OFFER purpose __________________________________________________

Q: What is your occupation Mr. Galeon?

A: I am a Medical Doctor, ma’am.

Q: Where do you practice your profession, Doctor Galeon?

A: At the Mariano Marcos Memorial Hospital & Medical Center, ma’am.

Q: What is your position there?

A: I am a colon and rectal surgeon of that Hospital, Ma’am.

Q: How many years are you working at the hospital?

A: I have been a colon and rectal surgeon at the MMMH&MC for five years already.

Q: What does a colon and rectal surgeon do?

A: Colon and Rectal surgeon specializes in health issues related to the colon, rectum and
intestinal system. We often treat patients with removal of polyps and cancerous tissue, as well as
provide procedures for inflammatory bowel diseases.

Q: Do you know the Plaintiff in this case, Mrs. Fulgencia Naanep Daga-Gappi?
A: Yes, ma’am

Q: How did you know Mrs. Fulgencia Naanep Daga-Gappi?

A; She was my patient, ma’am.

Q: Can you please elaborate on the circumstances which made Mrs. Fulgencia your patient?
A: On April 4, 2019, when I was at the surgery department of MMMH&MC, I got a call from the
Emergency Room about a patient experiencing difficulty of bowel movement accompanied with
bloody anal discharge. When I arrived at the emergency room, I took some general health,
medical and family history, and physical examination.

Q: What happened after that?

A: As our standard operating procedure, we conducted series of medical examinations such as
colonoscopy, blood tests, and PET scan.

Q: What are those tests, sir?

A: (1) Colonoscopy uses a long, flexible and slender tube attached to a video camera and
monitor to view your entire colon and rectum. (2) We also tested the blood for a chemical which
may sometimes produced by colon cancers. (3) On the other hand, a Positron emission
tomography (PET) scan is usually combined with a CT scan called a PET-CT scan. A PET scan
is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive
sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that
use the most energy. Because cancer tends to use energy actively, it absorbs more of the
radioactive substance. A scanner then detects this substance to produce images of the inside of
the body.

Q: What was the impression for the said tests?

A: After assessing the result of the tests, I found a tumor in Mrs. Fulgencia’s sigmoid area. So, I
diagnosed her to be suffering from cancer of the sigmoid.

Q: What is a sigmoid?
A: The sigmoid colon is the part of the large intestine; its function is to store fecal wastes until
they are ready to leave the body.

Q: What happened next?

A: I recommended for a surgery to be performed, ma’am.

Q: What surgery did you recommend?

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A: I recommended an anterior resection surgery, ma’am.

Q: Can you please elaborate on the said surgery/procedure?

A: An anterior resection surgery refers to removal of the sigmoid colon and upper rectum. During
the surgery, the part with the cancer will be removed. The remaining part of the rectum will be
reconnected to the colon. A patient will be able to have bowel movements as usual once
recovered from the surgery.

Q: Why did you think this surgery was necessary?

A: Anterior resection surgery was necessary to remove the area of bowel that is diseased,
ma’am. This will give the patient best chance of a cure or significant improvement in her bowel
problems.

Q: What happened after the recommendation you made?

A: As the surgeon, I explained the procedure involved and possible risks with the operation to the
plaintiffs.

Q: What did you do after that?

A: I asked them to sign a consent form to confirm that they understand and agree to have
surgery, after which they signed.

Q: Can you remember what happened on April 11, 2019, doctor?

A: Yes, ma’am.

Q: What happened on such date?

A: That was the date when I performed the anterior resection surgery to Mrs. Fulgencia, ma’am.

Q: Can you please elaborate the proper procedure before the surgery?
A: At the time of scheduled operation, I notified the operating room supervisor of the hospital as
to the type of surgery to be performed. Having been informed that an anterior resection surgery
will be performed, the operating room supervisor furnished the type, size, and number of
instruments that would be needed to use for the operation. In addition to the operating
instruments, the hospital furnished one (1) set of gauze sponges which contains 10 gauze
sponges, in case it will be needed.

Q: Who assisted you during the surgery?

A: I was assisted by Nurses Jane Gudoy and Alfredo Cortez. The anesthesiologist was Dr. Allan
Corpuz, ma’am.

Q: Since you already explained a while ago the nature of the surgery, can you tell us what
happened during the surgery performed to Mrs. Fulgencia?
A: During the surgery, Dr. Corpuz put her to sleep using general anesthesia, so that she’s safe
and unaware during the operation. Then I made one long incision (cut) down the middle of her
abdomen. Then, removed the sigmoid. Afterward I joined the two healthy ends together using
series of stiches/staples.

While performing the surgery, I discovered that the malignancy in Mrs. Fulgencia’ sigmoid area
had spread on her left ovary, necessitating the removal of certain portions of it.

Q: What is malignancy?
A: The term "malignancy" refers to the presence of cancerous cells that have the ability to spread
to other sites in the body or to invade nearby (locally) and destroy tissues.

Q: After discovering the malignancy, what did you do?

A: I informed Mr. Fernando about it, ma’am. I told him that an ob-gyne was needed to perform
hysterectomy on Fulgencia.

Q: What is hysterectomy?

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A: Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix,
ovaries, Fallopian tubes, and other surrounding structures. It is performed by a gynecologist.

Q: What is the response of Mr. Fernando?

A: Mr. Fernando consented to the hysterectomy to be conducted by the ob-gyne, ma’am.

https://www.acpgbi.org.uk/patients/conditions/anterior-resection/