Professional Services, Inc. vs. Court of Appeals

SUPREME COURT REPORTS ANNOTATED VOLUME 544 3/24/22, 8:32 AM
170 SUPREME COURT REPORTS ANNOTATED

Professional Services, Inc. vs. Court of Appeals
*
G.R. No. 126297. February 11, 2008.
PROFESSIONAL SERVICES, INC., petitioner, vs. THE

COURT OF APPEALS and NATIVIDAD and ENRIQUE
AGANA, respondents,
*
G.R. No. 126467. February 11, 2008.
NATIVIDAD (Substituted by her children MARCELINO

AGANA III, ENRIQUE AGANA, JR., EMMA AGANA AN-
DAYA, JESUS AGANA, and RAYMUND AGANA) and EN-
RIQUE AGANA, petitioners, vs. THE COURT OF
APPEALS and JUAN FUENTES, respondents,
_______________
* FIRST DIVISION.
171
VOL. 544, FEBRUARY 11, 2008 171

G.R. No. 127590. February 11, 2008.*
MIGUEL AMPIL, petitioner, vs. THE COURT OF

APPEALS and NATIVIDAD AGANA and ENRIQUE
AGANA, respondents.
Medical Malpractice; Negligence; Hospitals; Damages; The
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doctrine in Ramos v. Court of Appeals, 321 SCRA 584 (1999), still

obtains, i.e., for the purpose of allocating responsibility in medical
negligence cases, an employer-employee relationship exists between
hospitals and their consultants.·Actually, contrary to PSIÊs
contention, the Court did not reverse its ruling in Ramos. What it
clarified was that the De Los Santos Medical Clinic did not exercise
control over its consultant, hence, there is no employer-employee
relationship between them. Thus, despite the granting of the said
hospitalÊs motion for reconsideration, the doctrine in Ramos stays,
i.e., for the purpose of allocating responsibility in medical
negligence cases, an employer-employee relationship exists between
hospitals and their consultants.
Same; Same; Same; Doctrine of Apparent Authority; Words and

Phrases; While in general, a hospital is not liable for the negligence
of an independent contractor-physician, the hospital may be liable if
the physician is the „ostensible‰ agent of the hospital, an exception
also known as the „doctrine of apparent authority‰ or sometimes
referred to as the apparent or ostensible agency theory.·In Nograles,
et al. v. Capitol Medical Center, et al., through Mr. Justice Antonio
T. Car-pio, the Court held: „The question now is whether CMC is
automatically exempt from liability considering that Dr. Estrada is
an independent contractor-physician. 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 the „ostensible‰ agent of the hospital.
(Jones v. Phil-pott, 702 F. Supp. 1210 [1988]) This exception is also
known as the „doctrine of apparent authority.‰ (Sometimes referred
to as the apparent or ostensible agency theory. [King v. Mitchell, 31
A.D.3rd 958, 819 N.Y. S.2d 169 (2006)]. x x x The doctrine of
apparent authority essentially involves two factors to determine the
liability of an independent contractor-physician. The first factor
focuses on the hospitalÊs manifestations and is sometimes described
as an inquiry whether the hospital acted in a manner which would
lead a reasonable person to conclude that the individual who was
alleged to be
172
negligent was an employee or agent of the hospital. (Diggs v.

Novant Health, Inc., 628 S.E.2d 851 [2006] citing Hylton v. Koontz,
138 N.C. App. 629 [2000]). In this regard, the hospital need not
make express representations to the patient that the
treating physician is an employee of the hospital; rather a
representation may be general and implied. (Id.) * * * The
second factor focuses on the patientÊs reliance. It is sometimes
characterized as an inquiry on whether the plaintiff acted in
reliance upon the conduct of the hospital or its agent, consistent
with ordinary care and prudence. (Diggs v. Novant Health, Inc.)‰
Same; Same; Same; Same; Same; The act of a hospital in

displaying the names of physicians in the public directory at the
lobby of the hospital amounts to holding out to the public that it
offers quality medical service through the listed physicians; Under
the doctrine of apparent authority, the question in every case is
whether the principal has by his voluntary act placed the agent in
such a situation that a person of ordinary prudence, conversant with
business usages and the nature of the particular business, is
justified in presuming that such agent has authority to perform the
particular act in question.·PSI is estopped from passing the blame
solely to Dr. Ampil. Its act of displaying his name and those of the
other physicians in the public directory at the lobby of the hospital
amounts to holding out to the public that it offers quality medical
service through the listed physicians. This justifies Atty. AganaÊs
belief that Dr. Ampil was a member of the hospitalÊs staff. It must be
stressed that under the doctrine of apparent authority, the question
in every case is whether the principal has by his voluntary act placed
the agent in such a situation that a person of ordinary prudence,
conversant with business usages and the nature of the particular
business, is justified in presuming that such agent has authority to
perform the particular act in question. In these cases, the
circumstances yield a positive answer to the question.
Same; Same; Same; Doctrine of Corporate Responsibility; The

duty of providing quality medical service is no longer the sole
prerogative and responsibility of the physician because the modern
hospital now tends to organize a highly-professional medical staff
whose competence and performance need also to be monitored by the
hospital commensurate with its inherent responsibility to provide
quality medical care.·The challenged Decision also anchors its

ruling on the doctrine of corporate responsibility. The duty of
providing quality
173
VOL. 544, FEBRUARY 11, 2008 173
medical service is no longer the sole prerogative and responsibility

of the physician. This is because the modern hospital now tends to
organize a highly-professional medical staff whose competence and
performance need also to be monitored by the hospital
commensurate with its inherent responsibility to provide quality
medical care. Such responsibility includes the proper
supervision of the members of its medical staff. Accordingly,
the hospital has the duty to make a reasonable effort to
monitor and oversee the treatment prescribed and
administered by the physicians practicing in its premises.
Same; Same; Same; Same; Duties Imposed upon the Hospital

under the Doctrine of Corporate Responsibility.·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. These
special tort duties arise from the special relationship existing
between a hospital or nursing home and its patients, which are
based on the vulnerability of the physically or mentally ill persons
and their inability to provide care for themselves. 40 A Am Jur 2d
28 citing Funkhouser v. Wilson, 89 Wash. App. 644, 950 P 2d 501
(Div.1 1998), review granted, 135 Wash. 2d 1001, 959 P 2d 126
(1998).
MOTION FOR RECONSIDERATION of a decision of the

Supreme Court.
The facts are stated in the resolution of the Court.
Bengson, Narciso, Cudala, Pecson, Bengzon &

Jimenez for Professional Services, Inc.
Agcaoili Law Offices for Heirs of Natividad Agana.
RESOLUTION
SANDOVAL-GUTIERREZ, J.:
As the hospital industry changes, so must the laws and

jurisprudence governing hospital liability. The immunity
from
174

medical malpractice traditionally accorded to hospitals has

to be eroded if we are to balance the interest of the patients
and hospitals under the present setting.
Before this Court is a motion for reconsideration filed by
Professional Services, Inc. (PSI), petitioner in G.R. No.
126297, assailing the CourtÊs First Division Decision dated
January 31, 2007, finding PSI and Dr. Miguel Ampil,
petitioner in G.R. No. 127590, jointly and severally liable
for medical negligence.
A brief revisit of the antecedent facts is imperative. On
April 4, 1984, Natividad Agana was admitted at the
Medical City General Hospital (Medical City) because of
difficulty of bowel movement and bloody anal discharge. Dr.
Am-pil diagnosed her to be suffering from „cancer of the
sigmoid.‰ Thus, on 1
April 11, 1984, Dr. Ampil, assisted by
the medical staff of Medical City, performed an anterior
resection surgery upon her. During the surgery, he found
that the malignancy in her sigmoid area had spread to her
left ovary, necessitating the removal of certain portions of
it. Thus, Dr. Ampil obtained the consent of Atty. Enrique
Agana, NatividadÊs husband, to permit Dr. Juan Fuentes,
respondent in G.R. No. 126467, to perform hysterectomy
upon Natividad.
Dr. Fuentes performed and completed the hysterectomy.
Afterwards, Dr. Ampil took over, completed the operation

and closed the incision. However, the operation appeared to
be flawed. In the corresponding Record of Operation dated
April 11, 1984, the attending nurses entered these
remarks:
sponge count lacking 2

announced to surgeon searched done (sic) but to no avail
continue for closure.
After a couple of days, Natividad complained of

excruciating pain in her anal region. She consulted both Dr.
Ampil and
_______________
1 The medical staff was composed of physicians, both residents and

interns, as well as nurses.
175
VOL. 544, FEBRUARY 11, 2008 175

Dr. Fuentes about it. They told her that the pain was the
natural consequence of the surgical operation performed
upon her. Dr. Ampil recommended that Natividad consult
an on-cologist to treat the cancerous nodes which were not
removed during the operation.
On May 9, 1984, Natividad, accompanied by her
husband, went to the United States to seek further
treatment. After four (4) months of consultations and
laboratory examinations, Natividad was told that she was
free of cancer. Hence, she was advised to return to the
Philippines.
On August 31, 1984, Natividad flew back to the Philip-
pines, still suffering from pains. Two (2) weeks thereafter,
her daughter found a piece of gauze protruding from her
vagina. Dr. Ampil was immediately informed. He proceeded
to NatividadÊs house where he managed to extract by hand
a piece of gauze measuring 1.5 inches in width. Dr. Ampil
then assured Natividad that the pains would soon vanish.
Despite Dr. AmpilÊs assurance, the pains intensified,

prompting Natividad to seek treatment at the Polymedic
General Hospital. While confined thereat, Dr. Ramon
Gutierrez detected the presence of a foreign object in her
vagina·a foul-smelling gauze measuring 1.5 inches in
width. The gauze had badly infected her vaginal vault. A
rectovaginal fistula had formed in her reproductive organ
which forced stool to excrete through the vagina. Another
surgical operation was needed to remedy the situation.
Thus, in October 1984, Natividad underwent another
surgery.
On November 12, 1984, Natividad and her husband filed
with the Regional Trial Court, Branch 96, Quezon City a
complaint for damages against PSI (owner of Medical City),
Dr. Ampil and Dr. Fuentes.
On February 16, 1986, pending the outcome of the above
case, Natividad died. She was duly substituted by her
above-named children (the Aganas).
On March 17, 1993, the trial court rendered judgment in
favor of spouses Agana finding PSI, Dr. Ampil and Dr.
176

Fuentes jointly and severally liable. On appeal, the Court

of Appeals, in its Decision dated September 6, 1996,
affirmed the assailed judgment with modification in the
sense that the complaint against Dr. Fuentes was
dismissed.
PSI, Dr. Ampil and the Aganas filed with this Court
separate petitions for review on certiorari. On January 31,
2007, the Court, through its First Division, rendered a
Decision holding that PSI is jointly and severally liable
with Dr. Ampil for the following reasons: first, there is an
employer-employee relationship between Medical City and2
Dr. Ampil. The Court relied on Ramos v. Court of Appeals,
holding that for the purpose of apportioning responsibility
in medical negligence cases, an employer-employee
relationship in effect exists between hospitals and their
attending and visiting physicians; second, PSIÊs act of
publicly displaying in the lobby of the Medical City the

names and specializations of its accredited physicians,
including Dr. Ampil, estopped it from denying the existence
of an employer-employee relationship between them under
the doctrine of ostensible agency or agency by
estoppel; and third, PSIÊs failure to supervise Dr. Ampil
and its resident physicians and nurses and to take an
active step in order to remedy their negligence rendered it
directly liable under the doctrine of corporate
negligence.
In its motion for reconsideration, PSI contends that the
Court erred in finding it liable under Article 2180 of the
Civil Code, there being no employer-employee relationship
between it and its consultant, Dr. Ampil. PSI stressed that
the CourtÊs Decision in Ramos holding that „an employer-
employee relationship in effect exists between hospitals and
their attending and visiting physicians for the purpose of
apportioning re-sponsibility‰
3
had been reversed in a
subsequent Resolution. Further, PSI argues that the
doctrine of ostensible agency or agency by estoppel
cannot apply because spouses Agana
_______________
2 G.R. No. 124354, December 29, 1999, 321 SCRA 584.

3 Promulgated on April 11, 2002.
177
VOL. 544, FEBRUARY 11, 2008 177

failed to establish one requisite of the doctrine, i.e., that

Na-tividad relied on the representation of the hospital in
engaging the services of Dr. Ampil. And lastly, PSI
maintains that the doctrine of corporate negligence is
misplaced because the proximate cause of NatividadÊs
injury was Dr. AmpilÊs negligence.
The motion lacks merit.
As earlier mentioned, the First Division, in its assailed
Decision, ruled that an employer-employee relationship „in
effect‰ exists between the Medical City and Dr. Ampil.
Consequently, both are jointly and severally liable to the

Aganas. This ruling proceeds from the following
ratiocination in Ramos:
„We now discuss the responsibility of the hospital in this particular

incident. The unique practice (among private hospitals) of filling up
specialist staff with attending and visiting „consultants,‰ who are
allegedly not hospital employees, presents problems in apportioning
responsibility for negligence in medical malpractice cases.
However, the difficulty is only more apparent than real.
In the first place, hospitals exercise significant control in
the hiring and firing of consultants and in the conduct of
their work within the hospital premises. Doctors who apply for
„consultant‰ slots, visiting or attending, are required to submit
proof of completion of residency, their educational qualifications;
generally, evidence of accreditation by the appropriate board
(diplomate), evidence of fellowship in most cases, and references.
These requirements are carefully scrutinized by members of the
hospital administration or by a review committee set up by the
hospital who either accept or reject the application. This is
particularly true with respondent hospital.
After a physician is accepted, either as a visiting or
attending consultant, he is normally required to attend
clinicopathological conferences, conduct bedside rounds for
clerks, interns and residents, moderate grand rounds and
patient audits and perform other tasks and responsibilities,
for the privilege of being able to maintain a clinic in the
hospital, and/or for the privilege of admitting patients into
the hospi-
178

tal. In addition to these, the physicianÊs performance as a

specialist is generally evaluated by a peer review committee
on the basis of mortality and morbidity statistics, and
feedback from patients, nurses, interns and residents. A
consultant remiss in his duties, or a consultant who
regularly falls short of the minimum standards acceptable to
the hospital or its peer review committee, is normally
politely terminated.
In other words, private hospitals hire, fire and exercise real
control over their attending and visiting „consultant‰ staff. While
„consultants‰ are not, technically employees, a point which
respondent hospital asserts in denying all responsibility for
the patientÊs condition, the control exercised, the hiring, and
the right to terminate consultants all fulfill the important
hallmarks of an employer-employee relationship, with the
exception of the payment of wages. In assessing whether
such a relationship in fact exists, the control test is
determining. Accordingly, on the basis of the foregoing, we
rule that for the purpose of allocating responsibility in
medical negligence cases, an employer-employee
relationship in effect exists between hospitals and their
attending and visiting physicians. This being the case, the
question now arises as to whether or not respondent hospital is
solidarily liable with respondent doctors for petitionerÊs condition.
The basis for holding an employer solidarily responsible for the
negligence of its employee is found in Article 2180 of the Civil Code
which considers a person accountable not only for his own acts but
also for those of others based on the formerÊs responsibility under a
relationship of partia ptetas.‰
Clearly, in Ramos, the Court considered the peculiar

relationship between a hospital and its consultants on the
bases of certain factors. One such factor is the „control test‰
wherein the hospital exercises control in the hiring and
firing of consultants, like Dr. Ampil, and in the conduct of
their work.
Actually, contrary to PSIÊs contention, the Court did not
reverse its ruling in Ramos. What it clarified was that the
De Los Santos Medical Clinic did not exercise control over
its consultant, hence, there is no employer-employee
relationship between them. Thus, despite the granting of
the said hospi-
179
VOL. 544, FEBRUARY 11, 2008 179

talÊs motion for reconsideration, the doctrine in Ramos
stays, i.e., for the purpose of allocating responsibility in

medical negligence cases, an employer-employee
relationship exists between hospitals and their consultants.
In the instant cases, PSI merely offered a general
denial of responsibility, maintaining that consultants, like
Dr. Am-pil, are „independent contractors,‰ not employees of
the hospital. Even assuming that Dr. Ampil is not an
employee of Medical City, but an independent contractor,
still the said hospital is liable to the Aganas. 4
In Nograles, et al. v. Capitol Medical Center, et al.,
through Mr. Justice Antonio T. Carpio, the Court held:
„The question now is whether CMC is automatically exempt from

liability considering that Dr. Estrada is an independent con-tractor-
physician.
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 the
„ostensible‰ agent of the hospital. (Jones v. Philpott, 702 F. Supp.
1210 [1988]) This exception is also known as the „doctrine of
apparent authority.‰ (Sometimes referred to as the apparent or
ostensible agency theory. [King v. Mitchell, 31 A.D.3rd 958, 819 N.Y.
S.2d 169 (2006)].
xxx
The doctrine of apparent authority essentially involves two
factors to determine the liability of an independent contractor-
physician.
The first factor focuses on the hospitalÊs manifestations and is
sometimes described as an inquiry whether the hospital acted in a
manner which would lead a reasonable person to conclude that the
individual who was alleged to be negligent was an employee or
agent of the hospital. (Diggs v. Novant Health, Inc., 628 S.E.2d 851
[2006] citing Hylton v. Koontz, 138 N.C. App. 629 [2000]). In this
regard, the hospital need not make express representations
to the patient that the treating physician is an employee of
the
_______________
4 G.R. No. 142625, December 19, 2006, 511 SCRA 204.
180

hospital; rather a representation may be general and

implied. (Id.)
The doctrine of apparent authority is a specie of the doctrine of
estoppel. Article 1431 of the Civil Code provides that „[t]hrough
estoppel, an admission or representation is rendered conclusive
upon the person making it, and cannot be denied or disproved as
against the person relying thereon.‰ Estoppel rests on this rule:
„Whether a party has, by his own declaration, act, or omission,
intentionally and deliberately led another to believe a particular
thing true, and to act upon such belief, he cannot, in any litigation
arising out of such declaration, act or omission, be permitted to
falsify it. (De Castro v. Ginete, 137 Phil. 453 [1969], citing Sec. 3,
par. A, Rule 131 of the Rules of Court. See also King v. Mitchell, 31
A.D.3rd 958, 819 N.Y.S.2d 169 [2006]).
xxx
The second factor focuses on the patientÊs reliance. It is
sometimes characterized as an inquiry on whether the plaintiff
acted in reliance upon the conduct of the hospital or its agent,
consistent with ordinary care and prudence. (Diggs v. Novant
Health, Inc.)‰
PSI argues that the doctrine of apparent authority

cannot apply to these cases because spouses Agana failed to
establish proof of their reliance on the representation of
Medical City that Dr. Ampil is its employee.
The argument lacks merit.
Atty. Agana categorically testified that one of the
reasons why he chose Dr. Ampil was that he knew him to
be a staff member of Medical City, a prominent and
known hospital.
Q Will you tell us what transpired in your visit to Dr. Am-

pil?
A Well, I saw Dr. Ampil at the Medical City, I know him
to be a staff member there, and I told him about the case
of my wife and he asked me to bring my wife over so
she could be examined. Prior to that, I have known Dr.
Am-pil, first, he was staying in front of our house, he
was a neighbor, second, my daughter was his student in
the University of the East School of Medicine at Ramon

Mag-
181
VOL. 544, FEBRUARY 11, 2008 181

saysay; and when my daughter opted to establish a

hospital or a clinic, Dr. Ampil was one of our
consultants on how to establish that hospital. And from
there, I have known that he was a specialist when it
comes to that illness.
Atty. Agcaoili
On that particular occasion, April 2, 1984, what was
your reason for choosing to contact Dr. Ampil in
connection with your wifeÊs illness?
A First, before that, I have known him to be a specialist
on that part of the body as a surgeon; second, I have
known him to be a staff member of the Medical
City which is a prominent and known hospital.
And third, because he is a neighbor, I expect more than
the usual medical 5service to be given to us, than his
ordinary patients.
Clearly, PSI is estopped from passing the blame solely to

Dr. Ampil. Its act of displaying his name and those of the
other physicians in the public directory at the lobby of the
hospital amounts to holding out to the public that it offers
quality medical service through the listed physicians. This
justifies Atty. AganaÊs belief that Dr. Ampil was a member
of the hospitalÊs staff. It must be stressed that under
the doctrine of apparent authority, the question in
every case is whether the principal has by his
voluntary act placed the agent in such a situation
that a person of ordinary prudence, conversant with
business usages and the nature of the particular
business, is justified in presuming that such agent
has authority
6
to perform the particular act in
question. In these cases, the circumstances yield a
positive answer to the question.
_______________
5 TSN, April 12, 1985, pp. 25-26.

6 Id., citing Hudson V.C., Loan Assn., Inc. v. Horowytz, 116 N.J.L. 605,
608, 186 A 437 (Sup. Ct. 1936).
182

The challenged Decision also anchors its7 ruling on the

doctrine of corporate responsibility. The duty of
providing quality medical service is no longer the sole
prerogative and responsibility of the physician. This is
because the modern hospital now tends to organize a
highly-professional medical staff whose competence
and performance need also to be monitored by the hospital
commensurate with 8its inherent responsibility to provide
quality medical care. Such responsibility includes the
proper supervision of the members of its medical
staff. Accordingly, the hospital has the duty to make
a reasonable effort to monitor and oversee the
treatment prescribed and administered by the
physicians practicing in its premises.
Unfortunately, PSI had been remiss in its duty. It did
not conduct an immediate investigation on the reported
missing gauzes to the great prejudice and agony of its
patient. Dr. Jocson, a member of PSIÊs medical staff, who
testified on whether the hospital conducted an
investigation, was evasive, thus:
Q We go back to the operative technique, this was signed

by Dr. Puruganan, was this submitted to the hospital?
A Yes, sir, this was submitted to the hospital with the
record of the patient.
_______________
7 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. These
special tort duties arise from the special relationship existing between a
hospital or nursing home and its patients, which are based on the
vulnerability of the physically or mentally ill persons and their inability
to provide care for themselves. 40 A Am Jur 2d 28 citing Funkhouser v.
Wilson, 89 Wash. App. 644, 950 P 2d 501 (Div.1 1998), review granted,
135 Wash. 2d 1001, 959 P 2d 126 (1998).
8 Purcell v. Zimbelman, 18 Ariz. App. 75, 500 P2d 335 (1972).
183
VOL. 544, FEBRUARY 11, 2008 183

Q Was the hospital immediately informed about the

missing sponges?
A That is the duty of the surgeon, sir.
Q As a witness to an untoward incident in the operating
room, was it not your obligation, Dr., to also report to
the hospital because you are under the control and
direction of the hospital?
A The hospital already had the record of the two OS
missing, sir.
Q If you place yourself in the position of the hospital, how
will you recover.
A You do not answer my question with another question.
Q Did the hospital do anything about the missing gauzes?
A The hospital left it up to the surgeon who was doing the
operation, sir.
Q Did the hospital investigate the surgeon who did the
operation?
A I am not in the position to answer that, sir.
Q You never did hear the hospital investigating the
doctors involved in this case of those missing sponges,
or did you hear something?
xxx xxx
A I think we already made a report by just saying that

two sponges were missing, it is up to the hospital to
make the move.
Atty. Agana
Precisely, I am asking you if the hospital did a move, if
the hospital did a move.
A I cannot answer that.
Court
By that answer, would you mean to tell the Court that
you were aware if there was such a move done by the
hospital?
A I cannot answer that, your honor, because I did not
have any more
9
follow-up of the case that happened
until now.
_______________
9 TSN, February 26, 1987, pp. 26-28.
184

The above testimony obviously shows Dr. JocsonÊs lack of

concern for the patients. Such conduct is reflective
of the hospitalÊs manner of supervision. Not only did
PSI breach its duty to oversee or supervise all
persons who practice medicine within its walls, it
also failed to take an active step in fixing the
negligence committed. This renders PSI, not only
vicariously liable for the negligence of Dr. Ampil under
Article 2180 of the Civil Code, but also directly liable for
its own negligence under Article 2176.
Moreover, there is merit in the trial courtÊs finding that
the failure of PSI to conduct an investigation „established
PSIÊs part in the dark conspiracy of silence and
concealment about the gauzes.‰ The following
testimony of Atty. Agana supports such findings, thus:
Q You said you relied on the promise of Dr. Ampil and

despite the promise you were not able to obtain the said
record. Did you go back to the record custodian?
A I did not because I was talking to Dr. Ampil. He
promised me.
Q After your talk to Dr. Ampil, you went to the
record custodian?
A I went to the record custodian to get the clinical
record of my wife, and I was given a portion of
the records consisting of the findings, among
them, the entries of the dates, but not the 10
operating procedure and operative report.
In sum, we find no merit in the motion for reconsideration.

WHEREFORE, we DENY PSIÊs motion for
reconsideration with finality.
SO ORDERED.
Puno (C.J.), Corona, Azcuna and Leonardo-De

Castro, JJ., concur.
_______________
10 TSN, November 22, 1985, pp. 52-53.
185
VOL. 544, FEBRUARY 11, 2008 185

Philippine Cotton Corporation vs. Gagoomal
Motion for Reconsideration denied with finality.
Notes.·When a physician strays from his sacred duty

and endangers instead the life of his patient, he must be
made to answer therefor. Although society today cannot
and will not tolerate the punishment meted out by the
ancients, neither will it and this Court let the act go
unpunished. (Batiquin vs. Court of Appeals, 258 SCRA 334
[1996]).
The fact of want of competence or diligence is
evidentiary in nature, the veracity of which can best be
passed upon after a full-blown trial for it is virtually

impossible to ascertain the merits of a medical negligence
case without extensive investigation, research, evaluation
and consultations with medical experts·clearly, the City
Prosecutors are not in a competent position to pass
judgment on such a technical matter, especially when there
are conflicting evidence and findings. (Gar-cia-Rueda vs.
Pascasio, 278 SCRA 769 [1997])
··o0o··
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Professional Services, Inc. vs. Court of Appeals

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SUPREME COURT REPORTS ANNOTATED VOLUME 544 3/24/22, 8:32 AM

170 SUPREME COURT REPORTS ANNOTATED

PROFESSIONAL SERVICES, INC., petitioner, vs. THE

NATIVIDAD (Substituted by her children MARCELINO

VOL. 544, FEBRUARY 11, 2008 171

G.R. No. 127590. February 11, 2008.*

MIGUEL AMPIL, petitioner, vs. THE COURT OF

Medical Malpractice; Negligence; Hospitals; Damages; The

doctrine in Ramos v. Court of Appeals, 321 SCRA 584 (1999), still

Same; Same; Same; Doctrine of Apparent Authority; Words and

172 SUPREME COURT REPORTS ANNOTATED

Professional Services, Inc. vs. Court of Appeals

negligent was an employee or agent of the hospital. (Diggs v.

Same; Same; Same; Same; Same; The act of a hospital in

Same; Same; Same; Doctrine of Corporate Responsibility; The

quality medical care.·The challenged Decision also anchors its

VOL. 544, FEBRUARY 11, 2008 173

Professional Services, Inc. vs. Court of Appeals

medical service is no longer the sole prerogative and responsibility

Same; Same; Same; Same; Duties Imposed upon the Hospital

MOTION FOR RECONSIDERATION of a decision of the

The facts are stated in the resolution of the Court.

Bengson, Narciso, Cudala, Pecson, Bengzon &

As the hospital industry changes, so must the laws and

174 SUPREME COURT REPORTS ANNOTATED

medical malpractice traditionally accorded to hospitals has

Afterwards, Dr. Ampil took over, completed the operation

sponge count lacking 2

After a couple of days, Natividad complained of

1 The medical staff was composed of physicians, both residents and

VOL. 544, FEBRUARY 11, 2008 175

Despite Dr. AmpilÊs assurance, the pains intensified,

176 SUPREME COURT REPORTS ANNOTATED

Fuentes jointly and severally liable. On appeal, the Court

publicly displaying in the lobby of the Medical City the

2 G.R. No. 124354, December 29, 1999, 321 SCRA 584.

VOL. 544, FEBRUARY 11, 2008 177

failed to establish one requisite of the doctrine, i.e., that

Consequently, both are jointly and severally liable to the

„We now discuss the responsibility of the hospital in this particular

178 SUPREME COURT REPORTS ANNOTATED

tal. In addition to these, the physicianÊs performance as a

Clearly, in Ramos, the Court considered the peculiar

VOL. 544, FEBRUARY 11, 2008 179

talÊs motion for reconsideration, the doctrine in Ramos

stays, i.e., for the purpose of allocating responsibility in

„The question now is whether CMC is automatically exempt from

4 G.R. No. 142625, December 19, 2006, 511 SCRA 204.

180 SUPREME COURT REPORTS ANNOTATED

hospital; rather a representation may be general and

PSI argues that the doctrine of apparent authority

Q Will you tell us what transpired in your visit to Dr. Am-

the University of the East School of Medicine at Ramon

VOL. 544, FEBRUARY 11, 2008 181

saysay; and when my daughter opted to establish a

Clearly, PSI is estopped from passing the blame solely to

5 TSN, April 12, 1985, pp. 25-26.

182 SUPREME COURT REPORTS ANNOTATED

The challenged Decision also anchors its7 ruling on the

Q We go back to the operative technique, this was signed

7 The corporate negligence doctrine imposes several duties on a

physicians; (3) to oversee as to patient care all persons who practice

VOL. 544, FEBRUARY 11, 2008 183