Definition and Test of Negligence

PHILIPPINE NATIONAL RAILWAYS vs. COURT OF APPEALS

G.R. No. 157658 October 15, 2007

FACTS:

Jose Amores was driving in Pandacan, Manila and was about to cross a rail road. However, he was hit by
an oncoming train and was dragged ten meters away from where he was initially situated. Amores died due to the
said collision. there was neither a signal nor a crossing bar at the intersection to warn motorists of an approaching
train. It was established that aside from the railroad track, the only visible warning sign at that time was the defective
standard signboard STOP, LOOK and LISTEN wherein the sign LISTEN was lacking while that of LOOK was bent.
No whistle blow from the train was likewise heard before it finally crashed against the car of Amores.

The heirs of Amores filed a complaint for damages against PNR contending that it was the latter’s
negligence that brought about the accident.

In their Answer, the PNR denied the allegations, stating that the train was railroad-worthy and without any
defect. According to them, the proximate cause of the death of Amores was his own carelessness and negligence,
and Amores wantonly disregarded traffic rules and regulations in crossing the railroad tracks and trying to beat the
approaching train.

The RTC ruled in favor of PNR. However, the CA reversed such ruling on appeal.

ISSUE:

Whether or not there was negligence on the part of PNR.

HELD:

Yes. Negligence has been 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. Using the aforementioned philosophy, it may be reliably concluded that there is no hard and fast
rule whereby such degree of care and vigilance is calibrated; it is dependent upon the circumstances in which a
person finds himself. All that the law requires is that it is perpetually compelling upon a person to use that care and
diligence expected of sensible men under comparable circumstances.

The petitioners were negligent when the collision took place. The transcript of stenographic notes reveals
that the train was running at a fast speed because notwithstanding the application of the ordinary and emergency
brakes, the train still dragged the car some distance away from the point of impact. Evidence likewise unveils the
inadequate precautions taken by petitioner PNR to forewarn the public of the impending danger. Aside from not
having any crossing bar, no flagman or guard to man the intersection at all times was posted on the day of the
incident. A reliable signaling device in good condition, not just a dilapidated Stop, Look and Listen signage because
of many years of neglect, is needed to give notice to the public. It is the responsibility of the railroad company to use
reasonable care to keep the signal devices in working order. Failure to do so would be an indication of negligence.

As held in the case of Philippine National Railway v. Brunty, it may broadly be stated that railroad companies
owe to the public a duty of exercising a reasonable degree of care to avoid injury to persons and property at railroad
crossings, which duties pertain both to the operation of trains and to the maintenance of the crossings. Moreover,
every corporation constructing or operating a railway shall make and construct at all points where such railway
crosses any public road, good, sufficient, and safe crossings, and erect at such points, at sufficient elevation from
such road as to admit a free passage of vehicles of every kind, a sign with large and distinct letters placed thereon, to
give notice of the proximity of the railway, and warn persons of the necessity of looking out for trains. The failure of
the PNR to put a cross bar, or signal light, flagman or switchman, or semaphore is evidence of negligence and
disregard of the safety of the public, even if there is no law or ordinance requiring it, because public safety demands
that said device or equipment be installed.

Article 2180 of the New Civil Code discusses the liability of the employer once negligence or fault on the part
of the employee has been established. The employer is actually liable on the assumption of “juris tantum” that the
employer failed to exercise “diligentissimi patris families” in the selection and supervision of its employees. The
liability is primary and can only be negated by showing due diligence in the selection and supervision of the
employee, a factual matter that has not been demonstrated. Even the existence of hiring procedures and supervisory
employees cannot be incidentally invoked to overturn the presumption of negligence on the part of the employer.
 Definition and Test of Negligence
LA MALLORCA and PAMPANGA BUS COMPANY vs. VALENTIN DE JESUS, MANOLO TOLENTINO and
COURT OF APPEALS
G.R. No. L-21486 May 14, 1966

FACTS:

A head on collision accident between a passenger bus and a freight cargo truck happened in the morning of
October 8, 1959. This resulted to the death of Lolita De Jesus, passenger of the bus and daughter of Valentin De
Jesus and Manolo Tolentino.

It was established that the immediate cause of the accident was the fact that the driver of the bus lost control
of the wheel when its left front tire suddenly exploded.

The trial court ruled in favor of herein respondents and ordered the bus company to pay actual,
compensatory, and moral damages; and counsel fee to the heirs of the victim. The CA, upon appeal, affirmed the
decision of the trial court.

ISSUES:

1. Whether or not the petitioner is liable for the consequences of the accident.

2. Whether or not the petitioner is liable for moral damages.

HELD:

1. Yes. Petitioner maintains that a tire blow-out is a fortuitous event and gives rise to no liability for negligence.
Both the CFI and the CA found that the bus was running quite fast immediately before the accident.
Considering that the tire which exploded was not new, petitioner describes it as "hindi masyadong kalbo," or
not so very worn out, the plea of caso fortuito by petitioner cannot be entertained. The cause of the blow-out
was a mechanical defect of the conveyance or a fault in its equipment which was easily discoverable if the
bus had been subjected to a more thorough check-up before it took to the road. Hence, petitioners are liable
for the accident.

2. Yes. The second issue raised by petitioner is already a settled one. In this jurisdiction moral damages are
recoverable by reason of the death of a passenger caused by the breach of contract of a common carrier, as
provided in Article 1764, in relation to Article 2206, of the Civil Code.
 Definition and Test of Negligence
PHILIPPINE SAVINGS BANK vs. CHOWKING FOOD CORPORATION
G.R. No. 177526 July 3, 2008

FACTS:

Five checks were endorsed and encashed by Rino T. Manzano to the Bustos branch of the respondent PS
Bank. All the five checks were honored, even with only the endorsement of Manzano approving them. The signatures
of the other authorized officers of respondent corporation were absent in the five checks, contrary to usual banking
practice. Manzano, thereafter, absconded with the misappropriated funds of Chowking Food Corporation.

When Chowking Food Corporation discovered Manzano’s scheme, it demanded reimbursement from the
petitioner. When PS Bank refused to pay, Chowking Food Corporation filed a complaint for a sum of money with
damages before the RTC.

RTC rendered a decision in favor of Chowking Food Corporation but was later on reversed and the case
was dismissed through a motion for reconsideration. On appeal, the CA reinstated the earlier decision of the RTC.

ISSUE:

Whether or not the bank is required to exercise the diligence of pater familias.

HELD:

No. It cannot be over emphasized that the banking business is impressed with public interest. Of paramount
importance is the trust and confidence of the public in general in the banking industry. Consequently, the diligence
required of banks is more than that of a Roman pater familias or a good father of a family. The highest degree of
diligence is expected. In its declaration of policy, the General Banking Law of 2000 requires of banks the highest
standards of integrity and performance. Needless to say, a bank is under obligation to treat the accounts of its
depositors with meticulous care. The fiduciary nature of the relationship between the bank and the depositors must
always be of paramount concern.

Article 2176. Whoever by act or omission causes damage to another, there being fault or
negligence, is obliged to pay for the damage done.

Article. 2180. The obligation imposed by Art. 2176 is demandable not only for one's own acts or
omissions but also for those of persons for whom one is responsible.

Employers shall be liable for the damage caused by their employees and household helpers acting within
the scope of their assigned tasks even though the former are not engaged in any business or activity.

The responsibility treated of in this article shall cease when the persons herein mentioned prove that they
observed all the diligence of a good father of a family to prevent damage.

However, with banks like PS Bank, the degree of diligence required is more than that of a good father of a family
considering that the business of banking is imbued with public interest due to the nature of its functions. Highest
degree of diligence is needed which PSB, in this case, failed to observe.

Its argument that it should not be held responsible for the negligent acts of its employee because those were
independent acts perpetrated without its knowledge and consent is without basis in fact and in law. Assuming that PS
Bank did not err in hiring its employee for her position, its lack of supervision over her made it solidarily liable for the
unauthorized encashment of the checks involved. In the supervision of employees, the employer must formulate
standard operating procedures, monitor their implementation and impose disciplinary measures for the breach
thereof.

PS Bank, in this case, presented no evidence that it formulated rules/guidelines for the proper performance
of functions of its employees and that it strictly implemented and monitored compliance therewith.
 Standard of Conduct: Good Father of a Family
THE HEIRS OF REDENTOR COMPLETO and ELPIDIO ABIAD vs. SGT. AMANDO C. ALBAYDA, JR.
G.R. No. 172200 July 6, 2010

FACTS:

A Toyota Corolla Taxi driven by Redentor Completo, owned and operated by Elpidio Abiad, figured in an
accident with a bicycle that was being used by Amando C. Albayda, Jr., leaving a deep indentation on the rear right of
the taxicab and causing serious physical injuries on the part of Albayda. The respondent was immediately brought to
the Philippine Air Force General Hospital (PAFGH). However, he was transferred to the Armed Forces of the
Philippines Medical Center (AFPMC) on V. Luna Road, Quezon City, because there was a fracture on his left knee
and there was no orthopedic doctor available at PAFGH.

Albayda filed a complaint for physical injuries through reckless imprudence against Completo before the
Office of the City Prosecutor of Pasay City. On the other hand, Completo filed a counter- charge of damage to
property through reckless imprudence against Albayda which was later dismissed.

The trial court rendered a decision in favor of Albayda.

ISSUES:

1. Whether or not the CA erred in finding that Completo was the one who caused the accident.

2. Whether or not Abiad failed to prove that he observed the diligence of a good father of a family.

3. Whether or not the award of moral and temperate damages,and attorney’s fee to Albayda had no basis.

HELD:

1. No. As stated in Article 2176 of the Civil Code which provides that 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. In this
regard, the question of the motorist’s negligence is a question of fact. It was proven by a preponderance of
evidence that Completo failed to exercise reasonable diligence in driving the taxicab due to speeding. Such
negligence was the sole and proximate cause of the serious physical injuries sustained by Albayda.

2. Yes. Under article 2180 of the Civil Code, the obligation imposed by Article 2176 is demandable not only for
one’s own acts or omissions, but also for those persons for whom one is responsible. Employers shall be
liable for the damages caused by their employees, but the employer’s responsibility shall cease upon proof
that they observed all the diligence of a good father of the family in the selection and supervision of their
employees.

3. No. Temperate damages, more than nominal but less than compensatory damages, may be recovered
when the court finds that some pecuniary loss has been suffered but its amount cannot, from the nature of
the case, be proved with certainty. Moral damages are awarded in qausi-delicts causing physical injuries.
The permanent deformity and the scar left by the wounds suffered by Albayda will forever be a reminder of
the pain and suffering that he had endured and continues to endure because of petitioner’s negligence.
 Proof of Negligence
MERCURY DRUG CORPORATION and ROLANDO J. DEL ROSARIO vs. SPOUSES RICHARD HUANG and
CARMEN HUANG, and STEPHEN HUANG
G.R. No. 172122 June 22, 2007

FACTS:

A six-wheeler 1990 Mitsubishi Delivery truck driven by Rolando J. Del Rosario, owned by Mercury Drug
Corporation, and a 1991 Toyota Corolla GLI driven by Stephen Huang figured in an accident on December 20, 1996
at around 10:30pm within the municipality of Taguig, Metro Manila.

Both vehicles were traversing northbound with the car in the innermost lane and the truck on its side to the
right when the latter suddenly swerved to its left and slammed the car. The collision hurled the car over the island
where it hit a lamp post, spun around, and landed on the opposite side. Upon investigation, it was discovered that Del
Rosario only had a Traffic Violation Receipt because his driver’s license was confiscated due to an earlier traffic
infraction.

The car was totally wrecked and Stephen Huang sustained massive injuries to his spinal cord, face, head,
and lungs. This resulted to his paralysis from the chest down and requires continuous medical and rehabilitation
treatment.

ISSUES:

1. Whether or not Del Rosario is liable for the paralysis of Stephen Huang.

2. Whether or not Mercury Drug Corporation is solidarily liable.

HELD:

1. Yes. Del Rosario’s negligence as the direct and proximate cause of the injuries suffered by respondent
Stephen Huang. Del Rosario failed to do what a reasonable and prudent man would have done under the
circumstances, and it is highly improbable that the car swerved since it would not have leaped across the
other lane if that would have occurred.

2. Yes. In the case of petitioner Del Rosario, however he took the driving tests and psychological examination
when he applied for the position of Delivery Man, but not when he applied for the position of Truck Man.

Further, no tests were conducted on the motor skills development, perceptual speed, visual attention, depth
visualization, eye and hand coordination and steadiness of petitioner Del Rosario. No NBI and police
clearances were also presented. Lastly, petitioner Del Rosario attended only three driving seminars . In
effect, the only seminar he attended before the accident which occurred in 1996 was held twelve years ago
in 1984.

Petitioner Mercury Drug likewise failed to show that it exercised due diligence on the supervision and
discipline over its employees. In fact, on the day of the accident, petitioner Del Rosario was driving without a
license.

He was holding a TVR for reckless driving. He testified that he reported the incident to his superior, but
nothing was done about it. He was not suspended or reprimanded. No disciplinary action whatsoever was
taken against petitioner Del Rosario. We therefore affirm the finding that petitioner Mercury Drug has failed
to discharge its burden of proving that it exercised due diligence in the selection and supervision of its
employee, petitioner Del Rosario.

It also appears that petitioner Mercury Drug does not provide for a back-up driver for long trips. At the time
of the accident, petitioner Del Rosario has been out on the road for more than thirteen hours, without any
alternate.
 Res Ipsa Loquitur
THE SPOUSES BERNABE AFRICA and SOLEDAD C. AFRICA, and the HEIRS OF DOMINGA ONG vs.
CALTEX (PHIL.), INC., MATEO BOQUIREN and THE COURT OF APPEALS
G.R. No. L-12986 March 31, 1966

FACTS:

A fire broke out in a Caltex gasoline station during the transfer of said gasoline from the tank truck to the
receiving tank. The fire spread to and burned several neighboring houses, including the personal properties and
effects inside them. This prompted the homeowners to sue Caltex (Phil.), Inc. as the owner of the station and Mateo
Boquirenas as its agent in charge of operation. Negligence on the part of both of them was attributed as the cause of
the fire.

The trial court and the CA found that petitioners failed to prove negligence and that respondents had
exercised due care in the premises and with respect to the supervision of their employees.

CA also ruled out that the reports of the Manila and Police Department and a certain Captain Tinio of Armed
Forces of the Philippines (AFP) as “double hearsay” and hence, inadmissible.

Petitioners contended that first, that said reports were admitted by the trial court without objection on the part
of respondents; second, that with respect to the police report which appears signed by a Detective Zapanta allegedly
"for Salvador Capacillo," the latter was presented as witness but respondents waived their right to cross-examine
him; and third, that in any event the said reports are admissible as an exception to the hearsay rule under section 35
of Rule 123, now Rule 130.

ISSUES:

1. Whether or not, without proof as to the cause and origin of the fire, the doctrine of res ipsa loquitur should
apply so as to presume negligence.

2. Whether or not Caltex should be held liable for the damages.

HELD:

1. Yes. Under the Doctrine of res ipsa loquitur (the transaction speaks for itself), "where the thing which caused
injury, without fault of the injured person, is under the exclusive control of the defendant and the injury is
such as in the ordinary course of things does not occur if he having such control use proper care, it affords
reasonable evidence, in the absence of the explanation, that the injury arose from defendant's want of care."

Gasoline is a highly combustible material, in the storage and sale of which extreme care must be taken. On
the other hand, fire is not considered a fortuitous event, as it arises almost invariably from some act of man.
A gasoline station, with all its appliances, equipment and employees, was under the control of appellees. A
fire occurred therein and spread to and burned the neighboring houses. The persons who knew or could
have known how the fire started were appellees and their employees, but they gave no explanation thereof
whatsoever. It is a fair and reasonable inference that the incident happened because of want of care.

In the report submitted by, Caltex Gasoline Station 0ccupies a lot approximately 10 m x 10 m. Location is
within a very busy business district near the market, a railroad crossing and very thickly populated
neighborhood. Aside from precautions already taken by its operator the concrete walls south and west
adjoining the neighborhood are only 2-1/2 meters high at most and cannot avoid the flames from leaping
over. In addition, it is also used by its operator as a garage and repair shop for his fleet of taxicabs
numbering ten or more, adding another risk to the possible outbreak of fire.

These facts, strengthen the presumption of negligence under the doctrine of res ipsa loquitur, since on their
face they called for more stringent measures of caution than those which would satisfy the standard of due
diligence under ordinary circumstances. Defendants' negligence was not only with respect to the cause of
the fire but also with respect to the spread thereof to the neighboring houses.
2. Yes. The issue depends on whether Boquiren was an independent contractor or an agent of Caltex.

Boquiren made an admission that he was an agent of Caltex. Caltex admits that it owned the gasoline
station and the equipment but claims that the business at the station was owned and operated by Boquiren.
It presented a license agreement and gives rise to the conclusion that it was designed to free Caltex from
any responsibility with respect to the fire, as shown by the clause that Caltex "shall not be liable for any
injury to person or property while in the property herein licensed, it being understood and agreed that
LICENSEE (Boquiren) is not an employee, representative or agent of LICENSOR (Caltex)."

However, under that agreement Boquiren would pay Caltex the purely nominal sum for the use of the
premises and all the equipment. He could sell only Caltex Products. Maintenance of the station and its
equipment was subject to the approval of Caltex. Boquiren could not assign or transfer his rights as licensee
without the consent of Caltex. The license agreement was supposed to be from January 1, 1948 to
December 31, 1948, and thereafter until terminated by Caltex upon two days prior written notice. Caltex
could at any time cancel and terminate the agreement in case Boquiren ceased to sell Caltex products, or
did not conduct the business with due diligence, in the judgment of Caltex. Termination of the contract was
therefore a right granted only to Caltex but not to Boquiren. These provisions of the contract show the extent
of the control of Caltex over Boquiren. The control was such that the latter was virtually an employee of the
former. Hence, Caltex should be liable.
 Res Ipsa Loquitur
REPUBLIC OF THE PHILIPPINES vs. LUZON STEVEDORING CORPORATION
G.R. No. L-21749 September 29, 1967

FACTS:

In the early afternoon of August 17, 1960, Barge L-1892, owned by the Luzon Stevedoring Corporation was
being towed down the Pasig river by tugboats "Bangus" and "Barbero", also belonging to the same corporation, when
the barge rammed against one of the wooden piles of the Nagtahan bailey bridge, smashing the posts and causing
the bridge to list. The river, at the time, was swollen and the current swift, on account of the heavy downpour in
Manila and the surrounding provinces on August 15 and 16, 1960.

Sued by the Republic of the Philippines for actual and consequential damage caused by its employees,
amounting to P200,000, defendant Luzon Stevedoring Corporation disclaimed liability therefor, on the grounds that it
had exercised due diligence in the selection and supervision of its employees; that the damages to the bridge were
caused by force majeure; that plaintiff has no capacity to sue; and that the Nagtahan bailey bridge is an obstruction to
navigation.

After due trial, the court rendered judgment holding the defendant liable for the damage caused by its
employee and ordering it to pay to plaintiff the actual cost of the repair of the Nagtahan bailey bridge which amounted
to P192,561.72, with legal interest thereon from the date of the filing of the complaint.

ISSUES:

1. Whether or not the collision of appellant's barge with the supports or piers of the Nagtahan bridge was in law
caused by fortuitous event or force majeure.

2. Whether or not it was error for the Courts to have permitted the plaintiff-appellee to introduce additional
evidence of damages after said party had rested its case.

HELD:

1. No. Considering that the Nagtahan bridge was an immovable and stationary object and uncontrovertedly
provided with adequate openings for the passage of water craft, including barges like of appellant's, it is
undeniable that the unusual event that the barge, exclusively controlled by appellant, rammed the bridge
supports raises a presumption of negligence on the part of appellant or its employees manning the barge or
the tugs that towed it. For in the ordinary course of events, such a thing does not happen if proper care is
used. In Anglo American Jurisprudence, the inference arises by what is known as the res ipsa loquitur rule.

For caso fortuito or force majeure (which in law are identical in so far as they exempt an obligor from liability)
by definition, are extraordinary events not foreseeable or avoidable, "events that could not be foreseen, or
which, though foreseen, were inevitable.” It is, therefore, not enough that the event should not have been
foreseen or anticipated, as is commonly believed, but it must be one impossible to foresee or to avoid. The
mere difficulty to foresee the happening is not impossibility to foresee the same. The very measures adopted
by appellant prove that the possibility of danger was not only foreseeable, but actually foreseen, and was not
caso fortuito.

2. No. Appellant charges the lower court with having abused its discretion in the admission of plaintiff's
additional evidence after the latter had rested its case. There is an insinuation that the delay was deliberate
to enable the manipulation of evidence to prejudice defendant-appellant. The SC finds no merit in the
contention. Whether or not further evidence will be allowed after a party offering the evidence has rested his
case, lies within the sound discretion of the trial Judge, and this discretion will not be reviewed except in
clear case of abuse. In the present case, no abuse of that discretion is shown. What was allowed to be
introduced, after plaintiff had rested its evidence in chief, were vouchers and papers to support an item of
P1,558.00 allegedly spent for the reinforcement of the panel of the bailey bridge, and which item already
appeared in Exhibit GG. Appellant, in fact, has no reason to charge the trial court of being unfair, because it
 was also able to secure, upon written motion, a similar order dated November 24, 1962, allowing reception
of additional evidence for the said defendant-appellant.

Negligence of Health Care Professionals

DR. RUBI LI vs. SPOUSES REYNALDO and LINA SOLIMAN, as parents/heirs of deceased Angelica Soliman
G.R. No. 165279 June 7, 2011

FACTS:

Angelica Soliman, daughter of herein respondents, was diagnosed with bone cancer. Following this
diagnosis, Angelica’s right leg was amputated to remove the tumor. Further, to eliminate the remaining cancer cells,
chemotherapy was suggested by Dr. Tamayo. Angelica was referred to a medical oncologist, Dr. Rubi Li.

Angelica died 11 days after the first administration of chemotherapy. Because Saint Luke’s Medical Center
refused to release a death certificate without the full payment of their hospital bills, the respondents brought
Angelica’s cadaver to the Philippine National Police for autopsy where it was found that the cause of death was
"hypovolemic shock secondary to multiple organ hemorrhages and disseminated intravascular coagulation."

Respondents filed a damage suit against the petitioner for negligence and disregard of Angelicas safety,
health and welfare by their careless administration of the chemotherapy drugs, their failure to observe the essential
precautions in detecting early the symptoms of fatal blood platelet decrease and stopping early on the chemotherapy,
which bleeding led to hypovolemic shock that caused Angelicas untimely demise.

the trial court held that petitioner was not liable for damages as she observed the best known procedures
and employed her highest skill and knowledge in the administration of chemotherapy drugs on Angelica but despite
all efforts said patient died.

ISSUE:

Whether or not Dr. Rubi Li was negligent and, thus, liable for damages.

HELD:

No. There are four essential elements a plaintiff must prove in a malpractice action based upon the doctrine
of informed consent: "(1) the physician had a duty to disclose material risks; (2) he failed to disclose or inadequately
disclosed those risks; (3) as a direct and proximate result of the failure to disclose, the patient consented to treatment
she otherwise would not have consented to; and (4) plaintiff was injured by the proposed treatment." The gravamen
in an informed consent case requires the plaintiff to "point to significant undisclosed information relating to the
treatment which would have altered her decision to undergo it.

Examining the evidence on record, we hold that there was adequate disclosure of material risks inherent in
the chemotherapy procedure performed with the consent of Angelicas parents. Respondents could not have been
unaware in the course of initial treatment and amputation of Angelicas lower extremity, that her immune system was
already weak on account of the malignant tumor in her knee. When petitioner informed the respondents beforehand
of the side effects of chemotherapy which includes lowered counts of white and red blood cells, decrease in blood
platelets, possible kidney or heart damage and skin darkening, there is reasonable expectation on the part of the
doctor that the respondents understood very well that the severity of these side effects will not be the same for all
patients undergoing the procedure. In other words, by the nature of the disease itself, each patients reaction to the
chemical agents even with pre-treatment laboratory tests cannot be precisely determined by the physician. That
death can possibly result from complications of the treatment or the underlying cancer itself, immediately or sometime
after the administration of chemotherapy drugs, is a risk that cannot be ruled out, as with most other major medical
procedures, but such conclusion can be reasonably drawn from the general side effects of chemotherapy already
disclosed.

As a physician, petitioner can reasonably expect the respondents to have considered the variables in the
recommended treatment for their daughter afflicted with a life-threatening illness. On the other hand, it is difficult to
give credence to respondents claim that petitioner told them of 95% chance of recovery for their daughter, as it was
unlikely for doctors like petitioner who were dealing with grave conditions such as cancer to have falsely assured
patients of chemotherapy success rate. Besides, informed consent laws in other countries generally require only a
reasonable explanation of potential harms, so specific disclosures such as statistical data, may not be legally
necessary.

The element of ethical duty to disclose material risks in the proposed medical treatment cannot thus be
reduced to one simplistic formula applicable in all instances. Further, in a medical malpractice action based on lack of
informed consent, "the plaintiff must prove both the duty and the breach of that duty through expert testimony. Such
expert testimony must show the customary standard of care of physicians in the same practice as that of the
defendant doctor.
Negligence of Health Care Professionals
LEAH ALESNA REYES, ROSE NAHDJA, JOHNNY, and minors LLOYD and KRISTINE, all surnamed REYES,
represented by their mother, LEAH ALESNA REYES vs. SISTERS OF MERCY HOSPITAL, SISTER ROSE
PALACIO, DR. MARVIE BLANES, and DR. MARLYN RICO
G.R. No. 130547 October 3, 2000

FACTS:

Jorge Reyes was suffering from recurring fever with chills. This prompted his wife to take him to Mercy
Community Clinic wherein he was diagnosed to have typhoid fever by Dr. Marlyn Rico. Jorge was later on indorsed to
Dr. Marvie Blanse after Dr. Rico’s shift ended. The former gave Jorge antibiotics to combat his typhoid fever.
However, Jorge experienced chills and exhibited respiratory distress, nausea, vomiting, and convulsions. Dr. Blanes
put him under oxygen, used a suction machine, and administered hydrocortisone, temporarily easing the patient’s
convulsions. Jorge then ultimately died after not responding to treatments and slipped into cyanosis.

Petitioner filed a complaint for damages contending that Jorge did not die from typhoid fever but to the
wrongful administration of chloromycetin. The respondents denied the charges and filed a counterclaim. The trial
court and CA dismissed the complaint for damages and the counterclaim.

ISSUE:

Whether or not the doctrine of res ipsa loquitur is applicable to the present case making the respondents
liable for damages.

HELD:

No. Although generally, expert medical testimony is relied upon in malpractice suits to prove that a physician
has done a negligent act or that he has deviated from the standard medical procedure, when the doctrine of res ipsa
loquitor is availed by the plaintiff, the need for expert medical testimony is dispensed with because the injury itself
provides the proof of negligence. The reason is that the general rule on the necessity of expert testimony applies only
to such matters clearly within the domain of medical science, and not to matters that are within the common
knowledge of mankind which may be testified to by anyone familiar with the facts. Ordinarily, only physicians and
surgeons of skill and experience are competent to testify as to whether a patient has been treated or operated upon
with a reasonable degree of skill and care. However, testimony as to the statements and acts of physicians and
surgeons, external appearances, and manifest conditions which are observable by any one may be given by non-
expert witnesses. Hence, in cases where the res ipsa loquitur is applicable, the court is permitted to find a physician
negligent upon proper proof of injury to the patient, without the aid of expert testimony, where the court from its fund
of common knowledge can determine the proper standard of care. Where common knowledge and experience teach
that a resulting injury would not have occurred to the patient if due care had been exercised, an inference of
negligence may be drawn giving rise to an application of the doctrine of res ipsa loquitur without medical evidence,
which is ordinarily required to show not only what occurred but how and why it occurred. When the doctrine is
appropriate, all that the patient must do is prove a nexus between the particular act or omission complained of and
the injury sustained while under the custody and management of the defendant without need to produce expert
medical testimony to establish the standard of care. Resort to res ipsa loquitor is allowed because there is no other
way, under usual and ordinary conditions, by which the patient can obtain redress for injury suffered by him.

In the Ramos case, the question was whether a surgeon, an anesthesiologist, and a hospital should be
made liable for the comatose condition of a patient scheduled for cholecystectomy. In that case, the patient was given
anesthesia prior to her operation. Noting that the patient was neurologically sound at the time of her operation, the
Court applied the doctrine of res ipsa loquitur as mental brain damage does not normally occur in a gall blader
operation in the absence of negligence of the anesthesiologist. Taking judicial notice that anesthesia procedures had
become so common that even an ordinary person could tell if it was administered properly, we allowed the testimony
of a witness who was not an expert. In this case, while it is true that the patient died just a few hours after
professional medical assistance was rendered, there is really nothing unusual or extraordinary about his death. Prior
to his admission, the patient already had recurring fevers and chills for five days unrelieved by the analgesic,
antipyretic, and antibiotics given him by his wife. This shows that he had been suffering from a serious illness and
professional medical help came too late for him.

Respondents alleged failure to observe due care was not immediately apparent to a layman so as to justify
application of res ipsa loquitur. The question required expert opinion on the alleged breach by respondents of the
standard of care required by the circumstances. Furthermore, on the issue of the correctness of her diagnosis, no
presumption of negligence can be applied to Dr. Marlyn Rico.
Negligence of Health Care Professionals
DR. PEDRO DENNIS CERENO, and DR. SANTOS ZAFE vs. COURT OF APPEALS, SPOUSES DIOGENES S.
OLAVERE and FE R. SERRANO
G.R. No. 167366 September 26, 2012

FACTS:

Raymond S. Olavere, a victim of a stabbing incident, was rushed to a hospital wherein Dr. Ruel Levy
Realuyo recommended an emergency exploratory laparotomy. Dr. Realuyo then requested the parents of Raymond
to procure 500cc of blood type O needed for the operation. However, due to prior patients, Dr. Pedro Dennis Cereno
and Dr. Santos Zafe cannot immediately operate on Raymond. Further, Dr. Charles Maluluy, the only
anesthesiologist in the hospital was also busy with another patient.

After Dr. Cereno and Dr. Zafe finished their prior operation, they examined Raymond and noted that his
blood pressure was normal and “nothing in him was significant.” However, upon opening of Raymond’s thoracic
cavity, it was found that 3,200cc of blood was stocked therein. While the operation was ongoing, Raymond had a
cardiac arrest and died.

The parents of Raymond, respondents herein, filed a damage suit agains Dr. Cereno and Dr. Zafe. The trial
court ruled in favor of the respondents which was affirmed by the CA.

ISSUE:

Whether or not the petitioners were negligent in their duty making them liable for damages.

HELD:

No. In medical negligence cases, it is settled that the complainant has the burden of establishing breach of
duty on the part of the doctors or surgeons. It must be proven that such breach of duty has a causal connection to the
resulting death of the patient. A verdict in malpractice action cannot be based on speculation or conjecture. Causation
must be proven within a reasonable medical probability based upon competent expert testimony.

The parents of Raymond failed in this respect. Aside from their failure to prove negligence on the part of the
petitioners, they also failed to prove that it was petitioners’ fault that caused the injury. Their cause stands on the
mere assumption that Raymond’s life would have been saved had petitioner surgeons immediately operated on him;
had the blood been cross-matched immediately and had the blood been transfused immediately. There was,
however, no proof presented that Raymond’s life would have been saved had those things been done. Those are
mere assumptions and cannot guarantee their desired result. Such cannot be made basis of a decision in this case,
especially considering that the name, reputation and career of petitioners are at stake.

The Court understands the parents’ grief over their son’s death. That notwithstanding, it cannot hold
petitioners liable. It was noted that Raymond, who was a victim of a stabbing incident, had multiple wounds when
brought to the hospital. Upon opening of his thoracic cavity, it was discovered that there was gross bleeding inside
the body. Thus, the need for petitioners to control first what was causing the bleeding. Despite the situation that
evening i.e. numerous patients being brought to the hospital for emergency treatment considering that it was the
height of the Peñafrancia Fiesta, it was evident that petitioners exerted earnest efforts to save the life of Raymond. It
was just unfortunate that the loss of his life was not prevented.

In the case of Dr. Cruz v. CA, it was held that "doctors are protected by a special law. They are not
guarantors of care. They do not even warrant a good result. They are not insurers against mishaps or unusual
consequences. Furthermore, they are not liable for honest mistake of judgment"
 Negligence of Health Care Professionals
DR. FERNANDO P. SOLIDUM vs. PEOPLE OF THE PHILIPPINES
G.R. No. 192123 March 10, 2014

FACTS:

Gerald Albert Gercayo was born with an imperforate anus, requiring him to undergo a colostomy operation.
When Gerald was three years old, he was admitted to the Ospital ng Maynila for a pull-through operation wherein Dr.
Fernando P. Solidum was the anesthesiologist. During the operation, Gerald experience bradycardia and went into
coma which lasted for two weeks. Gerald regained consciousness after a month. However, he could no longer see,
hear or move.

A criminal complaint for Reckless Imprudence Resulting in Serious Physical Injuries was filed against Dr.
Solidium. The trial court held that Dr. Solidum was guilty and that the Ospital ng Maynila is jointly and severally liable.
The CA affirmed such decision. However, the SC acquitted Dr. Solidum for failure to prove that he was reckless and
negligent.

ISSUES:

1. Whether or not the acquittal of Dr. Solidum will absolve him of any civil liabilities arising from the case.

2. Whether or not the decree that the Ospital ng Maynila is jointly and severally liable correct.

HELD:

1. No. We have to clarify that the acquittal of Dr. Solidum would not immediately exempt him from civil liability.
But we cannot now find and declare him civilly liable because the circumstances that have been established
here do not present the factual and legal bases for validly doing so. His acquittal did not derive only from
reasonable doubt. There was really no firm and competent showing how the injury to Gerard had been
caused. That meant that the manner of administration of the anesthesia by Dr. Solidum was not necessarily
the cause of the hypoxia that caused the bradycardia experienced by Gerard. Consequently, to adjudge Dr.
Solidum civilly liable would be to speculate on the cause of the hypoxia. We are not allowed to do so, for civil
liability must not rest on speculation but on competent evidence.

2. No. For one, Ospital ng Maynila was not at all a party in the proceedings. Hence, its fundamental right to be
heard was not respected from the outset. The RTC and the CA should have been alert to this fundamental
defect. Verily, no person can be prejudiced by a ruling rendered in an action or proceeding in which he was
not made a party. Such a rule would enforce the constitutional guarantee of due process of law.

Moreover, Ospital ng Maynila could be held civilly liable only when subsidiary liability would be properly
enforceable pursuant to Article 103 of the Revised Penal Code. But the subsidiary liability seems far-fetched
here. The conditions for subsidiary liability to attach to Ospital ng Maynila should first be complied with.
Firstly, pursuant to Article 103 of the Revised Penal Code, Ospital ng Maynila must be shown to be a
corporation “engaged in any kind of industry.” The term industry means any department or branch of art,
occupation or business, especially one that employs labor and capital, and is engaged in industry.

However, Ospital ng Maynila, being a public hospital, was not engaged in industry conducted for profit but
purely in charitable and humanitarian work. Secondly, assuming that Ospital ng Maynila was engaged in
industry for profit, Dr. Solidum must be shown to be an employee of Ospital ng Maynila acting in the
discharge of his duties during the operation on Gerald. Yet, he definitely was not such employee but a
consultant of the hospital. And, thirdly, assuming that civil liability was adjudged against Dr. Solidum as an
employee (which did not happen here), the execution against him was unsatisfied due to his being insolvent.
 Negligence of Health Care Professionals
ROGELIO E. RAMOS and ERLINDA RAMOS, in their own behalf and as natural guardians of the minors,
ROMMEL RAMOS, ROY RODERICK RAMOS and RON RAYMOND RAMOS vs. COURT OF APPEALS, DELOS
SANTOS MEDICAL CENTER, DR. ORLINO HOSAKA and DRA. PERFECTA GUTIERREZ
G.R. No. 124354 December 29, 1999

FACTS:

Plaintiff Erlinda Ramos was, until the afternoon of June 17, 1985 a 47-year old robust woman. Except for
occasional complaints of discomfort due to pains allegedly caused by presence of a stone in her gall bladder, she
was as normal as any other woman. Married to Rogelio Ramos, an executive of PLDT, and has three children.
Because of the discomforts somehow interfered with her normal ways, she sought professional advice. She was told
to undergo an operation for the removal of a stone in her gall bladder. She underwent series of examination which
revealed that she was fit for the said surgery. Through the intercession of a mutual friend, she and her husband met
Dr. Osaka for the first time and she was advised by Dr. Osaka to go under the operation called cholecystectomy and
the same was agreed to be scheduled on June 17, 1985 at 9:00am at the Delos Santos Medical Center. Rogelio
asked Dr. Osaka to look for a good anesthesiologist to which the latter agreed to. A day before the scheduled
operation, she was admitted at the hospital and on the day of the operation, Erlinda’s sister was with her insider the
operating room. Dr. Osaka arrived at the hospital late, Dr. Guttierez, the anesthesiologist, started to intubate Erlina
when Herminda heard her say that intubating Erlinda is quite difficult and there were complications. This prompt Dr.
Osaka to order a call to another anesthesiologist, Dr. Caldron who successfully intubated Erlina. The patient’s nails
became bluish and the patient was placed in a trendelenburg position. After the operation, Erlina was diagnosed to
be suffering from diffuse cerebral parenchymal damage and that the petitioner alleged that this was due to lack of
oxygen supply to Erlinda’s brain which resulted from the intubation.

ISSUES:

1. Whether or not the doctors and the hospital are negligent against petitioner for the result of the said
operation.

2. Whether or not Ramos is entitled to damages.

HELD:

1. Yes. The private respondents were unable to disprove the presumption of negligence on their part in the
care of Erlinda and their negligence was the proximate case of her piteous condition.

Dr. Gutierrez was negligent in the care of Erlinda during the anesthesia phase. As borne by the records, she
failed to properly intubate the patient. This fact was attested to by Herminda Cruz who was in the operating
room right beside the patient when the tragic event occurred. Moreover, respondent Dr. Gutierrez' act of
seeing her patient for the first time only an hour before the scheduled operative procedure was an act of
exceptional negligence and professional irresponsibility. Her failure to perform pre- operative evaluation of
the patient is, therefore, a clear indicia of her negligence.

For Dr. Orlino Hosaka, as the head of the surgical team and as the so-called captain of the ship, it is the
surgeons responsibility to see to it that those under him perform their task in the proper manner. Dr.
Hosaka’s negligence can be found in his failure to exercise the proper authority (as the captain of the
operative team) in not determining if his anesthesiologist observed proper anesthesia protocols. In fact, no
evidence on record exists to show that respondent Dr. Hosaka verified if respondent Dra. Gutierrez properly
intubated the patient. Furthermore, it does not escape the court that respondent Dr. Hosaka had scheduled
another procedure in a different hospital at the same time as Erlinda's operation, and was in fact over three
hours late for the latter's operation. This indicates that he was remiss in his professional duties towards his
patient. Thus, he shares equal responsibility for the events which resulted in Erlindas condition.
 As for the hospital (employer) itself, an employer-employee relationship in effect exists between hospitals
and their attending and visiting physicians. Respondent hospital, failed to adduce evidence showing that it
exercised the diligence of a good father of a family in the hiring and supervision of the latter. In neglecting to
offer such proof, respondent hospital thereby failed to discharge its burden under the last paragraph of
Article 2180. Thus, respondent hospital is consequently solidarily responsible with its physicians for Erlindas
condition.

2. Yes. The Court modified in favor of petitioners, and solidarily against private respondents the following: 1)
P1,352,000 actual damages computed as of the date of promulgation plus a monthly payment of P8,000.00
up to the time that petitioner Erlinda Ramos expires or miraculously survives; 2) P2,000,000 moral damages,
3) P1,500,000 temperate damages; 4) P100,000 exemplary damages and P100,000 attorney's fees; and, 5)
the costs of the suit.

Art. 2199 of the New Civil Code states that except as provided by law or by stipulation, one is entitled to an
adequate compensation only for such pecuniary loss suffered by him as he has duly proved. Such
compensation is referred to as actual or compensatory damages.

In these cases, the amount of damages which should be awarded, if they are to adequately and correctly
respond to the injury caused, should be one which compensates for pecuniary loss incurred and proved, up
to the time of trial; and one which would meet pecuniary loss certain to be suffered but which could not, from
the nature of the case, be made with certainty. In other words, temperate damages can and should be
awarded on top of actual or compensatory damages in instances where the injury is chronic and continuing.
No incompatibility arises when both actual and temperate damages are provided for. The reason is that
these damages cover two distinct phases.

They should not be compelled by dire circumstances to provide substandard care at home without the aid of
professionals, for anything less would be grossly inadequate. An award of P1,500,000.00 in temperate
damages would therefore be reasonable. The damage done to her would not only be permanent and lasting,
it would also be permanently changing and adjusting to the physiologic changes which her body would
normally undergo through the years. Erlinda Ramos was in her mid-forties when the incident occurred. She
has been in a comatose state for over fourteen years now

Ramos' are charged with the moral responsibility of the care of the victim. The family's moral injury and
suffering in this case is clearly a real one. Award of P2,000,000 in moral damages would be appropriate.
Finally, by way of example, exemplary damages in the amount of P100,000.00 are hereby awarded.
Considering the length and nature of the instant suit we are of the opinion that attorney's fees valued at
P100,000 are likewise proper.
 Negligence of Lawyers
CESARIO ADARNE vs. ATTY. DAMIAN V. ALDABA
A.M. No. 801 June 27, 1978

FACTS:

Spouses Cumpio filed a forcible entry case against Cesario Adarne. However, the case was dismissed for
lack of jurisdiction. Upon appeal, the case was set for hearing. However, the lawyers of Adarne was not present in the
said hearing. This prompted Adarne to ask Atty. Damian V. Aldaba to make a special appearance for the former.
Learning that the opposing counsel was not in attendance as well, Atty. Aldaba moved for the dismissal of the case.
Through a Motion for Reconsideration, the case was again reopened. The respondent was again prevailed upon by
the complainant to appear in his behalf. The respondent entered a "special appearance" for the complainant and
argued that the interest of justice would best be served if the defendants were allowed to file an action for quieting of
title and the case heard jointly with the pending action for forcible entry. Finding merit in the argument, the court
ordered the defendant Adarne to file an action for quieting of title within one week and the plaintiffs to answer the
same within the reglementary period, after which both cases would be tried jointly. The hearing was deferred until
after the filing of the action for quieting of title.

However, the defendants were declared in default for their failure to appear at the hearing set for that day.
Because of this, Adarne filed and administrative case against the Atty. Aldaba for gross negligence and misconduct,
for failure to give his entire devotion to the interest of his client, warm zeal in the maintenance and defense of his
rights, and exertion of his utmost learning and ability in the prosecution and defense of his client, and for not taking
steps to protect the interests of his client in the face of an adverse decision.

ISSUE:

Whether or not Atty. Aldaba is guilty of such misconduct.

HELD:

No. The judgment by default rendered against the complainant cannot be attributed to the respondent
attorney. The blame lies with the complainant for having engaged the services of several lawyers to handle his case
without formally withdrawing the authority he had given to them to appear in his behalf as to place the responsibility
upon the respondent.

The rule followed on matters of substitution of attorneys as laid down by this Court is that no substitution of attorneys
will be allowed unless there be filed:

1. A written application for such substitution;

2. The written consent of the client;

3. The written consent of the attorney substituted; and

4. In case such written consent cannot be secured, there must be filed with the application proof of service of
notice of such motion upon the attorney to be substituted, in the manner prescribed by the rules.

It was neither gross negligence nor omission to have entertained such belief. An attorney is not bound to exercise
extraordinary diligence, but only a reasonable degree of care and skill.
Negligence of Lawyers