Summary of the Case

Pedro Clemente brought his daughter Anastacia Clemente to Dr. Gregorio Favis in Manila a few
days before May 26, 1929. On May 26, 1929, at 7 a.m., the surgeon decided to perform a
tonsillectomy and instructed the father and daughter to report to St. Paul's Hospital.
Valentina Andaya and Consolacion Montinola, two student nurses, assisted Lorenza Somera, a
head nurse. Dr. Bartolome served as the assistant surgeon. Dr. Favis requested a Novocain
solution from Dr. Bartholome during the procedure. Dr. Favis administered the medication to the
patient after receiving a syringe of the solution from Ms. Montinola. Dr. Bartolome saw the
patient's paleness and apparent death after a short while. Dr. Favis said that it was not unusual
when he brought it to his attention. The patient died a short while after a third syringe was
injected. Dr. Favis asked if the Novocain was fresh. Ms. Somera replied that the solution was not
Novocain but 10% cocaine.
The two doctors who were suspected of the crime were cleared, but Lorenza Somera was
sentenced to a year and a day in prison, must pay P1,000 in damages to Anastacia Clemente's
heirs and face additional jail time if she becomes insolvent, as well as to pay one-third of the
court fees.
What are the ethical principles violated in the case?
According to the due care idea, the patient is more vulnerable because they are less familiar with
the product. The doctors and staff in the OR are morally committed to delivering commodities
that will not violate the customer's expectations because of his/her vulnerability. This moral
requirement has definitely been broken. In addition, the Captain-of-the-Ship Doctrine, a body of
literature that is almost excessively cited in medical jurisprudence, states that the surgeon is
liable for both the wrongdoing of those who are under his control as well as those over whom he
has extended control. The surgeon has complete control over the operating room and is
responsible for any honor or disgrace that may arise in the small, sterile environment therefore,
Dr. Gregorio Favis should have potentially faced some consequences for the subordinates'
wrongdoing, just like any head or supervisor would.
Do you think justice was served in this case? Justify your answer.
No, justice has not been served to both the patient, Anastacia Clemente, and the head nurse,
Lorenza Somera. The only way, we can serve justice is by punishing all the medical
professionals present in the operating room due to their malpractices. It is not right for Somera to
face the consequences alone, the surgeon, Dr. Favis, and assistant surgeon, Dr. Bartolome must
take accountability as well since all actions made by the nurses are supervised by them.
Who do you think should be accountable for the said case? (The surgeon? The student
nurses? The nurse?) Justify your answer.
In my perspective, Dr. Favis and Dr. Bartolome, both surgeons, as well as the chief nurse
Somera, are accountable for Anastacia Clemente's passing. The problem with Dr. Favis, in this
case, was that he ordered the incorrect prescription. According to student nurse Montinola, he
made matters worse by confirming his mistake when Ms. Somera questioned him about it. Ms.
Somera performed her nursing duties exactly according to the book, but something was missing.
The order was obviously suspicious, as someone who had to work hard to earn the title of nurse,
she had a lot of experience in operating rooms, and undoubtedly none of them had ever involved
cocaine being used as a local anesthetic. In addition, since Dr. Favis is a surgeon with greater
experience and expertise in medical procedures, he is in a better position to fulfill his
responsibilities. There is an aphorism that goes along with the premise that "the more
knowledge, the greater the responsibility."
Similarly, it goes without saying that the two student nurses who assisted in the operating room
while were cleared of all charges. In other words, they were a part of Somera, and Somera bore
responsibility for their deeds. However this case is viewed, it is apparent that everyone present in
the operating room throughout the procedure is under a moral duty.
If you were Somera, how will you defend yourself?
If I were in Somera’s case, there is no way I can defend myself fully since I am aware that I am
somehow responsible for the patient’s death however, the court should have sentenced those who
are present in the operating room excluding the student nurses and with more weight to the
surgeons. I will do my best to testify that I don’t deserve to receive all the blame while the head
of the operating room whom I followed the orders from goes free unscathed.
What do you think Somera could have done?
She ought to have said to Dr. Favis at the very least, "I've never seen cocaine used as an
anesthetic in the OR.  Is this a new addition doc? " or "Doc, you know that this medicine is
frequently abused? I should use caution."  to attract the attention of the doctor. She shouldn't
have delivered the orders if they weren't noted on the chart. That way,  she would have both a
defense and a means of proof.

References:
GRENNAN, ELIZABETH M. R.N.. The Ultimate Problem in Ethics: A Brief Review of the
Somera Case. AJN, American Journal of Nursing: June 1930 - Volume 30 - Issue 6 - p 733-734