CMC]."22 Petitioners stressed that the
subjectmatterofthispetitionistheliabilityofCMCforthenegligenceofDr.Estrada.23
TheCourtissuedaResolutiondated9September200224dispensingwiththerequirementtosubmitthecorrectand
presentaddressesofrespondentsDr.Estrada,Dr.Enriquez,Dr.Villaflor,andNurseDumlao.TheCourtstatedthat
withthefilingofpetitioners'Manifestation,itshouldbeunderstoodthattheyareclaimingonlyagainstrespondents
CMC, Dr. Espinola, Dr. Lacson, and Dr. Uy who have filed their respective comments. Petitioners are foregoing
furtherclaimsagainstrespondentsDr.Estrada,Dr.Enriquez,Dr.Villaflor,andNurseDumlao.
TheCourtnotedthatDr.EstradadidnotappealthedecisionoftheCourtofAppealsaffirmingthedecisionofthe
RegionalTrialCourt.Accordingly,thedecisionoftheCourtofAppeals,affirmingthetrialcourt'sjudgment,isalready
finalasagainstDr.OscarEstrada.
Petitioners filed a motion for reconsideration25 of the Court's 9 September 2002 Resolution claiming that Dr.
Enriquez, Dr. Villaflor and Nurse Dumlao were notified of the petition at their counsels' last known addresses.
Petitionersreiteratedtheirimputationofnegligenceontheserespondents.TheCourtdeniedpetitioners'Motionfor
Reconsiderationinits18February2004Resolution.26
TheCourtofAppeals'Ruling
InitsDecisionof6February1998,theCourtofAppealsupheldthetrialcourt'sruling.TheCourtofAppealsrejected
petitioners' view that the doctrine in Darling v. Charleston Community Memorial Hospital27 applies to this case.
According to the Court of Appeals, the present case differs from the Darling case since Dr. Estrada is an
independentcontractorphysicianwhereastheDarlingcaseinvolvedaphysicianandanursewhowereemployees
ofthehospital.
Citing other American cases, the Court of Appeals further held that the mere fact that a hospital permitted a
physiciantopracticemedicineanduseitsfacilitiesisnotsufficienttorenderthehospitalliableforthephysician's
negligence.28Ahospitalisnotresponsibleforthenegligenceofaphysicianwhoisanindependentcontractor.29
TheCourtofAppealsfoundthecasesofDavidsonv.Conole30andCampbell v. Emma Laing Stevens Hospital31
applicabletothiscase.QuotingCampbell,theCourtofAppealsstatedthatwherethereisnoproofthatdefendant
physician was an employee of defendant hospital or that defendant hospital had reason to know that any acts of
malpracticewouldtakeplace,defendanthospitalcouldnotbeheldliableforitsfailuretointerveneintherelationship
ofphysicianpatientbetweendefendantphysicianandplaintiff.
Ontheliabilityoftheotherrespondents,theCourtofAppealsappliedthe"borrowedservant"doctrineconsidering
that Dr. Estrada was an independent contractor who was merely exercising hospital privileges. This doctrine
provides that once the surgeon enters the operating room and takes charge of the proceedings, the acts or
omissionsofoperatingroompersonnel,andanynegligenceassociatedwithsuchactsoromissions,areimputable
tothesurgeon.32Whiletheassistingphysiciansandnursesmaybeemployedbythehospital,orengagedbythe
patient,theynormallybecomethetemporaryservantsoragentsofthesurgeoninchargewhiletheoperationisin
progress,andliabilitymaybeimposeduponthesurgeonfortheirnegligentactsunderthedoctrineofrespondeat
superior.33
TheCourtofAppealsconcludedthatsinceRogelioengagedDr.Estradaastheattendingphysicianofhiswife,any
liabilityformalpracticemustbeDr.Estrada'ssoleresponsibility.
While it found the amount of damages fair and reasonable, the Court of Appeals held that no interest could be
imposedonunliquidatedclaimsordamages.
TheIssue
Basically,theissueinthiscaseiswhetherCMCisvicariouslyliableforthenegligenceofDr.Estrada.Theresolution
ofthisissuerests,ontheotherhand,ontheascertainmentoftherelationshipbetweenDr.EstradaandCMC.The
Courtalsobelievesthatadeterminationoftheextentofliabilityoftheotherrespondentsisinevitabletofinallyand
completelydisposeofthepresentcontroversy.
TheRulingoftheCourt
Thepetitionispartlymeritorious.
OntheLiabilityofCMC
Dr. Estrada's negligence in handling the treatment and management of Corazon's condition which ultimately
resultedinCorazon'sdeathisnolongerinissue.Dr.EstradadidnotappealthedecisionoftheCourtofAppeals
http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

4/12

9/8/2016

G.R. No. 142625

whichaffirmedtherulingofthetrialcourtfindingDr.Estradasolelyliablefordamages.Accordingly,thefindingofthe
trialcourtonDr.Estrada'snegligenceisalreadyfinal.
PetitionersmaintainthatCMCisvicariouslyliableforDr.Estrada'snegligencebasedonArticle2180inrelationto
Article2176oftheCivilCode.Theseprovisionspertinentlystate:
Art.2180.Theobligationimposedbyarticle2176isdemandablenotonlyforone'sownactsoromissions,but
alsoforthoseofpersonsforwhomoneisresponsible.
xxxx
Employers shall be liable for the damages caused by their employees and household helpers acting within
thescopeoftheirassignedtasks,eventhoughtheformerarenotengagedinanybusinessorindustry.
xxxx
The responsibility treated of in this article shall cease when the persons herein mentioned prove that they
observedallthediligenceofagoodfatherofafamilytopreventdamage.
Art.2176.Whoeverbyactoromissioncausesdamagetoanother,therebeingfaultornegligence,isobliged
topayforthedamagedone.Suchfaultornegligence,ifthereisnopreexistingcontractualrelationbetween
theparties,iscalledaquasidelictandisgovernedbytheprovisionsofthisChapter.
Similarly,intheUnitedStates,ahospitalwhichistheemployer,master,orprincipalofaphysicianemployee,
servant,oragent,maybeheldliableforthephysician'snegligenceunderthedoctrineofrespondeatsuperior.34
Inthepresentcase,petitionersmaintainthatCMC,inallowingDr.EstradatopracticeandadmitpatientsatCMC,
shouldbeliableforDr.Estrada'smalpractice.RogelioclaimsthatheknewDr.Estradaasanaccreditedphysicianof
CMC,thoughhediscoveredlaterthatDr.EstradawasnotasalariedemployeeoftheCMC.35Rogeliofurtherclaims
thathewasdealingwithCMC,whoseprimaryconcernwasthetreatmentandmanagementofhiswife'scondition.
Dr.EstradajusthappenedtobethespecificpersonhetalkedtorepresentingCMC.36Moreover,thefactthatCMC
madeRogeliosignaConsentonAdmissionandAdmissionAgreement37andaConsenttoOperationprintedonthe
letterheadofCMCindicatesthatCMCconsideredDr.Estradaasamemberofitsmedicalstaff.
Ontheotherhand,CMCdisclaimsliabilitybyassertingthatDr.Estradawasamerevisitingphysicianandthatit
admittedCorazonbecauseherphysicalconditionthenwasclassifiedanemergencyobstetricscase.38
CMCallegesthatDr.Estradaisanindependentcontractor"forwhoseactuationsCMCwouldbeatotalstranger."
CMCmaintainsthatithadnocontrolorsupervisionoverDr.Estradaintheexerciseofhismedicalprofession.
TheCourthadtheoccasiontodeterminetherelationshipbetweenahospitalandaconsultantorvisitingphysician
andtheliabilityofsuchhospitalforthatphysician'snegligenceinRamosv.CourtofAppeals,39towit:
Inthefirstplace,hospitalsexercisesignificantcontrolinthehiringandfiringofconsultantsandintheconduct
oftheirworkwithinthehospitalpremises.Doctorswhoapplyfor"consultant"slots,visitingorattending,are
required to submit proof of completion of residency, their educational qualifications generally, evidence of
accreditation by the appropriate board (diplomate), evidence of fellowship in most cases, and references.
These requirements are carefully scrutinized by members of the hospital administration or by a review
committee set up by the hospital who either accept or reject the application. This is particularly true with
respondenthospital.
After a physician is accepted, either as a visiting or attending consultant, he is normally required to attend
clinicopathological conferences, conduct bedside rounds for clerks, interns and residents, moderate grand
rounds and patient audits and perform other tasks and responsibilities, for the privilege of being able to
maintainaclinicinthehospital,and/orfortheprivilegeofadmittingpatientsintothehospital.Inadditionto
these,thephysician'sperformanceasaspecialistisgenerallyevaluatedbyapeerreviewcommitteeonthe
basis of mortality and morbidity statistics, and feedback from patients, nurses, interns and residents. A
consultantremissinhisduties,oraconsultantwhoregularlyfallsshortoftheminimumstandardsacceptable
tothehospitaloritspeerreviewcommittee,isnormallypolitelyterminated.
In other words, private hospitals, hire, fire and exercise real control over their attending and visiting
"consultant" staff. While "consultants" are not, technically employees, a point which respondent
hospital asserts in denying all responsibility for the patient's condition, the control exercised, the
hiring, and the right to terminate consultants all fulfill the important hallmarks of an employer
employee relationship, with the exception of the payment of wages. In assessing whether such a
relationshipinfactexists,thecontroltestisdetermining.Accordingly,onthebasisoftheforegoing,
http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

5/12

9/8/2016

G.R. No. 142625

we rule that for the purpose of allocating responsibility in medical negligence cases, an employer
employeerelationshipineffectexistsbetweenhospitalsandtheirattendingandvisitingphysicians.
Thisbeingthecase,thequestionnowarisesastowhetherornotrespondenthospitalissolidarilyliablewith
respondentdoctorsforpetitioner'scondition.
ThebasisforholdinganemployersolidarilyresponsibleforthenegligenceofitsemployeeisfoundinArticle
2180oftheCivilCodewhichconsidersapersonaccountablenotonlyforhisownactsbutalsoforthoseof
others based on the former's responsibility under a relationship of patria potestas. x x x40 (Emphasis
supplied)
While the Court in Ramos did not expound on the control test, such test essentially determines whether an
employment relationship exists between a physician and a hospital based on the exercise of control over the
physicianastodetails.Specifically,theemployer(orthehospital)musthavetherighttocontrolboththemeansand
thedetailsoftheprocessbywhichtheemployee(orthephysician)istoaccomplishhistask.41
Afterathoroughexaminationofthevoluminousrecordsofthiscase,theCourtfindsnosingleevidencepointingto
CMC's exercise of control over Dr. Estrada's treatment and management of Corazon's condition. It is undisputed
that throughout Corazon's pregnancy, she was under the exclusive prenatal care of Dr. Estrada. At the time of
Corazon'sadmissionatCMCandduringherdelivery,itwasDr.Estrada,assistedbyDr.Villaflor,whoattendedto
Corazon.TherewasnoshowingthatCMChadapartindiagnosingCorazon'scondition.WhileDr.Estradaenjoyed
staffprivilegesatCMC,suchfactalonedidnotmakehimanemployeeofCMC.42CMCmerelyallowedDr.Estrada
to use its facilities43 when Corazon was about to give birth, which CMC considered an emergency. Considering
thesecircumstances,Dr.EstradaisnotanemployeeofCMC,butanindependentcontractor.
The question now is whether CMC is automatically exempt from liability considering that Dr. Estrada is an
independentcontractorphysician.
Ingeneral,ahospitalisnotliableforthenegligenceofanindependentcontractorphysician.Thereis,however,an
exceptiontothisprinciple.Thehospitalmaybeliableifthephysicianisthe"ostensible"agentofthehospital.44This
exceptionisalsoknownasthe"doctrineofapparentauthority."45InGilbertv.SycamoreMunicipalHospital,46the
IllinoisSupremeCourtexplainedthedoctrineofapparentauthorityinthiswise:
[U]nderthedoctrineofapparentauthorityahospitalcanbeheldvicariouslyliableforthenegligentactsofa
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
elementsoftheactionhavebeensetoutasfollows:
"Forahospitaltobeliableunderthedoctrineofapparentauthority,aplaintiffmustshowthat:(1)thehospital,
oritsagent,actedinamannerthatwouldleadareasonablepersontoconcludethattheindividualwhowas
allegedtobenegligentwasanemployeeoragentofthehospital(2)wheretheactsoftheagentcreatethe
appearanceofauthority,theplaintiffmustalsoprovethatthehospitalhadknowledgeofandacquiescedin
them and (3) the plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent with
ordinarycareandprudence."
The element of "holding out" on the part of the hospital does not require an express representation by the
hospitalthatthepersonallegedtobenegligentisanemployee.Rather,theelementissatisfiedifthehospital
holdsitselfoutasaproviderofemergencyroomcarewithoutinformingthepatientthatthecareisprovided
byindependentcontractors.
Theelementofjustifiablerelianceonthepartoftheplaintiffissatisfiediftheplaintiffreliesuponthehospital
toprovidecompleteemergencyroomcare,ratherthanuponaspecificphysician.
The doctrine of apparent authority essentially involves two factors to determine the liability of an independent
contractorphysician.
The first factor focuses on the hospital's manifestations and is sometimes described as an inquiry whether the
hospitalactedinamannerwhichwouldleadareasonablepersontoconcludethattheindividualwhowasallegedto
be negligent was an employee or agent of the hospital.47In this regard, the hospital need not make express
representations to the patient that the treating physician is an employee of the hospital rather a
representationmaybegeneralandimplied.48
Thedoctrineofapparentauthorityisaspeciesofthedoctrineofestoppel.Article1431oftheCivilCodeprovides
that "[t]hrough estoppel, an admission or representation is rendered conclusive upon the person making it, and
cannotbedeniedordisprovedasagainstthepersonrelyingthereon."Estoppelrestsonthisrule:"Wheneveraparty
has,byhisowndeclaration,act,oromission,intentionallyanddeliberatelyledanothertobelieveaparticularthing
http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

6/12

9/8/2016

G.R. No. 142625

true, and to act upon such belief, he cannot, in any litigation arising out of such declaration, act or omission, be
permittedtofalsifyit."49
Intheinstantcase,CMCimpliedlyheldoutDr.Estradaasamemberofitsmedicalstaff.ThroughCMC'sacts,CMC
clothedDr.EstradawithapparentauthoritytherebyleadingtheSpousesNogalestobelievethatDr.Estradawasan
employeeoragentofCMC.CMCcannotnowrepudiatesuchauthority.
First,CMCgrantedstaffprivilegestoDr.Estrada.CMCextendeditsmedicalstaffandfacilitiestoDr.Estrada.Upon
Dr. Estrada's request for Corazon's admission, CMC, through its personnel, readily accommodated Corazon and
updatedDr.Estradaofhercondition.
Second, CMC made Rogelio sign consent forms printed on CMC letterhead. Prior to Corazon's admission and
supposedhysterectomy,CMCaskedRogeliotosignreleaseforms,thecontentsofwhichreinforcedRogelio'sbelief
that Dr. Estrada was a member of CMC's medical staff.50 The Consent on Admission and Agreement explicitly
provides:
KNOWALLMENBYTHESEPRESENTS:
I, Rogelio Nogales, of legal age, a resident of 1974 M. H. Del Pilar St., Malate Mla., being the
father/mother/brother/sister/spouse/relative/guardian/orpersonincustodyofMa.Corazon,andrepresenting
his/herfamily,ofmyownvolitionandfreewill,doconsentandsubmitsaidMa.CorazontoDr.OscarEstrada
(hereinafter referred to as Physician) for cure, treatment, retreatment, or emergency measures, that the
Physician,personallyorbyandthroughtheCapitolMedicalCenterand/oritsstaff,mayuse,adapt,or
employsuchmeans,formsormethodsofcure,treatment,retreatment,oremergencymeasuresashe
may see best and most expedient that Ma. Corazon and I will comply with any and all rules,
regulations,directions,andinstructionsofthePhysician,theCapitolMedicalCenterand/oritsstaff
and, that I will not hold liable or responsible and hereby waive and forever discharge and hold free the
Physician, the Capitol Medical Center and/or its staff, from any and all claims of whatever kind of nature,
arisingfromdirectlyorindirectly,orbyreasonofsaidcure,treatment,orretreatment,oremergencymeasures
orinterventionofsaidphysician,theCapitolMedicalCenterand/oritsstaff.
xxxx51(Emphasissupplied)
WhiletheConsenttoOperationpertinentlyreads,thus:
I, ROGELIO NOGALES, x x x, of my own volition and free will, do consent and submit said CORAZON
NOGALES to Hysterectomy, by the Surgical Staff and Anesthesiologists of Capitol Medical Center
and/orwhateversucceedingoperations,treatment,oremergencymeasuresasmaybenecessaryandmost
expedientand,thatIwillnotholdliableorresponsibleandherebywaiveandforeverdischargeandholdfree
the Surgeon, his assistants, anesthesiologists, the Capitol Medical Center and/or its staff, from any and all
claims of whatever kind of nature, arising from directly or indirectly, or by reason of said operation or
operations, treatment, or emergency measures, or intervention of the Surgeon, his assistants,
anesthesiologists,theCapitolMedicalCenterand/oritsstaff.52(Emphasissupplied)
Without any indication in these consent forms that Dr. Estrada was an independent contractorphysician, the
SpousesNogalescouldnothaveknownthatDr.Estradawasanindependentcontractor.Significantly,noonefrom
CMCinformedtheSpousesNogalesthatDr.Estradawasanindependentcontractor.Onthecontrary,Dr.Atencio,
whowasthenamemberofCMCBoardofDirectors,testifiedthatDr.EstradawaspartofCMC'ssurgicalstaff.53
Third, Dr. Estrada's referral of Corazon's profuse vaginal bleeding to Dr. Espinola, who was then the Head of the
Obstetrics and Gynecology Department of CMC, gave the impression that Dr. Estrada as a member of CMC's
medicalstaffwascollaboratingwithotherCMCemployedspecialistsintreatingCorazon.
The second factor focuses on the patient's reliance. It is sometimes characterized as an inquiry on whether the
plaintiffactedinrelianceupontheconductofthehospitaloritsagent,consistentwithordinarycareandprudence.54
The records show that the Spouses Nogales relied upon a perceived employment relationship with CMC in
accepting Dr. Estrada's services. Rogelio testified that he and his wife specifically chose Dr. Estrada to handle
Corazon'sdeliverynotonlybecauseoftheirfriend'srecommendation,butmoreimportantlybecauseofDr.Estrada's
"connectionwithareputablehospital,the[CMC]."55Inotherwords,Dr.Estrada'srelationshipwithCMCplayeda
significantroleintheSpousesNogales'decisioninacceptingDr.Estrada'sservicesastheobstetriciangynecologist
for Corazon's delivery. Moreover, as earlier stated, there is no showing that before and during Corazon's
confinementatCMC,theSpousesNogaleskneworshouldhaveknownthatDr.Estradawasnotanemployeeof
CMC.

http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

7/12

9/8/2016

G.R. No. 142625

Further,theSpousesNogaleslookedtoCMCtoprovidethebestmedicalcareandsupportservicesforCorazon's
delivery.TheCourtnotesthatpriortoCorazon'sfourthpregnancy,sheusedtogivebirthinsideaclinic.Considering
Corazon's age then, the Spouses Nogales decided to have their fourth child delivered at CMC, which Rogelio
regarded one of the best hospitals at the time.56 This is precisely because the Spouses Nogales feared that
Corazon might experience complications during her delivery which would be better addressed and treated in a
modernandbighospitalsuchasCMC.Moreover,Rogelio'sconsentinCorazon'shysterectomytobeperformedby
adifferentphysician,namelyDr.Espinola,isaclearindicationofRogelio'sconfidenceinCMC'ssurgicalstaff.
CMC'sdefensethatallitdidwas"toextendto[Corazon]itsfacilities"isuntenable.TheCourtcannotcloseitseyes
totherealitythathospitals,suchasCMC,areinthebusinessoftreatment.Inthisregard,theCourtagreeswiththe
observationmadebytheCourtofAppealsofNorthCarolinainDiggsv.NovantHealth,Inc.,57towit:
"Theconceptionthatthehospitaldoesnotundertaketotreatthepatient,doesnotundertaketoactthroughits
doctors and nurses, but undertakes instead simply to procure them to act upon their own responsibility, no
longerreflectsthefact.Presentdayhospitals,astheirmannerofoperationplainlydemonstrates,dofar
more than furnish facilities for treatment. They regularly employ on a salary basis a large staff of
physicians,nursesandinternes[sic],aswellasadministrativeandmanualworkers,andtheycharge
patients for medical care and treatment, collecting for such services, if necessary, by legal action.
Certainly,thepersonwhoavailshimselfof'hospitalfacilities'expectsthatthehospitalwillattemptto
curehim,notthatitsnursesorotheremployeeswillactontheirownresponsibility."xxx(Emphasis
supplied)
Likewise unconvincing is CMC's argument that petitioners are estopped from claiming damages based on the
ConsentonAdmissionandConsenttoOperation.Bothreleaseformsconsistoftwoparts.ThefirstpartgaveCMC
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,
releasesCMCanditsemployees"fromanyandallclaims"arisingfromorbyreasonofthetreatmentandoperation.
The documents do not expressly release CMC from liability for injury to Corazon due to negligence during her
treatmentoroperation.NeitherdotheconsentformsexpresslyexemptCMCfromliabilityforCorazon'sdeathdue
tonegligenceduringsuchtreatmentoroperation.Suchreleaseforms,beinginthenatureofcontractsofadhesion,
are construed strictly against hospitals. Besides, a blanket release in favor of hospitals "from any and all claims,"
whichincludesclaimsduetobadfaithorgrossnegligence,wouldbecontrarytopublicpolicyandthusvoid.
Even simple negligence is not subject to blanket release in favor of establishments like hospitals but may only
mitigateliabilitydependingonthecircumstances.58 When a person needing urgent medical attention rushes to a
hospital, he cannot bargain on equal footing with the hospital on the terms of admission and operation. Such a
personisliterallyatthemercyofthehospital.Therecanbenoclearerexampleofacontractofadhesionthanone
arisingfromsuchadiresituation.Thus,thereleaseformsofCMCcannotrelieveCMCfromliabilityforthenegligent
medicaltreatmentofCorazon.
OntheLiabilityoftheOtherRespondents
DespitethisCourt'spronouncementinits9September200259Resolutionthatthefilingofpetitioners'Manifestation
confinedpetitioners'claimonlyagainstCMC,Dr.Espinola,Dr.Lacson,andDr.Uy,whohavefiledtheircomments,
theCourtdeemsitpropertoresolvetheindividualliabilityoftheremainingrespondentstoputanendfinallytothis
morethantwodecadeoldcontroversy.
a)Dr.ElyVillaflor
PetitionersblameDr.ElyVillaflorforfailingtodiagnosethecauseofCorazon'sbleedingandtosuggestthecorrect
remedytoDr.Estrada.60PetitionersassertthatitwasDr.Villaflor'sdutytocorrecttheerrorofNurseDumlaointhe
administrationofhemacel.
TheCourtisnotpersuaded.Dr.Villafloradmittedadministeringalowerdosageofmagnesiumsulfate.However,this
wasafterinformingDr.EstradathatCorazonwasnolongerinconvulsionandthatherbloodpressurewentdownto
adangerouslevel.61Atthatmoment,Dr.EstradainstructedDr.Villaflortoreducethedosageofmagnesiumsulfate
from 10 to 2.5 grams. Since petitioners did not dispute Dr. Villaflor's allegation, Dr. Villaflor's defense remains
uncontroverted. Dr. Villaflor's act of administering a lower dosage of magnesium sulfate was not out of her own
volitionorwasincontraventionofDr.Estrada'sorder.
b)Dr.RosaUy
Dr. Rosa Uy's alleged negligence consisted of her failure (1) to call the attention of Dr. Estrada on the incorrect
dosageofmagnesiumsulfateadministeredbyDr.Villaflor(2)totakecorrectivemeasuresand(3)tocorrectNurse
Dumlao'swrongmethodofhemaceladministration.
http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

8/12

9/8/2016

G.R. No. 142625

TheCourtbelievesDr.Uy'sclaimthatasasecondyearresidentphysicianthenatCMC,shewasmerelyauthorized
totaketheclinicalhistoryandphysicalexaminationofCorazon.62However,thatroutineinternalexaminationdidnot
ipsofactomakeDr.UyliablefortheerrorscommittedbyDr.Estrada.Further,petitioners'imputationofnegligence
rests on their baseless assumption that Dr. Uy was present at the delivery room. Nothing shows that Dr. Uy
participated in delivering Corazon's baby. Further, it is unexpected from Dr. Uy, a mere resident physician at that
time,tocalltheattentionofamoreexperiencedspecialist,ifevershewaspresentatthedeliveryroom.
c)Dr.JoelEnriquez
Petitioners fault Dr. Joel Enriquez also for not calling the attention of Dr. Estrada, Dr. Villaflor, and Nurse Dumlao
about their errors.63 Petitioners insist that Dr. Enriquez should have taken, or at least suggested, corrective
measurestorectifysucherrors.
TheCourtisnotconvinced.Dr.Enriquezisananesthesiologistwhosefieldofexpertiseisdefinitelynotobstetrics
and gynecology. As such, Dr. Enriquez was not expected to correct Dr. Estrada's errors. Besides, there was no
evidence of Dr. Enriquez's knowledge of any error committed by Dr. Estrada and his failure to act upon such
observation.
d)Dr.PerpetuaLacson
PetitionersfaultDr.PerpetuaLacsonforherpurporteddelayinthedeliveryofbloodCorazonneeded.64Petitioners
claimthatDr.Lacsonwasremissinherdutyofsupervisingthebloodbankstaff.
Asfoundbythetrialcourt,therewasnounreasonabledelayinthedeliveryofbloodfromthetimeoftherequest
untilthetransfusiontoCorazon.Dr.Lacsoncompetentlyexplainedtheprocedurebeforebloodcouldbegiventothe
patient.65Takingintoaccountthebleedingtime,clottingtimeandcrossmatching,Dr.Lacsonstatedthatitwould
takeapproximately4560minutesbeforebloodcouldbereadyfortransfusion.66Further,noevidenceexiststhatDr.
Lacsonneglectedherdutiesasheadofthebloodbank.
e)Dr.NoeEspinola
Petitioners argue that Dr. Espinola should not have ordered immediate hysterectomy without determining the
underlyingcauseofCorazon'sbleeding.Dr.Espinolashouldhavefirstconsideredthepossibilityofcervicalinjury,
and advised a thorough examination of the cervix, instead of believing outright Dr. Estrada's diagnosis that the
causeofbleedingwasuterineatony.
Dr. Espinola's order to do hysterectomy which was based on the information he received by phone is not
negligence. The Court agrees with the trial court's observation that Dr. Espinola, upon hearing such information
about Corazon's condition, believed in good faith that hysterectomy was the correct remedy. At any rate, the
hysterectomydidnotpushthroughbecauseuponDr.Espinola'sarrival,itwasalreadytoolate.Atthetime,Corazon
waspracticallydead.
f)NurseJ.Dumlao
In Moore v. Guthrie Hospital Inc.,67 the US Court of Appeals, Fourth Circuit, held that to recover, a patient
complainingofinjuriesallegedlyresultingwhenthenursenegligentlyinjectedmedicinetohimintravenouslyinstead
ofintramuscularlyhadtoshowthat(1)anintravenousinjectionconstitutedalackofreasonableandordinarycare
(2)thenurseinjectedmedicineintravenouslyand(3)suchinjectionwastheproximatecauseofhisinjury.
In the present case, there is no evidence of Nurse Dumlao's alleged failure to follow Dr. Estrada's specific
instructions. Even assuming Nurse Dumlao defied Dr. Estrada's order, there is no showing that sidedrip
administration of hemacel proximately caused Corazon's death. No evidence linking Corazon's death and the
allegedwrongfulhemaceladministrationwasintroduced.Therefore,thereisnobasistoholdNurseDumlaoliable
fornegligence.
OntheAwardofInterestonDamages
TheawardofinterestondamagesisproperandallowedunderArticle2211oftheCivilCode,whichstatesthatin
crimesandquasidelicts,interestasapartofthedamagesmay,inapropercase,beadjudicatedinthediscretionof
thecourt.68
WHEREFORE, the Court PARTLY GRANTS the petition. The Court finds respondent Capitol Medical Center
vicariously liable for the negligence of Dr. Oscar Estrada. The amounts of P105,000 as actual damages and
P700,000asmoraldamagesshouldeachearnlegalinterestattherateofsixpercent(6%)perannumcomputed
fromthedateofthejudgmentofthetrialcourt.TheCourtaffirmstherestoftheDecisiondated6February1998and
Resolutiondated21March2000oftheCourtofAppealsinCAG.R.CVNo.45641.
http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

9/12

9/8/2016

G.R. No. 142625

SOORDERED.
Quisumbing,J.,Chairperson,CarpioMorales,Tinga,andVelasco,Jr.,JJ.,concur.

Footnotes
1UnderRule45oftheRulesofCourt.
2PennedbyAssociateJusticeArtemioG.Tuquero,withAssociateJusticesJorgeS.ImperialandEubuloG.

Verzola,concurring.Rollo,pp.4248.
3PennedbyAssociateJusticeEubuloG.Verzola,withAssociateJusticesRobertoA.BarriosandEribertoU.

Rosario,Jr.,concurring.Id.at49.
4PennedbyJudgeRodolfoG.Palattao.
5Edemaistheaccumulationofexcessfluid.Itismanifestedbytheswellingoftheextremities.

(http://www.preeclampsia.org/symptoms.asp)
6Asyndromeoccurringinlatepregnancymarkedbyanincreaseinbloodpressure,swellingoftheanklesby

fluid,andtheappearanceofalbuminintheurine,associatedwithreducedbloodflowtotheplacenta,
thereforeputtingthefetusatriskofdeath,orstillbirth,andputtingthemotheratriskofcomplicationsfrom
highbloodpressure,convulsions(eclampsia),kidneyfailure,liverfailureanddeath.Treatedwithdrugsto
lowerthebloodpressureandtopreventconvulsions,whileexpeditingthedeliveryofthebaby.
(http://www.jansen.com.au/Dictionary_PR.html)
7Rollo,p.42.
8Exh."A4,"FolderofExhibits.
9Exh."A1,"FolderofExhibits.
10Exh."A2,"FolderofExhibits.
11Exh."A5,"FolderofExhibits.
12Exh."A8,"FolderofExhibits.
13Exh."A20,"FolderofExhibits.
14Rollo,p.43.
15DocketedasCivilCaseNo.131873.
16ThenCourtofFirstInstance.
17Records,pp.92,93.
18Records,pp.639644.
19Rollo,pp.4248.
20Id.at49.
21Id.at237240.
22Id.at238.
23Id.at207.
24Id.at258.

http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

10/12

9/8/2016

G.R. No. 142625

25Id.at283285.
26Id.at312.
2733Ill.2d326,211N.E.2d253(1965).
28CitingClaryv.HospitalAuthorityofCityofMarietta,106Ga.App.134,126S.E.2d470(1962).
29CitingCramerv.Hoffman,390F.2d19,23(1968)Holzbergv.FlowerandFifthAve.Hospitals,39A.D.2d

526,330N.Y.S.2d682,684(1972)Snelsonv.MargaretvilleHospital,49A.D.2d991,374N.Y.S.2d579,581
(1975).
3079A.D.2d43,436N.Y.S.2d109(1981).
31118A.D.2d988,499N.Y.S.2d993(1986).
32CitingDavisv.Glaze,182Ga.App.18,354S.E.2d845,849(1987).
33CitingYbarrav.Spangard,25Cal.2d486,154P.2d687(1944).
3440AAm.Jur.2dHospitalsandAsylums46,40AAm.Jur.2dHospitalsandAsylums44.
35TSN,26July1984,pp.3132(RogelioNogales).
36Id.at4344.
37TSN,4April1983,pp.4849(RogelioNogales).
38Records,pp.4344.
39378Phil.1198(1999).
40Id.at12401241.
41SeeDiggsv.NovantHealth,Inc.,628S.E.2d851(2006)citingHyltonv.Koontz,138N.C.App.629(2000).
42SeeJonesv.TallahasseeMemorialRegionalHealthcare,Inc.,923So.2d1245(2006).
43SeeHalev.Sheikholeslam,724F.2d1205(1984)wheretheUSCourtofAppeals,FifthCircuit,foundthe

physiciananindependentcontractorsincethereisnoevidenceorpleadingthatthedoctorreceived
compensationfromthehospitalorthatthehospitalexercisedanycontroloverhistreatmentofpatients.The
doctorwasmerelyallowedtousethefacilitiesofthehospitalwhen,inthedoctor'sjudgment,hospitalcare
wasnecessary.
44Jonesv.Philpott,702F.Supp.1210(1988).
45Sometimesreferredtoastheapparent,orostensible,agencytheory.(Kingv.Mitchell,31A.D.3d958,819

N.Y.S.2d169[2006]).
46156Ill.2d511,622N.E.2d788(1993).
47Diggsv.NovantHealth,Inc.,supranote41.
48Id.
49DeCastrov.Ginete,137Phil.453(1969),citingSec.3,par.a,Rule131oftheRulesofCourt.Seealso

Kingv.Mitchell,31A.D.3d958,819N.Y.S.2d169(2006)wheretheNewYorkSupremeCourt,Appellate
Division,ThirdDepartment,statedasfollows:
Asageneralproposition,"[a]hospitalmaynotbeheldfortheactsofananesthetistwhowasnotan
employeeofthehospital,butoneofagroupofindependentcontractors."Vicariousliabilityformedical
malpracticemaybeimposed,however,underanapparent,orostensible,

http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

11/12

9/8/2016

G.R. No. 142625

agencytheory,"or,asitissometimescalled,agencybyestoppelorbyholdingout.""Essentialtothe
creationofapparentauthorityarewordsorconductoftheprincipal,communicatedtoathirdparty,thatgive
risetotheappearanceandbeliefthattheagentpossessesauthoritytoactonbehalfoftheprincipal."Also,
thethirdpartymustreasonablyrelyupontheappearanceofauthoritycreatedbytheprincipal.Finally,the
thirdpartymustaccepttheservicesoftheagentinrelianceupontheperceivedrelationshipbetweenthe
agentandtheprincipal.(emphasissuppliedandinternalcitationsomitted)
50InGilbertv.SycamoreMunicipalHospital,supranote46,citedinYorkv.RushPresbyterianSt.Luke's

MedicalCenter(222Ill.2d147,854N.E.2d635[2006]),theIllinoisSupremeCourtmadeasimilar
observation,thus:
xxxthelanguageemployedinthehospital'streatmentconsentformcouldhaveledplaintifftoreasonably
believethathewouldbetreatedbyphysiciansandemployeesofthehospital.Weconcludedthat,uponthe
recordbeforeus,theplaintiffadducedsufficientevidencetocreateagenuineissueofmaterialfactwith
respecttotherelianceelementoftheplaintiffsapparentagencyclaimagainstthehospital.
51Exh."A1,"FolderofExhibits.
52Exh."A20,"FolderofExhibits.
53TSN,17February1992,p.69(Dr.FranklinAtencio).
54Diggsv.NovantHealth,Inc.,supranote41.
55TSN,26July1984,pp.1213(RogelioNogales).
56Id.at37.
57Supranote41,citingRabonv.RowanMemorialHospital,Inc.,269N.C.1,152S.E.2d485(1967).
58Article1172oftheCivilCodeprovides:

"Responsibilityarisingfromnegligenceintheperformanceofeverykindofobligationisalsodemandable,but
suchliabilitymayberegulatedbythecourts,accordingtothecircumstances."
59Rollo,p.258.
60CArollo,pp.7879.
61Records,p.76.
62Id.at59.
63CArollo,p.89.
64Id.at90.
65TSN,11November1991,pp.912.
66Id.at14.
67403F.2d366(1968).
68Peoplev.Ocampo,G.R.No.171731,11August2006,citingPeoplev.Torellos,448Phil.287,301(2003).

SeealsoPeoplev.Duban,G.R.No.141217,26September2003,412SCRA131andPeoplev.DeVera,371
Phil.563(1999).
TheLawphilProjectArellanoLawFoundation

http://www.lawphil.net/judjuris/juri2006/dec2006/gr_142625_2006.html

12/12