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Legal Medicine

Is that branch of medicine that applies,
medical and surgical concepts, scientific knowledge and
skills to medico legal issues, in order to assist the trier of
facts in the proper dispensation of justice.
Medical Jurisprudence
is the study of the Medical Law and its
applicable Jurisprudence that governs, regulates and
defines the practice of medicine.
I. INTRODUCTION: THE FILIPINO PHYSICIAN
Medical education in the Philippines is principally
ofered and developed by accredited and government
recognized me dical schools in the country. The Philippine
medical schools are graduate schools ofering the Do ctor o f
Me dicine (M.D.) degree. The M.D. is a four-year
profe ssional de gree program which qualifies the degree
holder to take the licensure exam for medical doctors in
the Philippines.
Professiona l med ical degree
The Doct or of Med ic ine (M.D.) is a four-year
profe ssio nal de gree program dealing with me dical
t heories, practices, technologies, and problem
solving.
The completion of the degree program with one-year
postgraduate internship qualifies a candidate to take the
licensure exam for medical doctors in the Philippines.
After becoming a licensed doctor, a Physician may choose
to stop there and start earning as a G.P. (general
physician), or be a residence doctor or take a speciality in
a field he or she wants which will take almost 4-5 years
(for training.)
Admiss ion t o medical schools
Before applying to any medical school, a candidate must
earn
a bache lor's de gree with credits in certain required
subjects. The most common pre-medical degrees
include
biology, pharmacy, me dical te chnology, biochemistry,
nursing,
and physical therapy.
In addition, a candidate must take the Nationa l Medical
Admission Test (NMAT), the national entrance exam for
all medical schools in the Philippines.
PRACTIC E OF MEDIC INE
1. PRC vs De Guzman (G.R. No. 144681, June 21,
2004) DOCTRINE: Until the moral and mental fitness of
the respondents could be ascertained, according to
petitioners, the Board has discretion to hold in abeyance
the administration of the Hippocratic Oath and the issuance
of the certificates to them. The writ of mandamus does not
lie to compel performance of an act which is not duly
authorized.
The respondents nevertheless argue that under Section 20,
the Board
shall not issue a certificate of registration only in the
following instances: (1) to any candidate who has been
convicted by a court of competent jurisdiction of any
criminal ofense involving moral turpitude; (2) or has been
found guilty of immoral or dishonorable conduct after the
investigation by the Board; or (3) has been declared to be
of unsound mind. They aver that none of these
circumstances are present in their case.

Petitioners reject respondents argument. Section
8 [30] of Rep. Act No. 2382 prescribes, among
others, that a person who aspires to practice
medicine in the Philippines, must have satisfactorily
passed the corresponding Board Examination. Section
22, in turn, provides that the oath may only be
administered to physicians who qualified in the
examinations. The operative word here is
satisfactorily, defined as suficient to meet a condition or
obligation or capable of dispelling doubt or ignorance.
Gleaned from Board Resolution No. 26, the licensing
authority apparently did not find that the respondents
satisfactorily passed the licensure examinations. The Board
instead sought to nullify the examination results obtained
by the respondents.
2. DECS vs San Diego (GRN 89572, December 21, 1989)
FACTS: Roberto Rey San Diego, the private respondent is a
graduate of the University of the East with a degree of
Bachelor of Science
in Zoology. The petitioner claims that he took the NMAT
three times and flunked it as many times.
ISSUE: Petition whether the private respondent who has
thrice failed the National Medical Admission Test(NMAT)
is entitled to take it again as it is a requirement for
admission to any Medical School in the Philippines. He
invoked of his constitutional rights to academic freedom
and quality education, squarely challenging the
constitutionality of MECS Order No. 12, Series of 1972.
HELD:The private respondent cannot take the NMAT
again and pursue his medical profession because of the
following grounds:
F o r t h e p ur p o se of g a u g i n g at l e a s t i n i t i a l l y b y
the
a d m i s s i o n t e s t a n d by t h e t h r e e - f l u n k r u l e , a
student shall
not be allowed to take the NMAT again after three
successive failures.
The State ensures that medical profession is not
permeated by incompetents to whom patients may
unwarily hand over their lives and health.
It is not enough to simply invoke the right to quality education as
a guarantee of the Constitution, while one has the right to
aspire to be a doctor, he does not have the constitutional
right to be a doctor; one must show that he is entitled to it
because of his preparation and promise.
The conflict that the challenged rule vi
o l a t e s t h e e q u a l p r o t e c t i o n c l a u s e is n o
t w e l l - t a k e n . Conformable to Article
III, Section 1 of the Constitution, a law does not have to
operate with equal force on all person or things
II. MEDICAL ACT OF 1959, CODE OF
ETHICS Objectives. This Act provides for
and shall govern
(a) the standardization and regulation of medical education;
(b) the examination for registration of physicians; and
(c) the supervision, control and regulation of the practice of
medicine in the Philippines.
For the purpose of implementing the provisions of this Act,
there are created the following agencies:
(1) the Board of Medical Education under the Department of
Education, and
(2) the Board of Medical Examiners (Board of
Medicine) under the Commissioner of Civil Service NOW
Professional Regulation Commission

treat. 6. To promulgate and prescribe and enforce necessary rules and regulations for the proper implementation of the foregoing functions. serving without any professional fee in any government or private hospital. or through the radio. 2. apparatus. The oficials acting as chairman and members of the Board of Medical Education shall hold office during their incumbency in their respective positions. any legally registered dentist engaged exclusively in the practice of dentistry. and 8. 7. determine and approve hospitals or some departments of the hospitals for training which comply with the minimum specific physical facilities as provided in subparagraph (b) hereof: and 6. the Dean of the College of Medicine. 3. or in places where the services of a duly registered physician. Limited practice wit hout any certif icate of registrat ion ( Section 12) 1. Physicians and surgeons from other countries called in consultation only and exclusively in specific and definite cases. as chairman. laboratories. operate or prescribe any remedy for any human disease. 3. 3. paid to him directly or through another. Nothing in this Act shall be construed to inhibit any college of medicine from establishing. deformity. either ofer or undertake by any means or method to diagnose. a record showing completion of a bachelor's degree in science or arts. Acts Const itut ing Pract ice of Medic ine (Sect ion 10) A person shall be considered as engaged in the practice of medicine (1) who shall. physical examine any person. instruments. any person who administers or recommends any household remedy as per classification of existing Pharmacy Laws. including student. Admiss ion require ments (Sect ion 7) The medical college may admit any student who has not been convicted by any court of competent jurisdiction of any offense involving moral turpitude and who presents 1. written or printed matter. Funct ions: (Sect ion 5) The functions of the Board of Medical Education shall be: 1. or (3) who shall use the title M. and any psychologist or mental hygienist in the performance of his duties. birth certificate. (2) has satisfactorily passed the corresponding Board of Examination and (3) is a holder of a valid Certificate of Registration duly issued to him by the Board of Medical Examiners. in addition to the preceding. advertisements. 2. any medical student duly enrolled in an approved medical college or school under training. a certificate of good moral character issued by two former professors in the college of liberal arts. injury. salary or reward in any form. To select. provided that he applies massage or other physical means upon written order or prescription of a duly registered physician. by means of signs. cards. limbs or other similar appliances or who is engaged in the mechanical examination of eyes for the purpose of constructing or adjusting eye glasses. injury. treat. 5. or provided that such application of massage or physical means shall be limited to physical or muscular development. regardless of the nature of the remedy or treatment administered. 5. 7.The Board of Med ical Education Its Funct ions The Board of Medical Education shall be composed of the 1. and diagnose. or those attached to international bodies or organization assigned to perform certain definite work in the Philippines provided they shall limit their practice to the specific work assigned to them and provided further . for compensation. 4. or even without the same. television or any other means of communication. 3. fee. a representative of the Philippine Medical Association. appliances.teacher ratio and curriculum. mental or physical condition or any ailment. any duly registered masseur or physiotherapist. (1) he is at least twenty-one years of age. and others. physical. the chairman of the Board of Medical Examiners or his duly authorized representatives. 5. to wit: buildings. spectacles and lenses. mental or physical condition. a Representative of the Association of Philippine Medical Colleges. 2. bed capacity for instruction purposes. any person who renders any service gratuitously in cases of emergency. 4. Secretary of Education or his duly authorized representative. To determine and prescribe the minimum number and the minimum qualifications of teaching personnel. a representative of the Council of Deans of Philippine Medical Schools. after his name. provided that he renders such service under the direct supervision and control of a registered physician. General practice of Medic ine (Art 3 Section 8) No person shall engage in the practice of medicine in the Philippines unless: 6. any duly registered optometrist who mechanically fits or sells lenses. equipment and supplies. 2. 4. operating and delivery rooms. as members. Exempt ions (Sect ion 11): The preceding section shall not be construed to afect 1. artificial eyes. real or imaginary. University of the Philippines. To determine and prescribe the number of students who should be allowed to take up the preparatory course taking into account the capacity of the diferent recognized colleges of medicine. other entrance requirements that may be deemed admissible. including hospitals. or (2) who shall. and 4. nurse or midwife are not available.D. used for didactic and practical instructions in accordance with modern trends. physical. a certificate of eligibility for entrance to a medical school from the Board of Medical Education. To determine and prescribe minimum requirements for admission into a recognized college of medicine. the Secretary of Health or his duly authorized representative. the Director of the Bureau of Private Schools or his duly authorized representative. To determine and prescribe requirements for minimum physical facilities of colleges of medicine. prescribed or recommended. provided such performance is done in conjunction with a duly registered physician. deformity. facilities for out-patient services. operate or prescribe any remedy for any human disease.

(3) Insanity. and (5) to promulgate. (12) Violation of any provision of the Code of Ethics as approved by the Philippine Medical Association. (8) Performance of or aiding in any criminal abortion. without requiring him or her to answer the same. Commissioned medical officers of the United States armed forces stationed in the Philippines while rendering service as such only for the members of the said armed forces and within the limit of their own respective territorial jurisdiction. Foreign physicians employed as exchange professors in special branches of medicine or surgery whose service may in the discretion of the Board of Medical Education. (3) to exercise the powers conferred upon it by this article with the view of maintaining the ethical and professional standards of the medical profession. clinic hours. After two years. correction of examination papers. (11) Aiding or acting as a dummy of an unqualified or unregistered person to practice medicine. (1) Conviction by a court of competent jurisdiction of any criminal ofense involving moral turpitude. such rules and regulations as it may deem necessary for the performance of its duties in harmony with the provisions of this Act and necessary for the proper practice of medicine in the Philippines. are mentioned. during the same period. and registration of physicians Section 22. The decision of the Board of Medical Examiners (Board of Medicine) shall automatically become final thirty days after the date of its promulgation unless the respondent. limitation of practice. has appealed to the Professional Regulation Commission and later to the Court of Appeals. shall promulgate such rules and regulations as may be necessary for the proper conduct of the examinations. or may file in court a petition for certiorari. Section 27. Suspension or revocation of license Quantum of Evidence: Substantial Evidence Jurisdiction: Board of Medicine. graduates of medicine and registered nurses who may be given limited and special authorization by the Secretary of Health to render medical services during epidemics or national emergencies whenever the services of duly registered physicians are not available. (10) Issuing any statement or spreading any news or rumor which is derogatory to the character and reputation of another physician without justifiable motive. ignorance or incompetence in the practice of his or her profession resulting in an injury to or death of the patient. (7) False or extravagant or unethical advertisements wherein other things than his name. be necessary. (2) Immoral or dishonorable conduct. a physician’s profession is temporarily withdrawn from him to protect future patients. Medical students who have completed the first four years of medical course. Administrative Liability A practice of medicine is a privilege and not a right. with the approval of the Commissioner of Civil Service. Administrative liabilities 2. Philippine Medical Association Example: Non-compliance of National and Local laws which include Sanitary Code. Fire Code etc ii. ofice and home address.they shall secure a previous authorization from the Board of Medical Examiners. SECT ION 24. 3. GR OU NDS FOR REPR IMA ND. A ppeal from judgment. the Board may order the reinstatement of any physicians whose certificate of registration has been revoked. Pr ocedure and rules . 2. the Board of Medical Examiners shall perform the following duties: (1) to administer oath to physicians who qualified in the examination. or to any form of gambling. Criminal Liability . Refusal of a physician to attend a patient in danger of death is not a sufficient ground for revocation or suspension of his registration certificate if there is a risk to the physician's life. (6) Addiction to alcoholic beverages or to any habit forming drug rendering him or her incompetent to practice his or her profession. (9) Knowingly issuing any false medical certificate. If the final decision is not satisfactory. immoral or dishonorable act. if the respondent has acted in an exemplary manner in the community wherein he resides and has not committed any illegal. Professional Regulatory Commission (Quasijudicial body). LIABILITIES OF PHYSICIANS Kinds of Liabilit ies of P hys ic ians : 1. the respondent may ask for a review of the case. hence it could be taken away from the physician. DUE PR OCESS: Sect ion 23. A dministrative invest igat ions . Section 26. III. Penalty: Reprimand. with the approval of the Professional Service Commission. and the Board shall conduct the investigation within five days after the receipt of such copy by the respondent. Civil liabilities 3. SU SPE NSION OR REVOCAT ION OF REGIS TRAT ION CERT IFICA TE. Within five days after the filling of written charges under oath. Such authorization shall automatically cease when the epidemic or national emergency is declared terminated by the Secretary of Health. (4) Fraud in the acquisition of the certificate of registration. (4) to subpoena or subpoena duces tecum witnesses for all purposes required in the discharge of its duties. profession. (5) Gross negligence. (2) to study the conditions afecting the practice of medicine in all parts of the Philippines. 4. the respondent physician shall be furnished a copy thereof. In administrative liabilities. Funct ions of t he Board of Med ical Examiners (B oard of Med ic ine) The Board of Medical Examiners. The investigation shall be completed as soon as practicable. In addition to the functions provided for in the preceding sections. Criminal liabilities i. Re instatement .

 Key elements (Employeremployee relationship): 1. MATERIAL AND COMPETENT EVIDENCE. or its agent. Acts or omissions constituting a crime can be done with deceit (deliberate intent) and fault (negligence. The Physician must present RELEVANT. Wages 4.  If physician is an employee.-For Acts or Omissions constituting a crime. Control  How to make a hospital under the doctrine of apparent authority liable General Rule: A hospital is not liable for the negligence of an inde pende nt contractor-physician. acted in a manner that would lead a reasonable person to conclude that the individual who was alleged to be negligent was an employee or agent of the hospital. Ordinary testimony is restricted to statements concerning what the witness actually saw or heard. fines (from Special Laws/ RPC) Quantum of Evidence: Proof beyond reasonable doubt Jurisdiction: Regular Courts iii. the hospital may be held liable. As an expert witness he is allowed to express an opinion about the validity of the evidence in a case and may quote the statements of other experts in support of an opinion. It may include moral or punitive damages. MEDICAL NEGLIGENCE CASES LEGAL MEDIC INE A ND T HE LEGAL S YSTEM Courts routinely call upon physicians to give expert testimony in a trial.  Physicians are not employees but are considered as individual contractors. Penalty: Damages (NCC Arts 19-21 or Article 2176 Torts) Quantum of Evidence: Preponderance of Evidence Jurisdiction: Regular Courts IV. Firing 3. imprudence. Penalty: Imprisonment. lack of skill/foresight). Hiring 2. Civil Liability Civil liabilities make a physician liable to compensate the patient for the injury he sufered on account of his wrongful act or breach of contract. . HUMAN BODY V. especially concerning the findings of an autopsy and the results of laboratory tests. XPT: When physician is the "ostensible" agent of the hospital (doctrine of apparent authority) Requisites for the doctrine to apply: (1) the hospital. The evidence to be presented by the legal medicine expert must signify a relation between the facts called the “ Factum Probandum” or proposition to be established and the “ factum Probans” which is the material evidencing the proposition.

(2) where the acts of the agent create the appearance of authority. and (3) the injury sufered must not have been due to any voluntary action or contribution of the person injured. (2) the instrumentality or agency which cause d the injury was under the exclusive control of the person in charge. (4) Matter of convenience on the part of the injured party MEDICAL NEG LIGENC E CASES 3. A droplight can cause burn on the skin even just for ten (10) minutes. it must be gross negligence. about four (4) inches long.R. Nora experienced hypoglemic shock. The attending physician and her team performed the necessary steps to stop the bleeding. Dr. Forms 2. . Corporate Negligence: How to make physician liable o Captain of the Ship Doctrine  Still applicable in the Philippines though western countries are not applying the same.  Acting as an agent of the hospital 1. the plaintif must also prove that the hospital had knowledge of and acquiesced in them. Go (G. April 27. Thye filed a complaint for damages against the doctor and the hospital. Nora’s husband noticed a gaping wound on Nora’s left arm. Cantre vs. 160889.  Standard of care: failure to follow it must be established  Pre-operative procedure  Expert witness: to establish failure to follow standard of care o Same expertise as the accused o Preferably from the same locality  o EXCEPTION: res ipsa loquitur The injury of the patient is suficient Common sense will tell you that there was negligence Four (4) elements: (1) the accident was of a kind which does not ordinarily occur unless someone is negligent. 2007) FACTS: Hours after giving birth to her fourth child.  Mistakes not automatically negligence  Negligence is not sufficient. consistent with ordinary care and prudence. Waiver 3. The spouses went to the NBI for physical examination and found out that it was a burn caused by the droplight. No. o LEGAL BASIS:  Law on Agency  Negligent Act of an agent. After the operation. principal may be held liable. He asked the physician what caused the wound and he replied that it was due to the blood pressure cuf. The nurse forgot to remove the droplight. and (3) the plaintif acted in reliance upon the conduct of the hospital or its agent. The doctor said it was the nurse’s fault. List of physicians 5. Prescription pad 4. He used a droplight to warm Nora and her baby.

she discovered that a piece of rubber material. HELD: YES. since both are within the exclusive control of the physician in charge [Dr. Cantre] under the captain of the ship doctrine [surgeon in charge of an operation is held liable for his assistants' negligence during the time when they are under the surgeon's control]. Batiquin vs Court of Appeals (GRN 118231. The petitioners. The abdominal pains and fever kept on recurring and this prompted respondent to consult with another doctor. 1996) FACTS: On Sept 1988. Respondent then sued petitioner for damages. Batiquin performed a simple caesarean section on Respondent Mrs. First. failed to overcome the presumption of negligence arising from resort to the doctrine ofres ipsa loquitur. 4. needless to say. does not occur unless through the intervention of negligence. provided that the following requisites concur: Accident is of a kind which ordinarily does not occur absent someone's negligence The wound not an ordinary occurrence in the act of delivering a baby. In this light. Dr. Petitioner Dr. could not have happened unless negligence set in somewhere caused by an instrumentality within defendant's exclusive control It doesn't matter WON the injury was caused by the droplight or by the blood pressure cuf. Res ipsa loquitur. Kho opened the abdomen of respondent to check her out respondent’s infection. ISSUES: Whether petitioner is liable to respondent.. her good intentions characteristics do not justify negligence. which arises upon proof that the instrumentality causing injury was in defendant's exclusive control. the entire proceedings of the cesarean section were under the exclusive control of Dr. Batiquin is therefore liable for negligently leaving behind a piece of rubber in private respondent Villegas' abdomen and for all the adverse efects thereof. private respondent Villegas underwent no other operation which could have caused the ofending piece of rubber to appear in her uterus. respondent began to sufer abdominal pains and complained of being feverish. When Dr. CA reversed. Rebuttable presumption or inference that defendant was negligent. which looked like a piece of rubber glove and was deemed a foreign body. In the instant case. in this regard. and that the accident was one which . which.ISSUE: Is the petitioner liable for the injury sustained by Nora Go? HELD: YES. RTC held in favor of petitioner. was the cause of the respondent’s infection. the doctrine of res ipsa loquitur allows the mere existence of an injury to justify a presumption of negligence on the part of the person who controls the instrument causing the injury. ruling for the respondent. it stands to reason that such could only have been a byproduct of the cesarean section performed by Dr. Soon after leaving the hospital. DR. Res ipsa loquitur x Medical negligence cases In medical negligence cases. The doctrine of [r]es ipsa loquitur as a rule of evidence is peculiar to the law of negligence which recognizes that prima facie negligence may be established without direct proof and furnishes a substitute for specific proof of negligence. Batiquin. Second. UNDER THE RULE OF RES IPSA LOQUITUR. Kho. The thing speaks for itself. BATIQUIN IS LIABLE. since aside from the cesarean section. Dr. Villegas when the latter gave birth. all the requisites for recourse to the doctrine are present. July 5. Still. Batiquin. the private respondents were bereft of direct evidence as to the actual culprit or the exact cause of the foreign object finding its way into private respondent Villegas' body.

The doctrine is not a rule of substantive law. Due to persistent and profuse vaginal bleeding. the entire proceedings of the caesarean section were under the exclusive control of Dr. Batiquin is therefore liable for negligently leaving behind a piece of rubber in private respondent Villegas's abdomen and for all the adverse efects thereof. which. The rule. private respondent Villegas underwent no other operation which could have caused the ofending piece of rubber to appear in her uterus. Under this doctrine the happening of an injury permits an inference of negligence where plaintif produces substantial evidence that the injury was caused by an agency or instrumentality under the exclusive control and management of defendant. Editha was admitted to the LMC on the same day. The doctrine can be invoked when and only when. Upon advice of petitioner relayed Via telephone. under the circumstances involved. all the requisites for recourse to the doctrine are present. since aside from the caesarean section. The following day. does not occur unless through the intersection of negligence. direct evidence is absent a n d n o t readily available. 159132. three months pregnant Editha Ramolete was brought to the Lorma Medical Center (LMC) in San Fernando. On September 16. The doctrine of res ipsa loquitur as a rule of evidence is peculiar to the law of negligence which recognizes that prima facie negligence may be established without direct proof and furnishes a substitute for specific proof of negligence. Second.R. 2008) FACTS: On July 28. direct evidence as to the actual culprit or the exact cause of the foreign object finding its way into private respondent Villegas's body. petitioner advised Editha to undergo a Dilatation and Curettage Procedure (D&C) or "raspa. Ramolete (G.ordinary does not happen in absence of negligence. the private respondents were bereft of . In this light. 1994. Batiquin. but merely a mode of proof or a mere procedural convenience. It merely determines and regulates what shall be prima facie evidence thereof and facilitates the burden of plaintiff of proving a breach of the duty of due care. No. She was found to have a massive intra-abdominal hemorrhage and a ruptured uterus. Editha had to undergo a procedure for hysterectomy and as a result. Editha was once again brought at the LMC. First. Dr. no fetal movement was also appreciated. A pelvic sonogram was then conducted on Editha revealing the fetus’ weak cardiac pulsation. Thus. Res ipsa loquitur is a rule of evidence whereby negligence of the alleged wrongdoer may be inferred from the mere fact that the accident happened provided the character of the accident and circumstances attending it lead reasonably to belief that in the absence of negligence it would not have occurred and that thing which caused injury is shown to have been under the management and control of the alleged wrongdoer. when applicable to the facts and circumstances of a particular case." The procedure was performed by the petitioner and Editha was discharged the next day. December 18. is not intended to and does not dispense with the requirement of proof of culpable negligence on the party charged. 5. as she was sufering from vomiting and severe abdominal pains. and that the occurrence was such that in the ordinary course of things would not happen if reasonable care had been used. Fe Lasam vs. In the instant case. needless to say. Editha’s repeat pelvic sonogram showed that aside from the fetus’ weak cardiac pulsation. Batiquin. it stands to reason that such could only have been a by-product of the caesarean section performed by Dr. 1994. La Union due to vaginal bleeding. failed to overcome the presumption of negligence arising from resort to the doctrine of res ipsa loquitur. respondent. in this regard. she has no more chance to bear a child. The petitioners.

after the D&C was conducted. Estrada is not CMC’s employee. weak and injured condition. technically employees. respondents did not present any expert testimony to support their claim that petitioner failed to do something which a reasonably prudent physician or surgeon would have done. and the right to terminate consultants all fulfill the important hallmarks of an employer-employee relationship. that whether or not a D&C procedure was done by her or any other doctor. visit or administer medication on Editha during her first day of confinement at the LMC. Petitioner recommended that a D&C procedure be performed on Editha without conducting any internal examination prior to the procedure. and (3) the plaintif acted in reliance upon the conduct of the hospital or its agent. whenever it appears from the evidence in the case that the act or omission played a substantial part in bringing about or actually causing the injury or damage. Contributory negligence is the act or omission amounting to want of ordinary care on the part of the person injured. and that the injury or damage was either a direct result or a reasonably probable consequence of the act or omission. Estrada applied low forceps to extract Corazon's baby. 2006) FACTS: Dr. the immediate and proximate cause of the injury being the defendant’s lack of due care. acted in a manner that would lead a reasonable person to conclude that the individual who was alleged to be negligent was an employee or agent of the hospital. the respondent could have examined her thoroughly. we rule that for the purpose of allocating responsibility in medical neglige nce cases. a cervical tissue was allegedly torn. the hiring. he cannot recover damages for the injury. An injury or damage is proximately caused by an act or a failure to act. Petitioner: it was Editha’s gross negligence and/or omission in insisting to be discharged against doctor’s advice and her unjustified failure to return for check-up as directed by petitioner that contributed to her life-threatening condition on. Estrada 2) whether CMC is vicariously liable for the negligence of Dr. The baby came out in an apnic. Dr. but the courts shall mitigate the damages to be awarded. Capitol Medical Center (G. and in like surrounding circumstances.R. 1994 which is about 1½ months after the patient was discharged. In the present case. which contributed to the principal occurrence as one of its determining factors. the uterus would rupture just the same. (2) where the acts of the agent create the appearance of authority. which was an extremely rare and very unusual case of abdominal placental implantation. The husband sued CMC and the doctors. Applying the control test.1994. Had she returned. the plaintif must also prove that the hospital had knowledge of and acquiesced in them. 142625. Augusto M.Respondents: Petitioner’s failure to check up. The defenses in an action for damages. It is evident that the D&C procedure was not the proximate cause of the rupture of Editha’s uterus. While "consultants" are not. But if his negligence was only contributory. XPT: When physician is the "ostensible" agent of the hospital (doctrine of apparent authority) Requisites for the doctrine to apply: (1) the hospital. on the basis of the foregoing. He testified that the rupture occurred minutes prior to the hysterectomy or right upon admission on September 15. However. ISSUES: 1) Whether an employee-employer relationship existedbetween CMC and Dr. that Editha’s hysterectomy was brought about by her very abnormal pregnancy known as placenta increta. HELD: Medical malpractice is a particular form of negligence which consists in the failure of a physician or surgeon to apply to his practice of medicine that degree of care and skill which is ordinarily employed by the profession generally. SC did not find evidence pointing to CMC's exercise of control over Dr. unbroken by any eficient intervening cause. concurring with the defendant’s negligence is the proximate cause of the injury. December 19. Estrada to use its facilities when Corazon was about to give birth. General Rule: A hospital is not liable for the negligence of an inde pe nde nt contractor-physician. Two Factors to consider: 1) An inquiry on whether the hospital acted in a manner which would lead a reasonable person to conclude that the individual who was alleged to be negligent was an employee or agent of the hospital. the plaintif may recover damages. Proximate cause has been defined as that which. Petitioner immediately suggested a D&C procedure instead of closely monitoring the state of pregnancy of Editha. consistent with ordinary care and prudence. Rogelio Nogales vs. In assessing whether such a relationship in fact exists. No. Complainant failed to do so. Manalo. which. in natural and continuous sequence. injury and proximate causation. or its agent. Estrada HELD: In Ramos vs. there would be no diference at all because at any stage of gestation before term. But while SC held that Dr. presented the testimony of Dr. There are four elements involved in medical negligence cases: duty. fire and exercise real control over their attending and visiting "consultant" staf. The hospital need not make express representations to the . an employer-employee relationship in efect exists between hospitals and their attending and visiting physicians. breach. Estrada. CMC merely allowed Dr. In the process. the control test is determining. Estrada's treatment and management of Corazon's condition. who was clearly an expert on the subject. This being the case. Dificulty seems to be apprehended in deciding which acts of the injured party shall be considered immediate causes of the accident. provided for under Article 2179 of the Civil Code are: When the plaintiff’s own negligence was the immediate and proximate cause of his injury he cannot recover damages. Where the immediate cause of an accident resulting in an injury is the plaintif’s own act. CMC is vicariously liable under the doctrine of apparent authority. The Court notes the findings of the Board of Medicine: When complainant was discharged on July 31. This advice was clear in complainant’s Discharge Sheet. produces injury. Petitioner. Estrada is an independent contractor. cyanotic. The patient was under the exclusive prenatal care of Dr. weheld: In other words. 6. which CMC considered an emergency. and without which the result would not have occurred. the control exercised. 1994 or four (4) day s after the D&C. The bab survived. CA. on the other hand. Accordingly. herein respondent advised her to return on August 4. but the mother died of profuse vaginal bleeding. private hospitals. hire. the chain of continuity as required in order that the doctrine of proximate cause can be validly invoked was interrupted. under similar conditions. with the exception of the payment of wages.

.

Asian Hospital. thus: FACTS: Professional Services. Hosaka. Manila Medical Services. Hosaka. 8. Petitioner Erlinda was admitted to the DLSMC the day before the scheduled operation. Espinola. in reality it utilizes doctors. her sister-in-law. not under the principle of respondeat superior for lack of evidence of an employment relationship with Dr. petitioner Erlinda said to Cruz. Estrada's services 7. it being enough that it has the right to wield the power. (MMSI). Hosaka. after gathering its thoughts on the issues. who remarked that he was also tired of waiting for Dr. Gutierrez informed Cruz that the operation might be delayed due to the late arrival of Dr. or more than three (3) hours after the scheduled operation. Estrada. Court of Appeals (G. At around 9:30 in the morning. under the principle of corporate negligence for its failure to perform its duties as a hospital. He met Dr.patient that the treating physician is an employee of the hospital. "Mindy. No. Inc. unless modified. **That petitioner exercised control over respondents gains light from the undisputed fact that in the emergency room. which consisted of 24-hour shifts totaling forty-eight hours each week and which were strictly to be observed under pain of administrative sanctions. Dr. was allowed to accompany her inside the operating room. The operation was scheduled for June 17. inip na inip na ako. Agana (G. 2) Rogelio testified that he and his wife specifically chose Dr. nonetheless made the following pro hac vice doctrinal pronouncements on the liability of the respondent hospital based on the doctrines of “ostensible agency” and “corporate negligence”.employee relationship between. Miguel Ampil. regardless of its relationship with the doctor. 2002) FACTS: Erlinda Ramos. the hospital may be held vicariously liable under Article 2176 in relation to Article 2180 of the Civil Code or the principle of respondeat superior. 126297. rather a representation may be general and implied. In the meantime. CMC extended its medical staf and facilities to Dr. Gutierrez. when Dr. petitioner Erlinda was already being prepared for operation. Professional Services vs. as determined by petitioner through its medical director. Since neither petitioner Erlinda nor her husband. Estrada's relationship with CMC played a significant role in the Spouses Nogales' decision in accepting Dr. Dr. For control test to apply. **Where an employment relationship exists. the assailed decision and resolution will jeopardize the financial viability of private hospitals and jack up the cost of health care.R. **Under the "control test". private respondents maintained specific work-schedules. While in theory a hospital as a juridical entity cannot practice medicine. Ramos vs. Gutierrez tried to get in touch with him by phone. the hospital may still be vicariously liable under Article 2176 in relation to Article 1431 and Article 1869 of the Civil Code or the principle of apparent authority. ikuha mo ako ng ibang Doctor. surgeons and medical practitioners in the conduct of its business of facilitating medical and surgical treatment. 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. 2010) In this case. who was then the Head of the Obstetrics and Gynecology Department of CMC. Estrada's referral of Corazon's profuse vaginal bleeding to Dr. Dr. who was then still inside the operating room. 1985 at 9:00 in the morning at private respondent De Los Santos Medical Center (DLSMC). who was then Dean of the College of Nursing at the Capitol Medical Center. Cruz . Hosaka had not yet arrived so Dr. Dr. 124354 . Herminda Cruz. HELD: YES." In other words. while affirming the existing doctrine that hospitals as a general rule are not civilly liable for the tortuous acts of their medical consultants in view of the absence of an employer. charge nurses and orderlies. but more importantly because of Dr. While she held the hand of Erlinda. (PSI) filed a second motion for reconsideration urging referral thereof to the Court en banc and seeking modification of the decision dated January 31. the CMC. Hosaka finally arrived at the hospital at around 12:10 in the afternoon. Thereafter. Ampil and. She was referred to Dr. an employment relationship exists between a physician and a hospital if the hospital controls both the means and the details of the process by which the physician is to accomplish his task. it is not essential for the employer to actually supervise the performance of duties of the employee. a surgeon. (AHI). Garcia. 2) An inquiry on whether the plaintif acted in reliance upon the conduct of the hospital or its agent. Estrada as a member of CMC's medical staff was collaborating with other CMCemployed specialists in treating Corazon. No one from CMC informed the Spouses c) Dr. the patient. no operations can be undertaken in those areas. petitioner Rogelio already wanted to pull out his wife from the operating room.R. who agreed to perform the operation on her. a) CMC granted staf privileges to Dr. As priorly stated. Dr. Estrada's "connection with a reputable hospital. gave the impression that Dr. Inc. Without the approval or consent of petitioner or its medical director. consistent with ordinary care and prudence. Moreover. Estrada. 2007 and resolution dated February 11. These forms did not indicate that he was an independent contractor-physician. No. Cruz. Hosaka was still not around. respondents' work is monitored through its nursing supervisors. Ampil but under the principle of ostensible agency for the negligence of Dr. was advised to undergo an operation for the removal of a stone in her gall bladder (cholecystectomy). b) CMC made Rogelio sign consent forms printed on CMC letterhead. ISSUE: Whether or not Professional Services Inc. 2008 which affirmed its vicarious and direct liability for damages to respondents Enrique Agana and the heirs of Natividad Agana (Aganas). April 11. Hosaka recommended to them the services of Dr." By 10:00 in the morning. after seeking professional medical help. knew of any anesthesiologist. Estrada to handle Corazon's delivery not only because of their friend's recommendation. or any department or ward for that matter. this Court holds that PSI is liable to the Aganas. petitioner Rogelio. the operating room. heard about Dr. has been erred to be held liable for the Negligence of Dr. Upon the request of petitioner Erlinda. By 7:30 in the morning of the following day. Application of these factors to this case: 1) CMC impliedly held out Estrada as a member of its medical staf. and Private Hospital Association of the Philippines (PHAP) all sought to intervene in these cases invoking the common ground that. pro hac vice. February 2. the Court. Inc. Even when no employment relationship exists but it is shown that the hospital holds out to the patient that the doctor is its agent. Hosaka’s arrival.

ISSUE: Whether or not Drs. Dr. Blood was finally transfused on Raymond at 1:40 A. ORLINO HOSAKA (SURGEON) IS LIABLE FOR NEGLIGENCE. after all. the Supreme Cord reverse the finding of liability on the part of DLSMC for the injury sufered by petitioner Erlinda. Calderon. this Court promulgated the decision which private respondents now seek to be reconsidered. For these reasons. Zafe and Cereno decided to defer the operation on Raymond. urther.M. a woman who was giving birth to triplets and was brought to the operating room with the only anaesthesiologist. 1999. the trial court found that private respondents were negligent in the performance of their duties to Erlinda. Hosaka instruct someone to call Dr. the following issues were resolved as follows: 1) Dr. in the performance of his duties. Hence this appeal. 9. Cereno did not immediately transfuse the blood since the bleeders had to be controlled first. Drs. Parents of Raymond filed a case against the doctors. AND 3. Gutierrez trying to intubate the patient. O lumalaki ang tiyan. RULING: In the case at bar. PERFECTA GUTIERREZ (ANESTHESIOLOGIST) IS LIABLE FOR NEGLIGENCE. giving them always his best talent and skill. Cereno and Zafe started their operation on Raymond at around 12:15 A. upon opening of Raymonds thoracic cavity. the Court finds that respondent hospital’s position on this issue is meritorious. Dr.. Gutierrez and Hosaka which would hold DLSMC solidarily liable for the injury sufered by petitioner Erlinda under Article 2180 of the Civil Code. another anesthesiologist. Zafe and Cereno. The private respondents were then required to submit their respective comments thereon.M. during the operation. Cruz went out of the operating room to express her concern to petitioner Rogelio that Erlinda’s operation was not going well. or that he or she did something that a reasonably prudent provider would not have done. Gutierrez utter: "ang hirap ma-intubate nito. WHETHER OR NOT DR. a patient must prove that a health care provider. the hospital surgeons. Gutierrez’ claim of lack of negligence on her part is belied by the records of the case. The doctors explained to petitioner Rogelio that his wife had bronchospasm. Given that Dr. Raymond was brought inside the operating room. Erlinda remained in comatose condition until she died on August 3. Meanwhile. The nailbeds of the patient remained bluish. either failed to do something which a reasonably prudent health care provider would have done. thus. no evidence was adduced to show that the injury sufered by petitioner Erlinda was due to a failure on the part of respondent DLSMC to provide for hospital facilities and staf necessary for her treatment.saw Dr. . Cruz heard Dr. When he arrived. The doctors were found negligently liable. However. For During that time. Dr." 44 but also of Article 19 of the Civil Code which requires a person. Hosaka's irresponsible conduct of arriving very late for the scheduled operation of petitioner Erlinda is violative. proceeded to examine Raymond and they found that the latters blood pressure was normal and "nothing in him was significant. No. 2. 167366 September 26. Cruz quickly rushed back to the operating room and saw that the patient was still in trendelenburg position. Dr Tatad. to act with justice and give everyone his due. 1999. After some time." There being no other available anesthesiologist to assist them. At 11:15 P. she was placed in a trendelenburg position – a position where the head of the patient is placed in a position lower than her feet. On December 29. The type of lawsuit which has been called medical malpractice or. CA (G.M. She (Cruz) then heard Dr. medical negligence. After due trial. Zafe and Cereno. Drs. There is no question that Erlinda became comatose after Dr. Since the ill-fated operation. We find it reasonable that petitioners decided to wait for Dr. It must be proven that such breach of duty has a causal connection to the resulting death of the patient. another emergency case. On appeal by private respondents. WHETHER OR NOT THE HOSPITAL (DELOS SANTOS MEDICAL CENTER) IS LIABLE FOR ANY ACT OF NEGLIGENCE COMMITTED BY THEIR VISITING CONSULTANT SURGEON AND ANESTHESIOLOGIST. In order to successfully pursue such a claim. the court a quo rendered judgment in favor of petitioners. 3) After a careful consideration of the arguments raised by DLSMC. there is no cogent reason for the Court to reverse its finding that it was the faulty intubation on Erlinda that caused her comatose condition. Raymond died due to massive loss of blood. Cereno vs. they found that 3. Further. Petitioners filed with the Regional Trial Court of Quezon City a civil case for damages against private respondents. 2) Dr.R. At this point. There is no employeremployee relationship between DLSMC and Drs. Calderon attempted to intubate the patient. not only of his duty as a physician "to serve the interest of his patients with the greatest solicitude. She was released from the hospital only four months later or on November 15.M. were busy operating on gunshot victim. 1985. she saw Erlinda being wheeled to the Intensive Care Unit (ICU). more appropriately. and that the failure or action caused injury to the patient. There is.. Tatad was already engaged in another urgent operation and that Raymond was not showing any symptom of sufering from major blood loss requiring an immediate operation. Tatad to finish her surgery and not to call the standby anesthesiologist anymore. the Court of Appeals reversed the trial court’s decision and directed petitioners to pay their "unpaid medical bills" to private respondents. Gutierrez omitted to perform a thorough preoperative evaluation on Erlinda. ISSUES: 1. 2012) FACTS: At 10:30 P. Gutierrez performed a medical procedure on her.200 cc of blood was stocked therein. in most cases a physician. It has been sufficiently established that she failed to exercise the standards of care in the administration of anesthesia on a patient. At almost 3:00 in the afternoon. WHETHER OR NOT DR. HELD: NO. Petitioners filed with this Court a petition for review on certiorari. In medical negligence cases. Drs." Cruz noticed a bluish discoloration of Erlinda’s nailbeds on her left hand. Essentially. Erlinda stayed in the ICU for a month. it is settled that the complainant has the burden of establishing breach of duty on the part of the doctors or surgeons. mali yata ang pagkakapasok. is that type of claim which a victim has available to him or her to redress a wrong committed by a medical professional which has caused bodily harm. Drs. Zafe and Cereno are guilty of gross negligence in the performance of their duties. no evidence that shows that a prudent surgeon faced with similar circumstances would decide otherwise.

10. The elements of simple imprudence are as follows. simple negligence is resent if: (1) that there is lack of precaution on the part of the ofender. Dr. Jarcia vs. which is a direct and proximate result of the physician’s failure to disclose. In failing to perform an extensive medical examination to determine the extent of Roy Jr. Bastan) junior (general) residents of the said hospital conducted an X-ray of the victim’s ankle and it was alleged that the X-ray result showed no fracture (as read by Dr.R. And in accepting a case. Bastan were expected to know the medical protocol in treating leg fractures and in attending to victims of car accidents. Dissatisfied. represents that he has the needed training and skill possessed by physicians and surgeons practicing in the same field. Jarcia and Dr. (2) the physician’s failure to disclose. paraphrased as follows: (1) the physician’s duty to disclose material risks. Bastan and Dr. Jarcia and Dr. is generally a matter of expert opinion. Their assurance that everything is fine deprived the victim of seeking medical help. Dr. they should have referred the patient to another doctor with sufficient training and experience instead of assuring him and his mother that everything was all right. and (4) plaintif’s injury as a consequence the proposed treatment. (2) Whether or not the petitioner physicians are criminally negligent RULING: As to the first issue: The doctrine of res ipsa loquitur does not apply since the circumstances that caused patient Roy Jr. While it may be true that the circumstances pointed out by the courts below seem doubtless to constitute reckless imprudence on the part of the petitioners. No. Jarcia). Santiago brought him back to the hospital. was filed against Dr. Probable cause was found and a criminal case for reckless imprudence resulting to serious physical injuries. That the negligence exhibited by the two doctors does not approximate negligence of a reckless nature but merely amounts to simple imprudence. Thus. 11. No. that Dr. 187926 February 15. The decision was affirmed in toto by the CA. the need for petitioners to control first what was causing the bleeding. (3) the patient’s consent to the treatment she otherwise would not have consented to. and later assured the mother that everything was fine and that they could go home. Dr. Moreover. a physician-patient relationship is generated. Jarcia) and Dr. developed fever.Upon opening of his thoracic cavity. Soliman (G. the petitioners appealed to the CA. Bastan entered the emergency room(ER) and. Jr. there was no need to examine the upper leg. Bastan were remiss of their duties as members of the medical profession. They were found guilty beyond reasonable doubt of the crime of Simple Imprudence Resulting to Serious Physical Injuries. It was proven that a thorough examination was not performed on Roy Jr since as residents on duty at the emergency room. skill and diligence which physicians in the same general neighborhood and in the same general line of practice ordinarily possess and exercise in like cases. that the damage impending to be caused is not immediate of the danger is not clearly manifest. Jr. it was discovered that there was gross bleeding inside the body. and skill in the treatment of the patient. Simple imprudence consists in the lack of precaution displayed in those cases in which the damage impending to be caused is not the immediate nor the danger clearly manifest. Thus. Thus. of those risks. .ray revealed a right mid-tibial fracture and a linear hairline fracture in the shaft of the bone. Santiago that since it was only the ankle that was hit. informed Mrs. Stated otherwise. the physician has the obligation to use at least the same level of care that any other reasonably competent physician would use to treat the condition under similar circumstances. the physician. a physician is under a duty to exercise that degree of care. (Dr. Dr. Marilou Bastan (Dr. swelling of the right leg and misalignment of the right foot. since they are not the attending physicians but merely requested by the ER does not hold water. after conducting her own examination of the victim. Assuming for the sake of argument that they did not have the capacity to make such thorough evaluation at that stage. Petitioners were absolved in the criminal charge for the reason that a reasonable doubt existed but the are liable for damages. that eleven (11) days later. 1. not through the scholarly assumptions of a layman like the patient’s mother. Jarcia. or inadequate disclosure. ISSUES: (1) Whether or not res ipsa loquitor is applicable in this case. 2012) FACTS: Roy Alfonso Santiago Jr after being hit by a taxicab was brought by her mother to the Manila Doctors Hospital for an emergency treatment. and that the X. that there is lack of precaution on the part of the ofender. and 2. this conclusion is still best achieved.’s injury and the series of tests that were supposed to be undergone by him to determine the extent of the injury sufered were not under the exclusive control of Drs. Pamittan. It was established that they are mere residents of the Manila Doctors Hospital at that time who attended to the victim at the emergency room.’s injuries. As to whether the petitioners have exercised the requisite degree of skill and care in treating patient Roy. The NBI indorsed the matter to the Office of the City Prosecutor of Manila for preliminary investigation. After trial and applying the doctrine of res ipsa loquitor the RTC found petitioners to be guilty of simple negligence. Jarcia and Bastan. People (G. and (2) that the damage impending to be caused is not immediate or the danger is not clearly manifest. Roy Jr. that Mrs. 165279 June 7 2011) An Application of the Common-Law Doctrine of Informed Consent in a Medical Malpractice (Medical Negligence) Case under Article 2176 of the Civil Code The ponencia enumerated the four essential elements that a plaintif must prove in a medical malpractice action based on the doctrine of informed consent. before the RTC. the contention of petitioners that they cannot be held liable since Roy is not their patient. The gravamen in an informed consent case requires the plaintiff to point to significant undisclosed information relating to the treatment which would have altered her decision to undergo it. for all intents and purposes. As to the second issue: Petitioners were negligent in their obligation. Emmanuel Jarcia. care. in treating his patient. but by the unquestionable knowledge of expert witness/es.R. and that he will employ such training. Rubi Li vs. There is no direct evidence proving that it was their negligence that caused the sufering of Roy. Physician-patient relationship exists when a patient engages the services of a physician.” There is a physician-patient relationship in this case since the petitioner obliged themselves and examined the victim.

On the other hand. may not be legally necessary. it was held that petitioner Dr. As a physician.Applying the foregoing to this case. VII. there is reasonable expectation on the part of the doctor that the parents of the child understood very well that the severity of these side efects will not be the same for all patients undergoing the procedure. informed consent laws in other countries generally require only a reasonable explanation of potential harms. which includes lowered counts of white and red blood cells. Dr. possible kidney or heart damage and skin darkening. so specific disclosures such as statistical data. decrease in blood platelets. Rubi Li. as it was unlikely for doctors like petitioner who were dealing with grave conditions such as cancer to have falsely assured patients of chemotherapy’s success rate. adequately disclosed material risks inherent in the chemotherapy procedure performed with respondents’ consent. Li can reasonably expect the child’s parents to have considered the variables in the recommended treatment for their daughter aflicted with a life-threatening illness. who was sick with malignant bone cancer. Li told them of 95% chance of recovery for their daughter. it is dificult to give credence to the parents’ claim that petitioner Dr. PHYSICAL INJURIES  Diferent kinds of injuries: o Contrusion – discoloration o Humatona – bukol (elevation)  Regions of the body:  Head  Hands  Ankle  Fingers  Toes  Thighs  Legs  Forearms  Face o Frontal o Zygomatic – cheeks o Mandible – mouth/jaw o Maxillam – ilalim ng ilong o Temporal – side o Parietal – lalamunan o Occipital – batok o Orbit – eyes  Body o Chest (L/R) . Besides. When petitioner informed the respondents beforehand of the side efects of chemotherapy. an oncologist who performed chemotherapy on respondents’ daughter.

R. he assails the trial court for giving credence to the sole testimony of the victim. no BP.Quite incongruously. He appealed and questioned the decision on the ground that his guilt was not proved beyond reasonable doubt. the ponencia went on to declare that in the absence of expert testimony on the standard of care in obtaining consent in chemotherapy treatment [since the witness for respondents-parents was not an expert. SEX CRIMES o Sex crimes  Defense wounds  Document laceration  Position – clock  Extent/degree o Incomplete o Complete o compound 12. no heartbeat.’)-24” IX. GUNSHOT WOUNDS o Gunshot     Bullet Flame – (Singeing). People vs. He claims that the prosecution should have presented other witnesses to corroborate the testimony of the victim. No. no respiration. 194259. the Court felt hesitant in defining the scope of mandatory disclosure in cases of malpractice based on lack of informed consent such as this case involving chemotherapy treatment. however. Petitioner Dr. March 16.(Smudging)-12” Unburned powder – (asdfghjkl. Second. VI. he contends that the medical certificate presented as evidence was not testified to by the signatory . Alverio raises three (3) grounds in support of his argument. no heart rate o Temperature drop (3 hours) – cooling o Changes of muscle (3 stages)  Primary flaccidity (lupaypay)  Immediately || mainit pa  Rigor Mortis – rigidity  3-6 hours-12 hours – complete rigor mortis  Secondary Flaccidity (lupaypay ulit)  24-36 hours || malamig na o Putrefaction – 24-36 hours o Post mortem lividity – gravitating of the blood  (3 hours) while cooling || tells the position of the dead o Cadaveric spasm – local/certain  Portion of the muscle becomes rigid. Alverio (G. screw driver (pointed objects) VIII. not being an the oncologist but a mere Medical Specialist of the Department of Health charged with receiving complaints against hospitals]. Li was found NOT liable to pay damages to the suing parents. MEDICO-LEGAL ASPECTS OF DEATH o Clinically dead. 2011) FACTS: Alverio was found guilty of the crime of rape.6” Smoke. not the entire body  Does not happen to all o Cannot give time of death but give clue if suicide o Stomach contents (3-4 hours) o Presence of flies/maggots (24hours) o Abdomen Right upper  quadrant Right lower  Left upper  Left lower  Epigastrro – gitna   Injuries o Laceration – blunt o Incision – sharp-edged instrument o Abrasion – gasgas o Stab – knife o Punctured – ice pick. First.

the appeal is DENIED. Alverio’s defense of alibi cannot stand versus the positive identification of AAA. The gravamen of rape is carnal knowledge of a woman through force and intimidation.C. (2) the ofender had carnal knowledge of a woman. cannot prosper. as such. Ulili. Domantay appealed.R. Hymenal laceratio n is not nece ssary to prove rape. however. however. a physician's finding that the hymen of the alleged victim was lacerate d does not prove rape. WHEREFORE. he claims that the trial court gravely erred in convicting him of the crime of rape for failure of the prosecution to prove his guilt beyond reasonable doubt. 00020 finding accused-appellant Jimmy Alverio guilty of the crime charged is AFFIRMED 13. Furthermore.R. 53 However. only carnal knowledge had to be proved to establish rape. Besides.himself and should therefore not be considered as corroborative evidence. The surrounding genital area shows signs of infammation. 1999) FACTS: Domantay was found guilty with the crime of Rape with Homicide. Domantay (G. Lastly. People vs. standing alone. The elements needed to prove the crime of rape under paragraph 1(a) of Article 266-A of the Revised Penal Code are: (1) the ofender is a man. xxx xxx xxx REMARKS: 1) Findings at the genital area indicate the probability of penetration of that area by a hard. All these elements were sufficiently proved by the prosecution. We find that the prosecution has discharged its burden of proving the guilt of Alverio beyond reasonable doubt. Alverio submits that although the medical certificate was presented as evidence. of such contact. As the victim here was six years old. it is enough if there was even the slightest contact of the male sex organ with the labia of the victim's genitalia. there must be proof. ne ither doe s it s pre se nce prove it s co mmission . Nothing is more settled in criminal law jurisprudence than the rule that alibi and denial cannot prevail over the positive and categorical testimony and identification of the accused by the complainant. Ronald Bandonill's report on the genital examination he had performed on the deceased reads: GENITAL EXAMINATION. cannot be considered as corroborative of the claim of the victim that she was raped. 130612 May 11. After a careful perusal of the records of this case. and (3) the act is accomplished by using force or intimidation. Carnal knowledge is defined as the act of a man having sexual intercourse or sexual bodily connections with a woman. CR-H. No. Dr. a medical certificate or the testimony of the physician is presented not to prove that the victim was raped but to show that the latter had lost her virginity. The CA Decision in CA-G. Medical evidence is dispensable and merely corroborative in proving the crime of rape. It is only when this is corroborated by other evidence proving carnal knowledge that rape may be deemed to have been established. . Among his arguments was the fact thereis no sufficient evidence to hold him guilty of raping Jennifer Domantay. its contents were never testified to by the signatory himself and. a medical certificate is not even necessary to prove the crime of rape. Accordingly. showed a complete laceration of the right side of the hymen. rigid instrument. As held in People v. The testimony of AAA overwhelmingly proves that Alverio raped her with the use of force and intimidation. 52 For this purpose. the Court is satisfied that the prosecution’s evidence suficiently established Alverio’s guilt with moral certainty. No. by direct or indirect evidence. Such argument. Consequently. In addition.

that there was spermatozoa in the girl's vaginal canal. there is a huge bloodstain in the back portion of her shorts. Etis then consulted a dentist who scheduled him for a tooth extraction but the . Otherwise. neck. as in this case. In contrast. From the foregoing.This conclusion is based on the medically accepted fact that a hymenal tear may be caused by objects other than the male sex organ or may arise from other causes. He did not confess to having raped the victim. 159738 December 9. Maybe he simply inserted a blunt object into her organ. there is no circumstance from which it might reasonably be inferred that he abused her. extending from the back shoulder down to the lower back area from the left to the right. there is no sufficient proof that it was accused-appellant who had raped her. . these are usually caused by the downward pressure on the victim's body during the sexual assault. 2004) FACTS: Respondent Alejandro A. This must be because she wearing this piece of clothing when the stab wounds were inflicated or immediately thereafter. Indeed. Etis was hired by petitioner as an automotive mechanic. . thus causing the lacerations in the hymen. He opined that the laceration had been inflicted within 24 hours of the victim's death and that the inflammation was due to a trauma in that area. On 22 September 1997. he testified: [A]fter examining the body I took note that were several stab wounds . . It is noteworthy that the deceased was fully clothed in blue shorts and white shirt when her body was immediately after it was found. in the case at bar. the respondent made a phone call to the company nurse and informed her that he had to take a sick leave as he had painful and unbearable tootache. the usual location of the external bodily injuries of the victim is on the face. Bandonill himself admitted this. He testified that the right side of the victim's hymen had been completely lacerated while the surrounding genital area showed signs of inflammation.g. t here is no circumst ant ial evidence f rom which to infer that accuse dappellant se xually abuse d the victim. Even assuming that Jennifer had been raped. e. all the stab wounds (except for a minor cut in the lower left leg) had their entry points at the back running from the upper left shoulder to the lower right buttocks. NLRC (G. When asked by the private prosecutor whether the lacerations of the hymen could have been caused by the insertion of a male organ he said this was possible. we cannot find that accusedappellant also committed rape. In the special complex crime of rape with homicide. The only circumstance from which such inference might be made is that accusedappellant was seen with the victim walking toward the place where the girl's body was found. In describing the stab wounds on the body of the victim. thus allowing the blood to seep into her shorts to such an extent. Considering the relative physical positions of the accused and the victim in crimes of rape. Maybe he did not.. both the rape and the homicide must be established beyond reasonable doubt. Dr. No. It is unquestionably diferent when. that he was zipping up his pants. the very autopsy report of Dr. and anterior portion of her body.R. Maybe he raped the girl. Furthermore. Although it is not unnatural to find contusions on the posterior side. 14. these were all found at the back area sir . Union Motor vs. But he also said when questioned by the defense that the lacerations could have been caused by something blunt other than the male organ. . Bandonill militates against the finding of rape.

16. signed by Dr. since the originals cannot be produced. but made their own analysis and interpretation of said evidence. No. Solis. and intended to establish matters which are hearsay. they bear all the earmarks of regularity in their issuance and are entitled to full probative weight. Thus she underwent kidney operation. Respondent then appealed to the NLRC. instead of the left non . however. need not be proved as it is covered by mandatory judicial notice. It appears from their report that the forensic group used the same physical and testimonial evidence proferred during the trial. Sanchez’s medico-legal certificate.R. The tests revealed that her left kidney is normal but the left is non-functioning and non-visualizing. hence. b) the part of the tarmac where the lifeless bodies of the late Sen. The Labor Arbiter ruled that the respondent’s failure to report for work for ten (10) days without an approved leave of absence was equivalent to gross neglect of duty. ISSUE: Should the introduction of photocopied documents as evidence be allowed? RULING: YES. such as copies of the exhibits. 2012) FACTS: Neil Colorado was convicted by the RTC for raping his full. 17. Nowhere in our jurisprudence requires that all medical certificates be notarized to be accepted as a valid evidence. in cognizance with the liberality and the appreciation on the rules on evidence.R. x x x to the new building . The medical certificates were properly signed by the physicians. Furthermore. Colorado appealed from the RTC’s decision to the CA. after it was established that he succeeded in having carnal knowledge of the victim. Balonzo. He alleged that said exhibits are inadmissible because the same are mere photocopies. laceration of the hymen. Aquino and his escorts descended. 177407 February 2011) FACTS: Private respondent Editha Sioson wen to Rizal Medical Center for check-up. viz: MATERIALS AND METHODS MATERIALS: a. hence. is allowed. As explained by the Court in People v. No. The Labor Arbiter stressed that "unnotarized medical certificates were self-serving and had no probative weight. The introduction of secondary evidence. and that his claim that he had been absent due to severe toothache leading to a tooth extraction was unsubstantiated. Editha and her husband filed a complaint for gross negligence and/or incompetence committed by petitioner Atienza which consists of the removal of Editha’s fully functional right kidney. A reference human skull photos and X-rays of the same to demonstrate wound location and bullet trajectory . c. respondent was not able to report for work for 10 days. Witness Dr. They cited the materials and methods that they used for their study. not properly identified and authenticated. To prove that her kidneys were both in their proper anatomical locations at the time she was operated. Petitioner filed his comments/objections to private respondents [Editha Siosons] formal ofer of exhibits. Nancy Aquino testified that the Records Office of RMC no longer had the originals of the exhibits because [it] transferred from the previous building. Mu[]oz. People vs. ISSUE: Is a medical certificate necessary to prove the commission of rape? RULING: NO. she offered as evidence photocopied medical documents. is not always essential to establish the consummation of the crime of rape. As a result. Sioson (G. a medical certificate is not necessary to prove the commission of rape. thereafter. Colorado (G. No. An accused can still be convicted of rape on the basis of the sole testimony of the private complainant. the BOM shall determine the probative value thereof when it decides the case. the fact sought to be established by the admission of Edithas exhibits.R. 96027-28." unlike its ordinary connotation of sexual intercourse. does not necessarily require that the vagina be penetrated or that the hymen be ruptured. Aquino and Galman fell.same was rescheduled for several times due to inflammation. b. and the autopsy report of the late Sen. 15. NLRC reversed the Labor Arbiter’s Decision. Colorado also questions the weight of Dr. The Labor Arbiter rendered a Decision dismissing the complaint. 200792 November 14. the BOM properly admitted Edithas formal ofer of evidence and. even granting that AAA’s lacerations were not caused by Colorado. arguing that AAA’s hymenal lacerations could have resulted from the sexual aggressions allegedly committed against her by DDD and their brother-in-law. 2005) The report of the forensic group may not be considered as newly discovered evidence as petitioners failed to show that it was impossible for them to secure an independent forensic study of the physical evidence during the trial of the double murder case. The petitioner considered respondent’s consecutive absences as abandonment of office under the Company Rules and terminated the services of the respondent. Custodio vs. Common sense dictates that an ordinary worker does not need to have these medical certificates to be notarized for proper presentation to his company to prove his ailment. Ultimately. Thus. The gun and live ammunitions collected at the crime scene. especially photographs of: a) the stairway where the late Sen. BOM. admitted the said documents as evidence. even if considered the most telling and irrefutable physical evidence of sexual assault.] Jr. must not negate the acceptance of these medical certificates as valid pieces of evidence. Verification of documents is not necessary in order that the said documents could be considered as substantial evidence. Benigno Aquino[. Furthermore. CA affirmed NLRC’s Decision. Atienza vs. and c) the autopsy conducted by the NBI Medico-legal team headed by Dr. the latter could still be declared guilty of rape.functioning and non-visualizing kidney. reiterating in his appeal the defenses of denial and alibi. The respondent then filed a complaint for illegal dismissal before the arbitration branch of the NLRC against the petitioner. Court records of the case. He added that the exhibits are incompetent to prove the purpose for which they are ofered. ISSUE: Do medical certificates need to be notarized in order to be admissible as evidence? RULING: NO. After the operation. The CA affirmed Colorado’s conviction. In the context that is used in the RPC. Sandiganbayan (G. March 08.blood sister AAA who was then 12-year old when the crime was committed. "carnal knowledge. Expert testimony is merely corroborative in character and not essential to conviction. that her kidneys were both in their proper anatomical locations at the time of her operation. Mu[]oz and Dr. the Labor Arbiter a quo. as even a medical examination of the victim is not indispensable in a prosecution for rape.

g. i. Results of Forensic experiments conducted in relation to the case. Review of the forensic exhibits presented in the court. e. d. b. and other witnesses. Evaluation of the presented facts and opinions of local experts in relation to accepted forensic findings in international publications on forensic science. Conduct of ocular inspection and measurements on the actual crime scene (stairway and tarmac) at the old Manila International Airport (now NAIA). both in the Bilibid Prison where the convicts are confined and the MIA (now NAIA) stairway and tarmac. particularly on guns and [gunshot] wound injuries. Retracing the slugs trajectory based on the autopsy reports and experts testimonies using an actual human skull. c. e. METHODS: a. Forensic experiments and simulations of events in relation to this case. f. Study of and research on the guns. f. by the military escorts themselves in the Bilibid Prison and by volunteers at the NAIA Tarmac. Review of TSNs relevant to the forensic review. X-rays of the skull with the retraced trajectory based on the autopsy report and experts testimonies.] g.d. h. Re-enactment of the killing of Aquino based on the military escorts[] version. Various books and articles on forensic and the medico -legal field[.[18] . The reports of interviews and statements by the convicted military escorts. slugs and ammunitions allegedly involved in the crime. Interviews/re-enactment of the crime based on the militarys accounts.