Doctrine applied to

medical malpractice
cases

Sitti Ainnie J. Mansul

Arnalyn S. Ibrahim

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Legal Doctrines
associated with
Malpractice 1. Respondeat Superior
2.Proximate Cause
3. Res ipsa loquitor

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DOCTRINES
Pharmaceuticals

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1. Respondeat Superior

• which places ultimate liability with a superior

or employer;
• occurs when the servant (employee) commits a
tort or civil wrong within the scope of
employment and the master (employer) is held
liable although the master may have done
nothing wrong.
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Pharmaceuticals

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• Corporate liability under respondeat
superior generally requires three elements:
(1) the agent of the corporation committed
the crime, (2) while acting within the scope
of the agent’s authority, (3) with an intent
to benefit the corporation.

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Pharmaceuticals

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2. Proximate Cause

• which states that the professional's negligence

resulted in injury

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Pharmaceuticals

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2. Proximate Cause
• has been defined as that which, in natural and
continuous sequence, unbroken by any efficient
intervening cause, produces injury, and without which
the result would not have occurred.
• An injury or damage is proximately caused by an act
or a failure to act, whenever it appears from the
evidence in the case that the act or omission played a
substantial part in bringing about or actually causing
the injury or damage; and that the injury or damage
was either a direct result or a reasonably probable
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consequence of the act or omission. Pharmaceuticals

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3. Res ipsa loquitur

• The thing speaks for itself.

• which allows malpractice to be proved without
expert testimony
• allows juries to infer negligence from the
circumstances surrounding the injury.
• The elements of duty and breach are presumed
under this doctrine.
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Pharmaceuticals

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To use the doctrine of res ipsa successfully, a plaintiff
must show that:
1.Evidence of the actual cause of the injury is not
obtainable;
2.The injury is not the kind that ordinarily occurs in the
absence of negligence;
3.The plaintiff was not responsible for his or her own
injury;
4.The defendant, or its employees or agents, had
exclusive control of the instrumentality that caused the
injury; and
5.The injury could not have been caused by any
instrumentality other than that over which the defendant Contoso
Pharmaceuticals

had control. page 8

Case 1 BATIQUIN vs. COURT OF APPEALS [G.R. No. 118231. July 5, 1996]
Issue
Whether or not the testimony of Dr. Kho should be given credence
Held
Res ipsa loquitur. The thing speaks for itself. Rebuttable presumption or
inference that defendant was negligent, which arises upon proof that [the]
instrumentality causing injury was in defendant's exclusive control, and that
the accident was one which ordinary does not happen in absence of
negligence.
Under Res ipsa loquitur doctrine . . . the happening of an injury permits an
inference of negligence where plaintiff produces substantial evidence that
[the] injury was caused by an agency or instrumentality under [the] exclusive
control and management of defendant, and that the occurrence [sic] was
such that in the ordinary course of things would not happen if reasonable care Contoso
had been used. Pharmaceuticals

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Case 2 Urbano vs People [G.R. No. 182750 Jan. 20, 2009]
• Held
The high court citing the case of Urbano vs. People (GR 182750,
Jan. 20, 2009), penned by Associate Justice Presbitero Velasco Jr.,
further states that to be held liable for the death, the acts of the accused
must be the direct and natural cause of the death of the victim, viz:
“The rule is that the death of the victim must be the direct, natural, and
logical consequence of the wounds inflicted upon him by the accused.
And since we are dealing with a criminal conviction, the proof that the
accused caused the victim’s death must convince a rational mind
beyond reasonable doubt. The medical findings, however, lead us to a
distinct possibility that the infection of the wound by tetanus was an
efficient intervening cause later or between the time Javier was
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wounded to the time of his death. Pharmaceuticals

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Case 3 NOGRALES vs. CAPITOL MEDICAL CENTER
[G.R. No. 142625, Dec 19, 2006]

Held
General Rule: A hospital is not liable for the negligence of an
independent contractor-physician. Exception: The hospital may be
liable if the physician is the “ostensible” agent of the hospital.
This exception is also known as the “doctrine of apparent authority.”
Under the doctrine of apparent authority a hospital can be held
vicariously liable for the negligent acts of a physician providing care
at the hospital, regardless of whether the physician is an
independent contractor, unless the patient knows, or should have
known, that the physician is an independent contractor.
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Pharmaceuticals

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Other Doctrines
under vicarious 1.Captain of the Ship
liability Doctrine
2.Borrowed servant
doctrine
3.Doctrine of
Ostensible agent
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DOCTRINES
Pharmaceuticals

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1. Captain of the Ship
Doctrine

• the operating surgeon is the person in complete

charge of the surgery room and all personnel
connected with the operation
• Primary surgeon

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Pharmaceuticals

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Case 1 Professional Services Inc. vs. Agana
(G.R. No. 126297, February 2, 2010)

Held
The Supreme Court applied the Captain of the Ship Doctrine in
upholding the liability of the doctor. The Court stressed that as the lead
surgeon, the doctor had the duty to remove all foreign objects from the
patient’s body before the closure of the incision. At the very least, the
doctor should have informed the patient of his failure to do so. The act
of ordering the closure of the incision notwithstanding that the pieces
of gauze remained unaccounted for bolstered the application of the
doctrine.

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Pharmaceuticals

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2. Borrowed servant
doctrine
• Borrowed from the hospital by someone and for
any wrongful act committed by them during the
period, their new and temporary employer must
be held liable
• When a hospital employee is under the direct
control of an independent doctor or agency, the
person, who is actually controlling the
employee’s actions, is responsible for them. Contoso
Pharmaceuticals

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2. Doctrine of Ostensible
Agency
• Hired temporarily
• This doctrine imposes liability, not as the result of the reality of a
contractual relationship, but rather because of the actions of a
principal or an employer in somehow misleading the public into
believing that the relationship or the authority exists. (Irving v.
Doctors Hospital of Lake Worth, Inc., 415 So. 2d 55 (1982),
quoting Arthur v. St. Peters Hospital, 169 N.J. 575, 405 A 2d 443
(1979)). The concept is essentially one of estoppel.
• Under the rule, the principal is bound by the acts of his agent with
the apparent authority which he knowingly permits the agent to
assume, or which he holds to the agent out to the public as Contoso
possessing. Pharmaceuticals

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Thank You
Contoso
Pharmaceuticals

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