H.

45. What is res ipsa loquitur? (Ramos vs. CA)

The phrase "res ipsa loquitur" is a maxim for the rule that the fact of the
occurrence of an injury, taken with the surrounding circumstances, may
permit an inference or raise a presumption of negligence, or make out a
plaintiffs prima facie case, and present a question of fact for defendant to
meet with an explanation.
As applied in the case of Ramos vs. CA, The injury incurred by petitioner
Erlinda Ramos does not normally happen absent any negligence in the
administration of anesthesia and in the use of an endotracheal tube. As
was noted by the Court in its Decision, the instruments used in the
administration of anesthesia, including the endotracheal tube, were all
under the exclusive control of private respondents Dr. Gutierrez and Dr.
Hosaka. The court cited the case of Voss vs. Bridwell, which involved a
patient who suffered brain damage due to the wrongful administration of
anesthesia, and even before the scheduled mastoid operation could be
performed, the Kansas Supreme Court applied the doctrine of res ipsa
loquitur, reasoning that the injury to the patient therein was one which
does not ordinarily take place in the absence of negligence in the
administration of an anesthetic, and in the use and employment of an
endotracheal tube. The court went on to say that "ordinarily a person
being put under anesthesia is not rendered decerebrate as a consequence
of administering such anesthesia in the absence of negligence. That upon
these facts and under these circumstances, a layman would be able to
say, as a matter of common knowledge and observation, that the
consequences of professional treatment were not as such as would
ordinarily have followed if due care had been exercised.
46. What is captain of the ship doctrine? (Mendoza vs. Casumpang)
Mendoza v. Casumpang, a surgical operation is the responsibility of
the surgeon performing it. He must personally ascertain that the
counts of instruments and materials used before the surgery and prior to
sewing the patient up have been correctly done. To provide an example to
the medical profession and to stress the need for constant vigilance in
attending to a patients health, the award of exemplary damages in this
case is in order.
Hospital employee temporarily comes under the supervision and control of
another while performing duties. Liability rests with the captain for the
wrongful acts of thos under his control and those wherein he has
extension or control. Acts of ommissions are the responsibility of the
borrower not the hospital.

The operation requiring the placing of sponges in the incision is not

complete until the sponges are properly removed, and it is settled that the
leaving of sponges or other foreign substances in the wound after the
incision has been closed is at least prima facie negligence by the
operating surgeon. To put it simply, such act is considered so inconsistent
with due care as to raise an inference of negligence. There are even
legions of authorities to the effect that such act is negligence per se.
47. What is the Doctrine of Informed Consent? (Li vs. Soliman)
The Doctrine of Informed Consent refers to the duty imposed on a doctor
to explain the risks of recommended procedures to a patient before a
patient determines whether or not he or she should go forward with the
procedure.
There are four essential elements a plaintiff must proved in a malpractice
action based upon the doctrine of informed consent:
1.) The physician had a duty to disclose material risks;
2.) He failed to disclose or inadequately disclosed those risks;
3.) As a direct and proximate result of the failure to disclose, the patient
consented to treatment she otherwise would not have consented to; and
4.) Plaintiff was injured by the proposed treatment.
48. Are waivers signed by patients valid? (Nogales vs. Capitol Medical
Center)
No, waivers signed by patients are void. The Supreme Court stated in the
case of Nogales vs. Capitol Medical Center that such release forms, being
in the nature of contracts of adhesion, are construed strictly against
hospitals. Besides, a blanket release in favor of hospitals "from any and all
claims," which includes claims due to bad faith or gross negligence, would
be contrary to public policy and thus void.
49. What is the difference between Ramos vs. CA 321 SCRA 585, 588-589
(1999) and Ramos vs. CA 380 SCRA 467 (2002)

References:

Ramos v. Court of Appeals, G.R. No. 124354 April 11, 2002

https://www.law.cornell.edu/wex/informed_consent_doctrine
Li vs Spouses Soliman G.R. No. 165279 June 7, 2011

Nogales vs. Capitol Medical Center GR No. 142625 December 19,

2006