4.

MALPRACTICE

reasonably available to competent physician in the same

specialty or general field of practice in the Philippines.

1. A. Medical Malpractice is a particular form of negligence

which consists in the failure of a physician or surgeon to apply to

Locality Rule in Relation to Facilities: Duty based upon the

his practice of medicine that degree of care and skill which is

adept use of such medical facilities, services and equipment and

ordinarily employed by the profession generally under similar

options as are reasonably available.

conditions and in like surrounding circumstances.

Doctor-Patient Relationship - A physician-patient

Lost Chance Rule: Loss of chance is the lost opportunity

relationship is created when the professional services of a

for better result. The court must apportion damages by valuating

physician are rendered to and accepted by another for purposes

the chance of better result as a percentage of the value of the

of medical or surgical treatment. A contractual relationship.

entire life or limb.

Elements for Liability:

1. Duty A physician is under a duty to his patient to

Doctrine of Informed Consent Unless excused, the

exercise that degree of care, skill and diligence which

doctor must secure the consent of his patient to a particular

physicians in the same general neighborhood and in

treatment or an investigative procedure.

the same general line of practice ordinarily possess

and exercise in like cases.(Neighborhood Rule)
2. Breach There is a breach by the attending physician,
when the patient is injured in body or in health and
constitutes actionable malpractice.
3. Injury
4. Proximate Causation The negligence must be the
proximate cause of the injury.
Standard of Care: The doctor must use at least the same
level of care that any reasonably competent doctor would use to
treat a condition under the same circumstances.

The presence of doctor-client relationship must be

established before the doctrine of informed consent can be
applied. The SC ruled that the plaintiff must establish four
essential elements in a malpractice action based on the doctrine
of informed consent:
1. The physician had a duty to disclose material risks;
2. The physician 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;
4. The plaintiff was injured by the proposed treatment.

National Standards: Each physician may with reason and

fairness be expected to possess or have reasonable access to
such medical knowledge as is commonly possessed or

Professional Disclosure Standard: A charge of failure to

disclose should be judged by the standards of the reasonable

medical practitioner. Did the doctor disclose the information that,

by established medical practice, is required to be disclosed?

c. Where an employment relationship exists, the hospital may

be held vicariously liable under Art. 2176 in relation to Art.
2180.

Captain of the Ship Doctrine: The head surgeon, like a

ship captain, is made responsible for everything that goes wrong

Unlawful Restraint: A patient cannot be detained in a

within the four corners of the operating room. It enunciates the

hospital for non-payment of the hospital bill. However, the form

liability of the surgeon not only for the wrongful acts of those

of restraint must be total; movement must be restrained in all

who are under his physical control but also those wherein he has

directions.

extension of control.

The hospital may legally detain a patient against his will when he is a
detained or convicted prisoner, or when the patient is suffering from a very

Liability of Hospitals
a. When no employment relationship exists but it is shown that

contagious disease where his release will be prejudicial to public health, or when
the patient is mentally ill such that his release will endanger public safety or in
other exigent cases as may be provided by law.

the hospital holds out to the patient that the doctor is its
agent, the hospital may still be vicariously liable under Art.
2176.
b. The hospital may be held directly liable to the patient for its
own negligence or failure to follow established standard of
conduct to which it should conform as a corporation.
(Doctrine of Corporate Responsibility)
To use reasonable care in the maintenance of safe and adequate

facilities and equipment

To select and retain only competent physicians

B. Nurses
A nurse who assumes the care of a patient must exercise
that degree of skill, care and knowledge ordinarily possessed by
other nurses under the same circumstances.
Medical Error a preventable event that may cause or lead to
inappropriate use or patient harm while the medication is in the control of the
health care professional, patient or consumer.
Negligence of a nurse concurs with the negligence of the doctor, in
which case, the two of them are jointly and severally liable as tortfeasor.

To oversee as to patient care all persons who practice medicine

within its walls

To formulate, adopt, and enforce adequate rules and policies to

ensure quality care for its patients.

The hospital as a corporate entity may be direct and primary and not

merely vicarious.
It may only appropriately arise from law, contract and/or quasicontract

C. Pharmacists
Cause of action against pharmacists by a patient who has
been harmed through medication use is based on negligence
principle although strict liability and breach warranty may also be
used in proper cases.

Degree of Care: The highest degree of care and diligence

is expected of pharmacists. The highest degree of practicable

The accountant is liable based on contract and quasi-

degree of prudence, thoughtfulness, and vigilance, and the most

delict for any negligent act that caused damage or injury to its

exact and reliable safeguards consistent with the conduct of the

client. The standard to be applied is that of an ordinary

profession, in order that human life may not constantly be

accountant skilled in the knowledge, science skill and practice of

exposed to the danger flowing from the substitution of harmful

accounting rendering his professional services for his or her

medicines to harmless ones.

client.
Independent Auditors: In providing such service,

D. Clinical Laboratories
Their business is impressed with public interest, as such,
high standards of performance are expected from them.
2. Negligence of Lawyers
Code of Professional Responsibility: This Code
governs the conduct of lawyers.
The lawyers liability may not be based solely on that fact
that his client lost the case.

auditors may be held liable for breach of contract and

negligence; they may also be made liable for any perpetration of
fraud upon an unsuspecting client.
Standard of Care: An independent auditor hired by a
client and on whom the client reposed his trust and confidence is
expected to perform precisely those functions and apply the
appropriate procedures in accordance with generally accepted
auditing principles.

Proof of damage on the clients is necessary before being

able to recover for damages and imposing a liability on the
lawyer.

Liability regarding audited financial statements:

The duty is owed to those foreseeable users who received the
audited statements from business entity for a proper business

3. Accountants and Auditors

Philippine Accountancy Act of 2004: The law that
regulates accountants.

purpose to influence a business decision of the user. The duty

extends to any third party to whom the accountant specifically
understands the reports will be shown for business purposes.