Professional Services, Inc v.

Agana
GR no. 126297
FACTS

On 14 April 1984, Natividad Agana was rushed to The Medical City General
Hospital due to bowel movement difficulty and bloody anal discharge.
Dr. Ampils diagnosis is Cancer of the sigmoid.
Upon performing anterior resection surgery on Natividad, Dr. Ampil found
that cancer had spread on her left ovary.
Dr. Ampil sought the consent of Enrique Agana (Natividads husband) to permit
Dr. Juan Fuentes to perform hysterectomy.
After Dr. Fuentes completed hysterectomy, Dr. Ampil took over to complete the
operation and to close the incision.
A couple of days after her release, Natividad complained of
excruciating pain in her anal region. Her doctors told her that said pain
was the consequence of her operation.
Dr. Ampil recommended that she consult an oncologist to examine the
cancerous node they were not able to remove. Natividad then went to the US for
further treatment and was later found free from cancer. She then returned to the
Philippines.
Two weeks after Natividads arrival, her daughter found a piece of gauze
protruding from her vagina.
Dr. Ampil removed said piece, and assured her that the pains would vanish
soon.
Still suffering from pain, Natividad sought help from Polymedic General Hospital
where it was found that another piece of gauze badly infected her vaginal vault.
She took another surgery to remove the same.
The spouses Agana then filed a complaint for damages against Professional
Services, Inc (owner of The Medical City), Dr. Ampil and Dr. Fuentes. Enrique
likewise
filed administrative
cases against
Dr. Ampil
(who was
unfortunately abroad at that time, so case did not proceed) and Dr. Fuentes.
Pending said cases, Natividad died and was substituted by her children.
RTC favored the spouses, but the administrative complaint against Dr. Fuentes
was dismissed.
CA affirmed that Dr. Ampil was liable for damages but exonerated Dr. Fuentes
from liability. Hence, these three consolidated petitions for review on certiorari.

ISSUE: WON Dr. Ampil is liable for negligence and malpractice

HELD: Yes. All the major circumstances, taken together, directly point to Dr.
Ampil as the negligent party. Because after the operation the nurses
informed Dr. Ampil that 2 gauzes were lacking but still Dr. Ampil continue the

closure. And the 2 gauzes were extracted from the same spot of the body of
Mrs. Agana where the surgery was performed.
Dr. Ampil also did not inform Natividad about the missing two pieces of
gauze. Worse, he even misled her that the pain she was experiencing was
the ordinary consequence of her operation.

Reyes v. Sisters of Mercy Hospital

GR no. 130547
FACTS
Leah Alesna Reyes is the wife of late Jorge Reyes.
5 days before his death Jorge has been suffering from a recurring fever
with chills. After he failed to get relief from home medication, he
decided to see the doctor.
He was taken to Mercy Community Clinic by his wife. Dr. Rico, resident
physician and admitting physician on duty gave Jorge a physical
examination and took his medical history.
Typhoid fever was then prevalent in the locality and Jorge was
diagnosed with the same disease.
As he shift was only up to 5 pm, Dr. Rice indorsed Jorge to respondent
Dr. Blanes.
Dr. Blanes ordered that a compatibility test with antibiotic
chloromycetin be done to Jorge.
At around 1 am, Dr. Blanes was called as Jorges temperature rose to
41 degrees Celsius. The patient also experienced chills and exhibited
respiratory distress, nausea, vomiting, and convulsions. Dr. Blanes put
him under oxygen, used suction machine, and administered
hydrocortisone, temporarily easing the patients convulsions.
After 15 minutes, Jorge exhibited the same symptoms and Dr. Blanes
did the same thing but this time Jorge died.
The heirs of Jorge filed a case for damages stating that the real reason
of Jorges death is not typhoid fever but the wrongful administration of
chloromycetin.
RTC absolve the respondents. CA affirmed RTC.
ISSUE: WON the respondents are liable for damages
HELD: There is no showing that the attending physician in this case deviated
from the usual course of treatment with respect to typhoid fever. Jorge was
given antibiotic choloromycetin and some dose of triglobe after compatibility
test was made by the doctor and found that no adverse reactions manifested
which would necessitate replacement of the medicines. Indeed, the standard
contemplated is not what is actually the average merit among all known

practitioners
from
the best to the worst and from the most to the least experienced, but the rea
sonable average merit among the ordinarily good physicians. Here, the
doctors did not depart from the reasonable standard recommended by the
experts as they in fact observed the due care required under the
circumstances.

Ramos v. CA
GR no. 124354
FACTS
June 17, 1985 afternoon: Erlinda Ramos, 47-year old robust woman
underwent on an operation to the stone at her gall bladder removed
after being tested that she was fit for "cholecystectomy" operation
performed by Dr. Orlino Hozaka. Dr. Hosaka charged a fee of
P16,000.00, which was to include the anesthesiologist's fee and which
was to be paid after the operation. He assured Rogelio E. Ramos,
husband that he will get a good anesthesiologist who was Dra. Perfecta
Gutierrez. Erlinda's hand was held by Herminda Cruz, her sister -in-law
who was the Dean of the College of Nursing at the Capitol Medical
Center together with her husband went down with her to the operating
room.
Instead of 9:30 am, Dr. Hosaka arrived at about 12:15 P.M.
Herminda noticing what Dra. Perfecta Gutierrez was doing, saw the
nailbed of Erlinda becoming bluish and Dr. Hosaka called for
another anesthesiologist Dr. Calderon.
She went out of the operating room to tell Rogelio that something is
wrong.
When she went back she saw Erlinda in a trendelenburg position and at
3 p.m. she was taken to the Intensive Care Unit (ICU) where she stayed
for a month due to bronchospasm incurring P93,542.25 and she was
since then comatosed.
She suffered brain damage as a result of the absence of oxygen in her
brain for four to five minutes.
She was also diagnosed to be suffering from "diffuse cerebral
parenchymal damage"

RTC: favored the Ramos.

CA: reversed ordering the Ramos' to pay their unpaid bills.

ISSUE: WON the doctrine of res ipsa loquitur shall apply.

HELD: Yes. At the time of submission, Erlinda was neurologically sound and,
except for a few minor discomforts, was likewise physically fit in mind and
body. However, during the administration of the anesthesia and prior to the
performance of cholecystectomy she suffered irreparable damage to her
brain.
Obviously, brain damage, which Erlinda sustained, is an injury which does
not normally occur in the process of a gall bladder operation. In fact, this
kind of situation does not happen in the absence of negligence of someone
in the administration of anesthesia and in the use of endotracheal.
Considering the sound and unaffected member of the body (the brain) is
injured or destroyed while the patient is unconscious and uder the immediate
and exclusive control of the physicians, we hold that a practical
administration of justice dictates the application of res ipsa loquitur.
All respondent are liable for damages.