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Doctrines in Legal Medicine

1. Res Ipsa Loquitor or the Thing Speaks for Itself


A doctrine of law that one is presumed to be negligent if he/she/it had exclusive control of
whatever caused the injury even though there is no specific evidence of an act of negligence,
and without negligence the accident would not have happened.
Its function is to aid the plaintiff in proving the elements of a negligence case by
circumstantial evidence.
As discussed in different jurisprudence:
In the case of Jarcia vs. People (GR No. 187926, Feb,. 15, 2012)
Res ipsa loquitur is a Latin phrase which literally means the thing or the transaction speaks
for itself. The doctrine of res ipsa loquitur is simply a recognition of the postulate that, as a
matter of common knowledge and experience, the very nature of certain types of
occurrences may justify an inference of negligence on the part of the person who controls
the instrumentality causing the injury in the absence of some explanation by the accusedappellant who is charged with negligence. It is grounded in the superior logic of ordinary
human experience and, on the basis of such experience or common knowledge; negligence
may be deduced from the mere occurrence of the accident itself. Hence, res ipsa loquitur is
applied in conjunction with the doctrine of common knowledge.

Layugan vs. IAC (167 SCRA 376)


Where the thing which causes injury is shown to be under the management of the
defendant, and the accident is such as in the ordinary course of thing does not happen if
those who have the management use proper case, it affords reasonable evidence, in the
absence of an explanation by the defendant, that the accident arose from want of care.
Requisites for the application of the Doctrine:
i. The accident is of a kind which ordinary does not occur in the absence of
someones negligence;
ii. It is caused by an instrumentality within the exclusive control of the defendant
or defendants; and
iii. The possibility of contributing conduct which would make the plaintiff
responsible is eliminated.
In the above requisites, the fundamental element is the Control of the Instrumentality which
caused the damage. Such element of control must be shown to be within the dominion of the
defendant. In order to have the benefit of the rule, a plaintiff, in addition to proving injury or
damage, must show a situation where it is applicable, and must establish that the essential elements
of the doctrine were present in a particular incident,

Res Ipsa Loquitor as a rule of Evidence


Is peculiar to the law of negligence which recognizes that prima facie negligence may be
established without direct proof and furnishes for specific proof of negligence. The doctrine
is not a rule of substantive law but merely a mode of proof or a mere procedural
convenience.
The doctrine can be invoked when and only when, under circumstances involved, direct
evidence is absent and not readily available.
The res ipsa loquitor is not a rule of substantive law and, as such, does not create or
constitute an independent or separate ground for liability. It is considered as merely as
evidentiary or in the nature of procedural rule.
The res ipsa loquitor doctrine is a rule of necessity, in that it proceeds on the theory that
under the peculiar circumstances in which the doctrine to apply, it must appear that the
injured party had no knowledge or means of knowledge as to the cause of accident, or that
the party to be charged negligence has superior knowledge or opportunity for explanation of
the accident.
When Res ipsa loquitor is not applicable:
The doctrine of res ipsa loquitor is not applicable if there is direct proof of absence and
presence of negligence.
It is not applicable when an unexplained accident may be attributed to one of several
causes, for some of the defendant could not be responsible.
2. Captain of the Ship Doctrine
This doctrine holds the surgeon in charge of an operation liable for the negligence of his
assistants during the time when those assistants are under the surgeons control.
Under the Captain of the Ship rule, the operating surgeon is the person in complete charge
of the surgery room and all personnel connected with the operation. Their duty is to obey
his orders.
An adaption from the borrowed servant rule, as applied to an operating room, holding the
person in charge-e.g., a surgeon- responsible for all those under his supervision, regardless
of whether the captain is directly responsible for an alleged error or act of alleged
negligence.
Same as:
1. Vicarious Liability (Article 2176 in relation to article 2180, NCC)
Vicarious liability is a legal doctrine that assigns liability for an injury to a person who did
not cause the injury but who has aparticular legal relationship to the person who did act
negligently.

Article 2176: Whoever by act or omission causes damage to another, there being fault or
negligence, is obliged to pay for the damage done. Such fault or negligence, if there is no
pre-existing contractual relation between the parties, is called quasi-delict and is
governed by the provisions of this Chapter.
Article 2180: The obligation imposed by article 2176 is demandable not only for one's
own acts or omissions, but also for those of persons for whom one is responsible.
2. Respondeat Superior
[Latin, Let the master answer.] A common-law doctrine that makes an employer liable
for the actions of an employee when the actions take place within the scope of
employment.
An employee is an agent for her employer to the extent that the employee is authorized
to act for the employer and is partially entrusted with the employers business. The
employer controls, or has a right to control the time, place and the method of doing
work. When the facts show that an employer-employee relationship exists, the
employer can be held responsible for the injuries caused by the employee in the course
of employment.
Article 2176. Whoever by act or omission causes damage to another, there being fault or
negligence, is obliged to pay for the damage done. Such fault or negligence, if there is no
pre-existing contractual relation between the parties, is called a quasi-delict and is
governed by the provisions of this Chapter.
Article 2180: The obligation imposed by article 2176 is demandable not only for one's
own acts or omissions, but also for those of persons for whom one is responsible.
3. Doctrine of Imputed Liability
The doctrines of imputed liability and vicarious liability permit the personal injury
plaintiff to hold an innocent person liable for the wrongful conduct of another. The
inactive defendant did not commit any wrongful conduct; rather, her relationship to the
active wrongdoer renders her liable. Control over the wrongdoer is a common element.
Courts and legislatures impose imputed and vicarious liability as a matter of public
policy. Situations include: (1) an employers liability for an employees conduct during
the course and scope of her employment, (2) a principles responsibility for the conduct
of an agent when carrying out the agency (3) a parents responsibility for his childs
conduct, and (4) the mutual liability of members of a joint enterprise or partnership.
3. Master Servant Rule
Employers: Master
a. Owner and Manager of establishment or enterprises are liable for damage caused by their
employees in the service of employment or on the occasion of their functions.

b. Employer of household helper though not engaged in any business or industry are liable
for damages caused by helper acting within the scope of their assigned tasks.
Basis of Liability is not Respondent Superior (Anglo-American doctrine where the negligence of
the employee is conclusively presumed to be the negligence of the employer) but on the
relationship of Pater-Familias, (master-servant) a theory basing the liability of the master
ultimately on his own negligence and not that of the servant as manifested in his negligence in
the selection of their employee-servant (culpa eligiendo) or in the supervision over their
employee-servants (culpa in vigilando). This negligence is prima facie presumption juris tantumovercome or rebutted by proof that they have observed and exercised all the diligence of a good
father of a family (diligantissimi bonus fater familias). The theory is deduced from the last par of
Art 2180 NCC providing the responsibility shall cease upon proof of exercise of the diligence of a
good father of a family to prevent the damage.
4. Borrowed Servant Rule
The common law principle that the employer of a borrowed employee, rather than the
employees regular employer, is liable for the employees actions that occur while the employee
is under the control of the temporary employer. Sometimes referred to as borrowed employee
doctrine.
5. Contributory Negligence
It is a conduct on the part of the injured party, contributing as a legal cause to the harm he
has suffered, which falls below the standard which he is required to conform for his own
protection. It is an act or omission amounting to want of ordinary care on the part of the
person injured which, concurring with the defendants negligence, is the proximate cause of
the injury.
Art. 2179 of the New Civil Code is clear that if the plaintiffs negligence is merely
contributory, the plaintiff is not barred from recovering from the defendant. This statutory
rule is reiterated in Article 2214 which states that in quasi-delicts, the contributory
negligence of the plaintiff shall be reduced damages that he may recover.
Contributory negligence of the plaintiff merely results to mitigation of liability. Under this
rule, contributory negligence is defined as conduct on the part of the injured party,
contributing as a legal cause to the harm he has suffered, which falls below the standard to
which he is required to conform for his own protection.
The court is free to determine the extent of the mitigation of the defendants
liability depending on the circumstances.
6. Proximate Cause
Proximate cause has been defined as that cause, which, in natural and continuous sequence,
unbroken by any efficient intervening cause, produces the injury, and without which the result
would not have occurred.
Proximate cause vs. contributory negligence.

In the tort-related case of LAMBERT S. RAMOS vs. C.O.L. REALTY CORPORATION, G.R. No. 184905,
August 28, 2009, the issue for resolution by the Philippine Supreme Court was whether petitioner
could be held solidarily liable with his driver, Rodel Ilustrisimo, to pay respondent C.O.L. Realty the
amount of P51,994.80 as actual damages suffered in a vehicular collision. It declared the following
doctrines on proximate cause and contributory negligence, thus:
1. Articles 2179 and 2185 of the Civil Code on quasi-delicts apply in this case, viz:
Article 2179. When the plaintiffs own negligence was the immediate and proximate cause
of his injury, he cannot recover damages. But if his negligence was only contributory, the
immediate and proximate cause of the injury being the defendants lack of due care, the
plaintiff may recover damages, but the courts shall mitigate the damages to be awarded.
Article 2185. Unless there is proof to the contrary, it is presumed that a person driving a
motor vehicle has been negligent if at the time of the mishap, he was violating any traffic
regulation.
2. If the master is injured by the negligence of a third person and by the concurring contributory
negligence of his own servant or agent, the latters negligence is imputed to his superior and will
defeat the superiors action against the third person, assuming of course that the contributory
negligence was the proximate cause of the injury of which complaint is made.
3. Applying the foregoing principles of law to the instant case, Aquilinos act of crossing Katipunan
Avenue via Rajah Matanda constitutes negligence because it was prohibited by law. Moreover, it
was the proximate cause of the accident, and thus precludes any recovery for any damages suffered
by respondent from the accident.
4. Proximate cause is defined as that cause, which, in natural and continuous sequence, unbroken by
any efficient intervening cause, produces the injury, and without which the result would not have
occurred. And more comprehensively, the proximate legal cause is that acting first and producing
the injury, either immediately or by setting other events in motion, all constituting a natural and
continuous chain of events, each having a close causal connection with its immediate predecessor,
the final event in the chain immediately effecting the injury as a natural and probable result of the
cause which first acted, under such circumstances that the person responsible for the first event
should, as an ordinary prudent and intelligent person, have reasonable ground to expect at the
moment of his act or default that an injury to some person might probably result therefrom.
5. If Aquilino heeded the MMDA prohibition against crossing Katipunan Avenue from Rajah
Matanda, the accident would not have happened. This specific untoward event is exactly what the
MMDA prohibition was intended for. Thus, a prudent and intelligent person who resides within the
vicinity where the accident occurred, Aquilino had reasonable ground to expect that the accident
would be a natural and probable result if he crossed Katipunan Avenue since such crossing is
considered dangerous on account of the busy nature of the thoroughfare and the ongoing
construction of the Katipunan-Boni Avenue underpass. It was manifest error for the Court of Appeals
to have overlooked the principle embodied in Article 2179 of the Civil Code, that when the plaintiffs
own negligence was the immediate and proximate cause of his injury, he cannot recover damages.

6. Hence, we find it unnecessary to delve into the issue of Rodels contributory negligence, since it
cannot overcome or defeat Aquilinos recklessness which is the immediate and proximate cause of
the accident. Rodels contributory negligence has relevance only in the event that Ramos seeks to
recover from respondent whatever damages or injuries he may have suffered as a result; it will have
the effect of mitigating the award of damages in his favor. In other words, an assertion of
contributory negligence in this case would benefit only the petitioner; it could not eliminate
respondents liability for Aquilinos negligence which is the proximate result of the acciden
CASES:
Dr. Jarcia and Dr. Bastan vs. People
GR No. 187926, February 15, 2012
(Res ipsa Loquitor)
Facts: Roy was hit by a taxicab and was rushed to Manila Doctors Hospital for emergency medical
treatment. X-ray result of his ankle showed no fracture as per Dr. Jarcia. Dr. Bastan upon her own
examination informed the mother, Mrs. Santiago, that it was only the ankle that was hit and no need
to examine the whole leg. Eleven (11) days after, Roy developed fever, swelling upper right leg and
misalignment of foot. X-ray then revealed a right mid-tibial fracture and linear hairline fracture in the
shaft of the bone, thus, this case for simple imprudence resulting to serious physical injuries. RTC
found petitioners guilty beyond reasonable doubt. CA affirmed applying the doctrine res ipsa
loquitur.
Issue: Whether or not the doctrine of res ipsa loquitur is applicable in this case.
Held: No. This doctrine of res ipsa loquitur means "Where the thing which causes injury is shown to
be under the management of the defendant, and the accident is such as in the ordinary course of
things does not happen if those who have the management use proper care, it affords reasonable
evidence, in the absence of an explanation by the defendant, that the accident arose from want of
care." The Black's Law Dictionary defines the said doctrine. Thus:
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 ordinarily does not happen in absence of negligence. Res ipsa
loquitur is a rule of evidence whereby negligence of the alleged wrongdoer may be inferred from the
mere fact that the accident happened provided the character of the accident and circumstances
attending it lead reasonably to belief that in the absence of negligence it would not have occurred
and that thing which caused injury is shown to have been under the management and control of the
alleged wrongdoer. Under this 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
was such that in the ordinary course of things would not happen if reasonable care had been used.
The requisites for the application of the doctrine of res ipsa loquitur are: (1) the accident was of a
kind which does not ordinarily occur unless someone is negligent; (2) the instrumentality or agency

which caused the injury was under the exclusive control of the person in charge; and (3) the injury
suffered must not have been due to any voluntary action or contribution of the person injured.
In this case, the circumstances that caused patient Roy Jr.s injury and the series of tests that were
supposed to be undergone by him to determine the extent of the injury suffered were not under the
exclusive control of Drs. Jarcia and Bastan. It was established that they are mere residents of
the Manila Doctors Hospital at that time who attended to the victim at the emergency room. While it
may be true that the circumstances pointed out by the courts below seem doubtless to constitute
reckless imprudence on the part of the petitioners, this conclusion is still best achieved, not through
the scholarly assumptions of a layman like the patients mother, but by the unquestionable
knowledge of expert witness/es. As to whether the petitioners have exercised the requisite degree
of skill and care in treating patient Roy, Jr. is generally a matter of expert opinion.
Rogelio Ramos and Erlinda Ramos vs. CA
GR. No. 124354, April 2002
(Captain-of-the-ship Doctrine)
Facts: Erlinda Ramos was scheduled for an operation for the removal of her gall bladder on June 17,
1985 to be performed by Dr. Hosaka, a surgeon, and Dr. Guiterrez, an anesthesiologist at De Los
Santos Medical Center (DLSMC). Dr. Hosaka arrived late, three hours after the scheduled operation;
on the other hand, Dr. Guiterrez did the intubation. After the operation, Erlinda Ramos was in a
comatose condition until she died in 1999. It was found that the faulty intubation was the proximate
cause of Erlindas comatose condition.
RTC found the doctors negligent in the p0erformance of their duties. On appeal, CA reversed, thus,
this petition alleging that Dr. Hosaka was liable under the doctrine of Captain-of-the-Ship.
Issue: Whether or not Dr. Hosaka was liable on the basis of the captain-of-the-ship doctrine.
Held: Yes. As the so-called captain of the ship, it is the surgeons responsibility to see to it that
those under him perform their task in the proper manner. Respondent Dr. Hosakas negligence can
be found in his failure to exercise the proper authority (as the captain of the operative team) in
not determining if his anesthesiologist observed proper anesthesia protocols. In fact, no evidence on
record exists to show that respondent dr. Hosaka verified if respondent Dr. Guiterrez properly
intubated the patient.
Rogelio Nogales vs. Capitol Medical Center
GR. No. 142625, December 2006
(Borrowed Servant Doctrine)
Facts: Corazon Nogales was under the exclusive prenatal care of Dr. Estrada for her pregnancy with
her fourth child. Because of her increased blood pressure and development of leg edema indicating
preeclampsia which is a dangerous complication of pregnancy, she was advised to be immediately
admitted to CMC. Other doctors, resident physicians and anesthesiologist, aside from Dr. Estrada
attended to her delivery but the latter eventually died due to hemorrhage, post partum.

RTC found Dr. Estrada solely liable for damages as he was an independent contractor-physician. CA
affirmed but on the liability of other respondents applied the doctrine of borrowed-servant.
Issue: Whether or not the doctrine is applicable.
Held: Yes. In general, hospital is not liable for the negligence of an independent contractor-physician
except under the doctrine of apparent authority. In the instant case, CMC impliedly held out Dr.
Estrada as a member of its medical staff. Through CMCs acts, CMC clothed Dr. Estrada with
apparent authority thereby leading the spouses Nogales to believe that dr. Estrada was an employee
or agent of CMC. CMC cannot now repudiate such authority.
Borrowed-servant doctrine states that the employer of a borrowed employee, rather than
employees regular employer, is liable for the employees actions that occur while the employee is
under the control of the temporary employer.
Teodoro Umali vs. hon. Angel Bacani
GR. No. L-40570, January 1976
(Proximate Cause and Contributory Negligence)
Facts: On May 14, 1972, a storm with strong rain hit the Municipality of Alcala Pangasinan. During
the storm, the banana plants standing near the transmission line of the Alcala Electric Plant (AEP)
were blown down and fell on the electric wire. The live electric wire was cut, one end of which was
left hanging on the electric post and the other fell to the ground. The following morning, barrio
captain saw Cipriano Baldomero, a laborer of the AEP, asked him to fix it, but the latter told the
barrio captain that he could not do it but that he was going to look for the lineman to fix it.
Sometime thereafter, a small boy of 3 years and 8 months old by the name of Manuel P. Saynes,
whose house is just on the opposite side of the road, went to the place where the broken line wire
was and got in contact with it. The boy was electrocuted and he subsequently died. It was only after
the electrocution that the broken wire was fixed.
Issues: (1) WON the proximate cause of the boy's death is due to a fortuitous event- storm; (2) WON
boys parents negligence exempts petitioner from liability.
Ruling: Decision affirmed.
(1) A careful examination of the records convinces the SC that a series of negligence on the part of
defendants' employees in the AEP resulted in the death of the victim by electrocution. With ordinary
foresight, the employees of the petitioner could have easily seen that even in case of moderate
winds the electric line would be endangered by banana plants being blown down.
(2) Art. 2179 CC provides that if the negligence of the plaintiff (parents of the victim in this case) was
only contributory, the immediate and proximate cause of the injury being the defendants'
(petitioners) lack of due care, the plaintiff may recover damages, but the courts shall mitigate the
damages to be awarded. This law may be availed of by the petitioner but does not exempt him from
liability. Petitioner's liability for injury caused by his employees negligence is well defined in par. 4,
of Article 2180 of the Civil Code.