2018 LEGAL MEDICINE FINALS REVIEWER
I. NOGALES vs. CAPITOL | 142625 | 2006 determines
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In general, a hospital is not liable for the
negligence of an independent contractor-
physician. There is, however an exception to
this principle. The hospital may be liable if the
physician is an ostensible agent of the hospital.
This exception is also known as the doctrine of
apparent authority.
Under the doctrine of apparent authority a
hospital can be held vicariously liable for the
negligent acts of a physician providing care at
the hospital, regardless of whether the
physician is an independent contractor, unless
the patient knows, or should have known, that
the physician is an independent contractor.
For a hospital to be liable under the doctrine of
apparent authority, a plaintiff must show that:
1.) The hospital, or its agent, acted in a
manner that would lead a reasonable
person to conclude that the individual
who was alleged to be negligent was an
employee or agent of the hospital;
2.) Where the acts of the agent create the
appearance of authority, the plaintiff
must also prove that the hospital had
knowledge of and acquired in them; and
3.) The plaintiff acted in reliance upon the
conduct of the hospital or its agent,
consistent with ordinary care and
prudence.
While the Court in Ramos did not expound on
the control test, such test essentially
whether an employment
relationship exists between a physician and a
hospital based on the exercise of control over
the physician as to details. Specifically the
hospital must have the right to control both the
means and the details of the process by which
the physician is to accomplish his task.
II. RAMOS vs. CA | 124354 | 1999; 2002
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Previously, employers cannot be held liable for
the fault or negligence of its professionals.
However, this doctrine has weakened since
courts came to realize that modern hospitals
are taking a more active role in supplying and
regulating medical care to its patients, by
employing staff of physicians, among others.
Hence, there is no reason to exempt hospitals
from the universal rule of respondeat superior.
In determining whether an employer-employee
relationship exists between the parties, the
following elements must be present:
1.) Selection and engagement of services;
2.) Payment of wages;
3.) The power to hire and fire; and
4.) The power to control not only the end to
be achieved, but the means to be used in
reaching such an end.
There is no employer-employee relationship
between a hospital and medical consultants –
The contract between a medical consultant and
his patient is separate and distinct from the
contract between the hospital and said patient.
-1999 held all of the respondents as liable-------
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III. PSI vs. AGANA | 126297 | 2007; 2008; 2010
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-Focused si Sir sa 2008 decision----------------------
-Reiteration of the ruling in Nogales---------------
Under the doctrine of corporate responsibility,
the hospital has the duty to see that it meets
the standards of responsibilities for the care of
patients. Such duty includes the proper
supervision of the members of its medical staff.
The hospital accordingly has the duty to make a
reasonable effort to monitor and over see the
treatment prescribed and administered by the
physician practicing in its premises.
The corporate negligence doctrine imposes
several duties on a hospital:
(1) To use reasonable care in the
maintenance of safe and adequate
facilities and equipment;
(2) To select and retain only competent
physicians;
(3) To oversee as to patient care all persons
who practice medicine within its walls;
and
(4) To formulate, adopt, and enforce
adequate rules and policies to ensure
quality care for its patients.
OTHER DOCTRINES:
While in theory a hospital as a juridical entity
cannot practice medicine, in reality it utilizes
doctors, surgeons and medical practitioners in
the conduct of its business of facilitating
medical and surgical treatment. Within that
reality, three legal relationships crisscross:
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(1) Between the hospital and the doctor
practicing within its premises;
(2) Between the hospital and the patient
being treated or examined within its
premises; and
(3) Between the patient and the doctor. The
exact nature of each relationship
determines the basis and extent of the
liability of the hospital for the negligence
of the doctor.
Doctrine of Res Ipsa Loquitur – It is the rule
that the fact of the occurrence of an injury,
taken with the surrounding circumstances, may
permit an inference or raise a presumption of
negligence, or make out a plaintiff’s prima facie
case, and present a question of fact for
defendant to meet with an explanation.
The requisites for the applicability of the
doctrine of res ipsa loquitur are:
1.) The occurrence of an injury;
2.) The thing which caused the injury was
under the control and management of the
defendant;
3.) The occurrence was such that in the
ordinary course of things, would not have
happened if those who had control or
management used proper care; and
4.) The absence of explanation by the
defendant.
Medical malpractice – Failure of a physician to
properly perform the duty which devolves upon
him in his professional relation to his patient
which results to injury.
The elements of Medical Malpractice are:
1.) The physician has a duty to the patient;
2.) The physician failed to perform such duty
to his patient;
3.) As a consequence of the failure, injury
was sustained by the patient;
4.) The failure of the physician is the
proximate cause of the injury sustained
by the patient.
IV. SILVERIO CASE vs. CAGANDAHAN CASE
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Silverio had a sex change or reassignment
operation. On the other hand, Cagandahan has
Congenital Adrenal Hyperplasia which is a
condition where a person possesses both male
and female characteristics. As the Supreme
Court stated:
Cagandahan simply let nature take its course
and has not taken unnatural steps to arrest or
interfere with what he was born with. And
accordingly, he has already ordered his life to
that of a male. Respondent could have
undergone treatment and taken steps, like
taking lifelong medication, to force his body
into the categorical mold of a female but he
did not. He chose not to do so. Nature has
instead taken its due course in respondent's
development to reveal more fully his male
characteristics.
Silverio deliberately took the sex reassignment
operations to change his body to that of a
woman. Cagandahan, on the other hand, from
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birth had a female body, male hormones, two
sex organs, and no monthly period.
A. SILVERIO vs. REPUBLIC | 126297 | 2007
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A change of name does not alter one’s legal
capacity or civil status. RA 9048 does not
sanction a change of first name on the ground
of sex reassignment.
A change of name is a privilege and not a right.
It may be allowed in cases where the name is
ridiculous, tainted with dishonor, or difficult to
pronounce or write; a nickname is habitually
used; or if the change will avoid confusion. The
petitioner’s basis of the change of his name is
that he intends his first name compatible with
the sex he thought he transformed himself into
thru surgery. The Court held that his true name
does not prejudice him at all, and no law allows
the change of entry in the birth certificate as to
sex on the ground of sex reassignment. The
Court denied the petition.
B. REPUBLIC vs CAGANDAHAN | 166676 | 2008
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Where the person is biologically or naturally
intersex the determining factor in his gender
classification would be what the individual,
having reached the age of majority, with good
reason thinks of his/her sex – Sexual
development in cases of intersex persons makes
the gender classification at birth inconclusive —
it is at maturity that the gender of such persons,
like respondent, is fixed.
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V. ADMINISTERING INJURIOUS SUBSTANCE
How the crime of serious physical injuries is
committed: S.K.A.N
1.) That the offender inflicted upon another
any serious physical injury
2.) That it was done by knowingly
administering to him any injurious
substance or beverages or by taking
advantage of his weakness of mind or
credulity; and
3.) That he had no intent to kill.
VI. MUTILATION vs SERIOUS PHYSICAL INJURIES
In Serious Physical Injuries, the intent is simply
to inflict physical injuries. In mutilation, the
offender must have the intention to deprive the
offended party of a part of his body.
Q: Suppose there is no intent to deprive the
victim of the particular part of the body, what is
the crime committed?
A: The crime is only serious physical injury.
In mutilation, the body parts should have been
purposely and deliberately lopped or clipped
off. This intention is not present in serious
physical injuries.
PHYSICAL INJURIES MUTILATION
No intention to clip There is intention to
off some part of the clip off some part of
body so as to deprive the body so as to
the offended party of deprive him of such
such part. part.
A. SERIOUS PHYSICAL INJURIES
How the crime of serious physical injuries is
committed:
1.) By wounding;
2.) By beating;
3.) By assaulting; or
4.) By administering injurious substance.
Instances considered as the crime of serious
physical injuries: ISD30
1.) Insane 2.) Speech
3.) Deformed 4.) 30 Days
Explained as follows:
1.) When the injured person becomes
insane, imbecile, impotent or blind as a
consequence of the physical injuries
inflicted;
2.) When the injured person:
a) Loses the use of speech or the power
to hear, or to smell, or loses, an eye, a
hand, a foot, an arm, or a leg;
b) Loses the use of any such member; or
c) Becomes incapacitated for the work
in which he was therefore habitually
engage, in consequence of the
physical injuries inflicted
3.) When the person injured:
a) Becomes deformed
b) Loses any other member of his body;
c) Loses the use thereof
d) Becomes ill or incapacitated for the
performance of the work in which he
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was habitually engaged for more than
90 days, in consequence of the
physical injuries inflicted
4.) When the injured person becomes ill or
incapacitated for labor for more than 30
days (but must not be more than 90
days), as a result of the physical injuries
inflicted.
Requisites of deformity
1.) Physical ugliness;
2.) Permanent and definite abnormality; and
3.) Conspicuous and visible.
Once physical injuries resulted to deformity, it
is classified as serious physical injuries.
B. MUTILATION
FIRST MODE
Intentionally mutilating another by depriving
him, either totally or partially, of some essential
organ for reproduction. Its Elements are what
follows:
1.) There be a castration, that is, mutilation
of organs necessary for generation, such
as the penis or ovarium;
2.) The mutilation is caused purposely and
deliberately
SECOND MODE
Intentionally making other mutilation, that is,
by lopping or clipping off any part of the body of
the offended party, other than the essential
organ for reproduction, to deprive him of that
part of his body.
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VII. QUALIFIED SERIOUS PHYSICAL INJURIES
The qualifying circumstances of Serious
Physical Injuries are:
1.) If it is committed by any of the persons
referred to in the crime of parricide; or
2.) If any of the circumstances qualifying
murder attended its commission.
NOTE: The qualified penalties are not applicable
to parents who inflict serious physical injuries
upon their children by excessive chastisement.
CHASTISEMENT – Punishment by reason of
discipline
VIII. QUALIFIED LSPI
The qualifying circumstances of Less Serious
Physical Injuries are:
1.) A fine not exceeding P 500.00, in
addition to arresto mayor, when –
a) There is a manifest intent to insult or
offend the injured person; or
b) There are circumstances adding
ignominy to the offense.
2.) A higher penalty is imposed when the
victim is either –
a) The offender’s parents, ascendants,
guardians, curators or teachers; or
b) Persons of rank or person in
authority, provided the crime is not
direct assault.
Q filed after the wounds inflicted on the offended
A disagreement ensued between Cindy and
Carina which led to a slapping incident. Cindy
gave twin slaps on Carina’s beautiful face. What
is the crime committed by Cindy?
A -Read at your own risk. Read the full text first--
1. Slander by deed – If the slapping was done to
cast dishonor to the person slapped.
2. Slight physical injuries by ill-treatment – If
the slapping was done without the intention of
casting dishonor, or to humiliate or embarrass
the offended party out of a quarrel or anger.
NOTES:
 Slander by deed resulting to Slight
Physical Injuries – The former absorbs the
latter.
 Slander by deed resulting to Less Serious
Physical Injuries – The former is absorbed
by the latter.
 Slander by deed resulted to blindness –
The crime committed is that of Serious
Physical Injuries.
VIII. SEMINAL CASES ON BASIC DOCTRINES IN
PHYSICAL INJURIES
PEOPLE vs. ADIL | 41863 | 1977
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No double jeopardy exists where an
information for serious physical injuries was
filed after the filing of an information for slight
physical injuries against the same accused
arising out of the same incident where the
information for serious physical injuries was
victim had healed and it was found that there
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was a permanent deformity on the victim’s
face.
PEOPLE vs. YORAC | 29270 | 1971
For double jeopardy not to exist, there is then
the indispensable requirement of the existence
of a new fact which supervenes for which the
defendant is responsible changing the character
of the crime imputed to him and together with
the facts existing previously constituting a new
and distinct offense.
PEOPLE vs. BULING | 13315 | 1960
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FACTS: Accused was charged with the crime of
less serious physical injuries for inflicting
wounds on a person which, according to the
complaint, would require medical attendance
for a period from 10 to 15 days. Having pleaded
guilty, he served his sentence fully. Later, the
Provincial Fiscal filed an information against the
accused charging him with serious physical
injuries, the information alleging that the same
wounds inflicted by the accused would require
medical attendance for a period from 1½
months to 2½ months.
It appears that a different physician examined
the offended party anew, taking an X-ray
picture of the arm of the offended party which
had been wounded, which method of
examination was not adopted by the first
physician. The second physician's certification
was the basis of the second complaint.
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ISSUE: Whether or not there is double is an attempt to commit the offense or a

jeopardy? frustration thereof.

HELD: Yes. If the X-ray examination disclosed DOCTRINE OF SUPERVENING EVENT

the existence of a fracture when the second
examination was made, that fracture must have
existed when the first examination was made.
There was, therefore, no new or supervening
fact that could be said to have developed or
arisen since the filing of the original action.
Where after the first prosecution a new fact
supervenes for which the defendant is
responsible, which changes the character of the
offense and, together with the facts existing at
the time, constitutes a new and distinct offense,
the accused cannot be said to be in second
jeopardy, if indicted for the new offense.

NOTES:
First Scenario
A fracture happened, followed by arraignment,
and a conviction for the same. A 2 nd Charge for
SPI was subsequently made. Did double
jeopardy attach? – Yes. The same carried the
same set of facts.

Second Scenario
Manifestation of a scar after the 1 st Conviction.
Will double jeopardy attach for a subsequent
charge of SPI? – No, for there is no way to know
when such scar will develop.

DOUBLE JEOPARDY. SEC. 7, RULE 117, RC

Elements of Double Jeopardy:
1.) A first jeopardy must have validly
attached prior to the second;
2.) The first jeopardy must have been validly
terminated; and
3.) The second jeopardy must be for the
same offense or the second offense
includes or is necessarily included in the
offense charged in the first information or

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