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Agana
Professional Services Inc. (PSI) v. Natividad and Enrique Agana
Natividad and Enrique Agana v. Juan Fuentes
Miguel Ampil v. Natividad and Enrique Agana
2007 / Sandoval-Gutierrez / Petition for review on certiorari of CA decisions
Standard of conduct > Experts > Medical professionals
FACTS
Natividad Agana was rushed to Medical City because of difficulty of bowel
movement and bloody anal discharge. Dr. Ampil diagnosed her to be
suffering from cancer of the sigmoid. Dr. Ampil performed an anterior
resection surgery on her, and finding that the malignancy spread on her
left ovary, he obtained the consent of her husband, Enrique, to permit Dr.
Fuentes to perform hysterectomy on her. After the hysterectomy, Dr.
Fuentes showed his work to Dr. Ampil, who examined it and found it in
order, so he allowed Dr. Fuentes to leave the operating room. Dr. Ampil
was about to complete the procedure when the attending nurses made
some remarks on the Record of Operation: sponge count lacking 2;
announced to surgeon search done but to no avail continue for
closure (two pieces of gauze were missing). A diligent search was
conducted but they could not be found. Dr. Ampil then directed that the
incision be closed.
A couple of days after, she complained of pain in her anal region,
but the doctors told her that it was just a natural consequence of the
surgery. Dr. Ampil recommended that she consult an oncologist to examine
the cancerous nodes which were not removed during the operation. After
months of consultations and examinations in the US, she was told that she
was free of cancer. Weeks after coming back, her daughter found a piece
of gauze (1.5 in) protruding from her vagina, so Dr. Ampil manually
extracted this, assuring Natividad that the pains will go away. However,
the pain worsened, so she sought treatment at a hospital, where another
1.5 in piece of gauze was found in her vagina. She underwent another
surgery.
Sps. Agana filed a complaint for damages against PSI (owner of
Medical City), Dr. Ampil, and Dr. Fuentes, alleging that the latter are liable
for negligence for leaving 2 pieces of gauze in Natividads body,
and malpractice for concealing their acts of negligence. Enrique Agana
also filed an administrative complaint for gross negligence and
malpractice against the two doctors with the PRC (although only the case
against Dr. Fuentes was heard since Dr. Ampil was abroad). Pending the
outcome of the cases, Natividad died (now substituted by her
children). RTC found PSI and the two doctors liable for negligence
Duty to remove all foreign objects from the body before closure
of the incision; if he fails to do so, it was his duty to inform the patient
about it
o
Requisites for the applicability of res ipsa loquitur
1.
Occurrence of injury
2.
Thing which caused injury was under the control and
management of the defendant [DR. FUENTES] LACKING
SINCE CTRL+MGT WAS WITH DR. AMPIL
3.
Occurrence was such that in the ordinary course of things, would
not have happened if those who had control or management used
proper care
4.
Absence of explanation by defendant
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. That Dr. Ampil discharged such role is
evident from the following:
o
o
In the instant case, the Fuzo Cargo Truck would not have had
hit the rear end of the Mitsubishi Galant unless someone is
negligent. Also, the Fuzo Cargo Truck was under the exclusive
control of its driver, Reyes. Even if respondents avert
liability by putting the blame on the Nissan Bus driver, still,
this allegation was self-serving and totally unfounded. Finally,
no contributory negligence was attributed to the driver of
the Mitsubishi Galant. Consequently, all the requisites for
the application of the doctrine of res ipsa loquitur are present,
thereby creating a reasonable presumption of negligence on the part
of respondents.
Cantre v. Sps. Go
Dr. Milagros Cantre v. Sps. John David and Nora Go
2007 / Quisumbing / Petition for review on certiorari of CA decision
and resolution
FACTS
Nora Go gave birth to her 4th child. Two hours later, she suffered
profuse bleeding inside her womb due to some placenta parts
which were not completely expelled after delivery. She then
suffered hypovolemic shock, so her BP dropped to 40/0. Dr.
Milagros Cantre, an Ob-Gyne specialist and Nora's attending
physician, together with an assisting resident physician, performed
various medical procedures to stop the bleeding and to restore
Nora's BP. While Dr. Cantre was massaging Nora's uterus for it to
contract and stop bleeding, she ordered a droplight to warm Nora
and her baby. At that time, she was unconscious.
While in the recovery room, Nora's husband John David noticed
a fresh gaping wound (2 1/2 x 3 1/2 in) in the inner portion of her
left arm near the armpit. When he asked the nurses about the
cause of the injury, he was informed that it was due to a burn. John
David filed a request for investigation. Dr. Cantre said that what
caused the injury was the blood pressure cuff. John David brought
Nora to the NBI for a physical examination. The medico-legal said
that the injury appeared to be a burn and that a droplight when
placed near the skin for about 10 minutes could cause such burn.
He dismissed the likelihood that the wound was caused by a blood
pressure cuff since the scar was not around the arm, but just on
one side of the arm. Nora's injury was referred to a plastic surgeon
for skin grafting. However, her arm would never be the same--the
surgery left an unsightly scar, her movements are restricted, and
the injured arm aches at the slightest touch.
Sps. Go filed a complaint for damages against Dr. Cantre, the
medical director, and the hospital. In the RTC, parties have rested
their respective cases, but the court admitted additional exhibits
[consist mostly of medical records produced by the hospital during
trial pursuant to a subpoena duces tecum] offered by Sps. Go,
which were not testified to by any witness. RTC ruled in favor of the
spouses. CA affirmed RTC with modification (complaint dismissed
with respect to the medical director and the hospital; only moral
damages awarded).
ISSUES AND HOLDING
1.
WON the questioned additional exhibits are admissible in
evidence. YES
2.
WON Dr. Cantre is liable for the injury suffered by Nora
Go. YES
RATIO
Preliminary discussion
Dr. Cantre's counsel admitted the existence of the additional
exhibits when they were formally offered for admission by the RTC.
In any case, given the circumstances of this case, a ruling on Dr.
Cantre's negligence may be made based on the res ipsa
loquitur doctrine even in the absence of the additional exhibits.
Backgrounder
The Hippocratic
consideration to
live up to this
notwithstanding,
2.
Caused
by
exclusive control
an instrumentality
within defendant's
3.
Possibility of contributing conduct which would make
plaintiff responsible is eliminated
FACTS:
EnriqueAganatoldhiswifeNatividadAganatogolookfortheir
neighbor,Dr.Ampil,asurgeonstaffmemberofMedicalCity,aprominent
andknownhospital
Natividadsufferedfrominjurydueto2gaugesleftinsideherbodyso
theysuedProfessionalInc.(PSI)
Despite,thereportof2missinggauzesaftertheoperationPSIdidNOT
initiateaninvestigation
ISSUE:W/NPSIshouldbeliablefortort.
HELD:YES.15M+12%int.untilfullsatisfaction.
WhilePSIhadnopowertocontrolthemeans/methodbywhichDr.
AmpilconductedthesurgeryonNatividad,theyhadthepowertoreviewor
causethereview
PSIhadthedutytotreadonascaptainoftheshipforthepurposeof
ensuingthesafetyofthepatientsavailingthemselvesofitsservicesand
facilities
1.
Evenafterheroperationtoensurehersafetyasapatient
2.
NOTlimitedtorecordthe2missinggauzes
3.
ExtendedtodeterminingDr.Ampilsroleinit,bringingthe
mattertohisattentionandcorrectinghisnegligence
PSIdefineditsstandardsofcorporateconduct:
Admissionbarsitselffromarguingthatitscorp.resp.isNOTyetin
existenceatthetimeNatividadunderwenttreatment
LessonsApplicable:LiabilityforTorts(CorporateLaw)
Dr.Ampilmedialnegligence
PSICorporateNegligence
NOTE:
Liabilityuniquetothiscasebecauseofimpliedagencyand
admittedcorporateduty
26yearsalreadyandDr.Ampil'sstatuscouldnolongerbe
ascertained
RULING:
The Court ruled that the finding of the appellate court that PNB
failed to make a proper verification as the managers check do not
bear the signature of the bank verifier, thus casting doubt as
whether the signatures were indeed underwent the proper
verification. In view of the foregoing, the Court ruled that PNB was
FACTS
In the 1970s, NPC installed high-tension electrical transmission lines of 69
kilovolts traversing the trail leading to Sangilo, Itogon. Eventually, some
lines sagged, thereby reducing their distance from the ground to only
about 8-10 ft. This posed as a threat to passersby who were exposed to
the danger of electrocution. As early as 1991, the leaders of Ampucao,
Itogon made verbal and written requests for NPC to institute safety
measures to protect trail users from their high-tension wires. In 1995,
Engr. Banayot, NPC Area Manager, informed the Itogon mayor that NPC
installed 9 additional poles, and they identified a possible rerouting
scheme to improve the distance from its deteriorating lines to the ground.
19-year-old Noble Casionan worked as a pocket miner. In 1995, Noble
and his co-pocket miner Melchor Jimenez were at Dalicno. They cut 2
bamboo poles, and they carried one pole horizontally on their shoulder,
with Noble carrying the shorter pole. Noble walked ahead as they passed
through the trail underneath the NPC high-tension lines on their way to
their work place. As Noble was going uphill and turning left on a curve, the
tip of the bamboo pole that he was carrying touched one of the dangling
high-tension wires. Melchor narrated that he heard a buzzing sound for
only about a second or two, then he saw Noble fall to the ground. Melchor
rushed to him and shook him, but Noble was already dead.
A post-mortem examination by the municipal health officer
determined the cause of death to be cardiac arrest, secondary to
ventricular fibulation, secondary to electrocution. There was a small
burned area in the middle right finger of Noble.
Police investigators who visited the site confirmed that portions of the
wires above the trail hung very low. They noted that people usually used
the trail and had to pass directly underneath the wires, and that the trail
was the only viable way since the other side was a precipice. They did not
see any danger warning signs installed. After the GM of NPC was informed
of the incident, NPC repaired the dangling lines and put up warning signs
around the area.
Nobles parents filed a claim for damages against NPC. NPC denied
being negligent in maintaining the safety of the lines, averring that signs
were installed but they were stolen by children, and that excavations were
made to increase the clearance from the ground but some poles sank due
to pocket mining in the area. NPC witnesses testified that the cause of
death could not have been electrocution since Noble did not suffer
extensive burns. NPC argued that if Noble did die by electrocution, it was
due to his own negligence.
RTC decided in favor of Nobles parents. RTC observed that NPC
witnesses were biased because all but one were employees of NPC, and
they were not actually present at the time of the accident. RTC found NPC
negligent since the company has not acted upon the requests and
demands made by the community leaders since 1991. CA affirmed RTC
with modificationaward of moral damages was reduced from 100k to 50k,
and award of attorney fees was disallowed since the reason for the award
was not expressly stated in the decision.
RATIO
Negligence is the failure to observe, for the protection of the interest of
another, that degree of care, precaution, and vigilance which the
circumstances justly demand, whereby such other person suffers
injury. Contributory negligence is 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. There is contributory negligence when
the partys act showed lack of ordinary care and foresight that such
act could cause him harm or put his life in danger. 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 causeof the injury.
Damages awarded
Nobles unearned income of 720k [loss of earning capacity
formula: Net Earning Capacity = 2/3 x (80 age at time of death) x
(gross annual income reasonable and necessary living expenses)]