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vs. CA

Erlinda Ramos underwent a surgical procedure to remove stone from her gall bladder (cholecystectomy).
They hired Dr. Hosaka, a surgeon, to conduct the surgery at the De Los Santos Medical Center (DLSMC).
Hosaka assured them that he would find a good anesthesiologist. But the operation did not go as planned,
Dr. Hosaka arrived 3 hours late for the operation, Dra. Gutierrez, the anesthesiologist botched the
administration of the anesthesia causing Erlinda to go into a coma and suffer brain damage. The botched
operation was witnessed by Herminda Cruz, sister in law of Erlinda and Dean of College of Nursing of
Capitol Medical Center.

The family of Ramos (petitioners) sued the hospital, the surgeon and the anesthesiologist for damages.
The petitioners showed expert testimony showing that Erlinda's condition was caused by the
anesthesiologist in not exercising reasonable care in intubating Erlinda. Eyewitnesses heard the
anesthesiologist saying Ang hirap ma-intubate nito, mali yata ang pagkakapasok. O lumalaki ang tiyan.

Diagnostic tests prior to surgery showed that Erlinda was robust and fit to undergo surgery.

The RTC held that the anesthesiologist ommitted to exercise due care in intubating the patient, the
surgeon was remiss in his obligation to provide a good anesthesiologist and for arriving 3 hours late
and the hospital is liable for the negligence of the doctors and for not cancelling the operation after the
surgeon failed to arrive on time. The surgeon, anesthesiologist and the DLSMC were all held jointly and
severally liable for damages to petitioners. The CA reversed the decision of the Trial Court.

Whether or not the private respondents were negligent and thereby caused the comatose condition of

Yes, private respondents were all negligent and are solidarily liable for the damages.


Res ipsa loquitur a procedural or evidentiary rule which means the thing or the transaction speaks for
itself. It is a maxim for the rule that the fact of the occurrence of an injury, taken with the surrounding
circumstances, may permit an inference or raise a presumption of negligence, or make out a plaintiffs
prima facie case, and present a question of fact for defendant to meet with an explanation, where
ordinarily in a medical malpractice case, the complaining party must present expert testimony to prove
that the attending physician was negligent.

This doctrine finds application in this case. On the day of the operation, Erlinda Ramos already
surrendered her person to the private respondents who had complete and exclusive control over her.
Apart from the gallstone problem, she was neurologically sound and fit. Then, after the procedure, she
was comatose and brain damagedres ipsa loquitur!the thing speaks for itself!

Negligence Private respondents were not able to disprove the presumption of negligence on their part
in the care of Erlinda and their negligence was the proximate cause of her condition. One need not be an
anesthesiologist in order to tell whether or not the intubation was a success. [res ipsa loquitur applies
here]. The Supreme Court also found that the anesthesiologist only saw Erlinda for the first time on the
day of the operation which indicates unfamiliarity with the patient and which is an act of negligence and

The head surgeon, Dr. Hosaka was also negligent. He failed to exercise the proper authority as the
captain of the ship in determining if the anesthesiologist observed the proper protocols. Also, because
he was late, he did not have time to confer with the anesthesiologist regarding the anesthesia delivery.

The hospital failed to adduce evidence showing that it exercised the diligence of a good father of the
family in hiring and supervision of its doctors (Art. 2180). The hospital was negligent since they are the
one in control of the hiring and firing of their consultants. While these consultants are not employees,
hospitals still exert significant controls on the selection and termination of doctors who work there which
is one of the hallmarks of an employer-employee reationship. Thus, the hospital was allocated a share in
the liability.

Damages temperate damages can and should be awarded on top of actual or compensatory damages in
instances where the injury is chronic and continuing