Carillo v. People | G.R No. 86890 | January 21, 1994 |Feliciano, J.

Nature: Petition for review of a decision of the Court of Appeals.

Petitioner: Leandro Carillo
Respondent: People of the Philippines
TOPIC Torts > Basic Elements > Concept of Fault or Negligence > Specific Cases
SUMMARY 13yo Catherine Acosta underwent appendectomy under Dr. Madrid, with Petitioner Dr. Carillo as her
anesthesiologist. Post-op, she manifested signs of instability, but the 2 doctors left the hospital. When she developed
convulsions (and eventually lapsed into coma), the two couldn’t be found. She died 3 days later. Drs. Madrid and
Carillo were charged and convicted of simple negligence resulting in homicide. Dr. Carillo appealed his conviction,
saying that it wasn’t negligence on his part in administering the anesthetic drug Nubain that led to her death, but
blood poisoning from a perforated appendix. The Court held that it is not necessary to establish which of the two is
the exclusive and/or ultimate cause of Catherine’s death. What has to be proved, which was proven, was the
negligence on the part of Dr. Carillo. He failed to conduct standard procedures pre- and post-op [for specifics, see
discussion of the issue].

Simple negligence is defined in A365 of the RPC as “a mere lack of prevision in a situation where either the
threatened harm is not immediate or the danger not openly visible.” It is the failure to exercise the diligence
necessitated or called for by the situation which was not immediately life-destructive but which culminated, in the
present case, in the death of a human being.

FACTS
 May 31, 1981: Victim 13yo Catherine Acosta complained of pains in her abdomen so she was brought to Dr.
Elva Peña. Dr. Peña called for Dr. Emilio Madrid who concluded that she might have appendicitis. She was
taken to Baclaran General Hospital where a sample of her blood was taken. She was then scheduled to be
operated at 5pm. Dr. Madrid only arrived at 5:45pm.
o Catherine was feeling well when she was brought to the operating room, and she was not subjected
to ECG nor was she weighed.
o During the operation, Yolanda Acosta (mother) noticed “something very unfamiliar”. The nurses kept
going in and out of the operating room. At 7pm when the operation was over, Catherine was
shivering, pale, had abnormal heartbeat, not waking up, and had difficulty breathing.
o Catherine was transferred to her regular bed and given an oxygen tank. Dr. Madrid and Petitioner
Dr. Carillo (anesthesiologist) left the hospital. At 7:15, Catherine developed convulsion and
eventually lapsed into coma.
 The 2 doctors were nowhere to be found so Dra. Peña attended to Catherine, who called for
Dr. Madrid and a cardiologist. They concluded that Catherine suffered severe infection which
went up to her head. They called for Dr. Carillo who finally arrived at 10:30, evidently in a
bad temper. When the parents asked him what happened, he told them that it was nothing
and that Catherine will gain consciousness. He added that he will resign if she doesn’t.
o 3 days later, Catherine died. Her parents filed a complaint against Drs. Madrid and Carillo.
 RTC convicted both for simple negligence resulting in homicide, and awarded Catherine’s parents 30k
indemnity for death, 10k reimbursement for actual expenses, 50k moral damages, and costs of litigation. CA
affirmed.
o Court found that the proximate cause of Catherine’s death was the negligence of Petitioner. He
didn’t weigh her, when that was the standard procedure in administering anesthetic drug Nubain.
She overdosed, had an allergic reaction to the drug, had a cardiac arrest which deprived her brain of
oxygen, and eventually died.
 Dr. Carillo alone filed this present petition, asking for the reversal of his conviction, or at the very least for a
new trial.

ISSUE: WON the CA erred in finding that Dr. Carillo committed negligence that resulted in Catherine’s death? – NO
 Dr. Carillo: what caused Catherine’s death is Septicemia (blood poisoning) due to a perforated appendix with
peritonitis. This finding is consistent with the 2 expert witness testimonies that the ultimate cause of death
was the deprivation of oxygen to the brain. Cardiac arrest is not the only cause of oxygen-starvation of the
brain.
 Since there was no intensive pre-operative preparations taken (which was standard), we can’t really
know if the rupture in the appendix was already present pre-operation (it could very well be due to
 the operating doctors’ fault). But it is worthy to note that she was ambulatory (she could walk) when
she was brought to the operating room.
 No need to prove whether it was the administration of Nubain or the perforation of the appendix which was
the exclusive and/or ultimate cause of Catherine’s death. What has to be proved, which was proven, was the
negligence on the part of Dr. Carillo.
 Both doctors failed to appreciate the serious condition of Catherine post-op. After the operation,
Catherine manifested signs on post-op instability, yet both doctors left her and the hospital. She
should have been transferred to the ICU, not to a regular room.
 The hospital is ill-equipped and, while this fact could not be attributed against Dr. Carillo, it merited
a somewhat higher standard of professional diligence on the part of the doctors than one would
expect in well-equipped hospitals.
 Dr. Madrid and the cardiologist called for Dr. Carillo when they were containing Catherine’s convulsions.
Therefore, there is a strong implication here that her condition must have been considered by the 2 doctors
to be related to the anesthetic treatment she received from Dr. Carillo.
 Dr. Carillo couldn’t be found, and when he did arrive he was in a bad temper. He was unprofessional towards
the parents (saying he’ll resign). These indicated that he was not disposed to attend to the unexpected
call/Catherine. He wasn’t truthful to the parents when he didn’t inform them of the seriousness of her
condition.
 Nubain is an experimental drug, and patients have to be weighed before it is administered, as this will
determine the dose. Catherine wasn’t weighed. Also, there isn’t much experience as to the administration of
Nubain to patients below 18, and yet the doctor’s order sheet did not contain a precaution as to this.
 Order sheet was open-ended (“apply drug as warranted by the circumstances”) which is an abdication of
medical responsibility. Dr. Carillo left the determination of when to administer the drug to another person,
when it was his duty to determine when and how much of the drug is to be given to Catherine.
 Simple negligence is defined in A365 of the RPC as “a mere lack of prevision in a situation where either the
threatened harm is not immediate or the danger not openly visible.” It is the failure to exercise the
diligence necessitated or called for by the situation which was not immediately life-destructive but which
culminated, in the present case, in the death of a human being.
 It is a negative ingredient of the offense charged which may be proved by presentation of best
evidence procurable under the circumstances. Once a prima facie basis of the guilt is established,
the burden transferred to Dr. Carillo to disprove it. He failed to prove that they had in fact exercised
the necessary and appropriate degree of care and diligence to prevent the death of Catherine.

Other issue: WON Dr. Carillo was denied due process? – NO

 Dr. Carillo: his lawyer (Atty. Jose Puerto) was incompetent and exhibited gross negligence in failing to
manifest as intent to file a demurrer to the evidence. He submits that he is entitled to a new trial.
 Court held this contention to be a mere afterthought. If he indeed had doubts as to Atty. Puerto’s
competency, he should have fired him and got a new counsel, but he didn’t. The Court also found that Atty.
Puerto represented Dr. Carillo with competency, and even extensively cross-examined the prosecution
witnesses to the point that they got 2 favorable testimonies from them.

DISPOSITION: WHEREFORE, the Decision of the Court of Appeals dated 28 November 1988 is hereby AFFIRMED,
subject only to the modification that the indemnity for the death of Catherine Acosta is
hereby increased to P50,000.00, in line with current jurisprudence.