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GASGA, LAXEL B.

BLOCK B

LEGAL MEDICINE CASES


Tabao v. People of the Philippines
G.R. No. 187246, July 20, 2011

Facts:
At around 10:00 p.m. of January 21, 1993, the petitioner was driving his Toyota Corolla car
bearing plate number PCH-111 along Governor Forbes corner G. Tuazon Street towards
Nagtahan when it suddenly ramped on an island divider, bumping Rochelle Lanete who was
crossing the street. As a result of the impact, Rochelle was thrown into the middle of the road
on her back. Thereafter, Leonardo Mendez speeding blue Toyota Corona car with plate number
PES-764 ran over Rochelles body. Bystanders armed with stones and wooden clubs
followed Mendez car until it stopped near the Nagtahan Flyover. Francisco Cielo, a newspaper
delivery boy, pleaded with the bystanders not to hurt Mendez. Cielo went inside Mendez car,
sat beside him, got his drivers license, and ordered him to move the car backwards. Mendez
followed his order, but his car hit the center island twice while backing up.[3]Cielo went out of
the car and approached the sprawled body of Rochelle; he and the petitioner brought
Rochelles body inside Mendez car. The three of them (the petitioner, Cielo and Mendez)
brought Rochelle to the UST Hospital,[4]where she died on February 6, 1993 due to septicemia
secondary to traumatic injuries.
Dr. Sergio Alteza, Jr., the attending physician, testified that the victim suffered multiple injuries
compatible and consistent with a vehicular accident. He did not state that the injuries
suffered by the victim were only on her left side. In fact, a perusal of Dr. Altezas initial medical
report shows that the victim suffered injuries both on the left and right sides of her body. In
addition, Dr. Floresto Arizala, Jr., the National Bureau of Investigation medico-legal officer who
conducted an autopsy on Rochelles body, confirmed that the victim suffered injuries on
various parts of her lower right and left extremities as a result of the initial or primary impact.
The petitioner relies heavily on Dr. Altezas statement allegedly declaring that the victims
injuries on her lower left leg and left thigh were the primary impact injuries. However, this
statement was not based on the actual incident but on Dr. Altezas presumptions. For clarity,
we reproduce Dr. Altezas testimony:
ATTY. SERRANO:
Q:

Now doctor, you said that these injuries you found x x x on the body of
the victim are compatible and consistent with a vehicular accident.
Would you tell this court how these injuries were sustained?
xxxx
Doctor, what would be the possible situation when you use compatible
and consistent vehicular accident?

DR. ALTEZA:
A:

If I would be allowed to make some presumptions, if the patient was


standing up at that time he was hit by a vehicle, I would presume that
the primary impact injuries, injuries hit first by the vehicle are the
injuries of the lower leg and the left thighconsidering that the height of
the injuries are approximately the height of the bumper as well as the
hood of the car.

Q:

There are several kinds of vehicles, doctor?

GASGA, LAXEL B.
BLOCK B
A:

LEGAL MEDICINE CASES

Yes, Your Honor, I was thinking of a car. Now, after being hit by [a] car,
under normal condition, the victim is normally thrown at the surface of
the street.

Issue:
Whether or not the accused is guilty of the crime.
Ruling:
From this exchange, we find it clear that Dr. Alteza was merely making a hypothetical statement
that a person who is presumed to be standing when hit by a vehicle would suffer primary impact
injuries on his lower leg and left thigh. He never declared that Rochelle suffered primary impact
injuries on her lower left extremities. At any rate, it was not improbable for the victim to have been
hit on the left side of her body as Victor testified that she (victim) tried to avoid the petitioners
car, and was in fact facing the car when she was hit.
We likewise do not believe the petitioners claim that his vehicle was not involved in the
incident due to the absence of dents or scratches. As the petitioner himself admitted, his
vehicle was not subjected to any investigation after the incident. Moreover, the pictures of the
car, presented by the petitioner in court, were taken long after the incident and after a repair
had already been done to the vehicle. There was therefore no way of verifying petitioners
claim that his car did not have any dent or scratch after the incident. At any rate, the absence of
a dent or a scratch on the petitioners car, assuming it to be true, does not conclusively prove
his non-participation in the incident. The absence of any dent or scratch is influenced by several
factors: the type of paint, the speed of the car, the points of impact, and the material used on
the cars exteriors.
WHEREFORE, premises considered, the Court resolves to DENY the motion with FINALITY, no
substantial argument having been adduced to warrant the reconsideration sought. Costs
against the petitioner.

GASGA, LAXEL B.
BLOCK B

LEGAL MEDICINE CASES


Antonio v. Reyes
G.R. 155800, March 10, 2006

Facts:
Petitioner and respondent met in August 1989 when petitioner was 26 years old and
respondent was 36 years of age. Barely a year after their first meeting, they got married before
a minister of the Gospel at the Manila City Hall, and through a subsequent church wedding at
the Sta. Rosa de Lima Parish, Bagong Ilog, Pasig, Metro Manila on 6 December 1990. Out of
their union, a child was born on 19 April 1991, who sadly died five (5) months later.
On 8 March 1993, petitioner filed a petition to have his marriage to respondent declared null
and void. He anchored his petition for nullity on Article 36 of the Family Code alleging that
respondent was psychologically incapacitated to comply with the essential obligations of
marriage. He asserted that respondents incapacity existed at the time their marriage was
celebrated and still subsists up to the present.
As manifestations of respondents alleged psychological incapacity, petitioner claimed that
respondent persistently lied about herself, the people around her, her occupation, income,
educational attainment and other events or things.
Dr. Abcede, a psychiatrist who had headed the department of psychiatry of at least two (2)
major hospitals, testified as follows:
WITNESS:
Given that as a fact, which is only based on the affidavit provided to me, I can say that there are
a couple of things that [are] terribly wrong with the standards. There are a couple of things that
seems (sic) to be repeated over and over again in the affidavit. One of which is the persistent,
constant and repeated lying of the "respondent"; which, I think, based on assessment of normal
behavior of an individual, is abnormal or pathological. x x x
ATTY. RAZ: (Back to the witness)
Q- Would you say then, Mr. witness, that because of these actuations of the respondent she is
then incapable of performing the basic obligations of her marriage?
A- Well, persistent lying violates the respect that one owes towards another. The lack of
concern, the lack of love towards the person, and it is also something that endangers human
relationship. You see, relationship is based on communication between individuals and what we
generally communicate are our thoughts and feelings. But then when one talks and expresse[s]
their feelings, [you] are expected to tell the truth. And therefore, if you constantly lie, what do
you think is going to happen as far as this relationship is concerned. Therefore, it undermines
that basic relationship that should be based on love, trust and respect.
Q- Would you say then, Mr. witness, that due to the behavior of the respondent in constantly
lying and fabricating stories, she is then incapable of performing the basic obligations of the
marriage?
xxx
ATTY. RAZ: (Back to the witness)
Q- Mr. witness, based on the testimony of Mr. Levy Mendoza, who is the third witness for the
petitioner, testified that the respondent has been calling up the petitioners officemates and
ask him (sic) on the activities of the petitioner and ask him on the behavior of the petitioner.
And this is specifically stated on page six (6) of the transcript of stenographic notes, what can
you say about this, Mr. witness?
A- If an individual is jealous enough to the point that he is paranoid, which means that there is
no actual basis on her suspect (sic) that her husband is having an affair with a woman, if carried
on to the extreme, then that is pathological. That is not abnormal. We all feel jealous, in the

GASGA, LAXEL B.
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LEGAL MEDICINE CASES

same way as we also lie every now and then; but everything that is carried out in extreme is
abnormal or pathological. If there is no basis in reality to the fact that the husband is having an
affair with another woman and if she persistently believes that the husband is having an affair
with different women, then that is pathological and we call that paranoid jealousy.
Q- Now, if a person is in paranoid jealousy, would she be considered psychologically
incapacitated to perform the basic obligations of the marriage?
A- Yes, Maam.
The other witness, Dr. Lopez, was presented to establish not only the psychological incapacity
of respondent, but also the psychological capacity of petitioner. He concluded that respondent
"is [a] pathological liar, that [she continues] to lie [and] she loves to fabricate about herself."
Issue:
Whether or not the respondent is psychologically incapacitated.
Ruling:
These two witnesses based their conclusions of psychological incapacity on the case record,
particularly the trial transcripts of respondents testimony, as well as the supporting affidavits
of petitioner. While these witnesses did not personally examine respondent, the Court had
already held in Marcos v. Marcos that personal examination of the subject by the physician is
not required for the spouse to be declared psychologically incapacitated. We deem the
methodology utilized by petitioners witnesses as sufficient basis for their medical conclusions.
Admittedly, Drs. Abcede and Lopezs common conclusion of respondents psychological
incapacity hinged heavily on their own acceptance of petitioners version as the true set of
facts. However, since the trial court itself accepted the veracity of petitioners factual premises,
there is no cause to dispute the conclusion of psychological incapacity drawn therefrom by
petitioners expert witnesses.
There is little relish in deciding this present petition, pronouncing as it does the marital bond as
having been inexistent in the first place. It is possible that respondent, despite her psychological
state, remains in love with petitioner, as exhibited by her persistent challenge to the petition
for nullity. In fact, the appellate court placed undue emphasis on respondents avowed
commitment to remain in the marriage. Yet the Court decides these cases on legal reasons and
not vapid sentimentality. Marriage, in legal contemplation, is more than the legitimatization of
a desire of people in love to live together.
WHEREFORE, the petition is GRANTED. The decision of the RTC dated 10 August 1995, declaring
the marriage between petitioner and respondent NULL and VOID under Article 36 of the Family
Code, is REINSTATED. No costs.

GASGA, LAXEL B.
BLOCK B

LEGAL MEDICINE CASES


DR. LI v. SOLIMAN
G.R. No. 165279, June 7, 2011

Facts:
Angelica Soliman was diagnosed with cancer of the bone and had her leg amputated by Dr.
Jaime Tamayo to remove the tumor. The latter also recommended adjuvant chemotherapy to
eliminate any remaining cancer cells and prevent its spread to the other parts of the body, and
referred Angelica to the petitioner Dr. Rubi Li.
The petitioner claims that she did not then give the respondents any assurance that
chemotherapy would cure Angelicas cancer.
The respondents, however, disputed this claim and countered that the petitioner gave them an
assurance that there was a 95% chance of healing if Angelica would undergo chemotherapy.
On August 18, 1993, Angelica was readmitted to the SLMC for chemotherapy. Upon admission,
Angelicas mother, respondent Lina Soliman, signed the Consent for Hospital Care.
The following day, the petitioner intravenously administered three chemotherapy drugs,
namely: Cisplatin, Doxorubicin and Cosmegen. Thirteen days after the induction of the first
cycle of chemotherapy, Angelica died. The autopsy conducted by the Philippine National Police
(PNP) Crime Laboratory indicated the cause of death as Hypovolemic shock secondary to
multiple organ hemorrhages and Disseminated Intravascular Coagulation.
In the present case, expert testimony is required in determining the risks and or side effects of
chemotherapy that the attending physician should have considered and disclosed as these are
clearly beyond the knowledge of a layperson to testify on.
As expert witness, the respondents presented Dr. Balmaceda who testified on the physicians
general duty to explain to the patient or to his relatives all the known side effects of the
medical procedure or treatment. Specifically, Dr. Balmaceda gave the following expert
opinion:
ATTY. NEPOMUCENO
Q: Madam Witness, what is the standard operating procedure before a patient can be
subjected to procedures like surgery or administration of chemotheraphic (sic) drugs?
A: Generally, every physician base (sic) her or his assurance on the patient, on the mode of
recovery by her or his personal assessment of the patients condition and his knowledge of the
general effects of the agent or procedure that will be allowed to the patient.
Q: What is the duty of the physician in explaining the side effects of medicines to the patient?
A: Every known side effects of the procedure or the therapeutic agents should really be
explained to the relatives of the patient if not the patient.
Q: Right, what could be the extent of the side effect to the patient?
A: I said, all known side effects based on studies and observations.
Q: Should be?
A: Made known to the relatives of the patient or the patient.
Q: Then, after informing the relatives of the patient about [all the] side effects, what should be
the next procedure?
WITNESS
A: The physician should secure consent from the relatives or the patient himself for the
procedure for the administration of the procedure, the therapeutic agents.

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LEGAL MEDICINE CASES

ATTY. NEPOMUCENO
Q: Now, should the physician ask the patients relatives whether they understood the
explanation?
A: Yes, generally, they should.
On cross-examination, Dr. Balmaceda only clarified that all known side-effects of the
treatment, including those that may aggravate the patients condition, should be disclosed:
ATTY. CASTRO
Q: And you mentioned a while ago, Madam Witness that all known side effects of drugs should
be made known to the patient to the extent that even he dies because of making known the
side effect, you will tell him?
A: I said, all known side effect[s] should be made known to the relatives or to the patient so
that consent and the responsibility there lies on the patient and the patients relatives.
Q: So, even that information will aggravate his present condition?
A: Making known the side effect?
A: Yes.
A: In my practice, I did not encounter any case that will aggravate it. I make him know of the
side effect[s] and if indeed there is, I think the person that should approve on this matter
should be the relatives and not the patient. It is always the patient that become aggravated of
the side effects of the procedure in my experience.
Issues:
Whether or not there was medical negligence
Ruling:
In the present case, the plaintiffs utterly failed to establish their cause of action. They failed to
establish their claim of lack of informed consent, particularly on the first and fourth elements
which is duty to Disclose Material Risks & Causation.
In sum, the respondents failed to prove by expert testimony that Angelicas death was caused
by the chemotherapy the petitioner administered. This failure in establishing the fourth
requisite of the respondents cause of action fatally seals the fate of the respondents claim of
medical negligence due to lack of informed consent.