rogelio ramos vs ca

8/10/2019 Rogelio Ramos vs CA

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PHILIPPINE JURISPRUDENCE - FULL TEXTThe Lawphil Project - Arellano Law Fon!ation"#R# No# $%&'(& Dece)*er %+, $+++R"ELI E# RA.S, ET AL# /0# CURT F APPEALS, ET AL#

Rep*lic o1 the Philippine0SUPRE.E CURT

.anila

FIRST DI2ISIN

"#R# No# $%&'(& Dece)*er %+, $+++

R"ELI E# RA.S an! ERLINDA RA.S, in their own *ehal1 an! a0 natral 3ar!ian0 o1

the )inor0, R..EL RA.S, R4 RDERIC5 RA.S an! RN RA4.ND RA.S,petitioner0,/0#

CURT F APPEALS, DELS SANTS .EDICAL CENTER, DR# RLIN HSA5A an!DRA# PERFECTA "UTIERRE6, re0pon!ent0#

5APUNAN, J.:

The Hippocratic ath )an!ate0 ph70ician0 to 3i/e pri)or!ial con0i!eration to the health an!wel1are o1 their patient0# I1 a !octor 1ail0 to li/e p to thi0 precept, he i0 )a!e acconta*le 1or hi0

act0# A )i0ta8e, thro3h 3ro00 ne3li3ence or inco)petence or plain h)an error, )a7 0pell the!i11erence *etween li1e an! !eath# In thi0 0en0e, the !octor pla70 "o! on hi0 patient90 1ate# $

In the ca0e at *ar, the Cort i0 calle! pon to rle whether a 0r3eon, an ane0the0iolo3i0t an! aho0pital 0hol! *e )a!e lia*le 1or the n1ortnate co)ato0e con!ition o1 a patient 0che!le! 1or

cholec70tecto)7# %

Petitioner0 0ee8 the re/er0al o1 the !eci0ion 'o1 the Cort o1 Appeal0, !ate! %+ .a7 $++(,which o/ertrne! the !eci0ion &o1 the Re3ional Trial Cort, !ate! ': Janar7 $++%, 1in!in3pri/ate re0pon!ent0 lia*le 1or !a)a3e0 ari0in3 1ro) ne3li3ence in the per1or)ance o1 theirpro1e00ional !tie0 towar!0 petitioner Erlin!a Ra)o0 re0ltin3 in her co)ato0e con!ition#

The antece!ent 1act0 a0 0))ari;e! *7 the trial cort are repro!ce! heren!er(, a &=-7ear ol!?E@h# AB ro*0t wo)an ?TSN, cto*er $+, $+>+, p# $:B# E@cept 1or occa0ional

co)plaint0 o1 !i0co)1ort !e to pain0 alle3e!l7 ca0e! *7 the pre0ence o1 a0tone in her 3all *la!!er ?TSN, Janar7 $', $+>>, pp# &-(B, 0he wa0 a0 nor)al a0an7 other wo)an# .arrie! to Ro3elio E# Ra)o0, an e@ecti/e o1 Philippine Lon3Di0tance Telephone Co)pan7, 0he ha0 three chil!ren who0e na)e0 are Ro))el


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Ra)o0, Ro7 Ro!eric8 Ra)o0 an! Ron Ra7)on! Ra)o0 ?TSN, cto*er $+,$+>+, pp# (-B#

eca0e the !i0co)1ort0 0o)ehow inter1ere! with her nor)al wa70, 0he 0o3htpro1e00ional a!/ice# She wa0 a!/i0e! to n!er3o an operation 1or the re)o/al o1

a 0tone in her 3all *la!!er ?TSN, Janar7 $', $+>>, p# (B# She n!erwent a

0erie0 o1 e@a)ination0 which incl!e! *loo! an! rine te0t0 ?E@h0# A an! CBwhich in!icate! 0he wa0 1it 1or 0r3er7#

Thro3h the interce00ion o1 a )tal 1rien!, Dr# en/iaje ?TSN, Janar7 $',$+>>, p# =B, 0he an! her h0*an! Ro3elio )et 1or the first timeDr# rlino Ho;a8a?0hol! *e Ho0a8a seeTSN, Fe*rar7 %:, $++:, p# 'B, one o1 the !e1en!ant0 inthi0 ca0e, on Jne $:, $+>(# The7 a3ree! that their !ate at the operatin3 ta*le at

the DLS.C ?another !e1en!antB, wol! *e on Jne $=, $+>( at ++, pp# $&-$(, %%-%', '$-'' TSN, Fe*rar7

%=, $++:, p# $' an! TSN, No/e)*er +, $+>+, pp# '-&, $:, $=B#

A !a7 *e1ore the 0che!le! !ate o1 operation, 0he wa0 a!)itte! at one o1 theroo)0 o1 the DLS.C, locate! alon3 E# Ro!ri3e; A/ene, e;on Cit7 ?TSN,

cto*er $+,$+>+, p# $$B#

At aron! =>, pp# +-$$B# Her h0*an!, Ro3elio, wa0al0o with her ?TSN, cto*er $+, $+>+, p# $>B# At the operatin3 roo), Her)in!a0aw a*ot two or three nr0e0 an! Dr# Per1ecta "tierre;, the other !e1en!ant,who wa0 to a!)ini0ter ane0the0ia# Altho3h not a )e)*er o1 the ho0pital 0ta11,Her)in!a intro!ce! her0el1 a0 Dean o1 the Colle3e o1 Nr0in3 at the Capitol

.e!ical Center who wa0 to pro/i!e )oral 0pport to the patient, to the)#Her)in!a wa0 allowe! to 0ta7 in0i!e the operatin3 roo)#

At aron! +>, pp# $$-$%B# Dr# "tierre;

therea1ter in1or)e! Her)in!a Cr; a*ot the pro0pect o1 a !ela7 in the arri/al o1Dr# Ho0a8a# Her)in!a then went *ac8 to the patient who a08e!, .in!7, wala pa*a an3 Doctor The 1or)er replie!, Hwa3 8an3 )a3-alaala, !aratin3 na i7on

?Ibid#B#

Therea1ter, Her)in!a went ot o1 the operatin3 roo) an! in1or)e! the patient90h0*an!, Ro3elio, that the !octor wa0 not 7et aron! ?id#, p# $'B# hen 0he


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retrne! to the operatin3 roo), the patient tol! her, .in!7, inip na inip na a8o,i8ha )o a8o n3 i*an3 Doctor# So, 0he went ot a3ain an! tol! Ro3elio a*ot

what the patient 0ai! ?id#, p# $(B# Therea1ter, 0he retrne! to the operatin3 roo)#

At aron! $:+, pp# $+-%:B#He al0o tho3ht o1 the 1eelin3 o1 hi0 wi1e, who wa0 in0i!e the operatin3 roo)

waitin3 1or the !octor to arri/e ?ibid#B# At al)o0t $%


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o1 hi0 wi1e wol! not ha/e happene!, ha! he ?Dr# Ho0a8aB loo8e! 1or a 3oo!ane0the0iolo3i0t ?TSN, cto*er $+, $+>+, p# '$B#

Doctor0 "tierre; an! Ho0a8a were al0o a08e! *7 the ho0pital to e@plain whathappene! to the patient# The !octor0 e@plaine! that the patient ha!

*roncho0pa0) ?TSN, No/e)*er $(, $++:, pp# %-%=B#

Erlin!a Ra)o0 0ta7e! at the ICU 1or a )onth# A*ot 1or )onth0 therea1ter or onNo/e)*er $(, $+>(, the patient wa0 relea0e! 1ro) the ho0pital#

Drin3 the whole perio! o1 her con1ine)ent, 0he incrre! ho0pital *ill0 a)ontin3to P+',(&%#%( which i0 the 0*ject o1 a pro)i00or7 note an! a11i!a/it o1

n!erta8in3 e@ecte! *7 Ro3elio E# Ra)o0 in 1a/or o1 DLS.C# Since that 1ate1la1ternoon o1 Jne $=, $+>(, 0he ha0 *een in a co)ato0e con!ition# She cannot

!o an7thin3# She cannot )o/e an7 part o1 her *o!7# She cannot 0ee or hear# Shei0 li/in3 on )echanical )ean0# She 011ere! *rain !a)a3e a0 a re0lt o1 the

a*0ence o1 o@73en in her *rain 1or 1or to 1i/e )inte0 ?TSN, No/e)*er +, $+>+,pp# %$-%%B# A1ter *ein3 !i0char3e! 1ro) the ho0pital, 0he ha0 *een 0ta7in3 in

their re0i!ence, 0till nee!in3 con0tant )e!ical attention, with her h0*an!Ro3elio incrrin3 a )onthl7 e@pen0e ran3in3 1ro) P>,:::#:: to P$:,:::#::?TSN, cto*er $+, $+>+, pp# '%-'&B# She wa0 al0o !ia3no0e! to *e 011erin3

1ro) !i110e cere*ral parench7)al !a)a3e ?E@h# " see alsoTSN, Dece)*er%$, $+>+,

p# B# (

Th0, on > Janar7 $+>, petitioner0 1ile! a ci/il ca0e 1or !a)a3e0 with the Re3ional TrialCort o1 e;on Cit7 a3ain0t herein pri/ate re0pon!ent0 alle3in3 ne3li3ence in the

)ana3e)ent an! care o1 Erlin!a Ra)o0#

Drin3 the trial, *oth partie0 pre0ente! e/i!ence a0 to the po00i*le ca0e o1 Erlin!a90 injr7#Plainti11 pre0ente! the te0ti)onie0 o1 Dean Her)in!a Cr; an! Dr# .ariano "a/ino to pro/e that

the 00taine! *7 Erlin!a wa0 !e to lac8 o1 o@73en in her *rain ca0e! *7 the 1alt7)ana3e)ent o1 her airwa7 *7 pri/ate re0pon!ent0 !rin3 the ane0the0ia pha0e# n the otherhan!, pri/ate re0pon!ent0 pri)aril7 relie! on the e@pert te0ti)on7 o1 Dr# E!ar!o Ja)ora, a

pl)onolo3i0t, to the e11ect that the ca0e o1 *rain !a)a3e wa0 Erlin!a90 aller3ic reaction to theane0thetic a3ent, Thiopental So!i) ?PentothalB#

A1ter con0i!erin3 the e/i!ence 1ro) *oth 0i!e0, the Re3ional Trial Cort ren!ere! j!3)ent in1a/or o1 petitioner0, to wit

The !eci0ion o1 the Cort o1 Appeal0 wa0 recei/e! on + Jne $++( *7 petitioner Ro3elio Ra)o0who wa0 )i0ta8enl7 a!!re00e! a0 Att7# Ro3elio Ra)o0# No cop7 o1 the !eci0ion, howe/er,

wa0 0ent nor recei/e! *7 the Coronel Law 11ice, then con0el on recor! o1 petitioner0# Ro3eliore1erre! the !eci0ion o1 the appellate cort to a new law7er, Att7# Li30a7, onl7 on %: Jne $++(,

or 1or ?&B !a70 *e1ore the e@piration o1 the re3le)entar7 perio! 1or 1ilin3 a )otion 1orrecon0i!eration# n the 0a)e !a7, Att7# Li30a7, 1ile! with the appellate cort a )otion 1ore@ten0ion o1 ti)e to 1ile a )otion 1or recon0i!eration# The )otion 1or recon0i!eration wa0

0*)itte! on & Jl7 $++(# Howe/er, the appellate cort !enie! the )otion 1or e@ten0ion o1 ti)ein it0 Re0oltion !ate! %( Jl7 $++(# +.eanwhile, petitioner0 en3a3e! the 0er/ice0 o1 anothercon0el, Att7# Sillano, to replace Att7# Li30a7# Att7# Sillano 1ile! on = A30t $++( a )otion to

a!)it the )otion 1or recon0i!eration conten!in3 that the perio! to 1ile the appropriate plea!in3on the a00aile! !eci0ion ha! not 7et co))ence! to rn a0 the Di/i0ion Cler8 o1 Cort o1 the

Cort o1 Appeal0 ha! not 7et 0er/e! a cop7 thereo1 to the con0el on recor!# De0pite thi0e@planation, the appellate cort 0till !enie! the )otion to a!)it the )otion 1or recon0i!eration o1petitioner0 in it0 Re0oltion, !ate! %+ .arch $++, pri)aril7 on the 3ron! that the 1i1teen-!a7

?$(B perio! 1or 1ilin3 a )otion 1or recon0i!eration ha! alrea!7 e@pire!, to witIt i0 re3ar!e! a0 a)o!e o1 proo1, or a )ere proce!ral o1 con/enience 0ince it 1rni0he0 a 0*0titte 1or, an!

relie/e0 a plainti11 o1, the *r!en o1 pro!cin3 0peci1ic proo1 o1 ne3li3ence# $+In other wor!0,

)ere in/ocation an! application o1 the !octrine !oe0 not !i0pen0e with the reGire)ent o1 proo1o1 ne3li3ence# It i0 0i)pl7 a 0tep in the proce00 o1 0ch proo1, per)ittin3 the plainti11 to pre0ent

alon3 with the proo1 o1 the acci!ent, eno3h o1 the atten!in3 circ)0tance0 to in/o8e the!octrine, creatin3 an in1erence or pre0)ption o1 ne3li3ence, an! to there*7 place on the

!e1en!ant the *r!en o1 3oin3 1orwar! with the proo1# %:Still, *e1ore re0ort to the !octrine )a7*e allowe!, the 1ollowin3 reGi0ite0 )0t *e 0ati01actoril7 0hown

r!inaril7, onl7 ph70ician0 an! 0r3eon0 o1 08ill an! e@perience are co)petent to te0ti17 a0 to

whether a patient ha0 *een treate! or operate! pon with a rea0ona*le !e3ree o1 08ill an! care#Howe/er, te0ti)on7 a0 to the 0tate)ent0 an! act0 o1 ph70ician0 an! 0r3eon0, e@ternal

appearance0, an! )ani1e0t con!ition0 which are o*0er/a*le *7 an7 one )a7 *e 3i/en *7 non-e@pert witne00e0# %+Hence, in ca0e0 where the res ipsa loquituri0 applica*le, the cort i0

per)itte! to 1in! a ph70ician ne3li3ent pon proper proo1 o1 injr7 to the patient, withot the ai!o1 e@pert te0ti)on7, where the cort 1ro) it0 1n! o1 co))on 8nowle!3e can !eter)ine theproper 0tan!ar! o1 care# ':here co))on 8nowle!3e an! e@perience teach that a re0ltin3injr7 wol! not ha/e occrre! to the patient i1 !e care ha! *een e@erci0e!, an in1erence o1

ne3li3ence )a7 *e !rawn 3i/in3 ri0e to an application o1 the !octrine o1 res ipsa loquiturwithot)e!ical e/i!ence, which i0 or!inaril7 reGire! to 0how not onl7 what occrre! *t how an! wh7

it occrre!# '$hen the !octrine i0 appropriate, all that the patient )0t !o i0 pro/e a ne@0*etween the particlar act or o)i00ion co)plaine! o1 an! the injr7 00taine! while n!er the

c0to!7 an! )ana3e)ent o1 the !e1en!ant withot nee! to pro!ce e@pert )e!ical te0ti)on7 toe0ta*li0h the 0tan!ar! o1 care# Re0ort to res ipsa loquitur i0 allowe! *eca0e there i0 no other

wa7, n!er 0al an! or!inar7 con!ition0, *7 which the patient can o*tain re!re00 1or injr7011ere! *7 hi)#

Th0, cort0 o1 other jri0!iction0 ha/e applie! the !octrine in the 1ollowin3 0itation0< lea/in3 o1a 1orei3n o*ject in the *o!7 o1 the patient a1ter an operation, '%injrie0 00taine! on a health7part o1 the *o!7 which wa0 not n!er, or in the area, o1 treat)ent, ''re)o/al o1 the wron3 parto1 the *o!7 when another part wa0 inten!e!, '&8noc8in3 ot a tooth while a patient90 jaw wa0n!er ane0thetic 1or the re)o/al o1 hi0 ton0il0, '(an! lo00 o1 an e7e while the patient plainti11

wa0 n!er the in1lence o1 ane0thetic, !rin3 or 1ollowin3 an operation 1or appen!iciti0, '

a)on3 other0#

Ne/erthele00, !e0pite the 1act that the 0cope o1 res ipsa loquiturha0 *een )ea0ra*l7 enlar3e!,it !oe0 not ato)aticall7 appl7 to all ca0e0 o1 )e!ical ne3li3ence a0 to )echanicall7 0hi1t the*r!en o1 proo1 to the !e1en!ant to 0how that he i0 not 3ilt7 o1 the a0cri*e! ne3li3ence# Res

ipsa loquituri0 not a ri3i! or or!inar7 !octrine to *e per1nctoril7 0e! *t a rle to *e catio0l7applie!, !epen!in3 pon the circ)0tance0 o1 each ca0e# It i0 3enerall7 re0tricte! to 0itation0

in )alpractice ca0e0 where a la7)an i0 a*le to 0a7, a0 a )atter o1 co))on 8nowle!3e an!o*0er/ation, that the con0eGence0 o1 pro1e00ional care were not a0 0ch a0 wol! or!inaril7


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ha/e 1ollowe! i1 !e care ha! *eene@erci0e!# '=A !i0tinction )0t *e )a!e *etween the 1ailre to 0ecre re0lt0, an! the

occrrence o1 0o)ethin3 )ore n0al an! not or!inaril7 1on! i1 the 0er/ice or treat)entren!ere! 1ollowe! the 0al proce!re o1 tho0e 08ille! in that particlar practice# It )0t *econce!e! that the !octrine o1 res ipsa loquiturcan ha/e no application in a 0it a3ain0t a

ph70ician or 0r3eon which in/ol/e0 the )erit0 o1 a !ia3no0i0 or o1 a 0cienti1ic treat)ent# '>The

ph70ician or 0r3eon i0 not reGire! at hi0 peril to e@plain wh7 an7 particlar !ia3no0i0 wa0 notcorrect, or wh7 an7 particlar 0cienti1ic treat)ent !i! not pro!ce the !e0ire! re0lt# '+Th0, resipsa loquituri0 not a/aila*le in a )alpractice 0it i1 the onl7 0howin3 i0 that the !e0ire! re0lt o1an operation or treat)ent wa0 not acco)pli0he!# &:The real Ge0tion, there1ore, i0 whether ornot in the proce00 o1 the operation an7 e@traor!inar7 inci!ent or n0al e/ent ot0i!e o1 therotine per1or)ance occrre! which i0 *e7on! the re3lar 0cope o1 c0to)ar7 pro1e00ionalacti/it7 in 0ch operation0, which, i1 ne@plaine! wol! the)0el/e0 rea0ona*l7 0pea8 to thea/era3e )an a0 the ne3li3ent ca0e or ca0e0 o1 the ntowar! con0eGence# &$I1 there wa0

0ch e@traneo0 inter/ention0, the !octrine o1 res ipsa loquitur)a7 *e tili;e! an! the!e1en!ant i0 calle! pon to e@plain the )atter, *7 e/i!ence o1 e@clpation, i1 he col!# &%

e 1in! the !octrine o1 res ipsa loquiturappropriate in the ca0e at *ar# A0 will hereina1ter *e

e@plaine!, the !a)a3e 00taine! *7 Erlin!a in her *rain prior to a 0che!le! 3all *la!!eroperation pre0ent0 a ca0e 1or the application o1 res ipsa loquitur#

A ca0e 0tri8in3l7 0i)ilar to the one *e1ore 0 i0 oss !s# "rid#ell, &'where the 5an0a0 Spre)eCort in appl7in3 the res ipsa loquitur0tate!: o1 the Ci/il Co!e which con0i!er0 a per0on acconta*le not onl7 1or hi0

own act0 *t al0o 1or tho0e o1 other0 *a0e! on the 1or)er90 re0pon0i*ilit7 n!er a relation0hip o1patria potestas# ==Sch re0pon0i*ilit7 cea0e0 when the per0on0 or entit7 concerne! pro/e thatthe7 ha/e o*0er/e! the !ili3ence o1 a 3oo! 1ather o1 the 1a)il7 to pre/ent !a)a3e# =>In other

wor!0, while the *r!en o1 pro/in3 ne3li3ence re0t0 on the plainti110, once ne3li3ence i0 0hown,

the *r!en 0hi1t0 to the re0pon!ent0 ?parent, 3ar!ian, teacher or e)plo7erB who 0hol! pro/ethat the7 o*0er/e! the !ili3ence o1 a 3oo! 1ather o1 a 1a)il7 to pre/ent !a)a3e#

In the in0tant ca0e, re0pon!ent ho0pital, apart 1ro) a 3eneral !enial o1 it0 re0pon0i*ilit7 o/erre0pon!ent ph70ician0, 1aile! to a!!ce e/i!ence 0howin3 that it e@erci0e! the !ili3ence o1 a3oo! 1ather o1 a 1a)il7 in the hirin3 an! 0per/i0ion o1 the latter# It 1aile! to a!!ce e/i!ence

with re3ar! to the !e3ree o1 0per/i0ion which it e@erci0e! o/er it0 ph70ician0# In ne3lectin3 too11er 0ch proo1, or proo1 o1 a 0i)ilar natre, re0pon!ent ho0pital there*7 1aile! to !i0char3e it0*r!en n!er the la0t para3raph o1 Article %$>:# Ha/in3 1aile! to !o thi0, re0pon!ent ho0pital i0

con0eGentl7 0oli!aril7 re0pon0i*le with it0 ph70ician0 1or Erlin!a90 con!ition#

a0e! on the 1ore3oin3, we hol! that the Cort o1 Appeal0 erre! in acceptin3 an! rel7in3 on the

te0ti)onie0 o1 the witne00e0 1or the pri/ate re0pon!ent0# In!ee!, a0 0hown *7 the a*o/e!i0c00ion0, pri/ate re0pon!ent0 were na*le to re*t the pre0)ption o1 ne3li3ence# Uponthe0e !i0Gi0ition0 we hol! that pri/ate re0pon!ent0 are 0oli!aril7 lia*le 1or !a)a3e0 n!er

Article %$= =+o1 the Ci/il Co!e#

e now co)e to the a)ont o1 !a)a3e0 !e petitioner0# The trial cort awar!e! a total o1P'%,:::#:: pe0o0 ?0hol! *e P$,:::#::B in co)pen0ator7 !a)a3e0 to the plainti11, 0*jectto it0 *ein3 p!ate! co/erin3 the perio! 1ro) $( No/e)*er $+>( p to $( April $++%, *a0e! on

)onthl7 e@pen0e0 1or the care o1 the patient e0ti)ate! at P>,:::#::#

At crrent le/el0, the P>:::M)onthl7 a)ont e0ta*li0he! *7 the trial cort at the ti)e o1 it0!eci0ion wol! *e 3ro00l7 ina!eGate to co/er the actal co0t0 o1 ho)e-*a0e! care 1or a

co)ato0e in!i/i!al# The calclate! a)ont wa0 not e/en arri/e! at *7 loo8in3 at the actalco0t o1 proper ho0pice care 1or the patient# hat it re1lecte! were the actal e@pen0e0 incrre!

an! pro/e! *7 the petitioner0 a1ter the7 were 1orce! to *rin3 ho)e the patient to a/oi! )ontin3ho0pital *ill0#

An! 7et i!eall7, a co)ato0e patient 0hol! re)ain in a ho0pital or *e tran01erre! to a ho0pice0peciali;in3 in the care o1 the chronicall7 ill 1or the prpo0e o1 pro/i!in3 a proper )ilie

a!eGate to )eet )ini)) 0tan!ar!0 o1 care# In the in0tant ca0e 1or in0tance, Erlin!a ha0 to *econ0tantl7 trne! 1ro) 0i!e to 0i!e to pre/ent *e!0ore0 an! h7po0tatic pne)onia# Fee!in3 i0!one *7 na0o3a0tric t*e# Foo! preparation 0hol! *e nor)all7 )a!e *7 a !ietitian to pro/i!eher with the correct !ail7 caloric reGire)ent0 an! /ita)in 0pple)ent0# Frther)ore, 0he ha0

to *e 0een on a re3lar *a0i0 *7 a ph70ical therapi0t to a/oi! )0cle atroph7, an! *7 apl)onar7 therapi0t to pre/ent the acc)lation o1 0ecretion0 which can lea! to re0pirator7

co)plication0#

"i/en the0e con0i!eration0, the a)ont o1 actal !a)a3e0 reco/era*le in 0it0 ari0in3 1ro)ne3li3ence 0hol! at lea0t re1lect the correct )ini)) co0t o1 proper care, not the co0t o1 thecare the 1a)il7 i0 0all7 co)pelle! to n!erta8e at ho)e to a/oi! *an8rptc7# Howe/er, the

pro/i0ion0 o1 the Ci/il Co!e on actal or co)pen0ator7 !a)a3e0 pre0ent 0 with 0o)e!i11icltie0#


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ell-0ettle! i0 the rle that actal !a)a3e0 which )a7 *e clai)e! *7 the plainti11 are tho0e011ere! *7 hi) a0 he ha0 !l7 pro/e!# The Ci/il Co!e pro/i!e0:In other

wor!0, te)perate !a)a3e0 can an! 0hol! *e awar!e! on top o1 actal or co)pen0ator7!a)a3e0 in in0tance0 where the injr7 i0 chronic an! continin3# An! *eca0e o1 the niGenatre o1 0ch ca0e0, no inco)pati*ilit7 ari0e0 when *oth actal an! te)perate !a)a3e0 are

pro/i!e! 1or# The rea0on i0 that the0e !a)a3e0 co/er two !i0tinct pha0e0#

A0 it wol! not *e eGita*le an! certainl7 not in the *e0t intere0t0 o1 the a!)ini0tration o1j0tice 1or the /icti) in 0ch ca0e0 to con0tantl7 co)e *e1ore the cort0 an! in/o8e their ai!

in 0ee8in3 a!j0t)ent0 to the co)pen0ator7 !a)a3e0 pre/io0l7 awar!e! te)perate!a)a3e0 are appropriate# The a)ont 3i/en a0 te)perate !a)a3e0, tho3h to a certain e@tent

0peclati/e, 0hol! ta8e into accont the co0t o1 proper care#

In the in0tant ca0e, petitioner0 were a*le to pro/i!e onl7 ho)e-*a0e! nr0in3 care 1or aco)ato0e patient who ha0 re)aine! in that con!ition 1or o/er a !eca!e# Ha/in3 pre)i0e! or

awar! 1or co)pen0ator7 !a)a3e0 on the a)ont pro/i!e! *7 petitioner0 at the on0et o1liti3ation, it wol! *e now )ch )ore in 0tep with the intere0t0 o1 j0tice i1 the /ale awar!e! 1or

te)perate !a)a3e0 wol! allow petitioner0 to pro/i!e opti)al care 1or their lo/e! one in a1acilit7 which 3enerall7 0peciali;e0 in 0ch care# The7 0hol! not *e co)pelle! *7 !ire

circ)0tance0 to pro/i!e 0*0tan!ar! care at ho)e withot the ai! o1 pro1e00ional0, 1oran7thin3 le00 wol! *e 3ro00l7 ina!eGate# Un!er the circ)0tance0, an awar! o1

P$,(::,:::#:: in te)perate !a)a3e0 wol! there1ore *e rea0ona*le# >$

In ale%'uela !s# (ourt of Appeals, >%thi0 Cort wa0 con1ronte! with a 0itation where the injr7011ere! *7 the plainti11 wol! ha/e le! to e@pen0e0 which were !i11iclt to e0ti)ate *eca0e

while the7 wol! ha/e *een a !irect re0lt o1 the injr7 ?a)ptationB, an! were certain to *eincrre! *7 the plainti11, the7 were li8el7 to ari0e onl7 in the 1tre# e awar!e! P$,:::,:::#::in )oral !a)a3e0 in that ca0e#

De0cri*in3 the natre o1 the injr7, the Cort therein 0tate!'

The injr7 011ere! *7 Erlin!a a0 a con0eGence o1 pri/ate re0pon!ent09 ne3li3ence i0 certainl7)ch )ore 0erio0 than the a)ptation in the 2alen;ela ca0e#

Petitioner Erlin!a Ra)o0 wa0 in her )i!-1ortie0 when the inci!ent occrre!# She ha0 *een in aco)ato0e 0tate 1or o/er 1orteen 7ear0 now# The *r!en o1 care ha0 0o 1ar *een heroicall7

0hol!ere! *7 her h0*an! an! chil!ren, who, in the inter/enin3 7ear0 ha/e *een !epri/e! o1the lo/e o1 a wi1e an! a )other#

.eanwhile, the actal ph70ical, e)otional an! 1inancial co0t o1 the care o1 petitioner wol! *e/irtall7 i)po00i*le to Ganti17# E/en the te)perate !a)a3e0 herein awar!e! wol! *e

ina!eGate i1 petitioner90 con!ition re)ain0 nchan3e! 1or the ne@t ten 7ear0#

e reco3ni;e!, in 2alen;ela that a !i0c00ion o1 the /icti)90 actal injr7 wol! not e/en0cratch the 0r1ace o1 the re0ltin3 )oral !a)a3e *eca0e it wol! *e hi3hl7 0peclati/e to

e0ti)ate the a)ont o1 e)otional an! )oral pain, p07cholo3ical !a)a3e an! injr7 011ere! *7

the /icti) or tho0e actall7 a11ecte! *7 the /icti)90 con!ition#

>&

The h0*an! an! the chil!ren,all petitioner0 in thi0 ca0e, will ha/e to li/e with the !a7 to !a7 ncertaint7 o1 the patient90 illne00,8nowin3 an7 hope o1 reco/er7 i0 clo0e to nil# The7 ha/e 1a0hione! their !ail7 li/e0 aron! the

nr0in3 care o1 petitioner, alterin3 their lon3 ter) 3oal0 to ta8e into accont their li1e with aco)ato0e patient# The7, not the re0pon!ent0, are char3e! with the )oral re0pon0i*ilit7 o1 thecare o1 the /icti)# The 1a)il790 )oral injr7 an! 011erin3 in thi0 ca0e i0 clearl7 a real one# Forthe 1ore3oin3 rea0on0, an awar! o1 P%,:::,:::#:: in )oral !a)a3e0 wol! *e appropriate#


24/28

Finall7, *7 wa7 o1 e@a)ple, e@e)plar7 !a)a3e0 in the a)ont o1 P$::,:::#:: are here*7awar!e!# Con0i!erin3 the len3th an! natre o1 the in0tant 0it we are o1 the opinion that

attorne790 1ee0 /ale! at P$::,:::#:: are li8ewi0e proper#

r cort0 1ace niGe !i11iclt7 in a!j!icatin3 )e!ical ne3li3ence ca0e0 *eca0e ph70ician0are not in0rer0 o1 li1e an!, the7 rarel7 0et ot to intentionall7 ca0e injr7 or !eath to their

patient0# Howe/er, intent i0 i))aterial in ne3li3ence ca0e0 *eca0e where ne3li3ence e@i0t0an! i0 pro/en, the 0a)e ato)aticall7 3i/e0 the injre! a ri3ht to reparation 1or the !a)a3e

ca0e!#

E0ta*li0he! )e!ical proce!re0 an! practice0, tho3h in con0tant 1l@ are !e/i0e! 1or theprpo0e o1 pre/entin3 co)plication0# A ph70ician90 e@perience with hi0 patient0 wol!

0o)eti)e0 te)pt hi) to !e/iate 1ro) e0ta*li0he! co))nit7 practice0, an! he )a7 en! a!i0tin3i0he! career 0in3 northo!o@ )etho!0 withot inci!ent# Howe/er, when 1ailre to 1ollow

e0ta*li0he! proce!re re0lt0 in the e/il preci0el7 0o3ht to *e a/erte! *7 o*0er/ance o1 theproce!re an! a ne@0 i0 )a!e *etween the !e/iation an! the injr7 or !a)a3e, the ph70ician

wol! nece00aril7 *e calle! to accont 1or it# In the ca0e at *ar, the 1ailre to o*0er/e pre-operati/e a00e00)ent protocol which wol! ha/e in1lence! the int*ation in a 0altar7 wa7

wa0 1atal to pri/ate re0pon!ent09 ca0e#

HEREFRE, the !eci0ion an! re0oltion o1 the appellate cort appeale! 1ro) are here*7)o!i1ie! 0o a0 to awar! in 1a/or o1 petitioner0, an! 0oli!aril7 a3ain0t pri/ate re0pon!ent0 the

1ollowin3< $B P$,'(%,:::#:: a0 actal !a)a3e0 co)pte! a0 o1 the !ate o1 pro)l3ation o1 thi0!eci0ion pl0 a )onthl7 pa7)ent o1 P>,:::#:: p to the ti)e that petitioner Erlin!a Ra)o0e@pire0 or )iraclo0l7 0r/i/e0 %B P%,:::,:::#:: a0 )oral !a)a3e0, 'B P$,(::,:::#:: a0

te)perate !a)a3e0 &B P$::,:::#:: each a0 e@e)plar7 !a)a3e0 an! attorne790 1ee0 an!, (Bthe co0t0 o1 the 0it#

S RDERED#

)a!ide* Jr.* (.J.* Pu%o* Pardo a%d +%ares,Sa%tia-o* JJ.* co%cur.

Footnote0

$ In the Unite! State0 alone, a 3reat n)*er o1 people !ie e/er7 7ear a0 a re0lt o1)e!ical )i0hap0# The $' Dece)*er $+++ i00e o1 TI.E .A"A6INE 1eatre! an articleon )e!ical ne3li3ence entitle! Doctor09 Dea!l7 .i0ta8e0 which i0 Gote! in part< It i0har!l7 new0 that )e!ical pro1e00ional0 )a8e )i0ta8e0 e/en !)*, !ea!l7 )i0ta8e0#hat i0 0hoc8in3 i0 how o1ten it happen0# Depen!in3 on which 0tati0tic0 7o *elie/e, the

n)*er o1 A)erican 8ille! *7 )e!ical 0crew-p0 i0 0o)ewhere *etween &&,::: an!+>,::: e/er7 7ear the ei3hth lea!in3 ca0e o1 !eath e/en *7 the )ore con0er/ati/e

1i3re, ahea! o1 car cra0he0, *rea0t cancer an! AIDS# .ore a0toni0hin3 than the h3en)*er0 the)0el/e0, tho3h, i0 the 1act that p*lic health o11icial0 ha! 8nown a*ot thepro*le) 1or 7ear0 an! ha!n9t )a!e a concerte! e11ort to !o 0o)ethin3 a*ot it#

% Cholec70tecto)7 i0 the 0r3ical e@ci0ion o1 the 3all *la!!er#

' CA Rollo, pp# $%+-$&:#

& Recor!0, pp# %=:-%=+#


25/28

( Id# at %=:-%=(#

Doc8ete! a0 Ci/il Ca0e No# -&>>(#

= Recor!0, pp# %=-%=>#

> CA Rollo, p# $#

+ Id# at $&(#

$: Id# at $+(#

$$ Rollo, p# $+#

$% Id# at +$-+>#

$' (= A) Jr %!, &+' ?$+>+B#

$& A1rica, et al/0# Calte@ ?Phil#B, Inc#, et al, $ SCRA &&+, &(& ?$+B#

$( (= A) Jr %!, supranote $' at &++#

$ Ibid#

$= Id# at (:%#

$> Ibid#

$+ Id#

%: Id# at (:'#

%$ 2o00 /0# ri!well, '& P%! +((, +=: ?$+$B citi%-or!en /# Union "a0 S70te), $>%5an# >, '%& P#%! (:$ La)* /# Hart1or! Acci!ent an! In!e)nit7 Co#, Pri)) /# 5an0a0

Power O Li3ht Co#, $=' 5an# &&', %&+ P#%! &=#

%% St# John90 Ho0pital an! School o1 Nr0in3 /0# Chap)an, &'& P#%! $:, $ ?$+=B#

%' (= A) Jr %!, supranote $', at ($'#

%& It i0 the t7pe o1 clai) which a /icti) ha0 a/aila*le to hi) or her to re!re00 a wron3co))itte! *7 a )e!ical pro1e00ional which ha0 ca0e! *o!il7 har)# ?"arcia-Re!a /0#

Pa0ca0io, %=> SCRA =+, =>> $++=KB#

%( 2o00 /0# ri!well, supranote %$#

% Trne7 /0# An0pa3h, (>$ P#%! $':$, $':& ?$+=>B#


26/28


27/28

&> Stoc8ha) /0# Hall, supranote %+#

&+ $ A) Jr %!, ($' ?$+>+B#

(: TSN, Janar7 $', $+>>, p# '#

($ TSN, No/e)*er $(, $++:, p# $$#

(% TSN, cto*er +, $++:, p# $'#

(' STELTIN" an! .ILLER, ASICS F ANESTHESIA, $:' ?$++&B#

(& Ibid#

(( Id# at $:( ?E)pha0i0 0pplie!B#

( id# at $:#

(= Id#

(> TSN, No/e)*er $(, $++:, p# #

(+ Con0triction o1 the air pa00a3e0 o1 the ln3 *7 0pa0)o!ic contraction o1 the *ronchial)0cle0 ?a0 in a0th)aB#

: Per)anent !a)a3e to the *rain ca0e! *7 ina!eGate o@73enation#

$ TSN, Fe*rar7 %>, $++$, pp# $:-$$#

% Rle $':, RULES F CURT#

' $ A) Jr %!, supranote &+, ($#

& LAC59S LA DICTINAR4 ?FIFTH EDITINB, $$:' ?$+=+B#

( Ibid#

It i0 a *li0h coloration o1 the 08in or )co0 )e)*rane0 ca0e! *7 lac8 o1 o@73enor a*nor)al he)o3lo*in in the *loo!#

= TSN, .arch %=, $++:, p# %%#

> Recor!0, p# %=

+ FINUCAINE, AIRA4 .ANA"E.ENT, >% ?$++:B#

=: Ibid#


28/28

=$ Id# The *oo8 pro/i!e0 a thoro3h !i0c00ion on the )ana3e)ent o1 !i11icltint*ation0#

=% Id#

=' Un!er thi0 !octrine, the 0r3eon i0 li8ene! to a 0hip captain who )0t not onl7 *ere0pon0i*le 1or the 0a1et7 o1 the crew *t al0o o1 the pa00en3er0 o1 the /e00el# The hea!

0r3eon i0 )a!e re0pon0i*le 1or e/er7thin3 that 3oe0 wron3 within the 1or corner0 o1the operatin3 roo)# It ennciate0 the lia*ilit7 o1 the 0r3eon not onl7 1or the wron31l

act0 o1 tho0e who are n!er hi0 ph70ical control *t al0o tho0e wherein he ha0 e@ten0iono1 control#

=& The ter) con0ltant i0 loo0el7 0e! *7 ho0pital0 to !i0tin3i0h their atten!in3 an!/i0itin3 ph70ician0 1ro) the re0i!ent0, who are al0o ph70ician0# In )o0t ho0pital0 a*roa!,

the ter) /i0itin3 or atten!in3 ph70ician, not con0ltant, i0 0e!#

=( The0e reGire)ent0 are in 1act 1on! in the 0tan!ar! application 1or)0 1or /i0itin3 an!atten!in3 ph70ician0 o1 re0pon!ent ho0pital#

= The ho0pital90 control o/er re0pon!ent ph70ician0 i0 all the )ore 0i3ni1icant when onecon0i!er0 the 1act that it control0 e/er7thin3 which occr0 in an operatin3 roo), thro3hit0 nr0in3 0per/i0or0 an! char3e nr0e0# No operation0 can *e n!erta8en withot the

ho0pital90 !irect or in!irect con0ent#

== 2ITU", C.PENDIU. F CI2IL LA AND JURISPRUDENCE, >%% ?$++'B#

=> Art# %$>: o1 the Ci/il Co!e pro/i!e0: Art# %%%&, CI2IL CDE#

>$ Shol! petitioner re)ain in the 0a)e con!ition 1or another ten 7ear0, the a)ontawar!e! in the 1or) o1 te)perate !a)a3e0 wol! in 1act, *e ina!eGate#

>% %(' SCRA ':' ?$++B#

>' Id# at '%=-'%>#

>& Id# at '%>#

The Lawphil Project - Arellano Law Fon!ation
http://www.lawphil.net/judjuris/juri1999/dec1999/gr_124354_1999.html#tophttp://www.lawphil.net/judjuris/juri1999/dec1999/dec1999.html

rogelio ramos vs ca

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