PICART vs. SMITH, JR.

G.R. No. L-12219

March 15, 1918
STREET, J.:
FACTS: On the Carlatan Bridge in La Union. Picart was riding on his pony over
said bridge. Before he had gotten half way across, Smith approached from the
opposite direction in an automobile. As the defendant neared the bridge he
saw a horseman on it and blew his horn to give warning of his approach. He
continued his course and after he had taken the bridge he gave two more
successive blasts, as it appeared to him that the man on horseback before him
was not observing the rule of the road.
Picart saw the automobile coming and heard the warning signals. However,
being perturbed by the novelty of the apparition or the rapidity of the
approach, he pulled the pony closely up against the railing on the right side of
the bridge instead of going to the left. He says that the reason he did this was
that he thought he did not have sufficient time to get over to the other side. As
the automobile approached, Smith guided it toward his left, that being the
proper side of the road for the machine. In so doing the defendant assumed
that the horseman would move to the other side. Seeing that the pony was
apparently quiet, the defendant, instead of veering to the right while yet some
distance away or slowing down, continued to approach directly toward the
horse without diminution of speed. When he had gotten quite near, there
being then no possibility of the horse getting across to the other side, the
defendant quickly turned his car sufficiently to the right to escape hitting the
horse; but in so doing the automobile passed in such close proximity to the
animal that it became frightened and turned its body across the bridge, got hit
by the car and the limb was broken. The horse fell and its rider was thrown off
with some violenceAs a result of its injuries the horse died. The plaintiff
received contusions which caused temporary unconsciousness and required
medical attention for several days.

From a judgment of the CFI of La Union absolving Smith from liability Picart
has appealed.

ISSUE: WON Smith was guilty of negligence such as gives rise to a civil
obligation to repair the damage done
HELD: the judgment of the lower court must be reversed, and judgment is here
rendered that the Picart recover of Smith damages
YES
The test by which to determine the existence of negligence in a particular case
may be stated as follows: Did the defendant in doing the alleged negligent act
use that person would have used in the same situation? If not, then he is guilty
of negligence. The existence of negligence in a given case is not determined by
reference to the personal judgment of the actor in the situation before him.
The law considers what would be reckless, blameworthy, or negligent in the
man of ordinary intelligence and prudence and determines liability by that.
The question as to what would constitute the conduct of a prudent man in a
given situation must of course be always determined in the light of human
experience and in view of the facts involved in the particular case.

Could a prudent man, in the case under consideration, foresee harm as a

result of the course actually pursued? If so, it was the duty of the actor to take
precautions to guard against that harm. Reasonable foresight of harm,
followed by ignoring of the suggestion born of this prevision, is always
necessary before negligence can be held to exist. Stated in these terms, the
proper criterion for determining the existence of negligence in a given case is
this: Conduct is said to be negligent when a prudent man in the position of the
tortfeasor would have foreseen that an effect harmful to another was
sufficiently probable to warrant his foregoing conduct or guarding against its
consequences.

Applying this test to the conduct of the defendant in the present case we think
that negligence is clearly established. A prudent man, placed in the position of
the defendant, would in our opinion, have recognized that the course which he
was pursuing was fraught with risk, and would therefore have foreseen harm
to the horse and the rider as reasonable consequence of that course. Under
these circumstances the law imposed on the Smith the duty to guard against
the threatened harm.

It goes without saying that the plaintiff himself was not free from fault, for he
was guilty of antecedent negligence in planting himself on the wrong side of
the road. But as we have already stated, Smith was also negligent; and in such
case the problem always is to discover which agent is immediately and directly
responsible. It will be noted that the negligent acts of the two parties were not
contemporaneous, since the negligence of the defendant succeeded the
negligence of the plaintiff by an appreciable interval. Under these
circumstances the law is that the person who has the last fair chance to avoid
the impending harm and fails to do so is chargeable with the consequences,
without reference to the prior negligence of the other party.
CHILD LEARNING CENTER, INC. and SPOUSES EDGARDO L. LIMON and SYLVIA S. LIMON, vs. TIMOTHY
TAGARIO, assisted by his parents BASILIO TAGORIO and HERMINIA TAGORIO

GR No. 150920, November 25, 2005

FACTS:

Timothy Tagoria was a grade IV student at Marymount School, an academic institution operated and
maintained by Child Learning Center, Inc. (CLC). One afternoon, he found himself locked

inside the boy’s comfort room in Marymount. He started to panic so he banged and kicke

d the door and yelled for help. No help arrived. He then decided to open the window to call for help. As
he opened the window, Timothy went right through and fell down three stories. Timothy was
hospitalized and given medical treatment for serious multiple physical injuries. He, assisted by his
parents, filed a civil action against the CLC, the members of its Board of Directors which includes the
Spouses Limon. They claim that the school was negligent for not installing iron grills at the

window of the boy’

s comfort room. CLC, in its defense, maintained that there was nothing defective about the locking
mechanism of the door and that the fall of Timothy was not due to its fault or negligence. CLC further
maintained that it had exercised the due care and diligence of a good father of a family to ensure the
safety, well-being and convenience of its students. The trial court ruled in favor of the respondents. The
respondents proceeded their appeal to the Court of

Appeals who affirmed the trial court’s ruling in

toto.

ISSUE

Whether or not the school was negligent for the boy’s accidental fall.

RULING:

YES. In every tort case filed under Article 2176 of the Civil Code, plaintiff has to prove by a
preponderance of evidence: (1) the damages suffered by the plaintiff; (2) the fault or negligence of the
defendant or some other person for whose act he must respond; and (3) the connection of cause and
effect between the fault or negligence and the damages incurred. In this tort case, respondents contend
that CLC failed to provide precautionary measures to avoid harm and injury to its students in two
instances: (1) failure to fix a defective door knob despite having been notified of the problem; and (2)
failure to install safety grills on the window where Timothy fell from. During trial, it was found that the
lock was defective. The architect witness testified that he did not verify if the doorknob at the comfort
room was actually put in place. Further, the fact that Timothy fell out through the window shows that
the door could not be opened from the inside. That sufficiently points to the fact that something was
wrong with the door, if not the door knob, under the principle of
res ipsa loquitor

. The doctrine of

res ipsa loquitor

applies where (1) the accident was of such character as to warrant an inference that it would not have
happened

except for the defendant’s negligence; (2) the accident must have been caused by an agency or

instrumentality within the exclusive management or control of the person charged with the negligence
complained of; and (3) the accident must not have been due to any voluntary action or contribution on
the part of the person injured. Petitioners are clearly answerable for failure to see to it that the doors of
their school toilets are at all times in working condition. The fact that a student had to go through the
window, instead of the door, shows that something was wrong with the door. As to the absence of grills
on the window, petitioners contend that there was no such requirement under the Building Code.
Nevertheless, the fact is that such window, as petitioners themselves point out, was approximately 1.5
meters from the floor, so that it was within reach of a student who finds the regular exit, the door, not
functioning.

Torts And Damages Case Digest: Valenzuela

V. CA (1996)
G.R.No. 115024 February 7, 1996
Lessons Applicable:

 Calculation of Risk (Torts and Damages)

 Factors in Determining Amount (Torts and Damages)

FACTS:
 June 24, 1990 2 am: While driving from her restaurant at Araneta avenue
towards the direction of Manila, Ma. Lourdes Valenzuela noticed that she
had a flat tire so she parked along the sidewalk about 1 1/2 feet away,
place her emergency lights and seeked help
 She was with her companion Cecilia Ramon
 While she was pointing her tools to the man who will help her fixed the tires, she
was suddenly hit by another Mitsubishi Lancer driven by Richard Li who was
intoxicated and she slammed accross his windshield and fell to the ground
 She was sent to UERM where she stayed for 20 days and her leg was amputated
and was replaced with an artificial one.
 Her expenses totalled 147, 000 [120,000 php (confinement) + 27, 000 (aritificial
leg)]
 RTC: Richard Li guilty of gross negligence and liable for damages under Article
2176 of the Civil Code. Alexander Commercial, Inc., Li’s employer, jointly
and severally liable for damages pursuant to Article 2180 P41,840 actual
damages, P37,500 unrealized profits because of the stoppage of plaintiffs Bistro
La Conga restaurant 3 weeks after the accident on June 24, 1990, P20,000 a
month as unrealized profits of Bistro La Conga restaurant, from August, 1990
until the date of this judgment, P30,000.00, a month, for unrealized profits in 2 Beauty
salons, P1,000,000 in moral damages, P50,000, as exemplary
damages, P60,000, as reasonable attorney’s fees and costs.
 CA: there was ample evidence that the car was parked at the side but
absolved Li's employer
 Li: 55 kph - self serving and uncorraborated
 Rogelio Rodriguez, the owner-operator of an establishment located just
across the scene of the accident: Valenzuela’s car parked parallel and
very near the sidewalk and Li was driving on a very fast speed and there
was only a drizzle (NOT heavy rain)
ISSUE:
1. W/N Li was driving at 55 kph - NO
2. W/N Valenzuela was guilty of contributory negligence - NO
3. W/N Alexander Commercial, Inc. as Li's employer should be held liable -
YES
4. W/N the awarding of damages is proper. - YES.

HELD: CA modified with reinstating the RTC decision

1. NO
 If Li was running at only about 55 kph then despite the wet and slippery
road, he could have avoided hitting the Valenzuela by the mere expedient
or applying his brakes at the proper time and distance
 it was not even necessary for him to swerve a little to the right in order
to safely avoid a collision with the on-coming car since there is plenty of
space for both cars, since Valenzuela car was running at the right lane
going towards Manila and the on-coming car was also on its right lane
going to Cubao
2. NO.
 Contributory negligence is conduct on the part of the injured party,
contributing as a legal cause to the harm he has suffered, which falls
below the standard to which he is required to conform for his own
protection
 emergency rule
 an individual who suddenly finds himself in a situation of danger and is
required to act without much time to consider the best means that may
be adopted to avoid the impending danger, is not guilty of negligence if
he fails to undertake what subsequently and upon reflection may appear
to be a better solution, unless the emergency was brought by his own
negligence
 She is not expected to run the entire boulevard in search for a parking
zone or turn on a dark Street or alley where she would likely find no one
to help her
 She stopped at a lighted place where there were people, to verify
whether she had a flat tire and to solicit help if needed
 she parked along the sidewalk, about 1½ feet away, behind a Toyota
Corona Car
3. YES.
 Not the principle of respondeat superior, which holds the master liable for
acts of the servant (must be in the course of business), but that of pater
familias, in which the liability ultimately falls upon the employer, for his
failure to exercise the diligence of a good father of the family in the
selection and supervision of his employees
 Ordinarily, evidence demonstrating that the employer has exercised
diligent supervision of its employee during the performance of the latter‘s
assigned tasks would be enough to relieve him of the liability imposed by
Article 2180 in relation to Article 2176 of the Civil Code.
 situation is of a different character, involving a practice utilized by large
companies with either their employees of managerial rank or their
representatives.
 Moreover, Li’s claim that he happened to be on the road on the night of
the accident because he was coming from a social visit with an officemate
in Parañaque was a bare allegation which was never corroborated in the
court below. It was obviously self-serving. Assuming he really came from his officemate’s
place, the same could give rise to speculation that he and his officemate had just been from a
work-related function, or they were together to discuss sales and other work related strategies.
 Alexander Commercial, Inc. has not demonstrated, to our satisfaction,
that it exercised the care and diligence of a good father of the family in
entrusting its company car to Li
4. YES.
 As the amount of moral damages are subject to this Court’s discretion, we are of the
opinion that the amount of P1,000,000.00 granted by the trial court is in greater accord
with the extent and nature of the injury -. physical and psychological - suffered by
Valenzuela as a result of Li’s grossly negligent driving of his Mitsubishi Lancer in the
early morning hours of the accident.
 the damage done to her would not only be permanent and lasting, it would also be
permanently changing and adjusting to the physiologic changes which her body would
normally undergo through the years. The replacements, changes, and adjustments will
require corresponding adjustive physical and occupational therapy. All of these
adjustments, it has been documented, are painful.

McKee vs IAC:

Facts: Two boys suddenly darted before McKee’s car forcing McKee to swerve the car to avoid hitting
the boys and in the process entered into the opposite lane and collided with the oncoming cargo truck
in the opposite lane.

Cases: to illustrate the exception expressed in “unless the emergency in which he finds himself is
brought about by his own negligence”.

The failure to observe for the protection of the interest of another person, that degree of care,
precaution, and vigilance which the circumstances justly demand, whereby such person suffers injury.
(Mckee vs IAC, 211 SCRA 517, ’92, citing Black Law Dictionary and Judge Cooley: J. Davide Jr)

Reyes vs. Sisters of Mercy Hospital G.R No. 130547 (October 3, 2000) A.

Legal Issue Whether or not Sisters of Mercy Hospital is liable for the death of Jorge Reyes. B.

Facts Petitioner, Leah Alesna Reyes, is the wife of the deceased patient, Jorge Reyes. Five days
before the latter’s death, Jorge has been suffering from recurring fever with chills. The doctors

confirmed through the Widal test that Jorge has typhoid fever. However, he did not respond to the
treatment and

died. The cause of his death was “Ventric

ular Arrythemia Secondary to

Hyperpyrexia and typhoid fever.”

Consequently, petitioner filed the instant case for damages before the Regional Trial Court of Cebu
City, which dismissed the case and was affirmed by the Court of Appeals. The contention was that Jorge
did not die of typhoid fever. Instead, his death was due to the wrongful administration of chloromycetin.
They contended that had respondent doctors exercised due care and diligence, they would not have
recommended and rushed the performance of the Widal Test, hastily concluded that Jorge was suffering
from typhoid fever, and

administered chloromycetin without first conducting sufficient tests on the patient’s

compatibility with said drug. C.

Ruling Sisters of Mercy Hospital is not liable for the death of Jorge Reyes. D.

Reasoning of the Court There is no showing that the attending physician in this case deviated from the
usual course of treatment with respect to typhoid fever. Jorge was given antibiotic choloromycetin and
some dose of triglobe after compatibility test was made by the doctor and found that no adverse
reactions manifested which would necessitate replacement of the medicines. Indeed, the standard
contemplated is not what is actually the average merit among all known practitioners from the best to
the worst and from the most to the least experienced, but the reasonable average merit among the
ordinarily good physicians. Here, the doctors did not depart from the reasonable standard
recommended by the experts as they in fact observed the due care required under the circumstances. E.

Policy In Medical Negligence cases, it is incumbent upon the plaintiff to establish that the usual
procedure in treating the illness is not followed by the doctor. Failure to prove this, the doctor is not
liable. Physicians are not insurers of the success of every procedure undertaken and if the procedure
was shown to be properly done but did not work, they cannot be faulted for such result.

RAMOS vs. COURT OF APPEALS

G.R. No. 124354. December 29, 1999.

Ponente: Kapunan
FACTS:

Erlinda Ramos underwent a surgical procedure to remove stone from her gall bladder
(cholecystectomy). They hired Dr. Hosaka, a surgeon, to conduct the surgery at the De Los
Santos Medical Center (DLSMC). Hosaka assured them that he would find a good
anesthesiologist. But the operation did not go as planned, Dr. Hosaka arrived 3 hours late
for the operation, Dra. Gutierrez, the anesthesiologist “botched” the administration of the
anesthesia causing Erlinda to go into a coma and suffer brain damage. The botched
operation was witnessed by Herminda Cruz, sister in law of Erlinda and Dean of College of
Nursing of Capitol Medical Center.

The family of Ramos (petitioners) sued the hospital, the surgeon and the anesthesiologist
for damages. The petitioners showed expert testimony showing that Erlinda's condition was
caused by the anesthesiologist in not exercising reasonable care in “intubating” Erlinda.
Eyewitnesses heard the anesthesiologist saying “Ang hirap ma-intubate nito, mali yata ang
pagkakapasok. O lumalaki ang tiyan.”

Diagnostic tests prior to surgery showed that Erlinda was robust and fit to undergo surgery.

The RTC held that the anesthesiologist ommitted to exercise due care in intubating the
patient, the surgeon was remiss in his obligation to provide a “good anesthesiologist” and
for arriving 3 hours late and the hospital is liable for the negligence of the doctors and for
not cancelling the operation after the surgeon failed to arrive on time. The surgeon,
anesthesiologist and the DLSMC were all held jointly and severally liable for damages to
petitioners. The CA reversed the decision of the Trial Court.

ISSUES: Whether or not the private respondents were negligent and thereby caused the
comatose condition of Ramos.

HELD:

Yes, private respondents were all negligent and are solidarily liable for the damages.

RATIO:

Res ipsa loquitur – a procedural or evidentiary rule which means “the thing or the
transaction speaks for itself.” It 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 plaintiff’s prima facie case, and present a
question of fact for defendant to meet with an explanation, where ordinarily in a medical
malpractice case, the complaining party must present expert testimony to prove that the
attending physician was negligent.

This doctrine finds application in this case. On the day of the operation, Erlinda Ramos
already surrendered her person to the private respondents who had complete and exclusive
control over her. Apart from the gallstone problem, she was neurologically sound and fit.
Then, after the procedure, she was comatose and brain damaged—res ipsa loquitur!—the
thing speaks for itself!

Negligence – Private respondents were not able to disprove the presumption of negligence
on their part in the care of Erlinda and their negligence was the proximate cause of her
condition. One need not be an anesthesiologist in order to tell whether or not the intubation
was a success. [res ipsa loquitur applies here]. The Supreme Court also found that the
anesthesiologist only saw Erlinda for the first time on the day of the operation which
indicates unfamiliarity with the patient and which is an act of negligence and irresponsibility.

The head surgeon, Dr. Hosaka was also negligent. He failed to exercise the proper authority
as the “captain of the ship” in determining if the anesthesiologist observed the proper
protocols. Also, because he was late, he did not have time to confer with the
anesthesiologist regarding the anesthesia delivery.

The hospital failed to adduce evidence showing that it exercised the diligence of a good
father of the family in hiring and supervision of its doctors (Art. 2180). The hospital was
negligent since they are the one in control of the hiring and firing of their “consultants”.
While these consultants are not employees, hospitals still exert significant controls on the
selection and termination of doctors who work there which is one of the hallmarks of an
employer-employee reationship. Thus, the hospital was allocated a share in the liability.

Damages – temperate damages can and should be awarded on top of actual or

compensatory damages in instances where the injury is chronic and continuing.

GARCIA-RUEDA vs. PASCASIO

FACTS:Florencio V. Rueda, husband of petitioner Leonila Garcia-Rueda, underwent surgicaloperation at

the UST hospital for the removal of a stone blocking his ureter. He was attended byDr. Domingo
Antonio, Jr. who was the surgeon, while Dr. Erlinda Balatbat-Reyes was theanaesthesiologist. Six hours
after the surgery, however, Florencio died of complications of"unknown cause," according to officials of
the UST Hospital.Not satisfied with the findings of the hospital, petitioner requested the National
Bureau ofInvestigation (NBI) to conduct an autopsy on her husband's body. Consequently, the NBI ruled
thatFlorencio's death was due to lack of care by the attending physician in administering
anaesthesia.Pursuant to its findings, the NBI recommended that Dr. Domingo Antonio and Dr. Erlinda
Balatbat-Reyes be charged for Homicide through Reckless Imprudence before the Office of the
CityProsecutor.During the preliminary investigation, what transpired was a confounding series of
eventswhich we shall try to disentangle. The case was initially assigned to Prosecutor Antonio M.
Israel,who had to inhibit himself because he was related to the counsel of one of the doctors. As a
result,the case was re-raffled to Prosecutor Norberto G. Leono who was, however, disqualified on
motionof the petitioner since he disregarded prevailing laws and jurisprudence regarding
preliminaryinvestigation. The case was then referred to Prosecutor Ramon O. Carisma, who issued a
resolutionrecommending that only Dr. Reyes be held criminally liable and that the complaint against
Dr.Antonio be dismissed.The case took another perplexing turn when Assistant City Prosecutor Josefina
SantosSioson, in the "interest of justice and peace of mind of the parties," recommended that the case
bere-raffled on the ground that Prosecutor Carisma was partial to the petitioner. Thus, the case
wastransferred to Prosecutor Leoncia R. Dimagiba, where a

volte face

occurred again with theendorsement that the complaint against Dr. Reyes be dismissed and instead, a
correspondinginformation be filed against Dr. Antonio. Petitioner filed a motion for reconsideration,
questioningthe findings of Prosecutor Dimagiba.Pending the resolution of petitioner's motion for
reconsideration regarding ProsecutorDimagiba's resolution, the investigative "pingpong" continued
when the case was again assigned toanother prosecutor, Eudoxia T. Gualberto, who recommended that
Dr. Reyes be included in thecriminal information of Homicide through Reckless Imprudence. While the
recommendation ofProsecutor Gualberto was pending, the case was transferred to Senior State
Prosecutor GregorioA. Arizala, who resolved to exonerate Dr. Reyes from any wrongdoing, a resolution
which wasapproved by both City Prosecutor Porfirio G. Macaraeg and City Prosecutor Jesus F.
Guerrero.Aggrieved, petitioner filed graft charges specifically for violation of Section 3(e) ofRepublic Act
No. 3019

against Prosecutors Guerrero, Macaraeg, and Arizala for manifest partialityin favor of Dr. Reyes before
the Office of the Ombudsman. However, on July 11, 1994, theOmbudsman issued the assailed resolution
dismissing the complaint for lack of evidence.In fine, petitioner assails the exercise of the discretionary
power of the Ombudsman toreview the recommendations of the government prosecutors and to
approve and disapprove thesame. Petitioner faults the Ombudsman for, allegedly in grave abuse of
discretion, refusing to findthat there exists probable cause to hold public respondent City Prosecutors
liable for violation ofSection 3(e) of R.A. No. 3019.ISSUE:Whether or not expert testimony is necessary
to prove the negligent act of the respondent.RULING:In accepting a case, a doctor in effect represents
that,

having the needed training andskill possessed by physicians and surgeons practicing in the same field, he
will employ such training, care and skill in the treatment of his patients. He therefore has a duty to use
atleast the same level of care that any other reasonably competent doctor would use to treat acondition
under the same circumstances.

It is in this aspect of medical malpractice that experttestimony is essential to establish not only the
standard of care of the profession but also that thephysician's conduct in the treatment and care falls
below such standard. Further, inasmuch as thecauses of the injuries involved in malpractice actions are
determinable only in the light of scientificknowledge, it has been recognized that

expert testimony is usually necessary to support theconclusion as to causation.

Immediately apparent from a review of the records of this case is the absence of anyexpert testimony
on the matter of the standard of care employed by other physicians of goodstanding in the conduct of
similar operations. The prosecution's expert witnesses in the persons ofDr. Floresto Arizala and Dr. Nieto
Salvador, Jr. of the National Bureau of Investigation (NBI) onlytestified as to the possible cause of death
but did not venture to illuminate the court on the matterof the standard of care that petitioner should
have exercised.The better and more logical remedy under the circumstances would have been to appeal
theresolution of the City Prosecutors dismissing the criminal complaint to the Secretary of Justiceunder
the Department of Justice's Order No. 223, otherwise known as the "1993 Revised Rules onAppeals
From Resolutions In Preliminary Investigations/Reinvestigations," as amended byDepartment Order No.
359, Section 1 of which provides:Sec. 1.

What May Be Appealed

. — Only resolutions of the Chief StateProsecutor/Regional State Prosecutor/Provincial or City

Prosecutor dismissing acriminal complaint may be the subject of an appeal to the Secretary of
Justiceexcept as otherwise provided in Section 4 hereof.What action may the Secretary of Justice take
on the appeal? Section 9 of Order No. 223states: "The Secretary of Justice may reverse, affirm or modify
the appealed resolution." On theother hand, "He may

motu proprio

or on motion of the appellee, dismiss outright the appeal onspecified grounds."In exercising his
discretion under the circumstances, the Ombudsman acted within hispower and authority in dismissing
the complaint against the Prosecutors and this Court will notinterfere with the same.Petition is
dismissed.

Professional Services Inc. vs Agana

GR No. 126297 January 31, 2007

Facts: On April 4, 1984, Natividad Agana was rushed to the Medical City General Hospital because of difficulty of
bowel movement and bloody anal discharge. After a series of medical examinations, Dr. Miguel Ampil diagnosed her
to be suffering from Cancer of the sigmoid. On April 11, 1984, Dr. Ampil assisted by the medical staff of the Medical
City Hospital performed an Anterior resection surgery on Natividad. He found that the malignancy on her sigmoid
area had spread on her left ovary, necessitating the removal of certain portions of it. Thus, Dr. Ampil obtained the
consent of Natividad’s husband, Enrique Agana, to permit Dr. Juan Fuentes to perform hysterectomy on her. After
Dr. Fuentes had completed the hysterectomy, Dr. Ampil took over, completed the operation and closed the incision
after searching for the missing 2 gauzes as indicated by the assisting nurses but failed to locate it. After a couple of
days, Natividad complained of excruciating pains in her anal region but Dr. Ampil said it is a natural consequence of
the operation/surgery and recommended that she consult an oncologist to examine the cancerous nodes which were
not removed during the operation. Natividad and her husband went to the US to seek further treatment and she was
declared free from cancer. A piece of gauze portruding from Natividad’s vagina was found by her daughter which was
then removed by hand by Dr. Ampil and assured that the pains will vanished. However, it didn’t. The pains intensified
prompting Natividad to seek treatment at the Polymedic General Hospital. While confined there, Dr. Ramon Guttierez
detected the presence of another foreign object in her vagina – a foul smelling gauze measuring 1.5 inches in width
which badly infected her vagina. A recto-vaginal fistula had forced stool to excrete through her vagina. Another
surgical operation was needed to remedy the damage.

Issue: Whether or not Dr. Ampil and Fuentes are liable for medical malpractice and the PSI for damages due to the
negligence of the said doctors.

Held: Yes. No. Yes. An 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 inference of negligence. There are even legions of authorities to
the effect that such act is negligence per se.

This is a clear case of medical malpractice or more appropriately, medical negligence. To successfully pursue this
kind of case, a patient must only prove that a health care provider either failed to do something which a reasonably
prudent health care provider would have done, or that he did something that a reasonably prudent provider would not
have done; and that failure or action caused injury to the patient. Simply puts the elements are duty, breach, injury,
and proximate causation. Dr. Ampil, as the 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
by American doctors and another surgery. That Dr. Ampil’s negligence is the proximate cause of Natividad’s injury
could be traced from his act of closing the incision despite the information given by the attending nurses that 2 pieces
of gauze were still missing. That they were later on extracted from Natividad’s vagina established the causal link
between Dr. Ampil’s negligence and the injury. And what further aggravated such injury was his deliberate
concealment of this missing gauzes from the knowledge of Natividad and her family.

The requisites for the applicability of the doctrine of res ipsa liquitor are:

1. Occurrence of an injury;
2. The thing which caused the injury was under the control and management of the defendant;
3. The occurrence was such that in the ordinary course of things would not have happened if those who had
control or management used proper care, and;
4. The absence of explanation by the defendant

Of the foregoing, the most instrumental is the “Control and management of the thing which caused the injury.”

Under the “Captain of the ship” rule, the operating surgeon is the person in complete charge of the surgery room and
all personnel connected with the operation.

The knowledge of any of the staff of Medical City constitutes knowledge of PSI.

The doctrine of corporate responsibility, has the duty to see that it meets the standards of responsibilities for the care
of patients. Such duty includes the proper supervision of the members of its medical staff. The hospital accordingly
has the duty to make a reasonable effort to monitor and over see the treatment prescribed and administered by the
physician practicing in its premises.

MANILA ELECTRIC CO. vs. REMOQUILLO, et als.

MANILA ELECTRIC CO. vs. REMOQUILLO, et als.

Facts: Efren Magno went to repair a ¨media agua¨ of the house pf his brother-in-law. Whilw making the
repair, a galvanized iron roofing which was holding came into contact with the electric wire of the
petitioner Manila Electric Co. strung parallel to the edge of the ¨media agua¨ and 2 1/2 feet from it. He
was electrocuted and died as a result thereof. In an action for damages brought by the heirs of Magno
against manila Electric Co. the CA awarded damages to the heirs of Magno and that the company was at
fault and guilty of negligence because although the electric wire had been installed long before the
construction of the house the electric company did not exercise due diligence. Hence, this petition.

Issue: WON Manila Electric Co., is gulity of negligence.

Ruling : Decision of the CA reversed.

Ratio: A prior and remote cause cannot be made the basis of an action if such remote cause did nothing
more than furnish the condition or give rise to the occassion by which the injury was made possible, if
there intervened between such prior or remote cause and the injury a distinct, successive, unrelated, and
efficient cause of the injury, even though such injury would not have happened but for such condition or
occassion.

PEOPLE vs. VILLACORTA

G.R. No. 186412

September 7, 2011

FACTS:

While Cruz was ordering bread at Mendeja’s store, Villacorta suddenly appeared
and stabbed Cruz on the left side of Cruz’s body using a sharpened bamboo
stick.The bamboo stick broke and was left in Cruz’s body. Immediately after the
stabbing incident, Villacorta fled.
RTC rendered a Decision finding Villacorta guilty of murder, qualified by
treachery. The Court of Appeals promulgated its Decision affirming in toto the
RTC judgment of conviction against Villacorta.

ISSUE:

Whether or not there was an efficient intervening cause from the time Javier was
wounded until his death which would exculpate Urbano from any liability for
Javier's death

HELD:

The proximate cause of Cruz’s death is the tetanus infection and not the
stab wound.

In the event he is found to have indeed stabbed Cruz, he should only be held

liable for slight physical injuries for the stab wound he inflicted upon Cruz.

If Cruz acquired severe tetanus infection from the stabbing, then the symptoms
would have appeared a lot sooner than 22 days later. Ultimately, we can only
deduce that Cruz’s stab wound was merely the remote cause, and its subsequent
infection with tetanus might have been the proximate cause of Cruz's death. The
infection of Cruz’s stab wound by tetanus was an efficient intervening cause later
or between the time Cruz was stabbed to the time of his death.

The rule is that the death of the victim must be the direct, natural, and
logical consequence of the wounds inflicted upon him by the accused.
And since we are dealing with a criminal conviction, the proof that the accused
caused the victim's death must convince a rational mind beyond reasonable
doubt. The medical findings, however, lead us to a distinct possibility that the
infection of the wound by tetanus was an efficient intervening cause later or
between the time Javier was wounded to the time of his death. The infection was,
therefore, distinct and foreign to the crime.

Tison v. Sps. Pomasin GR No. 173180 Aug 24, 2011 PEREZ, J.: FACTS:

A tractor-trailer and a jitney collided along Maharlika Highway in Albay.

Laarni Pomasin (Laarni)

was the driver of the jitney while the tractor was driven by

Claudio Jabon (Jabon)

. Multiple death and injuries to those in the jitney resulted.

Albert Tison (Tison)

, the owner of the truck, extended financial assistance to respondents P1000 each, and P200,000.00 to

Cynthia Pomasin

(Cynthia)

, sister of Laarni. Cynthia, in turn, executed an Affidavit of Desistance. Still, respondents filed a complaint
for damages before the

RTC of Antipolo

. They alleged that the proximate cause of the accident was the negligence, imprudence and
carelessness of petitioners. In their Answer, petitioners countered that it was Laarnis negligence which
proximately caused the accident. They further claimed that Cynthia was authorized by Spouses Pomasin
to enter into an amicable settlement by executing an Affidavit of Desistance. Petitioners subsequently
filed a motion to dismiss the complaint in view of the Affidavit of Desistance executed by Cynthia.
However, the motion was denied. The

trial court ruled in favor Tison

giving more credence to the testimony of Jabon. The

CA disagreed

with the trial court and ruled that the reckless driving of Jabon caused the vehicular collision based on
the gravity of the

damage caused to the jitney. Also, it was noted that the restriction in Jabon’s driver’s license was
violated, thus, giving rise to the presumption that he was negligent at the time of the accident. Tison
was also held liable for damages for his failure to prove due diligence in supervising Jabon after he was
hired as driver of the truck.

ISSUE

: Whether CA is correct in its findings.

RULING:

NO. Petitioners are not negligent. It was found out during the direct examination of Jabon and

Gregorio Pomasin (Gregorio)

that it was actually the Jitney that was going down hill and the tractor trailer was going uphill at 34-40
kph

According to Article 2176 of the Civil Code, whoever by act or omission causes damage to another, there
being fault or negligence, is obliged to pay for the damage done. To sustain a claim based on

quasi-delict

, the following requisites must concur: (a) damage suffered by the plaintiff; (b) fault or negligence of
defendant; and (c) connection of cause and effect between the fault or negligence of defendant and the
damage incurred by the plaintiff. These requisites must be proved

by a preponderance of evidence. The claimants, respondents in this case, must, therefore, establish

their claim or cause of action by preponderance of evidence, evidence which is of greater weight, or
more convincing than that which is offered in opposition to it.

Driving without a proper license is a violation of traffic regulation. Under Article 2185 of the Civil Code,
the legal presumption of negligence arises if at the time of the mishap, a person was violating any traffic
regulation. However, in

Sanitary Steam Laundry, Inc. v. Court of Appeals,

the court held that a causal connection must exist between the injury received and the violation of the
traffic regulation. It must be proven that the violation of the traffic regulation was the proximate or legal
cause of the injury or that it substantially contributed thereto. Negligence, consisting in whole or in part,
of violation of law, like any other negligence, is without legal consequence unless it is a contributing
cause of the injury. Likewise controlling is our ruling in

Añonuevo v. Court of Appeals

where we reiterated that negligence

per se

, arising from the mere violation of a traffic statute, need not be sufficient in itself in establishing liability
for damages. In said case,

Añonuevo

who was driving a car, did not attempt “to establish a causal connection between the safety

violations imputed to the injured cyclist, and the accident itself. Instead, he relied on a putative
presumption that these violations in themselves sufficiently established negligence appreciable against
the cyclist. Since the onus on

Añonuevo

is to conclusively prove the link between the violations and the accident, we can deem him as having
failed to discharge his necessary burden of

proving the cyclist’s own liability.”

The rule on negligence

per se

must admit qualifications that may arise from the logical consequences of the facts leading to the
mishap. The doctrine (and Article 2185, for that matter) is undeniably useful as a judicial guide in
adjudging liability, for it seeks to impute culpability arising from the failure of the actor to perform up to
a standard established by a legal fiat. But the doctrine should not be rendered inflexible so as to deny
relief when in fact there is no causal relation between the statutory violation and the injury sustained.
Presumptions in law, while convenient, are not intractable so as to forbid rebuttal rooted in fact. After
all, tort law is remunerative in spirit, aiming to provide compensation for the harm suffered by those
whose interests have been invaded owing to the conduct of other. In the instant case, no causal
connection was established between the tractor-

trailer driver’s

restrictions on his license to the vehicular collision. Furthermore, Jabon was able to sufficiently explain
that the Land Transportation Office merely erred in not including restriction code 8 in his license