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2. PROFESSIONAL SERVICES, INC.

v NATIVIDAD and ENRIQUE AGANA
G.R. NO. 126297, 1/31/07

The PRC Board of Medicine dismissed the case against Dr.Fuentes, stating that the
prosecution failed to show that Dr. Fuentes was the one who left the gauze in
Natividas’s body.

FACTS:

CA dismissed Dr. Fuentes.

Natividad Agana was rushed to the Medical City General Hospital (Medical City)
because of difficulty of bowel movement and bloody anal discharge. After series of
medical examinations, Dr. Miguel Ampil, one of the petitioners in this consolidated
petition, diagnosed the former of having cancer of the sigmoid.

ISSUE: WON PSI and Dr. Ampil guilty of negligence and liable for damages?

Dr. Ampil conducted the anterior resection surgery on Natividad with the assistance
of the medical staff of the Medical City. During the procedure, Dr. Ampil found that
the malignancy in Natividad’s sigmoid area had spread on her left ovary; he obtained
consent from Enriuqe Agana to allow Dr. Fuentes to perform hysterectomy on
Natividad, to remove the ovary. Dr. Fuentes completed the hysterectomy, Dr. Ampil
took over, completed the operation and closed the wound. However, there was an
entry on the Record of Operation stating that sponge count lacking 2, announced to
surgeon, searched done but to no avail, continue for closure.
Natividad was released, however after a couple of days, she complaint of excruciating
pain in her anal region. The aforementioned doctors stated that it was the natural
consequence of the surgery. The spouses went to US to seek further treatment;
Natividad was declared cancer free after 4 months; and returned to the Philippines.
Natividad was still suffering from pains, and after weeks, her daughter found a piece
of gauze protruding from her private part, which was extracted by Dr. Ampil. The
pain intensified despite the said gauze was already extracted, hence she was admitted
in Polymedic General Hospital. In there, another gauze was found. Said gauze was a
foul smelling one, which badly infected her vaginal vault, caused for the formation of
recto-vaginal fistula in her reproductive organ which forced stool to excrete through
the vagina. Natividad had another surgery.
The spouses filed a complaint damages against Professional Services, Inc., the owner
of the Medical City, Dr. Ampil, and Dr. Fuentes due to negligence.
RTC favored Aganas, and held PSI, Dr. Ampil and Dr. Fuentes liable for damages.

HELD:
Yes.
As to Dr. Ampil:
The elements of Duty, Breach, Injury and Proximate Causation are present. Dr.
Ampil, as lead surgeon, had the duty to remove all foreign objects, such as gauzes,
from Natividad’s body before closure of the incision; When he failed to do so, it was
his duty to inform Natividad about it; Dr. Ampil breached both duties. Such breach
caused injury to Natividad, necessitating her further examination and surgery. Dr.
Ampil’s negligence is the proximate cause Natividad’s injury.
As to PSI:
Doctrine of apparent authority or sometimes referred to as the “Holding out”
Theory, or Doctrine of Ostensible Agency or Agency by Estoppel:
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Has its origin from the law of agency. It imposes liability, not as the result of
the reality of a contractual relationship, but rather because of the actions of a
principal or an employer in somehow misleading the public into believing
that the relationship or the authority exists.
ART. 1869. Agency may be express, or implied from the acts of the principal,
from his silence or lack of action, or his failure to repudiate the agency,
knowing that another person is acting on his behalf without authority.
PSI publicly displays in the lobby of the Medical City Hospital the names and
specializations of the physicians associated or accredited by it, including those
of Dr. Ampil and Dr. Fuentes. Hence, PSI is stopped from passing all the
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the duty of providing quality medical science is no longer the sole prerogative and responsibility of the physician. The offender does or fails to do an act The doing or failure to do that act is voluntary That it be without malice Material damage results from the reckless imprudence There is inexcusable lack of precaution on the part of the offender. 1. NINEVETH CRUZ v CA and LYDIA UMALI G. time and place. . Laguna. Nevertheless. DR. 2. 5. The fourth element is absent. Hence this petition. absent facts to support the application of respondeat superior or apparent authority. 4. the relatives were instructed to buy medicines and bags of blood for the respondent. 3.R. She was accompanied by her relatives and her daughter who noticed the untidiness of the clinic and suggested that the operation be cancelled. Hospitals now tend to organize a highly professional medical staff whose competence and performance need to be monitored by the hospitals commensurate with their inherent responsibility to provide quality medical care. MTCC. The elements of reckless imprudence are the following: 3. The modern hospitals have changed structure. The expert testimony by both side substantiated that the cause of the respondent’s death was DIC. ISSUE: WON Physician committed negligence in the treatment of the patient? HELD: No. RTC and CA favored Respondents side complaint against the petitioner. In there the respondent was re-operated due to blood oozing from her wound. and other circumstances regarding persons. and eventually died. Unfortunately. After sometime the relatives saw the respondent being brought out of the Operating Room and headed to San Pablo District Hospital without their consent. the operation still commenced. The foregoing circumstances are insufficient to sustain a judgment of conviction of petitioner for the crime of reckless imprudence resulting to homicide. it failed when to conduct an investigation of the matter reported in the Records of Operation.the judicial answer to the problem of allocating hospital’s liability for the negligent acts of health practitioners. PSI has the duty to exercise reasonable care to protect from harm all patients admitted into its facility for medical treatment. Doctrine of Corporate Negligence During the procedure. 2 . taking into consideration hi employment or occupation. 11/18/97 FACTS: Respondent had a hysterectomy operation (myoma) in the Perpetual Help Clinic and General Hospital in San Pablo City. which as attested by an expert witness cannot be attributed to fault or negligence. NO.blame to the physicians whose names it proudly paraded in the public directory leading the public to believe that it vouched for their skill and competence. Its formulation proceeds from the judiciary’s acknowledgment that in these modern times. degree of intelligence. had her BP dropped to 0/0. physical condition. 122445.

Estrada. and testified that hemorrhage due to DIC cannot be prevented. Whoever by act or omission cause damage to another. fire and exercise real control over their attending and visiting Consultant staff. the hospital granted staff privileges on Dr. Estrada in the exercise of his medical profession. The control exercised. There must be a proximate cause between the negligence and resulting injury. During the process. xxx Employers shall be liable for the damages caused by their employees and household helpers acting within the scope of their assigned tasks. DR. Art. 3 . is obliged to pay for the damage done. actions are determinable only in the light of scientific knowledge. RTC finds Dr. her BP dropped from 130/80 to 60/40. OSCAR ESTRADA et. ISSUE: WON CMC is liable for the negligence of Dr. Dr. anytime. Ely Villaflor – who administered 25g magnesium sulfate whilst it should be 10g only. Corazon had a convulsion. Estrada is an independent contractor for whom actuations CMC would be a total stranger. 2180.al. Uy who conducted internal examination. but also for those of persons for whom one is responsible. Noc Espinola – Head of Obstetrics and Gynecology Dept. and died due to hemorrhage post partum. Resident Physician Dr. technically employees. Estrada liable for damages. had a continous profuse bleeding. She then had a dangerous complication of pregnancy name preeclampsia on her delivery of her 4 th child. It has been recognized that expert testimony is usually necessary to support the conclusion as to causation. Dr. the control test is determining. Estrada 7. and maintains that it had no control or supervision over Dr.3 doctors preclude the probability that DIC caused the hemorrhage and consequently. Inasmuch as the causes of the injuries involved in malpractice. weak. HELD: Yes. NO. G. with the exception of payment of wages. The baby was extracted through low forceps. Petitioner petition to include CMC as liable for damages as well. she was attended by Dr. the hiring. In assessing whether such a relationship in fact exists. her cervical tissue was torn.. Corazon Nogales was admitted in the Capitol Medical Center during her last trimester of pregnancy. 142625. 2176is demandable not only for one’s own acts or omissions. and that it happens to anyone. ROGELIO NOGALES v CAPITOL MEDICAL CENTER. 2176. respondent’s death. x x x CMC alleges that Dr. The Court stated that private hospital hire. Estrada. there being fault or negligence. and the right to terminate consultants all fulfill the important hallmarks of an employer-employee relationship. Estrada and the consent letter even has the header of the hospital. Joel Enriquez – Anesthesiologist. CA affirmed RTC’s decision. but was denied. Art. While Consultants are not. The obligation imposed by Art. Dr. Lacson – head of CMC Laboratory. who came late due to fortuitous event. intubated and resuscitated. The petitioner filed a complaint for damages.R. injured. even though the former are not engaged in any business or industry. During the procedure. 12/19/06 FACTS: As advised by the respondent Dr. and Dr.

Various medical procedures were conducted on her. Nora left arm was never been the same. Physicians are not guarantors of care and they never set out to intentionally cause injury to their patients. and that the droplight may have caused it and not the BP cuff. The nurse said it was a burn cause by droplight. and her left arm aches at the slightest touch. she underwent skin grafting and scar recision. 160889 4/27/07 FACTS: Nora Go gave birth on her 4th child at Delgado Memorial Hospital. MILAGROS L. and the gaping wound.8. Either caused by droplight or BP cuff. During the procedure. suffered hypovolemic shock. Cantre. attended by herein petitioner Dr. both instruments are deemed within the exclusive control of the physician in charge under the “Captain of the Ship” Doctrine. and a droplight was ordered to warm her and the baby. it automatically gives the injured a right to reparation for the damage caused. GO G. A medico legal aid was sought. where negligence exists and is proven. However. by its very nature and considering the respondent’s condition. The injury in the left arm is not an ordinary consequence of delivering a baby. the petitioner said it was due to BP cuff. intent is immaterial in negligence cases because 4 . Milagros L. GO and NORA S. RTC and CA favored the spouses. The spouses filed a complaint for damages. a gaping wound on her left arm was noticed by her spouse. until she got consciousness and eventually recovered. Hence this petition ISSUE: WON petitioner is liable for the injury suffered by the respondent wife? HELD: Yes. the former had a profuse bleeding. However. DR. CANTRE v SPS JOHN DAVID Z.R. could only be caused by something external and outsider he control. Res ipsa loquitur elements are present. and the latter attested that the injury appeared to be burned. had her BP dropped to 40/0 and got unconscious. NO.