LEGAL PRINCIPLES AND DOCTRINES

APPLIED IN
MEDICAL MALPRACTICE CASES
MEDICAL MALPRACTICE

Doctrine of Res Ipsa Loquitor -

➢ “The thing speaks for itself”

➢ The fact of occurrence of injury raises

the presumption of negligence.
MEDICAL MALPRACTICE

Doctrine of Res Ipsa Loquitor -

1.The patient was injured in a manner

that would not normally occur but for a
breach of the applicable standard of care;
MEDICAL MALPRACTICE

Doctrine of Res Ipsa Loquitor -

2. He was injured by an agency or

instrumentality within the exclusive
control of the defendant;
MEDICAL MALPRACTICE

Doctrine of Res Ipsa Loquitor -

3. Other possible causes are sufficiently
eliminated by the evidence such that the
jury could reasonably conclude that the
negligence was, more probably than not,
that of the defendant.
MEDICAL MALPRACTICE

Doctrine of Vicarious Liability -

➢ Liability for the tort of another

➢ Secondary or indirect liability

 Art. 2180, Civil Code of the Philippines
◼ Obligations are demandable not only for ones own acts or omission but also
fort those persons whom one is responsible
◼ “….xxx the owners or managers of an establishment or enterprise are likewise
responsible for damages caused by their employees xxx in which the latter are
employed or on the occasion of their functions…
◼ Employers shall be liable for the damages caused by their employees and
household helpers acting within the scope of their assigned task xxx…
◼ The responsibility treated of this article shall cease when the person herein
mentioned prove that they observe all the diligence of a good father of a
family to prevent injury.”
MEDICAL MALPRACTICE

Doctrine of Vicarious Liability -

➢ Employer becomes liable for the acts of

an employee

➢ Employee must be acting within the

scope of their responsibilities
MEDICAL MALPRACTICE

Doctrine of Vicarious Liability

Employer – Employee relationship

must exist and proven.
MEDICAL MALPRACTICE

“Captain of the Ship” Doctrine

Assumes that the doctor is in

complete control of everything and
everyone in the OR.
MEDICAL MALPRACTICE

“Captain of the Ship” Doctrine

Largely abandoned in other

jurisdictions.
MEDICAL MALPRACTICE
“Borrowed Servant” Doctrine

The physician “borrows” the nurses, med

tech, residents etc. employed by the
hospital to help him provide medical care to
his patients.
“Borrowed Servant” Doctrine

❖ Nurses and other personnel of the hospital are employees

or servants of the hospital;
❖ In some instances, they are under the temporary
supervision and control of another other than their
employer while performing their duties;
❖ By fiction of law, they are borrowed from the hospital and
for any wrongful act committed by them during the period,
their temporary employer must be held liable.
“Borrowed Servant” Doctrine

When is an employee considered the “borrowed servant”

of another?
✓The employee is subject to the control of another with
regard to the work done and the manner of performing
it
✓The work to be done by the employee is for the benefit
of the temporary employer.
Related Civil Code Provisions
 The absence of reasonable care on the part of
the patient or his attendant that combines with
the negligent action of the doctor resulting in
the damage completed off directly and without
which damage should not have occurred.
Doctrine of Apparent Authority
Or Ostensible Agent

- Fixes liability when there is no

Employer-Employee relationship
Doctrine of Apparent Authority
Or Ostensible Agent

1. The principal holds itself out to the

public as a provider of medical services
through advertising or by an express
representation.
Doctrine of Apparent Authority
Or Ostensible Agent

2. The patient “looked” to the hospital

to provide competent medical care.
Doctrine of Apparent Authority
1. Plaintiff was led to believe that the
negligent person was an employee or
agent of the hospital – Appearance of
authority
Doctrine of Apparent Authority

2. The hospital knew that the person was

claiming to be an agent/employee of the
hospital
3. The person relied upon the conduct of
the hospital
Doctrine of Corporate Negligence

The hospital is liable if it fails to

uphold the proper standard of
care owed the patient, which is
to ensure the patient’s safety and
well-being while at the hospital.
 Doctrine of Corporate Negligence
The duty of providing quality medical service is
no longer the sole prerogative and
responsibility of the physician. Hospitals now
tend to organize a highly professional medical
staff whose competence and performance need
to be monitored by the hospitals commensurate
with their inherent responsibility to provide
quality medical care.
Duty of a hospital
1) the use of reasonable care in the
maintenance of safe and adequate
facilities and equipment;
2) the selection and retention of
competent physicians;
Duty of a hospital
3) the overseeing or supervision of all
persons who practice medicine
within its walls; and
4) the formulation, adoption and
enforcement of adequate rules and
policies that ensure quality care for
its patients