CASE NO.

1
LEAH ALESNA REYES, ROSE NAHDJA, JOHNNY, and minors LLYOD and KRISTINE, all
surnamed, REYES, represented by their mother, LEAH ALESNA REYES,-Petitioners
vs.
SISTERS OF MERCY HOSPITAL, SISTER ROSE PALACIO, DR. MARVIE BLANES, and DR.
MARLYN RICO,-Respondents
GR NO. 130547 October 03, 2000

FACTS: Petitioner, Leah Alesna Reyes, is the wife of the deceased patient,
Jorge Reyes. Five days before the latter’s death, Jorge has been suffering
from recurring fever with chills. Since typhoid fever was common at that
time, the doctors confirmed through the Widal test that Jorge has typhoid
fever. However, he did not respond to the treatment and died. The cause
of his death was “Ventricular Arrythemia Secondary to Hyperpyrexia and
typhoid fever.”
Consequently, petitioner filed the instant case for damages before
the Regional Trial Court of Cebu City, which dismissed the case and was
affirmed by the Court of Appeals. The contention was that Jorge did not
die of typhoid fever. Instead, his death was due to the wrongful
administration of chloromycetin. They contended that had respondent
doctors exercised due care and diligence, they would not have
recommended and rushed the performance of the Widal Test, hastily
concluded that Jorge was suffering from typhoid fever, and administered
chloromycetin without first conducting sufficient tests on the patient’s
compatibility with said drug.

ISSUE: Whether or not Sisters of Mercy Hospital is liable for the death of
Jorge Reyes.

RULING: No. Sisters of Mercy Hospital is not liable for the death of Jorge Reyes.
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 reasonable 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.

Policy in Medical Negligence cases, it is incumbent upon the plaintiff

to establish that the usual procedure in treating the illness is not followed by
the doctor. Failure to prove this, the doctor is not liable. Physicians are not
insurers of the success of every procedure undertaken and if the procedure
was shown to be properly done but did not work, they cannot be faulted
for such result.
CASE NO. 2
ROGELIO P. NOGALES, for himself and on behalf of the minors, ROGER ANTHONY,
ANGELICA, NANCY, and MICHAEL CHRISTOPHER, all surnamed NOGALES,-
Petitioners
vs.
CAPITOL MEDICAL CENTER, DR. OSCAR ESTRADA, DR. ELY VILLAFLOR, DR. ROSE UY,
DR. JOEL ENRIQUEZ, DR. PERPETUA LACSON, DR. NOE ESPINOLA, and NURSE J.
DUMLAO,- Respondents
GR No. 142625 December 19, 2006

FACTS: Pregnant with her fourth child, Corazon Nogales, who was then 37
y/o was under the exclusive prenatal care of Dr. Oscar Estrada beginning
on her fourth month of pregnancy or as early as December 1975. While
Corazon was on her last trimester of pregnancy, Dr. Estrada noted an
increase in her blood pressure and development of leg edemas indicating
preeclampsia which is a dangerous complication of pregnancy. Around
midnight of May 26, 1976, Corazon started to experience mild labor pains
prompting Corazon and Rogelio Nogales to see Dr. Estrada at his home.
After examining Corazon, Dr. Estrada advised her immediate admission to
Capitol Medical Center (CMC). Upon her admission, an internal
examination was conducted upon her by a resident-physician. Based on
the doctor’s sheet, around 3am, Dr. Estrada advised for 10mg valium to be
administered immediately by intramuscular injection, he later ordered the
start of intravenous administration of syntociron admixed with dextrose, 5%
in lactated ringer’s solution, at the rate of 8-10 micro-drops per minute.
When asked if he needed the services of anesthesiologist, he refused.
Corazon’s bag of water ruptured spontaneously and her cervix was fully
dilated and she experienced convulsions. Dr. Estrada ordered the injection
of 10g of magnesium sulfate but his assisting Doctor, Dr. Villaflor, only
administered 2.5g. She also applied low forceps to extract Corazon’s baby.
In the process, a 10 x 2.5cm piece of cervical tissue was allegedly torn. The
baby came out in an apric, cyanatic weak and injured condition.
Consequently, the baby had to be intubated and resuscitated. Corazon
had professed vaginal bleeding where a blood typing was ordered and
she was supposed to undergo hysterectomy, however, upon the arrival of
the doctor, she was already pronounced dead due to hemorrhage.

After more than 11 years of trial, the trial court rendered judgment on
22 November 1993 finding Dr. Estrada solely liable for damages. Petitioners
appealed the trial court’s decision. Petitioners claimed that aside from Dr.
Estrada, the remaining respondents should be held equally liable for
negligence. Petitioners pointed out the extent of each respondent’s
alleged liability.

On appeal, the Court of Appeals affirmed the trial court’s ruling and
applied the “borrowed servant doctrine” to release the liability of other
medical staff. This doctrine provides that once the surgeon enters the
operating room and takes charge of the proceedings, the acts or omissions
of operating room personnel, and any negligence associated with such
acts or omissions, are imputable to the surgeon. While the assisting
physicians and nurses may be employed by the hospital, or engaged by
the patient, they normally become the temporary servants or agents of the
surgeon in charge while the operation is in progress, and liability may be
 imposed upon the surgeon for their negligent acts under the doctrine of
respondeat superior.

ISSUE: Whether or not in the conduct of child delivery, the doctors and the
respondent hospital is liable for negligence.

RULING: Yes. In general, a hospital is not liable for the negligence of an

independent contractor-physician. There is, however an exception to this
principle. 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.

For a hospital to be liable under the doctrine of apparent authority, a plaintiff must
show that:
1. the hospital, or its agent, acted in a manner that would lead a reasonable
person to conclude that the individual who was alleged to be negligent was
an employee or agent of the hospital;

2. Where the acts of the agent create the appearance of authority, the plaintiff
must also prove that the hospital had knowledge of and acquired in them; and

3. the plaintiff acted in reliance upon the conduct of the hospital or its agent,
consistent with ordinary care and prudence.

Borrowed servant doctrine provides that once a surgeon enters the operating
room and takes charge of the acts or omissions of operating room personnel and
any negligence associated with each acts or omissions are imputable to the
surgeon, while the assisting physicians and nurses may be employed by the
hospital, or engaged by the patient, they normally become the temporary
servants or agents of the surgeon in charge while the operation is in progress, and
liability may be imposed upon the surgeon for their negligent acts under the
doctrine of respondeat superior.
CASE NO. 3
PROFESSIONAL SERVICES, INC.,-Petitioner
vs.
NATIVIDA and ENRIQUE AGANA,-Respondents
GR No. 126297 January 31, 2007

FACTS: On April 4, 1984, Natividad Agana was rushed to the Medical City
General Hospital because of difficulty of bowel movement and bloody
anal discharge. After a series of medical examinations, Dr. Miguel Ampil
diagnosed her to be suffering from Cancer of the sigmoid. On April 11, 1984,
Dr. Ampil assisted by the medical staff of the Medical City Hospital
performed an Anterior resection surgery on Natividad. He found that the
malignancy on her sigmoid area had spread on her left ovary,
necessitating the removal of certain portions of it. Thus, Dr. Ampil obtained
the consent of Natividad’s husband, Enrique Agana, to permit Dr. Juan
Fuentes to perform hysterectomy on her. After Dr. Fuentes had completed
the hysterectomy, Dr. Ampil took over, completed the operation and
closed the incision after searching for the missing 2 gauzes as indicated by
the assisting nurses but failed to locate it. After a couple of days, Natividad
complained of excruciating pains in her anal region but Dr. Ampil said it is
a natural consequence of the operation/surgery and recommended that
she consult an oncologist to examine the cancerous nodes which were not
removed during the operation. Natividad and her husband went to the US
to seek further treatment and she was declared free from cancer. A piece
of gauze portruding from Natividad’s vagina was found by her daughter
which was then removed by hand by Dr. Ampil and assured that the pains
will vanished. However, it didn’t. The pains intensified prompting Natividad
to seek treatment at the Polymedic General Hospital. While confined there,
Dr. Ramon Guttierez detected the presence of another foreign object in
her vagina – a foul smelling gauze measuring 1.5 inches in width which
badly infected her vagina. A recto-vaginal fistula had forced stool to
excrete through her vagina. Another surgical operation was needed to
remedy the damage.

ISSUE: Whether or not Dr. Ampil and Fuentes are liable for medical
malpractice and the PSI for damages due to the negligence of the said
doctors.

RULING: Yes. An operation requiring the placing of sponges in the incision is

not complete until the sponges are properly removed and it is settled that
the leaving of sponges or other foreign substances in the wound after the
incision has been closed is at least prima facie negligence by the operating
surgeon. To put it simply, such act is considered so inconsistent with due
care as to raise inference of negligence. There are even legions of
authorities to the effect that such act is negligence per se.

This is a clear case of medical malpractice or more appropriately,

medical negligence. To successfully pursue this kind of case, a patient must
only prove that a health care provider either failed to do something which
a reasonably prudent health care provider would have done, or that he
did something that a reasonably prudent provider would not have done;
and that failure or action caused injury to the patient. Simply puts the
elements are duty, breach, injury, and proximate causation. Dr. Ampil, as
the lead surgeon, had the duty to remove all foreign objects, such as
gauzes, from Natividad’s body before closure of the incision. When he
failed to do so, it was his duty to inform Natividad about it. Dr. Ampil
breached both duties. Such breach caused injury to Natividad,
necessitating her further examination by American doctors and another
surgery. That Dr. Ampil’s negligence is the proximate cause of Natividad’s
injury could be traced from his act of closing the incision despite the
information given by the attending nurses that 2 pieces of gauze were still
missing. That they were later on extracted from Natividad’s vagina
established the causal link between Dr. Ampil’s negligence and the injury.
And what further aggravated such injury was his deliberate concealment
of this missing gauzes from the knowledge of Natividad and her family.
VII. NUISANCE
CASE LETTER G.

JOSE "PEPITO" TIMONER, petitioner,

vs.
THE PEOPLE OF THE PHILIPPINES AND THE HONORABLE COURT OF APPEALS, IV
DIVISION, respondents

G.R. No. L-62050 November 25, 1983

FACTS: At about 10:00 in the evening of December 13, 1971, petitioner, then
Mayor of Daet, Camarines Norte, accompanied by two uniformed
policemen, Samuel Morena and Ernesto Quibral, and six laborers, arrived in
front of the stalls along Maharlika highway, the main thoroughfare of the
same town. Upon orders of petitioner, these laborers proceeded to nail
together rough lumber slabs to fence off the stalls which protruded into the
sidewalk of the Maharlika highway. Among the structures thus barricaded
were the barbershop of Pascual Dayaon, the complaining witness and the
store belonging to one Lourdes Pia-Rebustillos. These establishments had
been recommended for closure by the Municipal Health Officer, Dra.
Alegre, for non-compliance with certain health and sanitation
requirements.

Thereafter, petitioner filed a complaint in the Court of First Instance

of Camarines Norte against Lourdes Pia-Rebustillos and others for judicial
abatement of their stalls, alleged that these stalls constituted public
nuisances as well as nuisances per se. Dayaon was never able to reopen
his barbershop business.

Subsequently, petitioner and the two policemen, Morena and

Quibral, were charged with the offense of grave coercion before the
Municipal Court of Daet. As already noted, the said court exonerated the
two policemen, but convicted petitioner of the crime charged as principal
by inducement.

On appeal, the Court of Appeals affirmed in full the judgment of the

trial court. Hence, the present recourse.

ISSUE: Whether or not Timoner committed Grave Coercion?

RULING: No. The petitioner was acquitted of the crime charged. He did not
commit Grave Coercon as the elements of Grave Coercion required that
he acted not under the authority of the law. As the then Mayor of the City,
Timoner had the authority to act on behalf of the recommendation and his
constituents’ right to public order and safety, and that such stalls along the
sidewalk affected the community and general public, as it is in a public
place, and was annoying to all who come within its sphere. The Supreme
Court did contend that the barbershop did constitute a public nuisance,
as defined under Article 694 and 695 of the Civil Code of the Philippines.
Furthermore, it had been recommended for closure by the Municipal
Health Officer.
 In the case at bar, petitioner, as mayor of the town, merely
implemented the aforesaid recommendation of the Municipal Health Officer.
Having then acted in good faith in the performance of his duty, petitioner
incurred no criminal liability.

Grave coercion is committed when "a person who, without authority of law, shall
by means of violence, prevent another from doing something not prohibited by
law or compel to do something against his will, either it be right or wrong." 1 The
three elements of grave coercion are: [1] that any person be prevented by
another from doing something not prohibited by law, or compelled to do
something against his will, be it right or wrong; [2] that the prevention or
compulsion be effected by violence, either by material force or such display of it
as would produce intimidation and control the will of the offended party, and [3]
that the person who restrained the will and liberty of another had no right to do
so, or, in other words, that the restraint was not made under authority of law or in
the exercise of a lawful right.
II. ACTUAL/COMPENSATORY
CASE LETTER A.
W. E. HICKS, plaintiff-appellant,
vs.
MANILA HOTEL COMPANY, defendant-appellee.
G.R. No. L-9973 November 6, 1914

FACTS: on the 9th of November 1912, plaintiff and defendant entered into a
written contract by which the defendant ceded to the plaintiff the
exclusive right to serve its patrons with five-passenger automobiles for a
period of one year with certain rights with respect to a renewal of the
contract for a second year. Plaintiff entered on the performance of his
duties under the contract and successfully discharged them during the first
yea. When about half of the first year had expired, the defendant
company, disregarding, as plaintiff claims, the terms of its agreement with
him, invited proposals from various garages for its five-passenger
automobile privilege for the ensuing year, that is, from November, 1913, to
November, 1914, the time covered by the second year of plaintiff's
contract. Under these proposals various garages competed for the
privilege, including that of George E. Brown, and, after certain negotiations
with the latter, his offer was accepted by the defendant company and a
written contract made with him for the exclusive right to the privilege during
the year. This contract with Brown was executed some months prior to the
termination of the first year of plaintiff's contract. Upon the termination of
the first year of the contract the defendant company having, as we have
seen, already entered into a contract with Brown relative to the matter
included in plaintiff's contract for the period representing the second year
thereof, refused, over plaintiff's objections and protests, to permit him to
continue for the second year, deprived him of the privilege which the
contract conferred, and evicted him from the hotel where, under the terms
of the contract, he was entitled to have and did have an office.

This action was brought to recover damages for breach of contract.

ISSUE: Whether or not Hicks is entitled to the P10,800, basing that the claim
upon the profits which he would have received if he had continued the
business for the second year?

RULING: Yes. There is more or less inaccuracy in every action for damages for
breach of contract but inn order to justify a recovery in any case, assuming
that a breach has been committed, there are two necessary elements to
be considered: One that a damage has been done; the other that such
damage is the result of the breach. The amount of the one should be
computed with reasonable accuracy. The fact of the other must be
determined with reasonable certainty. A less degree of accuracy is
required in the former than of certainty in the latter, but neither is required
to be absolute or beyond conjectural possibilities. Where it reasonably
appears that a party has been damaged, and that such damage is the
direct result of the breach, then a recovery is justified. The next step is to
ascertain how much will reasonably compensate the injured party. This
should be computed by the plainest, easiest, and most accurate measure
which will do justice in the premises, and if from the conditions in the
contract, and the nature of the breach, it reasonably appears that the
extent or amount of damages may be more readily, easily, correctly, and
justly ascertained by applying the loss of profits as a measure, if it is evident
that profits were lost and the amount thereof can be calculated with
reasonable accuracy, then such profits are the true measure to be applied.
In such cases, however, it should appear evident that profits were lost. The
amount may be estimated with only reasonable accuracy; but the fact
that profits were lost should require stricter proof.

In the case before us there seems to be as little speculation in

determining the profits which the plaintiff might have recovered as is usual
in cases where the time for which the profits are to be recovered extends
over a considerable period of time. It is undisputed that the business was a
very profitable one the first year and that the second year would have
been more profitable than the first. While the estimate of the amount of
profits for the second year is an estimate of necessity, it is one which is based
upon facts testified to by the plaintiff, which were within his knowledge and
which appear to the court to sustain his contention. While the evidence is
not as conclusive as in cases where the damages are certain and capable
of accurate statement, we are satisfied with its sufficiency, particularly in
view of the fact that all that courts may require of litigants is the production
of the best evidence of which the case is susceptible.

As to whether or not the plaintiff in an action of this character may

recover only that portion of the profits which had accrued up to the time
of bringing the action, or whether he may sue for all the damages resulting
from the breach in a single action, even though that action is begun long
before the period during which the profits will accrue has expired, we may
say that, in our judgment, the weight of authority is to the effect that the
plaintiff need bring but one action and that he may recover the damages
sustained for the whole period even though it be by anticipation