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NOGALES v.

CAPITOL MEDICAL CENTER o The hospital must have the right to control both the means and the details of the
GR No. 142625 / December 19, 2006 / CARPIO, J./ LABOR 1 Control test /RLAurellano process by which the dr. is to accomplish his task.
NATURE Petition for certiorari to review of the decision of the NLRC The Court finds no evidence pointing to CMCs exercise of control over Dr. Estrada
PETITIONERS Rogelio Nogales, for himself and on behalf of minor Roger Anthony, o Corazon was under the exclusive pre-natal care of Dr. Estrada. During Corazons la-
Angelica, Nancy, and Michael Christopher, all Nogaleses bor, Dr. Estrada was assisted by Dr. Villaflor. There was no showing that CMC had a
RESPONDENTS Capitol Medical Center; Dr. Oscar Estrada; Dr. Ely Villaflor; Dr. Rosa Uy; part in diagnosing Corazons condition
Dr. Joel Enriquez; Dr. Perpetua Lacson; Dr. Noe Espinola; and Nurse J. o CMC merely allowed Dr. Estrada to use its facilities, as Corazons birth was consid-
Dumlao ered an emergency. Also, his staff privileges did not make him CMCs EE
Considering these circumstances, Dr. Estrada is not CMCs EE, but an independent
SUMMARY. Petitioner Nogaless wife died in childbirth. He is suing Dr. Estrada, their prima- contractor
ry OBGYNE, and Capitol Medical center (CMC) for negligence in causing Corazons death. SC
held that Dr. Estrada is NOT CMCs EE he is but an independent contractor. BUT CMC was 2. WON CMC could be held vicariously liable for Corazons death YES, under the doc-
still held vicariously liable under the doctrine of apparent authority trine of apparent authority, which is an exception to the general rule.
DOCTRINE. Control test for hospital-dr. relationships: The hospital must have the right to Nogales seeks to make CMC liable under NCC 2180, or under the ERs responsibility un-
control both the means and the details of the process by which the dr. is to accomplish his der patria potestas
task. In general, a hospital is not liable for the negligence of an independent contractor-
physician. There is, however, an exception to this principle. The hospital may be liable
FACTS. if the physician is the "ostensible" agent of the hospital. This exception is also known
The wife of petitioner Nogales, Corazon, died in childbirth. He is accusing respondent as the "doctrine of apparent authority.
Capitol Medical (CMC) and Dr. Estrada, the primary doctor of Corazon For a hospital to be liable under the doctrine of apparent authority, a plaintiff must
[Medical things] On Corazons last trimester, Dr. Estrada noted an increase in her blood show that:
pressure, and things indicating preeclampsia o (1) the hospital, or its agent, acted in a manner that would lead a reasonable person
o One day, Corazon started to experience mild labor pains, so she and Nogales went to Dr. to conclude that the individual who was alleged to be negligent was an employee or
Estrada who immediately recommended their admission in CMC agent of the hospital;
o After Corazons water broke, and her cervix was fully dilated, and she experienced con- o (2) where the acts of the agent create the appearance of authority, the plaintiff must
vulsions, Dr. Estrada ordered that she be injected with 10g of magnesium sulfate. As- also prove that the hospital had knowledge of and acquiesced in them; and
sisting dr. Dr. Villaflor only administered 2.5g o (3) the plaintiff acted in reliance upon the conduct of the hospital or its agent, con-
o Dr. Estrada applied low forceps to extract the baby. A piece of cervical tissue got torn sistent with ordinary care and prudence.
o The baby came out not okay1. After the baby came out, Corazon started bleeding pro- Factors to consider:
fusely o An inquiry on whether the hospital acted in a manner which would lead a reasonable
o Bags of blood arrived 1 hr after the bleeding started person to conclude that the individual who was alleged to be negligent was an employ-
o Emergency hysterectomy recommended by CMCs OBGYNE Dept head, but it was not ee or agent of the hospital. The hospital need not make express representations to the
performed patient that the treating physician is an employee of the hospital; rather a representa-
o In the end, Corazon died because of hemorrhage tion may be general and implied.
RTC: Dr. Estrada held civilly liable to Nogales. Complaint as to other respondents dis- As to this factor, CMC impliedly held out Dr. Estrada as a member of its medical staff
missed CMC granted staff privileges to Dr. Estrada and extended its medical staff and fa-
CA: RTC affirmed cilities to him
Note: Dr. Estradas liability is established, so the issue in this case in WON CMC is liable CMC made Nogales sign consent forms printed with the CMC letter head. These
forms did not indicate the Dr. Estrada was an independent contractor. Nogales
ISSUES & RATIO. and Corazon were not informed by anyone of this.
1. WON Dr. Estrada is CMCs EE NO, he is an independent contractor When Dr. Estrada referred Corazons profuse vaginal bleeding to Dr. Espinola,
SC used the control test2: whether an employment relationship exists between a physi- Head of CMCs OBGYNE Dept, it gave he impression that Dr. Estrada, as a mem-
cian and a hospital based on the exercise of control over the physician as to details. ber of CMCs medical staff, was collaborating with other CMC-employed people
o An inquiry on whether the plaintiff acted in reliance upon the conduct of the hospital or
its agent, consistent with ordinary care and prudence
As to this factor, Nogales testified that he and Corazon chose Dr. Estrada partly be-
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apric, cyanatic weak and injured condition cause of his connections to CMC.
2
As suggested (but not expounded upon) in Ramos v. CA
Dr. Estradas relationship with CMC played a significant role in Nogales and Cora-
zons decision to accept Dr. Estradas services.
The SC cited El Hogar, saying than an employer cannot be legally compelled to contin-
ue with the employment of a person who was admittedly guilty of misfeasance or mal-
feasance. They also believe that this situation is not unlike a hijack, because Vir-Jen was
coerced, threatened and intimidated when it was generally without recourse but to
yield to the peril of irreparable loss

3. What about the other respondents?


Dr. Villaflor (Assisting Dr) Not liable. Dr. Villaflor administered a lower dosage of
magnesium sulfate because Corazons BP went down to dangerous levels. The lower
dosage was known to, and was approved by Dr. Estrada
Dr. Uy (random resident physician at CMC) - Not liable. Did not participate in delivery,
and its not even sure that she was in the delivery room. That she makes a routine inter-
nal examiniation of Corazon does not make her ipso facto liable. Also, shes like, second
year resident physicial
Dr. Enriquez (anaesthesiologist) - Not liable. Not an expert in OBGYNE things lol
Dr. Lacson (blood bank supervisor) Not liable. No unreasonable delay in giving blood
to Corazon. She stated that the blood would be ready in 45-60 mins. Also, no evidence
that she neglected her duties
Dr. Espinola (CMCs OBGYNE Dept head) Not liable. Believed in good faith that hys-
terectomy was the correct remedy, based on info he received over the phone.
Nurse Dumlao Not liable. No showing of her failure to follow Dr. Estradas instructions

DECISION.
Petition partly granted. CMC held vicariously liable