Presentor: Abdulmoin W.

Mohammad
Case
CaseNo.
No. 11
Dr. Fernando P. Solidium vs People
G.R. No. 192123
March 10, 2014

BERSAMIN, J.:

Rationale of the case:

This appeal is taken by a physician-
anesthesiologist who has been pronounced guilty
of reckless imprudence resulting in serious
physical injuries by the Regional Trial Court (RTC)
and the Court of Appeals (CA). He had been part
of the team of anesthesiologists during the surgical
pull-through operation conducted on a three-year
old patient born with an imperforate anus.
Facts:
Gerald Albert Gercayo (Gerald) was born on June 2,
1992 with an imperforate anus. Two days after his
birth, Gerald underwent colostomy, a surgical
procedure to bring one end of the large intestine out
through the abdominal wall, enabling him to excrete
through a colostomy bag attached to the side of his
body.
On May 17, 1995, Gerald, then three years old, was
admitted at the Ospital ng Maynila for a pull-through
operation. The petitioner Dr. Fernando Solidum (Dr.
Solidum) was the anesthesioligist. During the
operation, Gerald experienced bradycardia, and went
into a coma. He regained consciousness only after a
month. He could no longer see, hear or move.
Agitated by her son’s helpless and unexpected condition, Ma.
Luz Gercayo (Luz) lodged a complaint for reckless
imprudence resulting in serious physical injuries with the City
Prosecutor’s Office of Manila against the attending
physicians.
Upon a finding of probable cause, the City Prosecutor’s Office
filed an information solely against Dr. Solidum.
The case was initially filed in the Metropolitan Trial Court of
Manila, but was transferred to the RTC pursuant to Section 5
of Republic Act No. 8369 (The Family Courts Act of 1997).
On July 19, 2004, the RTC rendered its judgment finding Dr.
Solidum guilty beyond reasonable doubt of reckless
imprudence resulting to serious physical injuries. On January
20, 2010, the CA affirmed the conviction of Dr. Solidum.
Issue:
A.) Whether the doctrine of res ipsa loquitur
was applicable in this case.

B.)Whether Dr. Solidum was liable for

criminal negligence.
Held:
A.) No, the court held that the application of the doctrine of res ipsa
loquitur in the case at bar is inappropriate.
Res ipsa loquitur is literally translated as "the thing or the transaction
speaks for itself." The doctrine res ipsa loquitur means that "where the
thing which causes injury is shown to be under the management of the
defendant, and the accident is such as in the ordinary course of things
does not happen if those who have the management use proper care, it
affords reasonable evidence, in the absence of an explanation by the
defendant, that the accident arose from want of care.
Jarcia, Jr. v. People26 has underscored that the doctrine is not a rule of
substantive law, but merely a mode of proof or a mere procedural
convenience.

The doctrine can be invoked when and only when, under the
circumstances involved, direct evidence is absent and not readily
available.
It must be conceded that the doctrine of res ipsa
loquitur can have no application in a suit against a
physician or surgeon which involves the merits of a
diagnosis or of a scientific treatment..

In order to allow resort to the doctrine, therefore, the

following essential requisites must first be satisfied, to
wit: (1) the accident was of a kind that does not
ordinarily occur unless someone is negligent; (2) the
instrumentality or agency that caused the injury was
under the exclusive control of the person charged;
and (3) the injury suffered must not have been due to
any voluntary action or contribution of the person
injured.29
B.)No, Dr. Solidum is not liable for criminal negligence.

In litigations involving medical negligence, the plaintiff has the

burden of establishing appellant's negligence and for a reasonable
conclusion of negligence; there must be proof of breach of duty on
the part of the surgeon as well as a causal connection of such
breach and the resulting death of his patient.

An action upon medical negligence – whether criminal, civil or

administrative – calls for the plaintiff to prove by competent
evidence each of the following four elements, namely: (a) the duty
owed by the physician to the patient, as created by the physician-
patient relationship, to act in accordance with the specific norms or
standards established by his profession; (b) the breach of the duty
by the physician’s failing to act in accordance with the applicable
standard of care; (3) the causation, i.e., there must be a reasonably
close and causal connection between the negligent act or omission
and the resulting injury; and (4) the damages suffered by the
patient.
Liability of Ospital ng Maynila

Ospital ng Maynila could not be held civilly liable because it was not
a party to the case. To hold it so would be to deny it due process of
law. Furthermore, before it can be held subsidiary liable, the
conditions therefor must first be established: (1) it must be a
corporation engaged in any kind of industry; (2) defendant must be
shown to be an employee of the corporation engaged in industry for
profit; and (3) defendant must be insolvent.
Applying the conditions in the case at bar, Ospital ng Maynila cannot
be held subsidiary liable because: (1) Ospital ng Maynila, being a
public hospital, was not engaged in industry conducted for profit but
purely in charitable and humanitarian work; (2) Dr. Solidumwas not
an employee of Ospital ng Maynila but a consultant; and (3) Dr.
Solidum was not insolvent.

Therefore, the petition granted.

Case No. 2
Carlos Borromeo vs Family Care Hospital Inc.
G.R. No. 191018
January 25, 2016

BRION, J.:
Rationale of the case:
Carlos Borromeo lost his wife Lillian when she died after undergoing a
routine appendectomy. The hospital and the attending surgeon submit
that Lillian bled to death due to a rare, life-threatening condition that
prevented her blood from clotting normally. Carlos believes, however,
that the hospital and the surgeon were simply negligent in the care of
his late wife.
On January 22, 2010, the Court of Appeals (CA) in CA-G.R CV No.
89096[1] dismissed Carlos' complaint and thus reversed the April 10,
2007 decision of the Regional Trial Court (RTC) in Civil Case No.
2000-603-MK[2] which found the respondents liable for medical
negligence.

The present petition for review on certiorari seeks to reverse the CA's
January 22, 2010 decision.
Facts:
On July 13, 1999, the Borromeo brought his wife to the Family Care
Hospital because she had been complaining of acute pain at the
lower stomach area and fever for two days. She was admitted at the
hospital and placed under the care of Dr. Inso.
Dr. Inso suspected that Lilian might be suffering from acute
appendicitis. However, there was insufficient data to rule out other
possible causes and to proceed with an appendectomy. Thus, he
ordered Lilian’s confinement for testing and evaluation. However,
the tests were not conclusive enough to confirm that she had
appendicitis. Lilian abruptly developed an acute surgical abdomen.
On July 15, 1999, Dr. Inso decided to conduct an exploratory
laparotomy on Lilian because of the findings on her abdomen and
his fear that she might have a ruptured appendix. During the
operation, Dr. Inso confirmed that Lilian was suffering from acute
appendicitis. He proceeded to remove her appendix which was
already infected and congested with pus. The operation was
successful.
Six hours after Lilian was brought back to her room, Dr. Inso
was informed that her blood pressure was low. After assessing
her condition, he ordered the infusion of more intravenous (IV)
fluids which somehow raised her blood pressure.
Subsequently, a nurse informed him that Lilian was becoming
restless. Dr. Inso immediately went to Lilian and saw that she
was quite pale. He immediately requested a blood transfusion.
Lilian did not respond to the blood transfusion even after
receiving two 500 cc-units of blood.
Eventually, an endotracheal tube connected to an oxygen tank
was inserted into Lilian to ensure her airway was clear and to
compensate for the lack of circulating oxygen in her body from
the loss of red blood cells. Nevertheless, her condition
continued to deteriorate.
At this point, Dr. Inso suspected that Lilian had Disseminated
Intravascular Coagulation (DIC), a blood disorder
characterized by bleeding in many parts of her body caused by
the consumption or the loss of the clotting factors in the blood.
However, Dr. Inso did not have the luxury to conduct further
tests because the immediate need was to resuscitate Lilian.
Dr. Inso and the nurses performed CPR on Lilian. Dr. Inso also
informed her family that there may be a need to re-operate on her,
but she would have to be put in an Intensive Care Unit (ICU).
Unfortunately, Family Care did not have an ICU because it was only
a secondary hospital and was not required by the Department of
Health to have one. Dr. Inso then personally coordinated with the
Muntinlupa Medical Center (MMC) which had an available bed.
Upon reaching the MMC, a medical team was on hand to
resuscitate. Unfortunately, Lilian passed away despite efforts to
resuscitate her.
According to the autopsy report, Dr. Reyes concluded that the cause
of Lilian’s death was haemorrhage due to bleeding petechial blood
vessels: internal bleeding. He further concluded that the internal
bleeding was caused by the 0.5 x 0.5 cm opening in the repair site.
He opined that the bleeding could have been avoided if the site was
repaired with double suturing instead of the single continuous suture
repair that he found.
Based on the autopsy, the petitioner filed a complaint for damages
against Family Care and against Dr. Inso for medical negligence.
Issues:
A.) Whether the respondent is guilty of medical
negligence.

B.) Whether the doctrine of res ipsa loquitur is

applicable in this case.
Held:
A.) No, the respondent is not guilty of medical negligence.

The requisites of establishing medical malpractice

Whoever alleges a fact has the burden of proving it. This is

a basic legal principle that equally applies to civil and
criminal cases. In a medical malpractice case, the plaintiff
has the duty of proving its elements, namely: (1) a duty of
the defendant to his patient; (2) the defendant's breach of
this duty; (3) injury to the patient; and (4) proximate
causation between the breach and the injury suffered. In
civil cases, the plaintiff must prove these elements by a
preponderance of evidence.
The standard is based on the norm observed by other
reasonably competent members of the
profession practicing the same field of medicine.
Because medical malpractice cases are often highly
technical, expert testimony is usually essential to
establish: (1) the standard of care that the defendant
was bound to observe under the circumstances; (2)
that the defendant's conduct fell below the acceptable
standard; and (3) that the defendant's failure to observe
the industry standard caused injury to his patient.
The expert witness must be a similarly trained and
experienced physician. Thus, a pulmonologist is not
qualified to testify as to the standard of care required of
an anesthesiologist and an autopsy expert is not
qualified to testify as a specialist in infectious diseases.
B.)The petitioner cannot invoke the doctrine of res ipsa
loquitur to shift the burden of evidence onto the
respondent. Res ipsa loquitur, literally, "the thing speaks for
itself;" is a rule of evidence that presumes negligence from
the very nature of the accident itself using common human
knowledge or experience.
The application of this rule requires: (1) that the accident was
of a kind which does not ordinarily occur unless someone is
negligent; (2) that the instrumentality or agency which caused
the injury was under the exclusive: control of the person
charged with negligence; and (3) that the injury suffered must
not have been due to any voluntary action or contribution
from the injured person. The concurrence of these elements
creates a presumption of negligence that, if unrebutted,
overcomes the plaintiffs burden of proof.
While this Court sympathizes with the
petitioner's loss, the petitioner failed to present
sufficient convincing evidence to establish: (1)
the standard of care expected of the
respondent and (2) the fact that Dr. Inso fell
short of this expected standard. Considering
further that the respondents established that
the cause of Lilian's uncontrollable bleeding
(and, ultimately, her death) was a medical
disorder - Disseminated Intravascular
Coagulation — we find no reversible errors in
the CA's dismissal of the complaint on appeal.
Case No. 3
American Express International, Inc. vs Noel Cordero
G.R. No. 138550
October 14, 2005

SANDOVAL – GUTIERREZ, J.:

Rationale of the case:

This is a petition for review on certiorari of the
Decision[1] of the Court of Appeals dated April 30, 1999
in CA-G.R. CV No. 51671, entitled, Noel Cordero,
Plaintiff-Appellee versus American Express
International, Inc., Defendant-Appellant. The
respondent filed a complaint for damages against
petitioner when the latter confiscat and cut
respondent’s extension card which exposed him to
public humiliation.
Facts:
American Express International was a foreign corporation that
issued charge cards used to purchase goods and services
at accredited merchants worldwide to its customers. Nilda
Cordero, wife of respondent Noel Cordero, was issued
an American Express charge card. An extension charge card
was likewise issued to respondent Noel Cordero which he also
signed. Respondent, together with his family went on a three-
day holiday trip to Hong Kong. The group went to the
Watson’s Chemist Shop. While there, Noel picked up chocolate
candies and handed his American
Express extension charge card to the sales clerk to pay for his
purchases. Susan Chong, the store manager, informed
respondent that she had to confiscate the card. Thereupon, she
cut respondent’s American Express card in half with a pair of
scissors. This, according to respondent, caused him
embarrassment and humiliation. Hence, Nilda had to pay for
the purchases using her own American Express charge card.
The card was placed in the Inspect Airwarn Support
System, asystem utilized by petitioner as a protection both for the
company and the cardholders against the fraudulent use of
their charge cards. Once a card suspected of unauthorized use is
placed in the system, the person to whom the card is tendered must
verify the identity of the holder. If the true identity of the card owner
is established, the card is honored and the charges are
approved. Otherwise, the card is revoked or confiscated.

Respondent filed with the Regional Trial Court a complaint for

damages against petitioner. He prayed for the award of moral
damages and exemplary damages, as well as attorney’s fees as a
result of the humiliation he suffered. According to the trial court,
petitioner should have informed respondent that on November 1,
1991, a person in Hong Kong attempted to use a charge
card bearing similar number to that of respondent’s card and that
petitioner’s inexcusable failure to do so is the proximate cause of
the “confiscation and cutting of respondent’s extension card which
exposed the latter to public humiliation for which the petitioner
should be held liable. Upon appeal, the Court of Appeals affirmed
the trial court’s decision. Hence, the instant petition filed.
Issue:
Whether the inexcusable failure of the petitioner
to inform the defendant of the November 1,
1991 incident is the proximate cause of the
confiscation and cutting plaintiffs’ extension card
which exposed the latter to public humiliation for
which the petitioner should be held liable.
Held:
No, because as stipulated in the paragraph 16 of the card member
agreement signed by the respondent, the petitioner can revoke
respondent’s card without notice as was done. The subject card would
not have been confiscated and cut when the respondent talked
to petitioner’s representative and identified himself as the
genuine cardholder. As explained by respondent himself, he could have
used his card upon verification by the sales clerk of Watson that indeed
he is the authorized cardholder. Clearly, no negligence which breached
the contract could have been attributed to petitioner. If at all, the cause
of respondent’s humiliation and embarrassment was his refusal to talk
to petitioner’s representative. It was thus safe to conclude that there
was no negligence on the part of petitioner and that, therefore, it cannot
be held liable to respondent for damages.

Respondent anchors his cause of action on the following provision of

the Civil Code:
Art. 2176. Whoever by act or omission causes damage to
another, there being fault or negligence, is obliged to pay for the
damage done. Such fault or negligence, if there is no pre-existing
contractual relation between the parties, is called a quasi-delict and is
governed by the provisions of this Chapter.
In order that an obligation based on quasi-delict may arise,
there must be no pre-existing contractual relation between the
parties. But there are exceptions. There may be an action for
quasi-delict notwithstanding that there is a subsisting contract
between the parties. A liability for tort may arise even under a
contract, where tort is that which breaches the contract. Stated
differently, when an act which constitutes a breach of contract
would have itself constituted the source of a quasi-delictual
liability, the contract can be said to have been breached by tort,
thereby allowing the rules on tort to apply.

Furthermore, to constitute quasi-delict, the fault or negligence

must be the proximate cause of the damage or injury suffered
by the plaintiff. Proximate cause is that cause which, in natural
and continuous sequence, unbroken by any efficient
intervening cause, produces the injury and without which the
result would not have occurred. Proximate cause is determined
by the facts of each case upon mixed considerations of logic,
common sense, policy and precedent.
THANK YOU!!!