Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon

G03 – Legal Medicine Case Digests

1. People v Ventura
GR NO. L-15079

Facts: Herein case is an appeal from the decision of the CFI finding Ventura guilty of illegal
practice of medicine. Accused was first convicted by the CFI of Rizal for a similar offense in
Pasay City and paid a fine of P200 in 1949. On Dec 16, 1995, the NBI sent Jose Natayan to
the Clinic of the accused where he pretended to be a patient. Natayan was diagnosed sick of
lumbago and was asked to Pay P5 and lie down on the table where his back was exposed to a
big bulb for 15 mins and then a red colored bulb for 10 mins. Accused asked him to come
back for 6 consecutive day.

The following day, the NBI raided said clinic and arrested the accused. Accused seeks the
reversal of judgement of conviction on the grounds that, (1) offense charged has already
prescribed; (2) laws involved are unconstitutional and void; (3) he has an implied license to
practice drugless healing from the People of the Philippines and Chairman of the Medical
Board of Examiners. He testifies he had been practicing for 36 years as a naturopathic
physician, treading ailments without the use of drugs and medicine, healing 500,000 or more
patients more or less about 90% of whom were healed. President of The Philippine Federation
of Private Medical Practitioners complained to the NBI that appellant was advertising himself
as capable of treating ailments without drugs. Upon investigation, he was found to be without
certificate of registration so practice either from Board of Medical Examiners or Committee
of Examiners of Masseurs

Issue: W/N accused should be held guilty for malpractice? YES

Held: The State may prescribe regulations as in its judgement will secure or tend to secure
the general welfare of the people, to protect them against the consequences of the ignorance
and incapacity as well as of deception and fraud. This profession requires a certain degree of
skill and learning upon which the community may confidently rely on. He argues his acts of
healing without medicine is not considered as the practice of medicine. His actions are actually
covered under Section 770 of the Revised Administrative Code, by continuously diagnosing,
as he admitted, 500,000 more or less and have prescribed remedies therefor. As regards the
two concurrent resolutions declaring formally that Congress has recognized the drugless
methods, we need not further elaborate until such recognition is embodied in statute. He
urges acquittal under the new Medical Act of 1959, where physiotherapy is recognized as a
distinct science and coverage of said law on the ground he practices physiotherapy by massage.
The argument has no merit because there is strong evidence to the effect that he alone
diagnoses patients’ ailments and applies remedies therefor without written order or
prescription by a registered physician.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
2. Decs v San Diego
GR NO. 89572

Facts: Roberto Rey C. San Diego (San Diego) is a graduate of the University of the East with
a degree of Bachelor of Science in Zoology. He failed the National Medical Admission Test
(NMAT) three times. When he applied to take it again, the Department of Education, Culture
and Sports (DECS) rejected San Diego’s application due to the rule that someone who fails
the NMAT after (3) successive takes would not be allowed to take the NMAT for the fourth
time.

San Diego went to the RTC. In his petition for mandamus, he invoked his constitutional rights
to academic freedom and quality education. San Diego was allowed to take the NMAT subject
to the outcome of the petition. In is amended petition, San Diego questioned the
constitutionality of the rule contained in MECS Order No. 12, Series of 1972. He also raised
the issue of due process and equal protection.

Respondent Judge Capulong rendered a decision invalidating the order and granting the
petition, holding that San Diego was deprived of his right to pursue a medical education and
that the order was an arbitrary exercise of police power.

Issue: Whether NMAT is constitutional? YES

Held: The Court held the constitutionality of NMAT. The Court considers NMAT as “a
measure intended to limit the admission to medical schools only to those who have initially
proved their competence and preparation for a medical education.”

A proper exercise of police power exhibited by the concurrence of a lawful subject – the
interest of the State in admitting individuals into the study of medicine, and lawful method –
a test to regulate such admission. It is certain that NMAT is within the State’s proper exercise
of police power.

It is the responsibility of the State to ensure that incompetent people would not be in the
medical profession. It is the responsibility of the State to make sure that the medical profession
would be reliable and that patients would be able to entrust their lives to these professionals.
The NMAT is a method that regulates the medical profession and prevents incompetent
people not qualified to be a doctor to intrude in the profession.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
3. Crisostomo v SEC
GR NO. 89095 & 89555

Facts: Sixto and Co. were known as the Crisostomo Group (Group) and they were the
original stockholders of the United Doctors Medical Center (UDMC), which was organized
in 1968 with an authorized capital stock of P1,000,00. The Group owned 40% of UDMC’s
outstanding capital stock, while the 60% majority belonged to the members of United Medical
Staff Association (UMSA), numbering at around 150 doctors and medical personnel of
UDMC. Despite their minority, the Group managed UDMC from the beginning, with their
members composing the officers. The investment was made through (1) Stock Purchase
Agreement; and (2) Amended Memorandum of Agreement whereby the group subscribed to
82.09% of the outstanding shares. As it had been agreed in the Memorandum, upon receiving
of shares of the Japanese, UDMC would be reorganized. Hence, a special stockholders’
meeting and board meeting were scheduled. However, on the supposed eve of meetings,
Crisostomo, acting for himself, filed an SEC case against the Group to (1) Stop the holding of
the meeting; (2) To disqualify the Japanese from holding controlling interest; (3) To annul
the memorandum.

Crisostomo also filed a civil case in the RTC, seeking a preliminary injunction and the reliefs
prayed by him in the SEC case.

Issue: W/N allowing the Japanese group to have control of UDMC will violate Sec. 7, Art.
XII and Sec. 4, Art. XIV of the Constitution? NO

Held: While 82% of UDMC’s capital stock is subscribed by the Japanese group, only 30%
belongs to the Japanese citizens. 52% is owned by Edita Enatsu, who is a Filipino. In its
application for approval of the foreign equity investments, UDMC declared that 70% of its
capital stock is owned by Filipinos, which includes Enatsu. This was approved by the Central
Bank.

The investments in UDMC do not violate the Constitutional prohibition against foreigners
practicing a profession in the PH (Sec. 14, XII of the Constitution) for they do not practice
medicine in the PH, neither have they applied for a license to do so. They only own shares of
stock in a corporation that operates in a hospital. No law limits the sale to doctors only. The
ownership of shares does not amount to illegally engaging in the practice of medicine here in
the PH. If so, Crisostomo’s stockholding would also be illegal.

WHEREFORE, petition is dismissed for lack of merit. TRO is lifted. CA is ordered to dismiss
the pending case before it regarding this matter. Crisostomo is censured for engaging in forum
shopping and he must pay double costs.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
4. Batiquin v CA
GR NO. 118231

Facts: Dr. Batiquin, Head of the Department of Obstetrics and Gynecologist of Negros
Oriental Provincial Hospital attended Mrs. Villegas for prenatal care. Dr. Batiquin and her
assistants performed a simple cesarean section on Mrs. Villegas and after 45 minutes
successfully delivered her first child. After a few days of confinement, Mrs. Villegas checked
out of the hospital and paid 1,500 to Dr. Batiquin as “professional fee” Soon after leaving the
hospital Mrs. Villegas began to suffer abdominal pains, fever, and loss of appetite. So, she
went back to Dr. Batiquin and the latter prescribed her certain medicines. The abdominal
pains and fever kept on recurring despite the medications prescribed by Dr. Batiquin. Mrs.
Villegas then consulted Dr. Kho at the Holy Child Hospital. The result of the examination
prompted Dr.Kho to suggest that Mrs. Villegas to submit to another surgery to which the
latter agreed. When Dr. Kho opened the abdomen of Mrs. Villegas she found an ovarian cyst
on each of the left and right ovaries and a foreign body -- piece of rubber material that looked
like a rubber glove. Dr. Kho said that his foreign body was the cause of the infection. Upon
going to trial, Dr. Kho testified that she sent the rubber gloves to a pathologist. According to
Dr. Batiquin after confronting Dr. Kho.

Dr. Kho said that she threw the rubber gloves away after the operation. The CA deemed that
Dr. Kho’s positive testimony was enough to establish that a piece of rubber was left in Mrs.
Villegas’ uterus.

Issue: W/N Dr. Batiquin violated the Code of Ethics of the Philippine Medical Association?
YES

Held:
The Court reiterates its recognition of the vital role the medical profession plays in the lives
of the people, and State's compelling interest to enact measures to protect the public from
"the potentially deadly effects of incompetence and ignorance in those who would undertake
to treat our bodies and minds for disease or trauma.

"Indeed, a physician is bound to serve the interest of his patients" with the greatest of
solicitude, giving them always his best talent and skill. "Through her tortuous conduct, the
petitioner endangered the life of Flotilde Villegas, in violation of her profession's rigid ethical
code and in contravention of the legal standards set forth for professionals, in the general, and
members of the medical profession, in particular.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
5. Rueda v Pascasio
GR NO. 118141

Facts: Florencio Rueda, husband of petitioner underwent surgical operation at the UST
hospital for the removal of a stone blocking his ureter. He was attended by Dr. Domingo
Antonio, surgeon, and Dr. Reyes anesthesiologist. 6 hours after surgery, Rueda died of
complications unknown of cause. Petitioner then requested the NBI to conduct an autopsy on
the body. NBI found the death was due to lack of care by attending physician in administering
anesthesia. The case was bounced off of numerous prosecutors who back and forth charged
and dismissed cases against Antonio and Reyes. Finally, Senior State Prosecutor Arizala,
approved by Macaraeg and Guerrero, both City Prosecutors only charged Antonio for the
crime. Aggrieved, petitioner filed graft charges for violation of RA 3019 against Prosecutors
Guerrero, Macaraeg, and Arizala for manifest partiality in favor of Dr. Reyes before the
Ombudsman, who dismissed the complaint for lack of evidence. Petitioner filed in this Court
a petitioner for review on Certiorari under Rule 65 of Rules of Court. This court is not
precluded from reviewing the Ombudsman’s action when there is an abuse of discretion

Issue: W/N both are guilty of malpractice? YES

Held: In order to successfully pursue this kind of claim, a patient must prove that the health
care provide either failed to do something, or he or she did something that a reasonably
prudent provider would not have done. The 4 elements of medical negligence cases are; duty,
breach, injury, and proximate causation. When the victim employed the services of Antonio
and Reyes, a physician-patient relationship was created. In effect, they represented that they
had the needed training and skill possessed by physicians and surgeons, they will employ such
training, care and skill. They have a duty to use at least the same level of care that any other
reasonably competent doctor would use to treat a condition. The breach of these professional
duties and skill care, constitutes malpractice. In malpractice or negligence cases involving the
administration of anesthesia, an expert testimony is essential to hold the defendant liable for
under excessive or improper anesthesia needing the recognized standards of the medical
community and showing that the physician negligently departed from this standard. Now, a
causal connection is discernible from the occurrence of the victim’s death after the negligent
act in administering the anesthesia. The NBI found the attending surgeons did not conduct the
necessary interview of the patient prior to the operation. The cause of death could have been
averted, had the proper drug been applied to cope with the symptoms of malignant
hyperthermia. Also, we cannot ignore the fact that an antidote was readily available to
counteract whatever deterious effect it might produce. Why these precautionary measure
were disregarded must be sufficiently explained. Petitioner is aggrieved that the Ombudsman
dismissed the complaint for lack of evidence. The better and more logical remedy would have
been to appeal the resolution of the City Prosecutor. In exercising his discretion under the
circumstances, the Ombudsman acted within his power and authority in dismissing the
complaint against the prosecutors and this Court will not interfere with the same.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
6. Cruz v CA
GR NO. 122445

Facts: Lydia Umali (Umali) was accompanied by her daughter Rowena to Perpetual Help
Clinic and General Hospital. When Umali was examined, it was found that she had a “myoma”
in her uterus and that she needed an immediate surgery. Rowena noticed that the hospital was
untidy. She tried to persuade her mother to have her surgery in another hospital, even talking
to Dr. Cruz about it. However, Dr. Cruz insisted that Umali be operated as scheduled. During
the surgery, Rowena and their family were asked to buy things needed for the operation
including tegument ampules and blood. Later on, after Umali went into a shock which
resulted to a need for her to be transferred to San Pablo District Hospital in order to be
connected to a respirator. The transfer was not consented.

When they arrived at San Pablo, Umali was brought into the operating room and Dr. Cruz
and Dr. Ercillo re-operated on her because she was bleeding from the incision. Dr. Angeles,
the head of the Obstetrics and Gynecology Department of San Pablo, arrived but Umali’s
blood pressure was already 0/0 and was possibly already dead. Umali died while Dr. Cruz
was closing the abdominal wall. “Shock” was written as the immediate cause of death. The
MTCC found her guilty of reckless imprudence resulting in homicide. The RTC affirmed.
Dr. Cruz filed for a petition for certiorari.

Issue: Whether Dr. Cruz was negligent in her performance of her duty? NO

Held: The Court held that the circumstances are insufficient to sustain Dr. Cruz to be guilty
of reckless imprudence resulting in homicide. The “inexcusable lack of precaution” in her
treatment of Umali needs to be determined according to a standard of care observed by the
members of good standing of the medical profession under the same circumstances.

In medical malpractice, it is important that there is an expert testimony in order to establish

that not only the standard of care but also the physician’s conduct in the treatment and care
fall below the standard. A testimony of an expert would be necessary in order to support the
conclusion that such lack of standard of care resulted to the medical malpractice to occur. In
this case, the Court finds that there was an absence of expert testimony and that Dr. Cruz
cannot be held guilty of reckless imprudence resulting in homicide without such testimony.
The other testimonies only testified about the possible cause of death but not the standard of
care exercised by Dr. Cruz. When a physician attends to a patient, it is assumed that she takes
the necessary precaution and that she applies the best of her knowledge and skill in attending
to her patients. This presumption may be rebutted by expert opinion, which was lacking in
this case.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
7. Ramos v CA
GR NO. 124354

Facts: Ramos underwent a surgical procedure to remove the stone from her gall bladder. Dr.
Hosaka, a surgeon, presided over the operation at De Los Santos Medical Center (DLSMC)
and assured them he will find a good anesthesiologist, which is Dra. Gutierrez. The operation
did not go as planned since Hosaka arrived 3 hours late and Gutierrez botched the
administration of anesthesia causing Ramos to go into a coma and suffer brain damage. This
was witnessed by Cruz, sister-in-law of Ramos and the dean of the College of Nursing in
Capitol Medical Center. Petitioners (Family of Ramos) sued the hospital, Hosaka, and
Gutierrez. They showed expert testimony showing Ramos’ condition was caused by Gutierrez
who did not exercise reasonable care in intubating her. Witnesses even heard her saying
“Mahirap ma-intubate nito, mali ang pagpasok. O lumaki ang tiyan.”

Diagnostics also showed Ramos was robust and fit to undergo the surgery. RTC: Gutierrez
omitted to exercise due care; Hosaka is liable for the negligence after arriving 3 hours late and
for not cancelling the operation. They are all held jointly liable. CA: Reversed RTC.

Issue: W/N respondents are all negligent and liable for damages? YES

Held: Respondents were not able to disprove the presumption of negligence on their part in
the care of Ramos and it is the proximate cause of her condition. One not need be an
anesthesiologist to determine the success of her intubation. SC also found that Gutierrez only
saw Ramos for the first time during the operation, which is negligent and irresponsible in
itself. Hosoka was also negligent since he failed to exercise proper authority as the captain of
the ship in determining if procedure was properly followed, which is also the effect of his
tardiness. The hospital also failed to adduce evidence showing it exercised the diligence of a
good father in hiring its doctors. Hence, they are all liable for damages.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
8. Reyes v Sister of Mercy Hospital
GR NO. 130547

Facts: Jorge Reyes has been suffering from recurring fever with chills for around days. Home
medication afforded him no relief, so he went to Mercy Community Clinic. He was then
attended by Dr. Marlyn Rico. Since typhoid fever was common at that time, the Widal test
was performed and he was found positive for typhoid. Thereafter, Dr. Marlyn Rico indorse
Jorge Reyes to Dr. Marvie Blanes. Suspecting that that Jorge had typhoid fever, Dr. Marvie
Blanes ordered that Jorge be tested for compatibility with chloromycetin, an antibiotic. Such
test was conducted by Nurse Pagente. As there was no adverse reaction, Dr. Blanes
administered 500 mg of the antibiotic. Another dose was given 3 hours later. Subsequently,
Jorge Reyes developed high fever and experienced vomiting and convulsions. He then turned
blue due to deficiency in oxygen – cyanosis – and died. The cause of death was stated to be
“ventricular arrhythmia secondary to hyperpyrexia and typhoid fever.” The heirs of Reyes filed
with the RTC a complaint for damages against Sisters of Mercy, Sister Rose Palacio, Dr.
Blanes, Dr. Rico and Mercy Community Clinic contending that the death of Jorge was due to
the wrongful administration of chloromycetin or medical malpractice. RTC ruled in favor of
the respondents. The CA affirmed in toto the RTC decision. Hence, this appeal.

Petitioners contend that: Dr. Marlyn Rico hastily and erroneously relied upon the Widal test,
diagnosed Jorge’s illness as typhoid fever, and immediately prescribed the administration of
the antibiotic chloromycetin. Dr. Marvie Blanes erred in ordering the administration of the
second dose of 500 milligrams of chloromycetin barely 3 hours after the first was given.
Testimony presented: That of Dr. Apolinar Vacalares, (Chief Pathologist of the Northern
Mindanao Training Hospital) who performed an autopsy on the body – Dr. Vacalares testified
that Reyes did not die of typhoid fever but of shock undetermined, which could be due to
allergic reaction or chloromycetin overdose.

Issue:
W/N there was medical malpractice? NO

Held:
There was no Medical Malpractice in this case. In order to determine W/N medical
malpractice is present, a patient must prove that the physician or surgeon either failed to do
something which a reasonably prudent physician or surgeon would have done, or that he or
she did something that a reasonably prudent physician or surgeon would not have done, and
that the failure or action caused injury to the patient. The standard contemplated for doctors
is simply the reasonable average merit among ordinarily good physicians. That is reasonable
diligence for doctor, or reasonable “skill and competence that a physician in the same or
similar locality should apply.”

Dr. Apolinar Vacalares is not a specialist of typhoid fever and he is thus not qualified to prove
that Dr. Marlyn Rico erred in her diagnosis. While petitioners presented Dr. Apolinar
Vacalares as an expert witness, we do not find him to be so as he is not a specialist on infectious
diseases like typhoid fever. Furthermore, although he may have had extensive experience in
performing autopsies, he admitted that he had yet to do one on the body of a typhoid victim
at the time he conducted the postmortem on Jorge Reyes.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
9. Professional Services, Inc. v Natividad and Enrique Agana
GR NO. 126297

Facts: April 4, 1984, Natividad Agana was rushed to Medical City because of difficulty of
bowel movement and bloody anal discharge. Dr. Miguel Ampil diagnosed her to be suffering
from cancer of sigmoid and performed a resection surgery and found it necessary to remove
portion of her ovary, thus obtained the consent of Natividad’s husband to permit Dr. Fuentes
to perform hysterectomy. After Dr. Fuentes, Dr. Ampil took over and closed the incision.
Nurse reports showed that 2 sponges were missing. Few days later, Natividad complained
about excruciating pain and Dr. Ampil claimed it was just pain from the operation. Spouses
sought other expert opinions on the US and was told she was cancer free. Upon return, her
daughter found a piece of gauze protruding from her vagina, and Dr. Ampil immediately came
over and removed it himself. Soon after, she became ill and was confined, and another piece
of Gauze was found. This caused an infection and was operated once again in October 1984.
Sps. Filed a complaint for damages and alleged that the Doctors are liable for leaving 2 pieces
of gauze. During pendency of the case, Natividad died, and was succeed by her children

Issue: W/N Dr. Ampil should be held liable? YES

Held: Records show that he did not present any evidence to prove that the American doctors
were the ones who put or left the gauzes in Natividad’s body. All major circumstances in fact,
point directly to Dr. Ampil. An operation in this case it not complete until the sponges are
properly removed. Hence, such omission is considered so inconsistent with due care as to
raise an inference of negligence. It was his legal duty to so inform his patient within a
reasonable time thereafter by advising her of what he had been compelled to do. Here, he did
not inform Natividad about the missing 2 pieces of gauze and even misled her that the pain
was the ordinary consequence of her operation. Had he been more candid, Natividad could
have taken the immediate and appropriate medical remedy to remove the gauzes from her
body. This is a clear case of medical malpractice, and medical negligence. The elements of
medical malpractice are duty, breach, injury, and proximate causation. As lead surgeon, he
had the duty to remove all foreign objects before closing the incision. When he failed to do
so, it was his duty to inform Natividad. He failed both duties. Such breach caused injury to
Natividad, necessitating her further examination by American doctors and another surgery.
Negligence is the proximate cause of Natividad’s injury.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
10. Jarcia and Bastan v People
GR NO. 187926

Facts: Belinda Santiago filed a complaint with the National Bureau of Investigation (NBI)
against Dr. Emmanuel Jarcia, Jr. and Dr. Marilou Bastan for their alleged neglect of
professional duty which caused Santiago’s son Roy, to suffer serious physical injuries. Upon
investigation of NBI, Roy was found to be hit by a taxicab. He was then rushed to Manila
Doctors Hospital where he received emergency medical treatment. As read by Dr. Jarcia, his
X-ray results showed that he had no fracture. When Dr. Bastan examined Roy, she informed
Mrs. Santiago that it was only the ankle that was hit and that no examination on the upper leg
was needed. Eleven days later, Roy developed fever. His right leg was swelling, and his right
foot was also misaligned. Mrs. Santiago brought him back to the hospital wherein the X-ray
reveals a right mid-tibial fracture and a linear hairline fracture in the shaft of the bone.

NBI endorsed the matter to the Office of the Prosecutor in Manila. Probable cause was found
and a criminal case for reckless imprudence resulting to serious physical injuries was filed
against Dr. Jarcia and Dr. Bastan. The RTC found them guilty beyond reasonable doubt of
the crime of simple imprudence resulting to serious physical injuries. The CA affirmed the
decision of the RTC.

Issue: W/N Dr. Jarcia and Dr. Bastan are liable for criminal negligence? NO

Held: While the CA is correct in holding that there is negligence on the part of Dr. Jarcia
and Dr. Bastan, the totality of the evidence on record does not convince the Court that Dr.
Jarcia and Dr. Bastan are guilty of criminal negligence.

Negligence is defined as the failure to observe for the protection of the interests of another
person that degree of care, precaution, and vigilance which the circumstances justly demand,
whereby such other person suffers injury. On the other hand, Reckless imprudence consists
of voluntarily doing or failing to do, without malice, an act from which material damage
results by reason of an inexcusable lack of precaution on the part of the person performing or
failing to perform such act.

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.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
11. Solidum v People
GR NO. 192123, March 10, 2014

Facts: Gercayo, born on June 2, 1992, had an imperforate anus at birth. Two days after his
birth, he went under colostomy, which is a surgical procedure to bring one end of the large
intestine out through the abdominal walls, enabling him to excrete through a colostomy bag.
Gercayo was admitted at the Ospital ng Maynila for a pull-through operation, which was
headed by Dr. Resurreccion and was assisted by Dr. Lucerio, Valeria, and Tibio.
Anesthesiologist included Dra. Abella, Razon, and Solidum. Gercayo, however, suffered
bradycardia and went into a coma during the operation. It lasted for two weeks and only
regained consciousness after a month. However, he could no longer see, hear, or move.
Gercayo’s parents filed a complaint for reckless imprudence resulting in serious physical
injuries against the team of doctors for failure in monitoring the administered anesthesia.

Issue: W/N petitioners are liable for medical negligence? NO

Held: Negligence is defined as the failure to observe the protection of the interests of another
person whereby such person suffers injury. Reckless imprudence consists of voluntarily doing
or failing to do, without malice, an act from which material damage results due to inexcusable
lack of precaution. The negligence must be the proximate cause of the injury since it cannot
create a right of action unless it is proven to be just that. Medical Negligence requires the
following competent evidence to be proven:
1) Duty owed by the physician to the patient or the physician-patient relationship;
2) Breach of the duty by the physician, failing to act in accordance with the
applicable standard of care;
3) Causation or there must be a reasonably close and casual connection between
the negligent act and the injury;
4) Damages suffered by the patient.

In the medical profession, there are norms on standard of care to protect the patient from
unreasonable risk. This standard is an objective standard which conduct of a physician sued
may be measured. Expert medical testimony from the plaintiff and defense is used to
determine this measure. Additionally, res ipsa liquitor does not automatically apply. It is
generally restricted to situations in malpractice cases where a layman is able to say that the
consequences of professional care were not as such as would ordinarily have followed if there
was due care. Hence, res ipsa liquitor can have no application in a suit against a physician
which involves the merits of a diagnosis. Therefore, res ipsa liquitor is not available in a
malpractice suit if the only showing is that the desired result of an operation was not
accomplished. The real question then is whether or not an extraordinary incident outside the
usual routine intervened. In this case, Solidum performed every single procedural routine
without any extraordinary incident intervening during the administration of the anesthesia to
his patient. He is therefore not liable for negligence or reckless imprudence. The side effects
of the anesthesia were taken into consideration during the operation and it just so happened
that it unfortunately occurred. However, despites Solidum’s criminal acquittal, his civil
liability may still be tried and ruled upon.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
12. Li v Sps. Reynaldo and Lina Soliman
GR NO. 165279

Facts: Respondents’ 11-year old daughter, Angelica Soliman, underwent a biopsy of the mass
located in her lower extremity at the St. Luke’s Medical Center (SLMC) results showed that
Angelica was suffering from osteosarcoma, osteoblastic type, (highly malignant) cancer of the
bone because of that a necessity of amputation was conducted by Dr, Tamayo on Angelica’s
right leg in order to remove the tumor and to prevent the metastasis that chemotherapy was
suggested by Dr. Tamayo, which he referred to petitioner Dr. Rubi Li, a medical oncologist.

The respondent was admitted to SLMC for Chemotherapy; however, she died eleven (11)
days after the (intravenous) administration of chemotherapy first cycle. Respondents brought
their daughter’s body to the Philippine National Police (PNP) Crime Laboratory at Camp
Crame for post-mortem examination done by Dr. Balmaceda and Dr. Vergara, after the
refusal of the hospital to release the death certificate without full payment of bills. The
Medico-Legal Report showed that the cause of death as "Hypovolemic shock secondary to
multiple organ hemorrhages and Disseminated Intravascular Coagulation. The respondents
filed charges against the SLMC and physicians involve for negligence and failure to observe
the essential precautions in to prevent Angelica’s untimely death. Petitioner denied the
allegation for damages as she observed best known procedures, highest skill and knowledge
in the administration of chemotherapy drugs despite all efforts the patient died.

The trial court was in favor of the petitioner and ordered to pay their unpaid hospital bill in
the amount of P139, 064.43, but the Court of Appeals reversed the decision supporting the
respondents pray.

Issue: W/N Dr. Rubi Li can be held liable for not fully disclosing serious side effects of
chemotherapy to the respondents? NO

Held: In this case medical malpractice is proven because the four essential elements of such
action are present based upon the doctrine of informed consent.

There are four essential elements a plaintiff must prove in a malpractice action based upon the
doctrine of informed consent:
(1) the physician had a duty to disclose material risks;
(2) he failed to disclose or inadequately disclosed those risks;
(3) as a direct and proximate result of the failure to disclose, the patient consented to
treatment she otherwise would not have consented to; and
(4) plaintiff was injured by the proposed treatment."

In this case Dr. Li, as her attending physician, failed to fully explain to the respondents all the
known side effects of chemotherapy. Respondents have been told of only three side effects of
chemotherapy, they readily consented thereto.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
13. Alano v Lagmao
GR 108854

Facts: March 1, 1988 Angelito Lagmao was brought to East Ave Medical Center by 2 sidewalk
vendors who allegedly saw him fall from the overpass in Cubao. Dr. Cabrera reported that
Lagmao was drowsy with alcoholic breath. At 4am of March 2, he developed seizures and was
transferred to NKI at 10am. In the NKI, he was immediately treated but since he had no
relatives around, Jennifer Misa was asked to locate the family by enlisting police and media
assistance. Dr. Ona requested the Lab to conduct a tissue typing and see if he would be a
suitable organ donor and his family would need to consent. His data sheet appeared to be
Angelito Lugmoso instead. On March 3, Dr. Ona was informed he had passed and inquired
from Jennifer Misa whether the relatives had been located

The extensive search yielded no positive result, and they secure a permission for the planned
organ retrieval with the NBI. Dr. Ona issued a Memorandum, making sure that the
department had exerted all reasonable efforts to locate the relatives of the deceased. The news
was broadcasted on the radio and was heard by the deceased’s cousin, who informed his
mother. She then filed with the court a complaint for damages against those involved alleging
they conspired to remove the organs of Arnelito while the latter was still alive, and they
concealed his true identity.

Issue: W/N anyone should be found guilty of violation of PD 856? NO

Held: If all have been complied with in accordance with RA 349 as amended and PD 856,
permission and authority is hereby given to the Department of Surgery to retrieve and remove
and said organs compatible of said organs to live and survive. A careful reading show that the
petitioner instructed “make certain” that “all reasonable efforts” are exerted to locations the
patient’s relatives. He could not have made his directives any clearer. He even specifically
mentioned that permission Is only being granted IF the department of Surgery has complied
with all requirements of the law. Also, prior to performing the procedure, doctors sought the
opinion and approval of the Medico-Legal of the NBI. Ultimately, it is respondent’s failure to
adduce adequate evidence that doomed this case. Party making allegations has the burden of
proving them by a preponderance of evidence. They failed to present any expert witness to
prove that given the medical technology and knowledge, the doctors could or should have
waited longer before harvesting the internal organs for transplantation
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
14. Lim v CA
GR NO. 91114

Facts: Petitioner Nelly Lim and private respondent Juan Sim are lawfully married to each
other. In November 1987, Juan Sim filed a petition for annulment of marriage on the ground
that Nelly Lim has been allegedly suffering from schizophrenia “before, during and after the
marriage and until the present.” After the issues were joined and the pre-trial was terminated,
trial on the merits ensued. Juan Sim presented (3) witnesses before taking the witness stand
himself. In January 1989, Juan Sim’s counsel announced that he would present as his next
witness the Chief of the Female Services of the National Mental Hospital, Dr. Lydia
Acampado, a Doctor of Medicine who specializes in Psychiatry. Nelly Lim’s counsel opposed
the motion requiring Dr. Acampado to testify on the ground that the testimony sought from
Dr. Acampado as a witness is privileged since she examined Nelly Lim in a professional
capacity and had diagnosed Lim to be suffering from schizophrenia. The subpoena was still
issued. Lim’s counsel filed an urgent motion to quash the subpoena and suspend the
proceedings pending the resolution of the motion. The Court heard this motion before Dr.
Acampado took the witness stand. Dr. Acampado is barred from testifying under the rule on
the confidentiality of a physician-patient relationship. Juan Sim contends that she would only
testify as an expert witness.

The RTC denied the motion and allowed Dr. Acampado testify. She neither revealed the
illness she examined and treated the petitioner for nor disclosed the results of her examination
and the medicines she had prescribed. Lim filed with CA a petition to prohibit him from
proceeding with the reception of Dr. Acampado’s testimony. However, the CA promulgated
a resolution denying due course to the petition.

Issue: W/N the information given by the physician in her testimony in open court a
privileged communication? NO

Held: The physician may be considered to be acting in his professional capacity when he
attends to the patient for curative, preventive, or palliative treatment. Thus, only disclosures
which would have been made to the physician to enable him "safely and efficaciously to treat
his patient" are covered by the privilege. Dr. Acampado was presented and qualified as an
expert witness. She did not disclose anything obtained in the course of her examination,
interview and treatment of the petitioner; moreover, the facts and conditions alleged in the
hypothetical problem did not refer to and had no bearing on whatever information or findings
the doctor obtained while attending to the patient. There is, no showing that Dr. Acampado’s
answers to the questions propounded to her relating to the hypothetical problem were
influenced by the information obtained from the petitioner.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
15. Krohn v CA
GR NO. 108854

Facts: Edgar and Fernandez were married and had three children – Edgar, Karl, and
Alexandra. Their relationship crumbled, and Fernandez underwent psychological testing to
ease the stress. However, they still separated. Edgar was able to secure a copy of the
confidential psychiatric report of Fernandez, which is signed by Dra. Banaag and Reyes.
Presenting this report, he obtained a decree from the court nullifying his marriage on the
ground of incapacitas assumendi onera conjugalia due to lack of due discretion existent at the
time of the wedding.

CFI: Granted the voluntary dissolution of the conjugal partnership. Edgar filed a petition for
the annulment before the court, presenting the report he secured. Fernandez answers that
such report is unfounded and irrelevant. Edgar, however, took the witness stand and revealed
the contents of the report, which was objected by Fernandez, saying it violated the rule on
privileged communication.

Issue: W/N the presentation of report violates privileged communication between the
patient and the physician? NO

Held: Fernandez argues that to allow Krohn to testify will set a very bad precedent since it
circumvents the relationship of the physician and patient; that the report is of privileged
nature; and that it prevents the physician from making public the information that will
humiliate his patient. Fernandez’s arguments are misplaced since in Lim v CA, the privilege
may only be invoked during the following:
1) Privilege is claimed in a civil case;
2) Person against whom the privilege is claimed is authorized to practice medicine;
3) Such person acquired the information while he was attending to his patient in his
professional capacity;
4) Information was necessary to enable him to act in such capacity;
5) Information was confidential and if disclosed, would blacken the reputation of the
patient.

In this case, the person against whom the privilege is claimed is no one duly authorized to
practice medicine. He is simply the patient’s husband who wishes to testify on a document
executed by medical practitioners. This does not fall within the prohibition. Neither can his
testimony be considered a circumvention since it cannot have the force and effect of a
physician who examined the patient and executed the report. On the matter of privileged,
Fernandez never questioned the testimony as hearsay, which is a fatal mistake. For failure to
object to Krohn’s testimony, Fernandez waived his right to make such objection and the
evidence that may be admitted. Hence, Fernandez’s petition for review is denied for lack of
merit.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
16. People v Pelones
GR NO. 86159 & 86160

Facts: Malto, Solina and Pelones were co-employees working for a farm. Solina reported to
the owner of the Farm, that Pelones stole chickens and brought a girl to the nipa hut in the
farm. Pelones was dismissed.

Shortly before midnight Malto and Solina were inside the poultry farmhouse when Pelones,
together with five others, armed with bladed weapons, suddenly appeared, forcibly dragged
the two outside, and made them face the wall. Upon signal of one of the malefactors, Pelones
started attacking Solina, and after a second, another unidentified attacker assaulted Malto with
a bladed weapon. Although critically wounded, Malto was able to escape finally from his
assailants. He sought refuge in the office of the New Star Farm where he fainted and regained
consciousness only in the Quezon Memorial Hospital, Lucena City. Although his wounds
were considered fatal, he nonetheless survived to testify against Pelones. Solina was not as
lucky; he succumbed to his injuries.

Pelones professed his innocence, however the court did not believe his alibi and proceeded to
convict him. Pelones challenges as without basis the doctor's findings that wounds Nos.1 and
2 of Solina were fatal and instantaneous cause of death, absent any indication that such wounds
penetrated the heart. In the same vein, Pelones asserts that "the probability is strong that the
wounds were inflicted much earlier than ten (10) hours before 10:30 A.M. of August 18
because death due to loss of blood is not instantaneous upon infliction of the wound.

Issue: W/N Pelones and his counsel’s medical evaluation should be given credence as a
defense? NO

Held: Under the Rules of Court, the opinion of a witness on a matter requiring special
knowledge, skill, experience or training, may be received in evidence only when he is shown
to possess such competence. Supposed medical evaluation made by appellant or his counsel,
without showing their competence in the field of medicine, must give way to the expert
testimony of the examining physical that Solina's wounds Nos. 1 and 2 were fatal and that he
expired about midnight of 18 August 1986.Transcript of stenographic notes evidently shows
the competence of Dr. Vicente G. Umali, a 1957 graduate of the College of Medicine,
University of Santo Tomas, who has been in medical practice since then, a municipal health
officer from 13 March 1971, and has performed more than 100 autopsies and post mortem
examinations
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
17. Cruz v CA
GR 122554

Facts: On March 22, 1991, Rowena accompanied her mother to the hospital where they slept
in a clinic and would be operated the next day. Rowena noticed the untidiness of the clinic
and tried to persuade her mother to not proceed with the operation. Lydia thus informed
Umali that the operation must proceed. During operation, Dr. Ercillo went out and instructed
the relatives to buy Tagamet ampules. After an hour, she then asked them to buy blood for
Lydia. When the operation was finished, they were asked once again to buy more blood.
Unfortunately, her blood type was no longer available at the blood bank

Rowena then noticed her mother gasping for breath and needed a new oxygen tank so
Rowena’s husband with the drive when to San Pablo Hospital. At 10pm she went into shock
and blood pressure dropped. At 3pm the next day, she died due to Disseminated Intravascular
Coagulation as the antecedent cause.

Trial ensued and the MTC convicted only Dr. Cruz therefore guilty under Art. 365 of the
RPC. MTC ruled that the clinic was untidy, there was lack of provision like blood and oxygen
to prepare for any contingency that might happen. The operation was even wished to be
postponed but Dra. Cruz insisted to proceed. Court finds Lydia died because of the negligence
and the carelessness of the surgeon because of loss of blood during the operation. She appealed
her conviction to the RTC which affirmed in toto.

Issue: W/N accused should be held guilty for malpractice? NO

Held: The elements of reckless imprudence are: (1) the offender does or fails to do an act;
(2) that the doing or the failure is voluntary; (3) it be without malice; (4) material damage
results from the reckless imprudence; and (5) that there is inexcusable lack of precaution on
the part of the offender.

In this case, there is absence of any expert testimony on the matter of the standard of care
employed by other physicians of good standing. Prosecution’s witnesses only testified as to
the possible cause of death but did not venture to illuminate the court on the matter of the
standard of care that the petitioner should have exercised. For whether a physician or surgeon
has exercised the requisite degree of skill and care, is a matter of expert opinion. Expert
testimony should have been offered to prove that the circumstances are constitutive of
conduct falling below standard of care. According to both doctors, possible causes of
hemorrhage during an operation are: (1) the failure of the surgeon to tie or suture a cut blood
vessel; (2) allowing a cut blood vessel to get out of control; (3) the subsequent loosening of
the tie or suture applied; and (4) a clotting defect known as DIC. The probability that Lydia’s
death was caused by DIC was unrebutted during trial, thus her acquittal of crime of reckless
imprudence resulting on homicide. Our hands are bound by the dictates of justice and fair
dealing which hold inviolable the right of an accused to be presumed innocent until proven
guilty beyond reasonable doubt. For insufficiency of evidence this Court was not able to
render a sentence of conviction, but it is not blind to the reckless and imprudent manner in
which the petitioner carried out her duties.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
18. Tablanin v Gutierrez
GR NO. 78164

Facts: The petitioners sought admission into colleges or schools of medicine for the school
year 1987-1988. However, the petitioners either did not take or did not successfully take the
National Medical Admission Test (NMAT) required by the Board of Medical Education, one
of the public respondents, and administered by the private respondent, the Center for
Educational Measurement (CEM).

On March 1987, the petitioners filed with the RTC a Petition for Declaratory Judgment and
Prohibition with a prayer for Temporary Restraining Order and Preliminary Injunction. The
petitioners sought to enjoin the Secretary of Education, Culture and Sports, the Board of
Medical Education and the Center for Educational Measurement from enforcing Section 5 (a)
and (f) of Republic Act No. 2382, as amended, and MECS Order No. 52, series of 1985,
dated 23 August 1985 and from requiring the taking and passing of the NMAT as a condition
for securing certificates of eligibility for admission, from proceeding with accepting
applications for taking the NMAT and from administering the NMAT as scheduled on 26 April
1987 and in the future. After hearing on the petition for issuance of preliminary injunction,
the trial court denied said petition. The NMAT was conducted and administered as previously
scheduled.

Issue: W/N Section 5 (a) and (f) of Republic Act No. 2382, as amended, and MECS Order
No. 52, s. 1985 are constitutional? YES

Held: We conclude that prescribing the NMAT and requiring certain minimum scores
therein as a condition for admission to medical schools in the Philippines, do not constitute an
unconstitutional imposition.

The police power, it is commonplace learning, is the pervasive and non-waivable power and
authority of the sovereign to secure and promote all the important interests and needs — in
a word, the public order — of the general community. An important component of that
public order is the health and physical safety and well-being of the population, the securing of
which no one can deny is a legitimate objective of governmental effort and regulation. Perhaps
the only issue that needs some consideration is whether there is some reasonable relation
between the prescribing of passing the NMAT as a condition for admission to medical school
on the one hand, and the securing of the health and safety of the general community, on the
other hand. This question is perhaps most usefully approached by recalling that the regulation
of the practice of medicine in all its branches has long been recognized as a reasonable method
of protecting the health and safety of the public.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
19. PRC v De Guzman
GR No. 144681

Facts: Respondents are graduates of Fatima College of Medicine. They passed the Physician
Licensure Examination by the Board. PRC then released their names as passers in the medical
licensure examination. The Board observed that the grades of the 79 Respondents in the two
most difficult subjects in the exam, Bio-Chem and OB-Gyne, were unusually and
exceptionally high. 11 scored 100 in Bio-Chem, 10 scored 100 in OB-Gyne, 11 got 99 in Bio-
Chem, and 21 scored 99 in OB-Gyne. It also noticed that many of them got 95 or better in
both subjects and no one got lower than 90. Hence, a comparison with other schools was
made. It showed that the high ratings only applied to Fatima, which is a record-breaking
phenomenon.

The Board issued Res. No. 19, withholding their registration. PRC asked the NBI to
investigate if there are any anomalies. It also asked Nebres, a mathematician and president of
ADMU, to conduct a statistical analysis of the results. The report shows that the scores were
unusually clustered close to each other. After comparing it to the examinees from DLSU and
Perpetual, he concluded that there must be some unusual reason for such clustering.

NBI found that the questionable passing rate leads to the conclusion that the students gained
early access to the questions. The Board charged them with immorality, dishonesty, fraud,
and deceit based on its resolution and RA 2382 as a basis for police power. Hence, the exams
must be nullified.

Issue: W/N RA 2382 or the Medical Act of 1959 is a valid exercise of police power? YES

Held: It is true that this court has upheld the constitutional right of every citizen to select a
profession subject to a fair, reasonable, and equitable admission with academic requirements.
But like all rights, their exercise may be regulated pursuant to the police power of the State
to safeguard the general welfare of the people. Thus, persons who desire to engage in the
learned professions may be required to take an examination as a prerequisite to engage in their
careers. This regulation takes particular pertinence in the field of medicine, to protect the
public from the potentially deadly effects of incompetence and ignorance among practitioners.
They must meet satisfactorily the criteria set, which means sufficient to meet a condition or
obligation or capable of dispelling doubt or ignorance. It must be stressed that the power to
regulate the exercise of a profession or pursuit of an occupation cannot be exercised by the
State in arbitrary manner. A political body that regulates the exercise of a particular privilege
has the authority to both forbid and grant such privilege in accordance with certain conditions.
Such conditions may not, however, require giving up one’s constitutional rights as a condition
to acquire a license.
Danielle Casipit – Paui Costales – Miguel Gayares – Marc Ligon
G03 – Legal Medicine Case Digests
20. Board of Medicine v Ota
GR NO. 166097

Facts: Yasuki Ota is Japanese National married to a Filipina, who has continuously resided in
the Philippines for more than 10 years. He graduated from Bicol Christian College of Medicine
with a degree of Doctor of Medicine. He filed an application to take the medical board
examination in order to obtain a medical license. He was required by the Professional
Regulations Commission(PRC) to submit an affidavit of undertaking, stating that should he
successfully pass the same, he would not practice medicine until he submits proof that
reciprocity exists between Japan and Philippines in admitting foreigners into the practice of
medicine. He submitted the same, took the exams, and passed. However, board of medicine
of the PRC denied his request for a license to practice medicine in the Philippines on the
ground that there is no genuine reciprocity that exists between Japan and the Philippines to
practice said profession as there is no Filipino or foreigner who can possibly practice there.

Respondent filed a petition for certiorari and mandamus with the RTC and Alleged that the
Board and the PRC violated sec.20 of RA 2382 or Medical Act of 1959 by depriving him of
his legitimate right to practice his profession in the Philippines to his great damage and
prejudice

Issue: W/N there is a genuine reciprocity to practice medicine between Philippines and
Japan? YES

Held: It is enough that the laws in the foreign country permit a Filipino to practice and get a
license therein – the fact that there is no reported Filipino who has successfully penetrated the
medical practice in Japan does not mean that there is no reciprocity between the two
countries.

RA 2382 merely requires a foreign citizen to submit competent and conclusive documentary
evidence, confirmed by the Department of Foreign Affairs (DFA), showing that his country's
existing laws permit citizens of the Philippines to practice medicine under the same rules and
regulations governing citizens thereof. Nowhere in said statutes is it stated that the foreign
applicant must show that the conditions for the practice of medicine in said country are
practical and attainable by Filipinos. Neither is it stated that it must first be proven that a
Filipino has been granted license and allowed to practice his profession in said country before
a foreign applicant may be given license to practice in the Philippines.

In this case there is no doubt as to the competence and qualifications of the respondent, the
only matter being questioned by the petitioners is the alleged failure of respondent to prove
that there is reciprocity between laws of Japan and Philippines in admitting foreigners into the
practice of medicine. Since Respondent has satisfactorily complied with the requirements of
RA2382 sec. 9 the CA did not commit any error in rendering its decision.