equally negligent for not making available and accessible the oxygen unit on that same hospital floor at
FIRST DIVISION
[ G.R. No. 189218, March 22, 2017 ]
OUR LADY OF LOURDES HOSPITAL, PETITIONER, VS. SPOUSES ROMEO AND REGINA
CAPANZANA, RESPONDENTS.
DECISION
SERENO, C.J.:
We resolve the instant Petition for Review on Certiorari [1] assailing the Decision[2] and
Resolution[3] rendered by the Court of Appeals (CA), Second Division, in CA-G.R. CV No. 89030.
THE ANTECEDENT FACTS
Regina Capanzana (Regina), a 40-year-old nurse and clinical instructor pregnant with her third child,
was scheduled for her third caesarean section (C-section) on 2 January 1998. However, a week earlier,
on 26 December 1997, she went into active labor and was brought to petitioner hospital for an
emergency C-section. She first underwent a pre-operative physical examination by Dr. Miriam
Ramos[4] (Dr. Ramos) and Dr. Milagros Joyce Santos,[5] (Dr. Santos) the same attending physicians in
her prior childbirths. She was found fit for anesthesia after she responded negatively to questions about
tuberculosis, rheumatic fever, and cardiac diseases. On that same day, she gave birth to a baby boy.
When her condition stabilized, she was discharged from the recovery room and transferred to a regular
hospital room.[6]
At 2:30 a.m. the following day, or 13 hours after her operation, Regina who was then under watch by her
niece, Katherine L. Balad (Balad), complained of a headache, a chilly sensation, restlessness, and
shortness of breath. She asked for oxygen and later became cyanotic. After undergoing an x-ray, she
was found to be suffering from pulmonary edema. She was eventually transferred to the Intensive Care
Unit, where she was hooked to a mechanical ventilator. The impression then was that she was showing
signs of amniotic fluid embolism.[7]
On 2 January 1998, when her condition still showed no improvement, Regina was transferred to the
Cardinal Santos Hospital. The doctors thereat found that she was suffering from rheumatic heart disease
mitral stenosis with mild pulmonary hypertension, which contributed to the onset of fluid in her lung
tissue (pulmonary edema). This development resulted in cardio-pulmonary arrest and, subsequently,
brain damage. Regina lost the use of her speech, eyesight, hearing and limbs. She was discharged, still
in a vegetative state, on 19 January 1998. [8]
Respondent spouses Capanzana filed a complaint for damages[9] against petitioner hospital, along with
co-defendants: Dr. Miriam Ramos, an obstetrician/gynecologist; Dr. Milagros Joyce Santos, an
anesthesiologist; and Jane Does, the nurses on duty stationed on the second floor of petitioner hospital
on 26-27 December 1997.[10]
Respondents imputed negligence to Drs. Ramos and Santos for the latter's failure to detect the heart
disease of Regina, resulting in failure not only to refer her to a cardiologist for cardiac clearance, but also
to provide the appropriate medical management before, during, and after the operation. They further
stated that the nurses were negligent for not having promptly given oxygen, and that the hospital was
the time.[11]
They prayed for actual damages amounting to P814,645.80; compensatory damages, P3,416,278.40;
moral damages, P5,000,000; exemplary damages, P2,000,000; attorney's fees, P500,000 as well as
P5,000 per hearing and the costs of suit. They likewise prayed for other just and equitable reliefs. [12]
Petitioner hospital, defendants Dr. Ramos and Dr. Santos filed their respective Answers.[13] On the other
hand, the service of summons on the nurses was unsuccessful, as they were no longer connected with
the hospital. Thus, only defendant Florita Ballano (Ballano), who was later proven to be a midwife and
not a nurse, filed her Answer.[14]
Petitioner hospital and defendant Ballano claimed that there was no instruction to the hospital or the staff
to place Regina in a room with a standby oxygen tank. They also claimed that the nurses on duty had
promptly attended to her needs. They prayed that the complaint be dismissed and respondents ordered
to pay unpaid medical bills.[15]
Meanwhile, defendant Dr. Ramos claimed that in all of the consultations and prenatal check-ups of
Regina in the latter's three pregnancies, she never complained nor informed the doctor of any symptom
or sign of a heart problem. Before the last C-section of Regina, Dr. Ramos examined her and found no
abnormal cardiac sound, murmur or sign of rheumatic heart ailment. The doctor further claimed that
since the operation was an emergency, she had no time or chance to have Regina undergo any cardiac
examination and secure a cardiac clearance. Moreover, Dr. Ramos claimed that the cardio-pulmonary
arrest took place 14 hours after the operation, long after she had performed the operation. She prayed
that judgment be rendered ordering spouses Capanzana to pay her moral damages amounting to
P500,000; exemplary damages, P200,000; and attorney's fees, P100,000. [16]
On the other hand, defendant Dr. Santos claimed that she was the anesthesiologist in Regina's first and
second childbirths via C-section. The doctor further stated that prior to the third emergency C-section,
she conducted a pre-operative evaluation, and Regina showed no sign or symptom of any heart problem
or abnormality in the latter's cardiovascular, respiratory, or central nervous systems. She then
administered the anesthesia to Regina. She also stated that Regina's condition before, during, and after
the operation was stable. Dr. Santos prayed that the complaint against her be dismissed. [17]
Trial ensued. Plaintiffs presented Dr. Erwin Dizon, a cardiologist; Dr. Godfrey Robeniol, a neurologist;
Mrs. Elizabeth Tayag; Dr. Eleonor Lopez, a cardiologist; Kathleen Lucero Balad; Romeo Capanzana;
and Dr. Asuncion Ranezes, a physician.[18]
After the plaintiffs rested their case, an amended complaint was filed, this time identifying and
impleading as defendants the nurses on duty who included Czarina Ocampo, H.R. Bolatete, Evelyn S.
David, and Angelica Concepcion.[19] After conducting a deposition of the person in charge of the nurses'
schedule, spouses Capanzana further amended their complaint to implead nurses Rochelle Padolina
and Florita Ballano, while dropping defendants Czarina Ocampo, H.R. Bolatete, and Angelica
Concepcion.[20]
The trial continued with the presentation of defense evidence. The defense presented Dr. Santos; Dr.
Ramos; Atty. Nicolas Lutero III, director of the Bureau of Licensing and Facilities of the Department of
Health; Lourdes H. Nicolas, the assistant nursing service director; Dr. Grace de los Angeles; Ma.
Selerina Cuvin, the account receivable clerk; and Milagros de Vera, the administrative supervisor of the
hospital.[21]
On 11 May 2005, and pending the resolution of the case before the trial court, Regina died and was
substituted by her heirs represented by Romeo Capanzana.[22] 2. The amount of Pesos: One Hundred Thousand (P100,000.00), as and by way of moral
damages;

THE RULING OF THE RTC 3. The amount of Pesos: One Million Nine Hundred Fifty Thousand Two Hundred Sixty Nine and
80/100 (P1,950,269.80), as and by way of compensatory damages;
On 29 December 2006, the RTC rendered judgment, finding no negligence on the part of Dr. Ramos or
Dr. Santos. It found that the medical community's recognized standard practices in attending to a patient 4. The amount of Pesos: One Hundred Thousand (P100,000.00), as and by way of attorney's
in connection with a C-section had been duly observed by the doctors. [23] fees;

The RTC also found that the primary cause of Regina's vegetative state was amniotic fluid embolism, an 5. The cost of suit.
unfortunate condition that was not within the control of any doctor to anticipate or prevent. This condition
was the root cause of the pulmonary edema that led to hypoxic encephalopathy, brain damage and, B. Ordering the DISMISSAL of the case as against defendants Our Lady of Lourdes Hospital, Inc., Dr.
ultimately, Regina's vegetative state. On the other hand, the trial court noted that hypoxic Mirriam Ramos and Dr. Milagros Joyce (Jocelyn) Santos; and
encephalopathy was manageable. It could have been prevented, or at least minimized, had there been a
timely administration of oxygen.[24] C. DISMISSING the counterclaims of the defendants.
On the strength of the testimony of Balad, the RTC found that negligence on the part of the nurses SO ORDERED.[27]
contributed to the injury of Regina. It found that they failed to respond immediately when Regina was Respondents Capanzana filed their appeal[28] before the CA, arguing that the RTC committed error in
experiencing shortness of breath. It took the nurses more or less 10 minutes after being informed of the holding that amniotic fluid embolism, which could not have been foreseen or prevented by the exercise
condition of Regina before they checked on her, called for the resident doctor, and requested oxygen. of any degree of diligence and care by defendants, caused the cardio-pulmonary arrest, brain damage,
While the trial court acknowledged that the immediate administration of oxygen was not a guarantee that and death of the patient (instead of rheumatic heart mitral valve stenosis which could have been
Regina's condition would improve, it gave credence to the testimony of the expert witness. The latter detected and managed). Respondents further argued that it was error for the trial court to hold that
opined that the delay contributed to the onset of hypoxic encephalopathy or diffuse brain damage due to defendants Dr. Ramos and Dr. Santos and petitioner hospital exercised due diligence and to absolve
lack of oxygen in Regina's brain. The expert witness also said that had there been a timely them from liability for the untimely death of Regina.[29]
administration of oxygen the risk of brain damage would have been lessened, if not avoided, and the
onset of hypoxic encephalopathy reduced. The RTC therefore found the nurses liable for contributory Petitioner hospital also filed its notice of appeal.[30] It imputed error to the trial court for holding that the
negligence.[25] nurses had not exercised due diligence in attending to the needs of Regina, particularly because (1)
respondent spouses failed to prove any breach of duty on the part of the nurses, particularly Ballano; (2)
On the issue of whether petitioner hospital could be held liable for the negligence of its nurses, the RTC there was no delay in the delivery of oxygen to Regina; and (3) Regina was afflicted with amniotic fluid
ruled that the hospital was able to discharge the burden of proof that it had exercised the diligence of a embolism, a condition that could not have been foreseen or prevented by any degree of care by
good father of a family in the selection and supervision of its employees. The trial court arrived at this defendants.[31] Also, petitioner hospital decried the dismissal of its counterclaims and the exclusion of the
finding on the basis of the testimony of the assistant nursing director, Lourdes Nicolas. She stated that material testimony of one of the hospital nurses.[32]
the selection and hiring of their nurses was a rigorous process, whereby the applicants underwent a
series of procedures - examination, orientation, training, on-the-job observation, and evaluation - before
they were hired as regular employees. The nurses were supervised by their head nurses and the charge THE RULING OF THE CA
nurse. The nurses were also inspected by their clinical supervisor and nursing director. Consequently,
only the nurses were held liable to pay damages. However, since the trial court acquired jurisdiction only The CA rendered the assailed decision affirming the RTC ruling with modification. The appellate court
over Ballano among those on duty on that day, she was the only one held liable.[26] The dispositive upheld the finding of the trial court that the proximate cause of Regina's condition was hypoxic
portion of the RTC decision states: encelopathy, a diffuse brain damage secondary to lack of oxygen in the brain. Specifically, the cause
was hypoxic encelopathy secondary to pulmonary cardiac arrest on the background of pulmonary
WHEREFORE, all foregoing considered, judgment is rendered as follows: edema. The CA decreed that the failure of Dr. Ramos to diagnose the rheumatic heart disease of Regina
was not the proximate cause that brought about the latter's vegetative condition as a probable or natural
A. Ordering the defendant FLORITA BALLANO to pay the plaintiff Romeo R. Capanzana and the effect thereof. Even if the appellate court were to concede that Regina indeed suffered from rheumatic
children of the spouses Capanzana, namely: Roxanne, Rizelle, and Reginald (all minors) who are heart mitral valve stenosis, it was not established that Dr. Ramos ignored standard medical procedure
represented by plaintiff Romeo R. Capanzana in respect to the children's right to the interest of their and exhibited an absence of the competence and skill expected of practitioners similarly situated. [33]
deceased mother Regina in this case:
The CA especially took note of the fact that when Regina was operated on for the third time, albeit in an
emergency situation, she had the benefit of her complete medical history. Also, even the expert witness
1. The amount of Pesos: Two Hundred Ninety Nine Thousand One Hundred Two and 04/100 presented by the plaintiffs, Dr. Dizon, testified that most patients suffering from mild mitral valve stenosis
(P299,102.04), as and by way of actual damages; are asymptomatic, so the disease cannot be detected on physical examination. He further testified that a
request for cardio-pulmonary clearance is discretionary, and that a referral to a pulmonologist can be
done away with if the attending physician finds the patient's heart normal. Thus, the appellate court
upheld the ruling of the trial court absolving Dr. Ramos.[34]
On the issue of the liability of Dr. Santos, the CA discredited the theory of Dr. Dizon that the normal post-
operation dosage of 3 liters of intravenous fluid for 24 hours, or 1 liter every 8 hours, could be fatal to a
patient with a heart problem. It ruled that Dr. Dizon was presented as an expert witness on cardiology,
and not on anesthesiology. Upholding the RTC, the appellate court gave more credence to the testimony
of Dr. Santos, who was accepted as an expert witness in the fields of anesthesiology and obstetric
anesthesiology. She had testified that even if the dosage was beyond the recommended amount, no
harmful effect would have ensued if the patient's kidney were functioning properly. She examined
Regina before the operation and found no edema - an indication that the latter's kidney was functioning
well. The testimony of Dr. Santos remained uncontroverted. The CA also upheld the ruling that
respondents similarly failed to prove that Dr. Santos had ignored standard medical procedure and
exhibited an absence of the competence and skill expected of practitioners similarly situated.
Consequently, the appellate court also upheld the ruling of the trial court absolving Dr. Santos. [35]
Meanwhile, the CA absolved Ballano. Like the RTC, the appellate court found evidence that the nurses
were negligent. But contrary to the trial court, the CA held that there was no showing whether Ballano,
who was later identified as a midwife, was negligent in attending to the needs of Regina. Further, it was
not shown whether Ballano was even one of the nurses on duty who had attended to Regina. The
appellate court also noted that the execution of health care procedures and essential primary health care
is a nurse's (not a midwife's) duty.[36]
Finally, the CA ruled that petitioner hospital should be held liable based on the doctrine of corporate
responsibility. It was found that while there was evidence to prove that petitioner hospital showed
diligence in its selection and hiring processes, there was no evidence to prove that it exercised the
required diligence in the supervision of its nurses. Also, the appellate court ruled that the non-availability
of an oxygen unit on the hospital floor, a fact that was admitted, constituted gross negligence on the part
of petitioner hospital. The CA stressed that, as borne out by the records, there was only one tank in the
ward section of 27 beds. It said that petitioner hospital should have devised an effective way for the staff
to properly and timely respond to a need for an oxygen tank in a situation of acute distress. [37]
Accordingly, the CA awarded to respondents exactly the same amounts decreed by the RTC. This time,
however, instead of Ballano, petitioner hospital was deemed directly liable to pay for those amounts. [38]
Only petitioner hospital filed a Motion for Reconsideration,[39] which the CA denied. The denial came
after a finding that the errors raised in support of the motion were substantially a mere reiteration of
those already passed upon and considered in the assailed decision.[40]
Hence, this petition.
Petitioner hospital is now before this Court assailing the rulings. First, it argues that the CA ruled
contrary to law and evidence, because there was no proof of any breach of duty on the part of the
nurses. Petitioner argues that even if there was a failure to provide oxygen, it did not cause the injury
sustained by Regina. It emphasizes that she suffered from amniotic fluid embolism, a condition that
could not be detected or prevented by any degree of care on the part of the hospital or its nurses.
Second, it argues that it was an error for the CA to hold the former liable on the basis of the doctrine of
corporate responsibility. Third, it alleges that the appellate court erroneously neglected to find
respondents liable for the unpaid hospital bill. Fourth, it claims that the CA supposedly erred in upholding
the exclusion of the testimony of defendant David.[41] Petitioner ultimately prays that the present petition
be granted, the assailed rulings of the CA reversed and set aside, the second amended complaint
dismissed, and petitioner's counterclaims granted.[42]
Respondents filed their Comment,[43] saying that the CA committed no error in finding petitioner liable for
the negligence of the nurses to timely administer oxygen to Regina. Neither did the appellate court, they
claim, err in applying the doctrine of res ipsa loquitur or in decreeing that petitioner hospital had failed to
exercise due diligence in the selection and supervision of the latter's nurses. They further claim that the
CA was correct in holding petitioner liable under the doctrines of vicarious liability and corporate
negligence. Respondents also insist that Regina did not die of amniotic fluid embolism.[44] Hence, they
pray that the instant petition be denied and that the assailed ruling of the CA, which affirmed that of the
RTC, be upheld.[45]
Petitioner filed its Reply.[46] It vehemently protests the idea that Regina died at its hands. It reiterates that
respondents failed to prove that its purported negligent act caused the injury she sustained, and that the
administration of oxygen would have prevented the brain damage she later suffered. Petitioner also
disputes the ruling that the nurses were negligent in attending to her needs. It bewails the exclusion of
the testimony of one of the defendant nurses who could have debunked the testimony of Balad. It
restates its prayer that the present petition be granted and the assailed rulings of the CA reversed and
set aside. Further, it prays that the second amended complaint be dismissed and its counterclaims
granted. Additionally, albeit belatedly, it asks that the case be remanded to the trial court for the
reception of the testimony of defendant nurse David.
OUR RULING
We find the petition partially meritorious.
We reiterate the elementary rule that only questions of law are entertained in a Rule 45
petition.[47] Findings of fact of the lower courts are generally conclusive and binding on this Court whose
function is not to analyze or weigh the evidence all over again. While there are exceptional cases in
which this Court may review findings of fact of the CA, none of these exceptions is present in the case at
bar.[48] We see no compelling reason to deviate from this general rule now. We therefore defer to the
pertinent factual findings of the lower courts, especially because these are well-supported by the
records. It is in this light that we affirm the findings of both the trial and the appellate courts which found
negligence on the part of the nurses.
In order to successfully pursue a claim in a medical negligence case, the plaintiff must prove that a
health professional either failed to do something which a reasonably prudent health professional would
have or have not done; and that the action or omission caused injury to the patient. Proceeding from this
guideline, the plaintiff must show the following elements by a preponderance of evidence: duty of the
health professional, breach of that duty, injury of the patient, and proximate causation between the
breach and the injury.[49] Meanwhile, in fixing a standard by which a court may determine whether the
physician properly performed the requisite duty toward the patient, expert medical testimonies from both
plaintiff and defense are resorted to.[50]
In this case, the expert testimony of witness for the respondent Dr. Godfrey Robeniol, a neurosurgeon,
provided that the best time to treat hypoxic encephalopathy is at the time of its occurrence; i.e., when the
patient is experiencing difficulty in breathing and showing signs of cardiac arrest.[51]
To recall, the records, including petitioner's Nurses' Notes, indisputably show that Regina complained of
difficulty in breathing before eventually showing signs of cyanosis.[52] We agree with the courts below in
their finding that when she was gasping for breath and turning cyanotic, it was the duty of the nurses to
intervene immediately by informing the resident doctor. Had they done so, proper oxygenation could
have been restored and other interventions performed without wasting valuable time. That such high
degree of care and responsiveness was needed cannot be overemphasized - considering that according Q: About how many time[s] did you buzz for help?
to expert medical evidence in the records, it takes only five minutes of oxygen deprivation for irreversible Several times, sir, because I saw Tita Regie[Regina] as if she doesn't [sic] take it
A:
brain damage to set in.[53] Indeed, the Court has emphasized that a higher degree of caution and an anymore, sir.
exacting standard of diligence in patient management and health care are required of a hospital's staff, Q: How long did it take before any nurse come [sic] to the room?
as they deal with the lives of patients who seek urgent medical assistance.[54] It is incumbent upon A: Ten (10) to fifteen (15 minutes) because they were not in the nurse's station, sir.
nurses to take precautions or undertake steps to safeguard patients under their care from any possible xxxx
injury that may arise in the course of the latter's treatment and care. [55] Q: What did the nurse do when she entered the room?
A: She asked me if we have an [sic] history of asthma, sir, in the family.
The Court further notes that the immediate response of the nurses was especially imperative, since Q: What was your answer.
Regina herself had asked for oxygen. They should have been prompted to respond immediately when A: We have, sir, then she hold [sic] the hand of Tita Regie.
Regina herself expressed her needs, especially in that emergency situation when it was not easy to What, if anything, did Tita Regie saying [sic] at that time when the nurse was inside the
Q:
determine with certainty the cause of her breathing difficulty. Indeed, even if the patient had not asked room?
for oxygen, the mere fact that her breathing was labored to an abnormal degree should have impelled A: She was running her breath and she was mentioning "oxygen, oxygen," sir.
the nurses to immediately call the doctor and to administer oxygen. Q: What happened after that?
The nurse went out, sir, I was holding Tita Regie at the same time I called up Tito Romy,
A:
Tn this regard, both courts found that there was a delay in the administration of oxygen to the patient, sir.
caused by the delayed response of the nurses of petitioner hospital. They committed a breach of their xxxx
duty to respond immediately to the needs of Regina, considering her precarious situation and her Going back to the time when the nurse came in and asked you if your family has an [sic]
physical manifestations of oxygen deprivation. We quote below the crucial finding of the trial court: Q: history of asthma. After that and after touching the hands of Regina, what did the nurse
do?
[W]hen Kathleen [Balad] went to the nurse station to inform the nurses thereat that her aunt was A: She went out because Tita Regie was asking for an oxygen, sir.
experiencing shortness of breathing and needed oxygen nobody rushed to answer her urgent call. It took Q: Did the nurse say anything or give any instruction before leaving the room?
more or less 10 minutes for these nurses to go inside the room to attend and to check the condition of A: I cannot recall, sir, because I was already afraid of the color [cyanosis] of Tita Regie, sir.
their patient. When the nurse came in she saw the patient was having chilly sensation with difficulty in Q: How long did it take before any oxygen arrived if ever?
breathing [and was] at the same time asking for oxygen. The nurse learned from Kathleen that the A: About 20 minutes, sir.[57] (Emphases supplied)
patient was having an asthma attack. The nurse immediately called resident physician Dr. De Los The appellate court also correctly noted that even the witness for petitioner, resident physician Dr. Grace
Angeles to proceed to room 328 and the hospital aide to bring in the oxygen tank in the said room. de los Angeles, noticed that it took some time before the oxygen arrived as shown in her testimony:
Thereafter, resident doctors Gonzalez and de Los Angeles arrived and followed by the hospital aide with
the oxygen tank. It was clear that the oxygen tank came late because the request for it from the nurses Q [Atty.But do you know how much time elapsed from the time oxygen was first requested since
also came late. Had the nurses exercised certain degree of promptness and diligence in responding to Tanada]: you were not yet there?
the patient[']s call for help[,] the occurrence of "hypoxic encephalopathy" could have been avoided since xxxx
lack or inadequate supply of oxygen to the brain for 5 minutes will cause damage to it. (Underscoring A [Dr. DelosThe one who first orders not considering the nurse's order, it was me who first ordered
supplied)[56] Angeles]: for the oxygen.
The CA agreed with the trial court's factual finding of delay in the administration of oxygen as Q: A nurse made an earlier order also?
competently testified to by Balad. Her testimony, which is uncontroverted in the records, proceeded as A: Yes, sir.
follows: xxxx
Do you recall having heard a statement made by any doctor to the effect why did the
Q:
Q [Atty.During this time from about 1:30 in the morning up to approximately 2:00 in the morning, oxygen tank just arrive[d] at that moment?
Diokno]: did any nurse enter the room that you were in? xxxx
A [Balad]: None, sir. When the nurse, said 'nagpakuha na ng oxygen,' I could not recall if it is [sic] me or Dra.
A:
After that conversation between your aunt when she's asking you to [turn] off the aircon Gonzales, we asked her 'Bakit wala pa?'
Q: and turning on [sic] again and then turned it off, do you have any occasion to talk with Q: So your answer is there was somebody who made that comment?
her? A: Yes, Your Honor.[58] (Underscoring supplied)
A: None, sir. The CA also found that there was negligent delay in referring Regina to the physicians.[59] In fact, a
How did you describe her physical appearance when she was telling you that "hinihika member of the medical staff chided the nurses for not immediately referring the patient's condition to the
Q:
yata ako"? physicians as the following excerpt shows:
She feels [sic] very cold even if several blankets were placed in [sic] her body and she is
A:
[sic] coughing at the same time. Q [Atty.Without mentioning anymore whom you believed to be the speaker. Could you just relay
Q: What about during the time that you dropped some pillows at her back? Diokno]: what were the things that you heard, said at that time.
A: She was running her breath sir, "at inaalala niya ang operasyon niya." xxxx
Q: Seeing her condition like that what did you do if anything to get any help for her? "Why is it that the dextrose is only now, why did you not ask for assistance immediately,"
A [Balad]:
A: I buzzered, sir. sir.[60] (Underscoring supplied)
The records also show another instance of negligence, such as the delay in the removal of Regina's
consumed dextrose, a condition that was already causing her discomfort. In fact, Balad had to inform the
nurses and the patient had to instruct one of them, on what to do as can be seen in this part of Balad's
testimony:
Q [Atty.Would you try to recall what were the words that were used by your aunt in telling you
Diokno]: about the dextrose?
According to her you call [the] nurse at the nurse station for her to remove the dextrose
A [Balad]:
from my hand, sir.
xxxx
Q: When you saw that [sic] two (2) nurses there at the nurse station, what were they doing?
The other one is sitting eating pansit, sir, and the other one is standing holding a bottle,
A:
sir.
Q: What did you tell them, if anything, when you arrived at the nurse station?
A: I told them that the dextrose at Room 238 was already finished, sir.
xxxx
Q: How long did it take before any nurse arrived inside Room 238?
A: I went back to the nurse station because no one responded from [sic] my call, sir.
About how many minutes had elapsed from the time you went to the nurse station for the
Q:
first time and from the time you went for the second time?
About three (3) to five (5) minutes, sir. "Yung pangalawang tawag ko na sa kanya ay
A:
nakasunod na siya sa akin," sir.
The second time when the nurse was already following you back to the room. What
Q:
happened there when you go [sic] inside the room?
The nurse approached my Tita Regie and according to my Tita Regie, "Nurse, please
A:
remove it because my hand was already bulging," sir.
Q: What is the response of the nurse to that comment of your auntie?
She was following the instruction of my Tita Regie and then she told me to get a towel,
A:
sir, to be placed on her hand, "namaga na", sir.[61] (Underscoring supplied)
Taken together, the above instances of delay convinced the courts below, as well as this Court, that
there was a breach of duty on the part of the hospital's nurses. The CA therefore correctly affirmed the
finding of the trial court that the nurses responded late, and that Regina was already cyanotic when she
was referred to the resident doctor.
Regina suffered from brain damage, particularly hypoxic encephalopathy, which is caused by lack of
oxygen in the brain. The testimonies of Dr. Dizon and Dr. Robeniol proved this fact. And the proximate
cause of the brain damage was the delay in responding to Regina's call for help and for oxygen. The trial
court said:
Had the nurses exercised certain degree of promptness and diligence in responding to the patient[']s call
for help[,] the occurrence of "hypoxic encephalopathy" could have been avoided since lack or
inadequate supply of oxygen to the brain for 5 minutes will cause damage to it.[62]
The CA affirmed the above ruling of the RTC, that whatever the cause of the oxygen deprivation was, its
timely and efficient management would have stopped the chain of events that led to Regina's condition.
We affirm the findings of the courts below that the negligent delay on the part of the nurses was the
proximate cause of the brain damage suffered by Regina. In Ramos, the Court defines proximate cause
as follows:
Proximate cause has been defined as that which, in natural and continuous sequence, unbroken by any
efficient intervening cause, produces injury, and without which the result would not have occurred. An
injury or damage is proximately caused by an act or a failure to act, whenever it appears from the
evidence in the case, that the act or omission played a substantial part in bringing about or actually
causing the injury or damage; and that the injury or damage was either a direct result or a reasonably
probable consequence of the act or omission. It is the dominant, moving or producing cause.
(Underscoring supplied; citations omitted).[63]
Thus, a failure to act may be the proximate cause if it plays a substantial part in bringing about an injury.
Note also that the omission to perform a duty may also constitute the proximate cause of an injury, but
only where the omission would have prevented the injury.[64] The Court also emphasizes that the injury
need only be a reasonably probable consequence of the failure to act. In other words, there is no need
for absolute certainty that the injury is a consequence of the omission. [65]
Applying the above definition to the facts in the present case, the omission of the nurses - their failure to
check on Regina and to refer her to the resident doctor and, thereafter, to immediately provide oxygen -
was clearly the proximate cause that led to the brain damage suffered by the patient. As the trial court
and the CA both held, had the nurses promptly responded, oxygen would have been immediately
administered to her and the risk of brain damage lessened, if not avoided.
For the negligence of its nurses, petitioner is thus liable under Article 2180[66] in relation to Article
2176[67] of the Civil Code. Under Article 2180, an employer like petitioner hospital may be held liable for
the negligence of its employees based on its responsibility under a relationship of patria potestas.[68] The
liability of the employer under this provision is "direct and immediate; it is not conditioned upon a prior
recourse against the negligent employee or a prior showing of the insolvency of that employee." [69] The
employer may only be relieved of responsibility upon a showing that it exercised the diligence of a good
father of a family in the selection and supervision of its employees. The rule is that once negligence of
the employee is shown, the burden is on the employer to overcome the presumption of negligence on
the latter's part by proving observance of the required diligence.[70]
In the instant case, there is no dispute that petitioner was the employer of the nurses who have been
found to be negligent in the performance of their duties. This fact has never been in issue. Hence,
petitioner had the burden of showing that it exercised the diligence of a good father of a family not only in
the selection of the negligent nurses, but also in their supervision.
On this point, the rulings of the RTC and the CA diverge. While the trial court found due diligence in both
the selection and the supervision of the nurses, the appellate court found that petitioner proved due
diligence only in the selection, but not in the supervision, of the nurses.
After a careful review of the records, we find that the preponderance of evidence supports the finding of
the CA that the hospital failed to discharge its burden of proving due diligence in the supervision of its
nurses and is therefore liable for their negligence. It must be emphasized that even though it proved due
diligence in the selection of its nurses, the hospital was able to dispose of only half the burden it must
overcome.[71]
We therefore note with approval this finding of the CA:
While Lourdes Hospital adduced evidence in the selection and hiring processes of its employees, it
failed to adduce evidence showing the degree of supervision it exercised over its nurses. In neglecting to
offer such proof, or proof of similar nature, respondent [herein petitioner] hospital failed to discharge its
burden under the last paragraph of Article 2180. Consequently, it should be held liable for the negligence
of its nurses which caused damage to Regina.[72]
Indeed, whether or not the diligence of a good father of a family has been exercised by petitioner is a
matter of proof,[73] which under the circumstances in the case at bar has not been clearly established.
The Court finds that there is not enough evidence on record that would overturn the presumption of
negligence. In explaining its basis for saying that petitioner proved due diligence in the supervision of the
nurses, the trial court merely said:
As testified to by Ms. Lourdes Nicolas, the assistant nursing director, the process of selection and hiring
of their nurses was a rigorous process whereby the applicants undergo series of examination,
orientation, training, on the job observation and evaluation before they are hired as regular employees.
The nurses are supervised by their head nurses and the charge nurse and inspected by their clinical
supervisor and nursing director. Based from this evidence the court believes that defendant hospital had
exercised prudence and diligence required of it. The nurses it employed were equipped with sufficient
knowledge and instructions and are able to perform their work and familiar with the duties and
responsibilities assigned to them.[74]
Indeed, the formulation of a supervisory hierarchy, company rules and regulations, and disciplinary
measures upon employees in case of breach, is indispensable. However, to prove due diligence in the
supervision of employees, it is not enough for an employer such as petitioner to emptily invoke the
existence of such a formulation. What is more important is the actual implementation and monitoring of
consistent compliance with the rules. Understandably, this actual implementation and monitoring should
be the constant concern of the employer, acting through dependable supervisors who should regularly
report on their supervisory functions. Thus, there must be proof of diligence in the actual supervision of
the employees' work.[75]
In the present case, there is no proof of actual supervision of the employees' work or actual
implementation and monitoring of consistent compliance with the rules. The testimony of petitioner's
Assistant Nursing Service Director, Lourdes H. Nicolas is belied by the actual records [76] of petitioner.
These show that Nurses David and Padolina had been observed to be latecomers and absentees; yet
they were never sanctioned by those supposedly supervising them. While the question of diligent
supervision depends on the circumstances of employment, [77] we find that by the very nature of a
hospital, the proper supervision of the attendance of its nurses, who are its frontline health professionals,
is crucial considering that patients' conditions can change drastically in a matter of minutes. Petitioner's
Employee Handbook[78] recognized exactly this as it decreed the proper procedure in availing of
unavoidable absences and the commensurate penalties of verbal reprimand, written warning,
suspension from work, and dismissal in instances of unexcused absence or tardiness.[79] Petitioner's
failure to sanction the tardiness of the defendant nurses shows an utter lack of actual implementation
and monitoring of compliance with the rules and ultimately of supervision over its nurses.
More important, on that fatal night, it was not shown who were the actual nurses on duty and who was
supervising these nurses. Although Lourdes H. Nicolas explained in her testimony that two nurses are
assigned at the nurses' station for each shift and that they are supervised by the head nurses or the
charge nurses, the documents of petitioner show conflicting accounts of what happened on the fateful
days of 26 and 27 of December 1997.
The schedule of nurses initially submitted by the director of the nursing service of petitioner hospital,
Sister Estrella Crisologo, indicated that David was on duty from 2 p.m. to 11 p.m. on 26 December 1997
and that Padolina and Ballano were on duty from 10 p.m. of 26 December 1997 to 6 a.m. of 27
December 1997. Ballano, however, was employed as a midwife and not a nurse.[80] Also, the oral
deposition of Sister Estrella Crisologo indicated that a certain Molina, a nurse, did not report for work
from 10 p.m. of 26 December 1997 to 6 a.m. of 27 December 1997 leaving only Padolina as the nurse
on duty during the said period while Evelyn David was on duty only from 2 p.m. to 11 p.m. on 26
December 1997.[81] However, in a Manifestation[82] dated 15 July 1999, petitioner submitted a revised
and more accurate schedule of nurses prepared by the nurse supervisor, Charina G. Ocampo, which
curiously contained erasures on the portion pertaining to Evelyn David in that David was now shown to
be on duty from 10 p.m. on 26 December 1997 to 6 a.m. on 27 December 1997.[83]
Another piece of documentary evidence, the Nurses' Notes, was also not without inconsistencies. In a
Manifestation and Motion[84] dated 3 June 2003, petitioner admitted to having inadvertently failed to
include an entry or page in the Nurses' Notes initially submitted to the trial court.[85] That entry was the
Nurse's Observation and Report on Capanzana from 8 p.m. of 26 December 1997 to 3:20 a.m. of 27
December 1997 signed by David.[86] Moreover, in the testimony of witness for petitioner, Milagros de
Vera, the administrative supervisor of the hospital, it was revealed that entries in the Nurses' Notes were
made in different colors of ink depending on the shift of the nurse: blue ink for the morning shift, black for
afternoon, and red for night. Interestingly, as manifested by the counsel for respondents, the entries
made from 2:45 to 2:50 a.m. of 27 December 1997 were in both blue and red.[87]
All these negate the due diligence on the part of the nurses, their supervisors, and ultimately, the
hospital.
We therefore affirm the appellate court in finding petitioner directly liable for the negligence of its nurses
under Article 2180 in relation to Article 2176 of the Civil Code.
We are left with two minor issues that need to be addressed in order to completely resolve the petition.
To recall, petitioner questioned before the CA not only the trial court's denial of petitioner's Motion for
Leave to take the deposition of a witness but also the denial of its counterclaims. In the assailed
Decision and Resolution, the appellate court failed to make a pronouncement expressly addressing the
issues. Petitioner now prays that we remand the case to the trial court for the reception of the testimony
of its witness and that we grant its counterclaims.
In support of the first issue, petitioner invokes our pronouncements in Hyatt Manufacturing Corp. v. Ley
Construction Development Corp.,[88] in which this Court affirmed the appellate court's ruling to remand
the case to the trial court and to order the deposition-taking to proceed. To bring this issue to a close, we
see the need to present a nuanced parsing of the difference between the circumstances in Hyatt and in
the present petition. First, in the cited case, the party opposing the deposition made unwarranted claims
of delay. This Court found that it was not the request for deposition, but the voluminous pleadings filed
by the opposing party, that caused the delay in the court proceedings. In this case, however, there is
reason to suspect that the request was indeed meant to delay because the intended deposition in 2004
was meant to be an additional sur-rebuttal evidence to Balad's testimony which, we characteristically
take note, was given in 1999, a long five years before. Moreover, the trial court reasoned that the case
had been tried for many years and was about to be decided:
The timeliness of the motion for leave of court to take deposition through written interrogatories cast
doubt whether or not it was intended to further delay the proceedings of this case. The instant case has
obtained considerable length in its adjudication and to allow movant-defendants to take deposition of Ms.
David [the witness-deponent] would only further delay its disposition and would certainly defeat the
purpose of a disposition which is to expedite proceedings.[89]
Second, in Hyatt, the trial court arbitrarily cancelled the taking of depositions, which had been scheduled
previously. In other words, everything had been set, and the deponents were available for deposition.
Delay, if any, would have been minimal. In the present case, no deposition was ever scheduled, and the
availability of the supposed deponent was not even ascertained. In fact, the uncertainty in the taking of
the deposition was one of the reasons cited by the trial court when it denied the Motion for Leave. [90]
Third, the RTC in this case noted that petitioner had agreed to a self-imposed deadline for the
submission of its sur-rebuttal evidence. When the scheduled hearing came, petitioner's counsel failed to
attend purportedly because he was indisposed. But as curiously observed by the trial court, the
reception of sur-rebuttal evidence on that date could not have proceeded anyway since petitioner had no
witnesses.[91] The trial court likewise noted that petitioner failed to state any solid ground to justify the
grant of the taking of that deposition, except for the latter's naked assertion that the witness to be
deposed was out of the country.[92] The Court finds that these considerations, taken together, provided
one of the reasons for the RTC to properly deny the Motion for Leave to take the deposition of a witness.
In Hyatt, the movant was completely faultless; in the present case, petitioner failed not only to be present
at the scheduled hearing for the submission of its sur-rebuttal evidence, but also to show good faith in its
request.

Fourth, the movant in Hyatt was clearly prejudiced by the denial of its request, which it had promptly
made before pretrial. The same cannot be said in the present case because petitioner filed the motion to
take deposition six years after trial had started. In fact, petitioner was confident enough to agree to a
deadline for the submission of its sur-rebuttal evidence, a deadline that had long passed when it filed a
Motion for Leave. Petitioner is, therefore, estopped from claiming that it was ever prejudiced.

All in all, petitioner's argument regarding the trial court's denial of petitioner's Motion for Leave to take
the deposition fails to impress us.

This notwithstanding, we find merit in another argument successively raised by petitioner before the
Court of Appeals and before this Court with respect to the unpaid hospital bill of respondents - an issue
not addressed again by the CA in the assailed ruling. The unpaid hospital bill at petitioner hospital
amounted to P20,141.60 as of 30 October 1998.[93] This fact was uncontroverted by respondents. Since
the amount for actual damages as listed by respondents in their complaint was already inclusive of the
hospital bills incurred at petitioner hospital and at Cardinal Santos Hospital, we deem it proper to deduct
the unpaid hospital bill from the actual damages decreed by the lower court and affirmed by the
appellate court. However, we additionally impose the payment of interest on the resulting amount to
conform with prevailing jurisprudence.[94]

WHEREFORE, premises considered, we AFFIRM WITH MODIFICATION the Decision and Resolution
rendered by the Court of Appeals in CA-G.R. CV No. 89030 in that petitioner is hereby declared liable for
the payment to respondents of the total amount of P299,102.04 as actual damages minus P20,141.60
representing the unpaid hospital bill as of 30 October 1998; P1,950,269.80 as compensatory damages;
P100,000.00 as moral damages; P100,000.00 as and by way of attorney's fees; and the costs of suit, as
well as interest at the rate of six percent (6%) per annum on the resulting amount from the finality of this
judgment until full payment.

SO ORDERED.

Leonardo-De Castro, Del Castillo, Perlas-Bernabe, and Caguioa, JJ., concur.

G.R. No. 209906, November 22, 2017 - COCA-COLA BOTTLERS PHILS., INC., Petitioner, v. the waitresses who passed it among themselves to smell it. All of the waitresses confirmed that the
ERNANI GUINGONA MEÑEZ, Respondent. bottle smelled of kerosene and not of Sprite.

Meñez then went out of the restaurant taking with him the bottle. He found a person manning the traffic
immediately outside the restaurant, whom he later came to know as Gerardo Ovas, Jr. of the Traffic
Assistant Unit. He reported the incident and requested the latter to accompany him to the Silliman
[University] Medical Center (SUMC). Heading to SUMC for medical attention, Ovas brought the bottle of
Sprite with him.

While at the Emergency Room, [Meñez] again vomited before the hospital staff could examine him.
[Meñez] had to be confined in the hospital for three (3) days.
SECOND DIVISION Later, [Meñez] came to know that a representative from [Rosante] came to the hospital and informed the
hospital staff that Rosante [would] take care of the hospital and medical bills.
G.R. No. 209906, November 22, 2017
The incident was reported to the police and recorded in the Police Blotter. The bottle of Sprite was
COCA-COLA BOTTLERS PHILS., INC., Petitioner, v. ERNANI GUINGONA MEÑEZ, Respondent. examined by Prof. Chester Dumancas, a licensed chemist of Silliman University. The analysis identified
the contents of the liquid inside the bottle as pure kerosene.
DECISION As a result of the incident, [Meñez] filed a complaint against [CCBPI and Rosante] and prayed for the
following damages:
CAGUIOA, J.: (a) Three Million Pesos (P3,000,000.00) as actual damages;
(b) Four Million Pesos (P4,000,000.00) as moral damages;
(c) Five Hundred Thousand Pesos (P500,000.00) as exemplary damages;
This is a Petition for Review on Certiorari1 (Petition) under Rule 45 of the Rules of Court assailing the
(d) One Hundred Thousand Pesos (P100,000[.00]) as attorney's fees;
Decision2 of the Court of Appeals3 (CA) dated April 22, 2013 in CA-G.R. CV No. 02361 and the
(e)Cost of Suit.
Resolution4 dated October 11, 2013 denying the motion for reconsideration filed by petitioner, Coca-Cola
Bottlers Phils., Inc. (CCBPI). The CA Decision granted the appeal and reversed the Decision 5 dated
October 29, 2007 of the Regional Trial Court, 7th Judicial Region, Branch 39, Dumaguete City (RTC) in In answer to the complaint filed, [CCBPI and Rosante] set out their own version of facts. Rosante x x x
Civil Case No. 11316. alleged that [Meñez] was heard to have only felt nausea but did not vomit when he went to the comfort
room. Rosante further denied that the waitresses confirmed the content of the bottle to be kerosene. In
fact, [Meñez] refused to have the waitresses smell it.
Facts and Antecedent Proceedings
As an affirmative defense, [Rosante] argued that [Meñez] has no cause of action against it as it merely
received said bottle of Sprite allegedly containing kerosene from [CCBPI], as a matter of routinary
The Decision of the CA dated April 22, 2013 states the facts as follows: procedure. It argued that Rosante is not expected to open and taste each and every [content] in order to
make sure it is safe for every customer.
Research [s]cientist Ernani Guingona Meñez [Meñez] was a frequent customer of Rosante Bar and
Restaurant [Rosante] of Dumaguete City. On March 28, 1995, at about 3:00 o'clock in the afternoon, It further alleged that Robert Sy was made as representative of [Rosante] when in fact he is not the
Me[ñ]ez went to Rosante and ordered two (2) bottles of beer. Thereafter, he ordered pizza and a bottle registered owner of the establishment but merely involved in the management.
of "Sprite". His additional order arrived consisting of one whole pizza and a bottled softdrink Sprite with a
drinking straw, one end and about three-fourths of which was submerged in the contents of the bottle, CCBPI for its part filed a motion to dismiss the complaint. The motion was founded on the grounds that:
with the other and the remaining third of the straw outside the bottle, as is the usual practice in eateries
when one orders a bottled softdrink. 1) [Meñez] failed to allege all the requisites of liability under Article 2187 of the Civil Code, not even for
the law on torts and quasi-delict to apply against [CCBPI].
Meñez then took a bite of pizza and drank from the straw the contents of the Sprite [b]ottle. He noticed
that the taste of the softdrink was not one of Sprite but of a different substance repulsive to taste. The 2) [Meñez] failed to exhaust administrative remedies and/or comply with the Doctrine of the Prior Resort.
substance smelled of kerosene. He then felt a burning sensation in his throat and stomach and could not
control the urge to vomit. He left his table for the toilet to vomit but was unable to reach the toilet room.
Instead, he vomited on the lavatory found immediately outside the said toilet. CCBPI interposed that a perusal of the complaint revealed that there is no allegation therein which
states that CCBPI uses noxious or harmful substance in the manufacture of its products. What the
Upon returning to the table, he picked up the bottle of Sprite and brought it to the place where the complaint repeatedly stated is that the bottle with the name SPRITE on it contained a substance which
waitresses were and angrily told them that he was served kerosene. [Meñez] even handed the bottle to was later identified as pure kerosene.
As to the second ground, [CCBPI] cited Republic Act No. 3720, as amended x x x "An Act to Ensure the
Safety and Purity of Foods and Cosmetics, and the Purity, Safety, Efficacy and Quality of Drugs and The RTC further noted that since kerosene had a characteristic smell, and considering that the "Sprite"
Devices Being Made Available to the Public, Vesting the Bureau of Food and Drugs with Authority to bottle allegedly contained pure kerosene, it was quite surprising why the employees of [Rosante] did not
Administer and Enforce the Laws pertaining thereto, and for other Purposes[.]" CCBPI argued that notice its distinct smell.
pursuant to the law, [Meñez] failed to avail of and exhaust an administrative remedy provided for prior to
a filing of a suit in court. It quoted, Finally, the RTC held that the complaint was devoid of merit as it should have first ventilated [Meñez's]
grievance with the Bureau of Food and Drugs pursuant to R.A. 3720 as amended by Executive Order
(d) When it appears to the Director xxx that any article of food xxx is adulterated or misbranded, he shall No. 175.
cause notice thereof to be given to the person or persons concerned and such person or persons shall
be given an opportunity to be heard before the Board of Food and Drug Inspection and to submit Thus, the [RTC] disposed,
evidence impeaching the correctness of the finding or charge in question.
"WHEREFORE, the complaint is hereby DISMISSED for insufficiency of evidence, with costs against the
From this provision, CCBPI concluded that an administrative remedy was existing and that [Meñez] plaintiff.
failed to avail thereof.
Likewise, the counterclaims of defendants are hereby DISMISSED.
CCBPI further argued that the doctrine of strict liability tort on product liability is but a creation of
American Jurisprudence, as clearly shown by the cases cited in support thereof, and never before SO ORDERED."
adopted as a doctrine of the Supreme Court. Hence, it submits that at most it only has a persuasive
effect and should not be used as a precedent in fixing the liability of CCBPI. Aggrieved, [Meñez went to the CA] on appeal.7

Pre-[t]rial and [t]rial ensued. [Meñez] introduced several exhibits to substantiate the damages he prayed
for. Among others were Explanation of Benefits and Statements of Account from healthcare providers to
show that he had to undergo a series of examinations in the United States as consequence of the
incident. [Meñez] also included in his exhibits his profile as a scientist in attempt to prove that damages
were also incurred with the delay of his work; still as a consequence of the kerosene poisoning.
With the termination of the trial, and the directive to parties to file their respective memoranda, the case
was finally submitted for decision.6
The RTC Ruling
The CA Decision further states:
The CA Ruling
In its Decision8 dated April 22, 2013, the CA granted the appeal and reversed the Decision of the RTC.
The CA ruled that the RTC erred in dismissing the case for failing to comply with an administrative
remedy because it is not a condition precedent in pursuing a case for damages under Article 2187 of the
Civil Code which is the basis of Meñez's complaint for damages.9 The CA also ruled that Meñez was not
entitled to actual damages given the observation of his attending physician, Dr. Juanito Magbanua, Jr.
(Dr. Magbanua, Jr.), that "his hospital stay was uneventful" and "to [his] mind, he had taken in x x x only
a small amount [of kerosene] because the degree of adverse effect on his body [was] very minimal
knowing that if he had taken in a large amount he would have been in x x x very serious trouble and we
would have seen this when we examine him."10 The CA, however, awarded moral and exemplary
damages in favor of Meñez.11

The Regional Trial Court (RTC) dismissed the complaint for insufficiency of evidence. The [RTC] found The dispositive portion of the CA Decision states:
the evidence for [Meñez] to be ridden with gaps. It declared that there was failure of [Meñez] to
categorically establish the chain of custody of the "Sprite" bottle which was the very core of the evidence WHEREFORE, the appeal is hereby GRANTED. The decision in Civil Case No. 11316
in his complaint for damages. The Court noted that from the time of the incident, thirty-six (36) hours is REVERSED. Defendant-Appellee Coca-Cola Bottlers Philippines Inc. is ORDERED to pay the
have lapsed before the "Sprite" bottle was submitted for laboratory examination. During such time, the following with six [per cent] (6%) interest per annum reckoned from May 5, 1995:
"Sprite" bottle changed hands several times. The RTC then ruled that the scanty evidence presented by
[Meñez] concerning the chain of custody of the said "Sprite" bottle and [his] unexplained failure x x x to 1. Moral damages in the amount of two hundred thousand pesos (P200,000.00);
present several vital witnesses to prove such fact indeed casts a serious doubt on the veracity of his 2. Exemplary [d]amages in the amount of two hundred thousand pesos (P200,000.00);
allegations. 3. Fifty thousand pesos (P50,000.00) as attorney's fees and cost of suit.
The [RTC] observed,
The total aggregate monetary award shall in turn earn 12% per annum from the time of finality of this
"In this case, the results of the laboratory examination conducted on the "Sprite" bottle show that the
Decision until fully paid.
same contained PURE KEROSENE, and not "Sprite" containing traces of kerosene or "Sprite"
adulterated with kerosene. [x]xx A test result showing that the said "Sprite" bottle contained traces of
SO ORDERED.12
kerosene would have been more in consonance with [Meñez]'s claim of negligence[.]"
 (2) Quasi-delicts causing physical injuries;
CCBPI filed a motion for reconsideration, which was denied in the CA Resolution13dated October 11,
2013. (3) Seduction, abduction, rape, or other lascivious acts;

Hence, this Petition. Meñez filed a Comment14 dated April 9, 2014. CCBPI filed a Reply15 dated May 30, (4) Adultery or concubinage;
2014.
(5) Illegal or arbitrary detention or arrest;
Issues
(6) Illegal search;

Whether the CA erred in awarding moral damages to Meñez. (7) Libel, slander or any other form of defamation;

Whether the CA erred in awarding exemplary damages to Meñez. (8) Malicious prosecution;

Whether the CA erred in awarding attorney's fees to Meñez. (9) Acts mentioned in Article 309;

Whether the CA erred in holding that Meñez did not violate the doctrine of exhaustion of administrative (10) Acts and actions referred to in Articles 21, 26, 27, 28, 29, 30, 32, 34, and 35.
remedies and prior resort to the Bureau of Food and Drugs (BFD) is not necessary.
x x x x (Emphasis supplied)

The Court's Ruling Article 2220 provides the following additional legal grounds for awarding moral damages: (1) willful injury
to property if the court should find that, under the circumstances, such damages are justly due; and (2)
breaches of contract where the defendant acted fraudulently or in bad faith.
The Petition is meritorious.
In justifying the award of moral damages to Meñez, the CA invoked the U.S. cases Escola v. Coca-Cola
The CA correctly ruled that prior resort to BFD is not necessary for a suit for damages under Article 2187 Bottling Co.16 and Wallace v. Coca-Cola Bottling Plants, Inc.17 The CA, however, failed to show the
of the Civil Code to prosper. Article 2187 unambiguously provides: direct connection of these cases with the instances when moral damages may be awarded under the
Civil Code.
ART. 2187. Manufacturers and processors of foodstuffs, drinks, toilet articles and similar goods shall be
liable for death or injuries caused by any noxious or harmful substances used, although no contractual Apparently, the only ground which could sustain an award of moral damages in favor of Meñez and
relation exists between them and the consumers. against CCBPI is Article 2219 (2) — quasi-delict under Article 2187 causing physical injuries.

Unfortunately, Meñez has not presented competent, credible and preponderant evidence to prove that
Quasi-delict being the source of obligation upon which Meñez bases his cause of action for damages he suffered physical injuries when he allegedly ingested kerosene from the "Sprite" bottle in question.
against CCBPI, the doctrine of exhaustion of administrative remedies is not applicable. Such is not a Nowhere in the CA Decision is the physical injury of Meñez discussed. The RTC Decision states the
condition precedent required in a complaint for damages with respect to obligations arising from quasi- diagnosis of the medical condition of Meñez in the medical abstract prepared by Dr. Abel Hilario Gomez,
delicts under Chapter 2, Title XVII on Extra-Contractual Obligations, Article 2176, et seq. of the Civil who was not presented as a witness,18 and signed by Dr. Magbanua, Jr. (Exhibit "R"): "the degree of
Code which includes Article 2187. poisoning on the plaintiff [Meñez] was mild, since the amount ingested was minimal and did not have
severe physical effects on his body."19 In his testimony, Dr. Magbanua, Jr. stated: "To my mind, [Meñez]
However, the CA erred in ruling that Meñez is entitled to moral damages, exemplary damages and had taken in kerosene of exactly undetermined amount, apparently or probably, only a small amount
attorney's fees. because the degree of adverse effect on his body is very minimal knowing that if he had taken in a large
amount he would have been in x x x very serious trouble and we would have seen this when we
The cases when moral damages may be awarded are specific. Unless the case falls under the examined him."20 The statements of the doctors who tended to the medical needs of Meñez were
enumeration as provided in Article 2219, which is exclusive, and Article 2220 of the Civil Code, moral equivocal. "Physical effects on the body" and "adverse effect on his body" are not very clear and definite
damages may not be awarded. Article 2219 provides: as to whether or not Meñez suffered physical injuries and if these statements indicate that he did, what
their nature was or how extensive they were.
ART. 2219. Moral damages may be recovered in the following and analogous cases:
Consequently, in the absence of sufficient evidence on physical injuries that Meñez sustained, he is not
(1) A criminal offense resulting in physical injuries; entitled to moral damages.
As to exemplary or corrective damages, these may be granted in quasi-delicts if the defendant acted
with gross negligence pursuant to Article 223121 of the Civil Code. (11) In any other case where the court deems it just and equitable that attorney's fees and expenses of
litigation should be recovered.
The CA justified its award of exemplary damages in the following manner:
In all cases, the attorney's fees and expenses of litigation must be reasonable.
On the liability of manufacturers, the principle of strict liability applies. It means that proof of negligence
is not necessary. It appl[i]es even if the defendant manufacturer or processor has exercised all the
possible care in the preparation and sale of his product x x x. Extra-ordinary diligence is required of them The CA Decision did not even provide the basis for the award of P50,000.00 as attorney's fees and cost
because the life of the consuming public is involved in the consumption of the foodstuffs or processed of suit. The award is found only in the dispositive portion and, unlike the award of moral and exemplary
products.22 damages, there was no explanation provided in the body of the Decision. It can only be surmised that
the CA awarded attorney's fees only because it awarded exemplary damages.

Evidently, the CA's reasoning is not in accord with the gross negligence requirement for an award of In any event, based on Article 2208 of the Civil Code, Meñez is not entitled to attorney's fees and
exemplary damages in a quasi-delict case. expenses of litigation because, as with his claim for exemplary damages, he has not established any
other ground that would justify this award.
Moreover, Meñez has failed to establish that CCBPI acted with gross negligence. Other than the opened
"Sprite" bottle containing pure kerosene allegedly served to him at the Rosante Bar and Restaurant WHEREFORE, the Petition is hereby GRANTED. The Court of Appeals Decision dated April 22, 2013
(Rosante), Meñez has not presented any evidence that would show CCBPFs purported gross and Resolution dated October 11, 2013 in CA-G.R. CV No. 02361 are REVERSED and SET
negligence. The Court agrees with the RTC's finding that there was failure on the part of Meñez to ASIDE. The dismissal of the complaint for insufficiency of evidence by the Regional Trial Court,
categorically establish the chain of custody of the "Sprite" bottle which was the very core of the evidence 7th Judicial Region, Branch 39, Dumaguete City in its Decision dated October 29, 2007 in Civil Case No.
in his complaint for damages and that, considering that the "Sprite" bottle allegedly contained pure 11316 is AFFIRMED.
kerosene, it was quite surprising why the employees of Rosante did not notice its distinct, characteristic
smell. Thus, Meñez is not entitled to exemplary damages absent the required evidence. The only SO ORDERED.
evidence presented by Meñez is the opened "Sprite" bottle containing pure kerosene. Nothing more.
Carpio, (Chairperson), Peralta, and Perlas-Bernabe, JJ., concur.
Regarding attorney's fees, Article 2208 of the Civil Code provides: Reyes, Jr., on leave.

ART. 2208. In the absence of stipulation, attorney's fees and expenses of litigation, other than judicial
costs, cannot be recovered, except:

(1) When exemplary damages are awarded;

(2) When the defendant's act or omission has compelled the plaintiff to litigate with third persons or to
incur expenses to protect his interest;

(3) In criminal cases of malicious prosecution against the plaintiff;

(4) In case of a clearly unfounded civil action or proceeding against the plaintiff;

(5) Where the defendant acted in gross and evident bad faith in refusing to satisfy the plaintiffs plainly
valid, just and demandable claim;

(6) In actions for legal support;

(7) In actions for the recovery of wages of household helpers, laborers and skilled workers;

(8) In actions for indemnity under workmen's compensation and employer's liability laws;

(9) In a separate civil action to recover civil liability arising from a crime;
SECOND DIVISION
(10) When at least double judicial costs are awarded;
[ G.R. No. 217426, December 04, 2017 ]
ST. MARTIN POLYCLINIC, INC., PETITIONER, V. LWV CONSTRUCTION CORPORATION,
RESPONDENT.
DECISION
PERLAS-BERNABE, J.:
Assailed in this petition for review on certiorari[1] are the Decision[2] dated July 11, 2014 and the
Resolution[3] dated February 27, 2015 of the Court of Appeals (CA) in CA-G.R. SP No. 125451, which
affirmed with modification the Decision[4] dated December 15, 2011 and the Order dated May 25, 2012 of
the Regional Trial Court of Mandaluyong City, Branch 211 (RTC) in SCA Case No. MC11-879 (Civil
Case No. 21881), and thereby ordered herein petitioner St. Martin Polyclinic, Inc. (petitioner) to pay
respondent LWV Construction Corporation (respondent) temperate damages in the amount of
P50,000.00.
The Facts
Respondent is engaged in the business of recruiting Filipino workers for deployment to Saudi
Arabia.[5] On the other hand, petitioner is an accredited member of the Gulf Cooperative Council
Approved Medical Centers Association (GAMCA) and as such, authorized to conduct medical
examinations of prospective applicants for overseas employment.[6]
On January 10, 2008, respondent referred prospective applicant Jonathan V. Raguindin (Raguindin) to
petitioner for a pre-deployment medical examination in accordance with the instructions from
GAMCA.[7] After undergoing the required examinations, petitioner cleared Raguindin and found him "fit
for employment," as evidenced by a Medical Report[8] dated January 11, 2008 (Medical Report).[9]
Based on the foregoing, respondent deployed Raguindin to Saudi Arabia, allegedly incurring expenses
in the amount of P84,373.41.[10] Unfortunately, when Raguindin underwent another medical examination
with the General Care Dispensary of Saudi Arabia (General Care Dispensary) on March 24, 2008, he
purportedly tested positive for HCV or the hepatitis C virus. The Ministry of Health of the Kingdom of
Saudi Arabia (Ministry of Health) required a re-examination of Raguindin, which the General Care
Dispensary conducted on April 28, 2008.[11] However, the results of the re-examination remained the
same, i.e., Raguindin was positive for HCV, which results were reflected in a Certification[12] dated April
28, 2008 (Certification). An undated HCV Confirmatory Test Report[13] likewise conducted by the Ministry
of Health affirmed such finding, thereby leading to Raguindin's repatriation to the Philippines.[14]
Claiming that petitioner was reckless in issuing its Medical Report stating that Raguindin is "fit for
employment" when a subsequent finding in Saudi Arabia revealed that he was positive for HCV,
respondent filed a Complaint[15] for sum of money and damages against petitioner before the
Metropolitan Trial Court of Mandaluyong City, Branch 60 (MeTC). Respondent essentially averred that it
relied on petitioner's declaration and incurred expenses as a consequence. Thus, respondent prayed for
the award of damages in the amount of P84,373.41 representing the expenses it incurred in deploying
Raguindin abroad.[16]
In its Answer with compulsory counterclaim,[17] petitioner denied liability and claimed that: first,
respondent was not a proper party in interest for lack of privity of contract between them; second, the
MeTC had no jurisdiction over the case as it involves the interpretation and implementation of a contract
of employment; third, the action is premature as Raguindin has yet to undergo a post-employment
medical examination following his repatriation; and fourth, the complaint failed to state a cause of action
as the Medical Report issued by petitioner had already expired on April 11, 2008, or three (3) months
after its issuance on January 11, 2008.[18]
The MeTC Ruling
In a Decision[19] dated December 17, 2010, the MeTC rendered judgment in favor of respondent and
ordered petitioner to pay the amount of P84,373.41 as actual damages, P20,000.00 as attorney's fees,
and the costs of suit.[20]
At the onset, the MeTC held that it had jurisdiction over the case, since respondent was claiming actual
damages incurred in the deployment of Raguindin in the amount of P84,373.41. [21] It further ruled that
respondent was a real party in interest, as it would not have incurred expenses had petitioner not issued
the Medical Report certifying that Raguindin was fit to work.
On the merits, the MeTC found that respondent was entitled to be informed accurately of the precise
condition of Raguindin before deploying the latter abroad and consequently, had sustained damage as a
result of the erroneous certification.[22] In this relation, it rejected petitioner's contention that Raguindin
may have contracted the disease after his medical examination in the Philippines up to the time of his
deployment, there being no evidence offered to corroborate the same.[23]
Aggrieved, petitioner appealed to the RTC, contending,[24] among others, that respondent failed to
comply with the requirements on the authentication and proof of documents under Section 24,[25] Rule
132 of the Rules of Court, considering that respondent's evidence, particularly the April 28, 2008
Certification issued by the General Care Dispensary and the HCV Confirmatory Test Report issued by
the Ministry of Health, are foreign documents issued in Saudi Arabia.
The RTC Ruling
In a Decision[26] dated December 15, 2011, the RTC dismissed petitioner's appeal and affirmed the
MeTC Decision in its entirety.[27] Additionally, the RTC pointed out that petitioner can no longer change
the theory of the case or raise new issues on appeal, referring to the latter's argument on the
authentication of respondent's documentary evidence.[28]
Petitioner's motion for reconsideration[29] was denied in an Order[30] dated May 25, 2012. Dissatisfied,
petitioner elevated the case to the CA.[31]
The CA Ruling
In a Decision[32] dated July 11, 2014, the CA affirmed the RTC Decision, with the modification deleting
the award of actual damages and instead, awarding temperate damages in the amount of P50,000.00.[33]
The CA held that petitioner failed to perform its duty to accurately diagnose Raguindin when it issued its
Medical Report declaring the latter "fit for employment", considering that he was subsequently found
positive for HCV in Saudi Arabia.[34] Further, the CA opined that the Certification issued by the General
Care Dispensary is not a public document and in such regard, rejected petitioner's argument that the
same is inadmissible in evidence for not having been authenticated. Moreover, it remarked that
petitioner's own Medical Report does not enjoy the presumption of regularity as petitioner is merely an
accredited clinic.[35] Finally, the CA ruled that petitioner could not disclaim liability on the ground that
Raguindin tested positive for HCV in Saudi Arabia after the expiration of the Medical Report on April 11,
2008, noting that the General Care Dispensary issued its Certification on April 28, 2008, or a mere
seventeen (17) days from the expiration of petitioner's Medical Report.[36] Hence, the CA concluded that
"it is contrary to human experience that a newly-deployed overseas worker, such as Raguindin, would
immediately contract a serious virus at the very beginning of a deployment."[37]
However, as the records are bereft of evidence to show that respondent actually incurred the amount of
P84,373.41 as expenses for Raguindin's deployment, the CA deleted the award of actual damages and
instead, awarded temperate damages in the amount of P50,000.00.[38]
Aggrieved, petitioner filed a motion for partial reconsideration,[39] which the CA denied in a
Resolution[40] dated February 27, 2015; hence, this petition.
The Issue Before the Court
The essential issue advanced for the Court's resolution is whether or not petitioner was negligent in
issuing the Medical Report declaring Raguindin "fit for employment" and hence, should be held liable for
damages.
The Court's Ruling
The petition is granted.
I.
At the outset, it should be pointed out that a re-examination of factual findings cannot be done acting on
a petition for review on certiorari because the Court is not a trier of facts but reviews only questions of
law.[41] Thus, in petitions for review on certiorari, only questions of law may generally be put into issue.
This rule, however, admits of certain exceptions, such as "when the inference made is manifestly
mistaken, absurd or impossible"; or "when the findings are conclusions without citation of specific
evidence on which they are based."[42] Finding a confluence of certain exceptions in this case, the
general rule that only legal issues may be raised in a petition for review on certiorari under Rule 45 of the
Rules of Court would not apply, and the Court retains the authority to pass upon the evidence presented
and draw conclusions therefrom.[43]
II.
An action for damages due to the negligence of another may be instituted on the basis of Article 2176 of
the Civil Code, which defines a quasi-delict:
Article 2176. Whoever by act or omission causes damage to another, there being fault or negligence, is
obliged to pay for the damage done. Such fault or negligence, if there is no pre-existing contractual
relation between the parties, is called a quasi-delict and is governed by the provisions of this Chapter.
The elements of a quasi-delict are: (1) an act or omission; (2) the presence of fault or negligence in
the performance or non-performance of the act; (3) injury; (4) a causal connection between the
negligent act and the injury; and (5) no pre-existing contractual relation.[44]
As a general rule, any act or omission coming under the purview of Article 2176 gives rise to a cause of
action under quasi-delict. This, in turn, gives the basis for a claim of damages.[45] Notably, quasi-delict is
one among several sources of obligation. Article 1157 of the Civil Code states:
Article 1157. Obligations arise from:
(1) Law;
(2) Contracts;
(3) Quasi-contracts;
(4) Acts or omissions punished by law; and
(5) Quasi-delicts.
However, as explained by Associate Justice Marvic M.V.F. Leonen (Justice Leonen) in his opinion
in Alano v. Magud-Logmao[46] (Alano), "Article 2176 is not an all-encompassing enumeration of all
actionable wrongs which can give rise to the liability for damages. Under the Civil Code, acts
done in violation of Articles 19, 20, and 21 will also give rise to damages."[47] These provisions -
which were cited as bases by the MTC, RTC and CA in their respective rulings in this case - read as
follows:
Article 19. Every person must, in the exercise of his rights and in the performance of his duties, act with
justice, give everyone his due, and observe honesty and good faith.
Article 20. Every person who, contrary to law, willfully or negligently causes damage to another, shall
indemnify the latter for the same.
Article 21. Any person who willfully causes loss or injury to another in a manner that is contrary to
morals, good customs, or public policy shall compensate the latter for the damage.
"[Article 19], known to contain what is commonly referred to as the principle of abuse of rights, sets
certain standards which must be observed not only in the exercise of one's rights, but also in the
performance of one's duties."[48] Case law states that "[w]hen a right is exercised in a manner which
does not conform with the norms enshrined in Article 19 and results in damage to another, a legal wrong
is thereby committed for which the wrongdoer must be held responsible. But while Article 19 lays down a
rule of conduct for the government of human relations and for the maintenance of social order, it does
not provide a remedy for its violation. Generally, an action for damages under either Article 20 or Article
21 would [then] be proper."[49] Between these two provisions as worded, it is Article 20 which applies to
both willful and negligent acts that are done contrary to law. On the other hand, Article 21 applies only
to willful acts done contra bonos mores.[50]
In the Alano case, Justice Leonen aptly elaborated on the distinctive applications of Articles 19, 20 and
21, which are general provisions on human relations, vis-a-vis Article 2176, which particularly governs
quasi-delicts:
Article 19 is the general rule which governs the conduct of human relations. By itself, it is not the basis of
an actionable tort. Article 19 describes the degree of care required so that an actionable tort may arise
when it is alleged together with Article 20 or Article 21.
Article 20 concerns violations of existing law as basis for an injury. It allows recovery should the
act have been willful or negligent. Willful may refer to the intention to do the act and the desire to achieve
the outcome which is considered by the plaintiff in tort action as injurious. Negligence may refer to a
situation where the act was consciously done but without intending the result which the plaintiff
considers as injurious.
Article 21, on the other hand, concerns injuries that may be caused by acts which are not necessarily
proscribed by law. This article requires that the act be willful, that is, that there was an intention to do the
act and a desire to achieve the outcome. In cases under Article 21, the legal issues revolve around
whether such outcome should be considered a legal injury on the part of the plaintiff or whether the
commission of the act was done in violation of the standards of care required in Article 19.
Article 2176 covers situations where an injury happens through an act or omission of the defendant.
When it involves a positive act, the intention to commit the outcome is irrelevant. The act itself must
not be a breach of an existing law or a pre-existing contractual obligation. What will be considered
is whether there is "fault or negligence” attending the commission of the act which necessarily leads to
the outcome considered as injurious by the plaintiff. The required degree of diligence will then be
assessed in relation to the circumstances of each and every case.[51] (Emphases and underscoring
supplied)
Thus, with respect to negligent acts or omissions, it should therefore be discerned that Article 20 of the
Civil Code concerns "violations of existing law as basis for an injury", whereas Article 2176
applies when the negligent act causing damage to another does not constitute "a breach of an
existing law or a pre-existing contractual obligation."
In this case, the courts a quo erroneously anchored their respective rulings on the provisions of Articles
19, 20, and 21 of the Civil Code. This is because respondent did not proffer (nor have these courts
mentioned) any law as basis for which damages may be recovered due to petitioner's alleged negligent
act. In its amended complaint, respondent mainly avers that had petitioner not issue a "fit for
employment" Medical Report to Raguindin, respondent would not have processed his documents,
deployed him to Saudi Arabia, and later on - in view of the subsequent findings that Raguindin was
positive for HCV and hence, unfit to work - suffered actual damages in the amount of
P84,373.41.[52] Thus, as the claimed negligent act of petitioner was not premised on the breach of any
law, and not to mention the incontestable fact that no pre-existing contractual relation was averred to
exist between the parties, Article 2176 - instead of Articles 19, 20 and 21 - of the Civil Code should
govern.
III.
Negligence is defined as the failure to observe for the protection of the interests of another person, that
degree of care, precaution and vigilance which the circumstances justly demand, whereby such other
person suffers injury.[53]
As early as the case of Picart v. Smith,[54] the Court elucidated that "the test by which to determine the
existence of negligence in a particular case is: Did the defendant in doing the alleged negligent act
use that reasonable care and caution which an ordinarily prudent person would have used in the
same situation? If not, then he is guilty of negligence."[55] Corollary thereto, the Court stated that "[t]he
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. Abstract speculation cannot here be of much value x x x: Reasonable men govern their
conduct by the circumstances which are before them or known to them. They are not, and are not
supposed to be, omniscient of the future. Hence[,] they can be expected to take care only when
there is something before them to suggest or warn of danger."[56]
Under our Rules of Evidence, it is disputably presumed that a person takes ordinary care of his concerns
and that private transactions have been fair and regular. [57] In effect, negligence cannot be presumed,
and thus, must be proven by him who alleges it.[58] In Huang v. Philippine Hoteliers, Inc.:[59]
[T]he negligence or fault should be clearly established as it is the basis of her action. The burden of
proof is upon [the plaintiff]. Section 1, Rule 131 of the Rules of Court provides that "burden of proof is the
duty of a party to present evidence on the facts in issue necessary to establish his claim or defense by
the amount of evidence required by law." It is then up for the plaintiff to establish his cause of action or
the defendant to establish his defense. Therefore, if the plaintiff alleged in his complaint that he was
damaged because of the negligent acts of the defendant, he has the burden of proving such
negligence. It is even presumed that a person takes ordinary care of his concerns. The quantum
of proof required is preponderance of evidence.[60] (Emphasis and underscoring supplied)
The records of this case show that the pieces of evidence mainly relied upon by respondent to establish
petitioner's negligence are: (a) the Certification[61] dated April 28, 2008; and (b) the HCV Confirmatory
Test Report.[62] However, these issuances only indicate the results of the General Care Dispensary and
Ministry of Health's own medical examination of Raguindin finding him to be positive for HCV. Notably,
the examination conducted by the General Care Dispensary, which was later affirmed by the Ministry of
Health, was conducted only on March 24, 2008, or at least two (2) months after petitioner issued its
Medical Report on January 11, 2008. Hence, even assuming that Raguindin's diagnosis for HCV was
correct, the fact that he later tested positive for the same does not convincingly prove that he was
already under the same medical state at the time petitioner issued the Medical Report on January 11,
2008. In this regard, it was therefore incumbent upon respondent to show that there was already
negligence at the time the Medical Report was issued, may it be through evidence that show that
standard medical procedures were not carefully observed or that there were already palpable signs that
exhibited Raguindin's unfitness for deployment at that time. This is hardly the case when respondent
only proffered evidence which demonstrate that months after petitioner's Medical Report was issued,
Raguindin, who had already been deployed to Saudi Arabia, tested positive for HCV and as such, was
no longer "fit for employment".
In fact, there is a reasonable possibility that Raguindin became exposed to the HCV only after his
medical examination with petitioner on January 11, 2008. Based on published reports from the World
Health Organization, HCV or the hepatitis C virus causes both acute and chronic infection. Acute HCV
infection is usually asymptomatic,[63] and is only very rarely associated with life-threatening diseases.
The incubation period[64] for HCV is two (2) weeks to six (6) months, and following initial infection,
approximately 80% of people do not exhibit any symptoms.[65] Indisputably, Raguindin was not deployed
to Saudi Arabia immediately after petitioner's medical examination and hence, could have possibly
contracted the same only when he arrived thereat. In light of the foregoing, the CA therefore erred in
holding that "[h]ad petitioner more thoroughly and diligently examined Raguindin, it would likely have
discovered the existence of the HCV because it was contrary to human experience that a newly-
deployed overseas worker, such as Raguindin, would immediately have contracted the disease at the
beginning of his deployment"[66]
While petitioner's Medical Report indicates an expiration of April 11, 2008, the Court finds it fitting to
clarify that the same could not be construed as a certified guarantee coming from petitioner that
Raguindin's medical status at the time the report was issued on January 11, 2008 (i.e., that he was fit for
employment) would remain the same up until that date (i.e., April 11, 2008). As earlier intimated, the
intervening period could very well account for a number of variables that could have led to a change in
Raguindin's condition, such as his deployment to a different environment in Saudi Arabia. If at all, the
expiration date only means that the Medical Report is valid - and as such, could be submitted - as a
formal requirement for overseas employment up until April 11, 2008; it does not, by any means, create
legal basis to hold the issuer accountable for any intervening change of condition from the time of
issuance up until expiration. Truly, petitioner could not be reasonably expected to predict, much less
assure, that Raguindin's medical status of being fit for employment would remain unchanged. Thus, the
fact that the Medical Report's expiration date of April 11, 2008 was only seventeen (17) days away from
the issuance of the General Care Dispensary's April 28, 2008 Certification finding Raguindin positive for
HCV should not - as it does not - establish petitioner's negligence.
IV.
At any rate, the fact that Raguindin tested positive for HCV could not have been properly established
since the courts a quo, in the first place, erred in admitting and giving probative weight to the
Certification of the General Care Dispensary, which was written in an unofficial language. Section 33,
Rule 132 ofthe Rules of Court states that:
Section 33. Documentary evidence in an unofficial language. - Documents written in an unofficial
language shall not be admitted as evidence, unless accompanied with a translation into English or
Filipino. To avoid interruption of proceedings, parties or their attorneys are directed to have such
translation prepared before trial.[67]
A cursory examination of the subject document would reveal that while it contains English words, the
majority of it is in an unofficial language. Sans any translation in English or Filipino provided by
respondent, the same should not have been admitted in evidence; thus their contents could not be given
probative value, and deemed to constitute proof of the facts stated therein.
Moreover, the due execution and authenticity of the said certification were not proven in accordance with
Section 20, Rule 132 of the Rules of Court:
Section 20. Proof of private document. - Before any private document offered as authentic is received in
evidence, its due execution and authenticity must be proved either:
(a) By anyone who saw the document executed or written; or
(b) By evidence of the genuineness of the signature or handwriting of the maker.
(c) Any other private document need only be identified as that which it is claimed to be.
Notably, the foregoing provision applies since the Certification does not fall within the classes of public
documents under Section 19, Rule 132 of the Rules of Court[68] - and hence, must be considered as
private. It has been settled that an unverified and unidentified private document cannot be
accorded probative value.[69] In addition, case law states that "since a medical certificate involves
an opinion of one who must first be established as an expert witness, it cannot be given weight
or credit unless the doctor who issued it is presented in court to show his qualifications. It is
precluded because the party against whom it is presented is deprived of the right and opportunity to
cross-examine the person to whom the statements or writings are attributed. Its executor or author
should be presented as a witness to provide the other party to the litigation the opportunity to question its
contents. Being mere hearsay evidence, failure to present the author of the medical certificate renders
its contents suspect and of no probative value,"[70] as in this case.
Similarly, the HCV Confirmatory Test Report issued by the Ministry of Health of Saudi Arabia should
have also been excluded as evidence. Although the same may be considered a public document, being
an alleged written official act of an official body of a foreign country,[71] the same was not duly
authenticated in accordance with Section 24,[72] Rule 132 of the Rules of Court. While respondent
provided a translation[73] thereof from the National Commission on Muslim Filipinos, Bureau of External
Relations, Office of the President, the same was not accompanied by a certificate of the secretary of the
embassy or legation, consul-general, consul, vice-consul, or consular agent or any officer in the foreign
service of the Philippines stationed in Saudi Arabia, where the record is kept, and authenticated by the
seal of his office.[74]
To be sure, petitioner - contrary to respondent's contention[75] - has not changed its theory of the case by
questioning the foregoing documents. As petitioner correctly argued, it merely amplified its
defense[76] that it is not liable for negligence when it further questioned the validity of the issuances of the
General Care Dispensary and Ministry of Health. In Limpangco Sons v. Yangco[77], the Court explained
that "[t]here is a difference x x x between a change in the theory of the case and a shifting of the
incidence of the emphasis placed during the trial or in the briefs." "Where x x x the theory of the case as
set out in the pleadings remains the theory throughout the progress of the cause, the change of
emphasis from one phase of the case as presented by one set of facts to another phase made
prominent by another set of facts x x x does not result in a change of theory x x x". [78] In any case,
petitioner had already questioned the validity of these documents in its Position Paper[79] before the
MeTC.[80] Hence, there is no change of theory that would preclude petitioner's arguments on this score.
All told, there being no negligence proven by respondent through credible and admissible evidence,
petitioner cannot be held liable for damages under Article 2176 of the Civil Code as above-discussed.
WHEREFORE, the petition is GRANTED. Accordingly, the Decision dated July 11, 2014 and the
Resolution dated February 27, 2015 of the Court of Appeals in CA-G.R. SP No. 125451
are REVERSED and SET ASIDE, and a NEW ONE is entered, DISMISSING the complaint of
respondent LWV Construction Corporation for lack of merit.
SO ORDERED.
Carpio (Chairperson), Peralta, Caguioa, and Reyes, Jr., JJ., concur.