Lasam vs. Sps. Ramolete G.R. No.

159132 December 8, 2008

Facts:

In the case of Lasam vs. Sps. Ramolete (G.R. No. 159132, December 8, 2008), the respondent, Editha
Ramolete, was three months pregnant when she experienced vaginal bleeding. She was taken to the
Lorma Medical Center (LMC), where a pelvic sonogram revealed weak fetal cardiac pulsation. A
subsequent sonogram showed no fetal movement. Due to persistent bleeding, Dr. Fe Cayao-Lasam, the
petitioner, recommended a Dilatation and Curettage Procedure (D&C) to Editha, which the petitioner
performed.

In September 1994, Editha returned to LMC due to severe abdominal pains and vomiting. Dr. Mayo, one
of the attending physicians, allegedly informed her that she had a dead fetus in her womb. During a
laparotomy, it was discovered that Editha had a massive intra-abdominal hemorrhage and a ruptured
uterus. Consequently, she had to undergo a hysterectomy, which meant she could no longer bear
children.

In November 1994, Editha and her husband filed a complaint for gross negligence and malpractice
against Dr. Cayao-Lasam before the Professional Regulation Commission (PRC). They alleged that the
petitioner's negligence and incompetence during the D&C procedure, as well as her failure to remove
the fetus, led to Editha's hysterectomy

The PRC initially exonerated the petitioner from the charges in March 1999. However, the respondents
appealed to the PRC, which subsequently reversed the decision, revoking the petitioner's license to
practice medicine. The petitioner appealed the decision to the Court of Appeals (CA), but the case was
dismissed for being improper and premature.

Issue: Whether there was medical malpractice in the case.

Held: There was no medical malpractice in the case.

The court defined medical malpractice as a form of negligence where a physician or surgeon fails to
apply the degree of care and skill commonly employed by the profession under similar conditions. To
establish a medical malpractice claim, the patient must prove that the physician failed to do something
that a reasonably prudent physician would have done and that this failure caused injury.

In this case, the court found that the D&C procedure was not the proximate cause of Editha's ruptured
uterus. The petitioner conducted the procedure in accordance with standard medical practice,
exercising the same level of care as any competent doctor would under similar circumstances. The
expert witness testifying in the case supported this conclusion.

The court identified four elements in medical negligence cases: duty, breach, injury, and proximate
causation. It determined that the petitioner had fulfilled her duty and had not breached the standard of
care. Therefore, there was no medical malpractice.

Furthermore, the court considered the defense provided under Article 2179 of the Civil Code. It found
that Editha's failure to return for a follow-up evaluation, despite the petitioner's advice, constituted
negligence on her part. This omission was a substantial factor in causing her injury. If she had followed
the recommended follow-up evaluation, the petitioner could have conducted appropriate tests and
procedures to prevent the rupture of Editha's uterus. Therefore, Editha's own negligence was the
proximate cause of her injury, not merely contributory negligence.

In summary, the court concluded that there was no medical malpractice in the case. The D&C procedure
was performed in accordance with standard practice, and Editha's omission to follow up with the
recommended evaluation was the proximate cause of her own injury.