Human Body Examination

Head Injury
People v. Tabobo
G.R. No. 137274-75 October 18, 2002
FACTS:
The appellant, DAN AVE, was charged with the crimes of Frustrated Murder and Murder before the Regional Trial
Court of Urdaneta, Pangasinan.

The prosecution established that in the evening of August 24, 1996, Pedro Valenzuela, Jr., Atty. Napoleon
Valenzuela, Isidro (Benito) Ave, Calixto Valenzuela, Leopoldo Valenzuela, and Rogelio Gacad had a drinking
spree in the vicinity of the house of Pedro Valenzuela, Jr.

At about 9:00 p.m., Rogelio Gacad found the need to answer the call of nature. With his back facing his
companions, he relieved himself on a spot about five (5) or six (6) meters away from them.

Out of nowhere, the appellant appeared. Unnoticed by the group, the appellant stood behind Pedro and fired at
him with a long firearm from a distance of about three (3) meters. Pedro was hit at the back of his head and he
slumped on the makeshift table. Atty. Valenzuela stood up and checked on Pedro. However, the appellant shot
Atty. Valenzuela, the bullet hitting his stomach. The group scampered to safety.

Atty. Valenzuela survived the attack due to the immediate medical treatment he received from Dr. Candido San
Juan of the Urdaneta Sacred Heart Hospital (USHH).

Diagnosis on the injuries sustained by Atty. Valenzuela: Dr. San Juan explained that the bullets point of entry
was in the abdomen. The slug entered the abdominal cavity and hit the right lobe of the liver and the ascending
portion of the large intestine or colon. The slug lodged near the pelvic area, at the back, of Atty. Valenzuela.

He opined that Atty. Valenzuela would have died if not for the immediate medical assistance he got at the hospital.
Considering the location of the gunshot wound, Dr. San Juan said that the assailant could have been facing Atty.
Valenzuela, or could have been standing beside him during the attack.

Autopsy Report to the body of Pedro Valenzuela: Gunshot wound head, left parietal region 5mm. x 5mm. x 6
cm. deep directed upwards. Fracture, circular left parietal bone; Slug recovered at right frontal area between brain
and right frontal bone.; Cerebral hemorrhage and injury, left parietal lobe to right frontal lobe brain.

Cause of Death is Cerebral Hemorrhage and Injury, left parietal lobe to right frontal lobe, brain due to Gunshot
Wound Head.

Defense’s version: On his way home, the appellant again passed by the place where Pedros group had been
drinking. Leopoldo Valenzuela confronted him and said, We were calling for you when you passed by, but you did
not even mind us. The appellant apologized and explained that he did not notice them. Leopoldo asked him to join
them. At first, the appellant refused but later relented in order not to slight Leopoldo.

Calixto still badmouthed him and charged him of being arrogant. Thereafter, Calixto reached out for a long firearm
and aimed it at him. They grappled for the firearm. During the struggle, the trigger accidentally went off. Calixto
uttered, vulva of your mother, get loose of the gun. The appellant was able to push Calixto away and ran to his
house. He related the incident to his mother.

Essentially, these evidence, according to the appellant are: (1) The prosecution’s evidence on the sitting
arrangements of the deceased victim and his companions during the shooting incident are allegedly full of
inconsistencies. (2) Rogelio lied when he demonstrated at the trial how the appellant shot the victims since, at
that time, Rogelio was urinating and he turned around only after he had heard the two (2) successive gunshots.
(3) The trajectory of the bullets that hit Pedro and Atty. Valenzuela, per the medical findings of Dr. San Juan, are
inconsistent with the testimonies of Leopoldo and Rogelio on the position of the appellant vis-a-vis his victims,
Pedro and Atty. Valenzuela. For instance, Rogelio claimed that he (the appellant) was on the east side of the two
(2) victims when he shot Pedro. However, the medical report of Dr. Gonzales, Jr. showed that the fatal bullet
entered the left portion of Pedros head. The appellant argues that if he were in the east when he shot Pedro, the
head injury would have been on the right side, not on the left side.

ISSUE:
Whether his guilt was established beyond reasonable doubt
RULING:
YES, his guilt was established beyond reasonable doubt
It is elementary that not all inconsistencies in the witnesses testimony affect their credibility. Inconsistencies on
minor details and collateral matters do not affect the substance of their declaration, their veracity, or the weight of
their testimonies.43 Thus, although there may be inconsistencies on the testimonies of witnesses on minor
details, the same do not impair the credibility of the witnesses where there is consistency in relating the principal
occurrence and positive identification of the assailants.

In the cases at bar, it was fully established that prosecution witnesses Leopoldo, Atty. Valenzuela and Rogelio
Gacad were at the crime scene during the shooting incident. They unanimously identified the appellant as the
assailant. They declared that the appellant appeared at the scene unnoticed and suddenly fired two (2)
successive shots at them. One shot was for Pedro who was hit in the head, the other, for Atty. Valenzuela who
was seriously wounded in the stomach. They identified the weapon used as a long firearm.

It is clear that Rogelio did not see the exact positions of the appellant and Pedro when the first shot was fired.
What he saw then was that Pedro was hit in the head and slumped on the bamboo bed while Atty. Valenzuela was
hit in the stomach while about to help Pedro. It was only then that Rogelio saw the appellant who was armed with
a long firearm, standing behind Pedro. Clearly, the sketch drawn by Rogelio pertains to the positions of the
protagonists after, and not during the shots were fired. The alleged inconsistency is, therefore, more imaginary
than real.

As for the injury of Atty. Valenzuela, the records show that he was moving when the appellant shot himhe was
turning to his right to check on Pedro after the first gunshot. Thus, the appellant was almost in front, or, at the very
least, at the side of Atty. Valenzuela, although he was still standing behind Pedro, when the second shot was fired.

The foregoing position of the parties is consistent with the medical opinion of Dr. San Juan. He explained that the
trajectory of the bullet as it entered the right side of the stomach of Atty. Valenzuela showed that the appellant was
in front or at the side of the said victim. 46 He opined that Atty. Valenzuela could have been in a stooping position
when he was shot in such a stooping position, it was not far-fetched that the bullets entry was at the right side of
his stomach and for the slug to lodge on the right side of his pelvic area, at the back.
Trunk Injuries
People v. Togahan
G.R. No. 174064 2007
FACTS:
On 12 May 2000, at around 6:30 p.m., Magdalena Villar (Mrs. Villar), her daughter Vilma Villar-Richardson (Mrs.
Richardson), son-in-law Richardson, grandchildren Kenneth, Kevin, Junelyn, Jovelyn and Michelle, and brother
Pedro Castillo were all watching television in the living room of their residence in Spring, Amaga, Barobo, Surigao
del Sur. Without warning, two armed men wearing bonnets suddenly arrived. At that time, the victim Villar,
husband of Mrs. Villar, was in his room. When Villar heard the commotion, he went to the door and tried to
prevent the armed men from entering, but he was shot twice, pulled towards the balcony and clubbed to death.

When Mrs. Richardson heard gunfire, she asked the men: Who are you, what do you want? To this, Lauro replied:
We are here for war.[7] Mrs. Richardson told her husband to run away but the latter, in an attempt to protect his
wife, struggled and tried to wrestle the gun away from Togahan instead. In the course thereof, Lauro shot
Richardson then ran out of the house with Richardsons 3-year old son.[8] Richardson, in spite of his wound,
chased Lauro but was later found sitting on the mud, unable to talk and dying. The rest of the family had fled
during the commotion and sought refuge. Villar and Richardson were brought to DO Plaza Memorial Hospital in
Patin-ay, Prosperidad, Surigao del Sur but were dead upon arrival.

Eyewitness Lowelito Villar (Lowelito), grandson of victim Villar, testified that on the evening of the incident, he was
in his home about fifteen (15) meters away from his grandparents house when he heard a gun burst. He
immediately ran towards the house of his grandparents and hid behind a coconut tree, also about fifteen (15)
meters from victim Villars house. He claims to have seen three (3) armed and masked men he identified as
Togahan, Lauro and Balindo enter the victims house. According to the witness, Lauro shot Richardson in the
house whereas Lauro and Balindo shot and clubbed his grandfather in the balcony. After the attack, all the
accused ran out of the house, removing their masks in the process. Witness Lowelito maintained that he had
been friends with the accused for five (5) years and recognized them because of their physical features and
movements and that he could see the events that transpired as there were fluorescent lamps lit inside and outside
the house.

Dr. Edgar Savella, Medico-Legal Officer of the National Bureau of Investigation Caraga Region, conducted an
autopsy of the bodies of the victims. Dr. Savella testified that the gunshot wound sustained by Richardson on his
abdomen was fatal and caused his death, the bullet having hit the sciatic artery on his right leg, as well as his
vertebrae in the lumbar area. Gunshot wound[,] right lower quadrant; Hematoma[,] right leg lateral aspect;
Abrasion, [l]inear right shoulder; Abrasion, linear lumbar area

Villar, on the other hand, died of multiple gunshot wounds to his chest and abdomen.[16] Dr. Savella found no
indication of self-defense or struggle-related injuries on both Villar and Richardson. Gunshot wound[,]
suprasternal area; Gunshot wound[,] left flank at the level of umbilicus; Gunshot wound[,] right upper quadrant
parasternal; Lacerated wound[,] on left post auricular area

Defense version: An alibi was given stating that they were in their respective homes while the crime took place

ISSUE:
Whether their guilt was established beyond reasonable doubt

RULING:
YES, their guilt was established beyond reasonable doubt
Concomitantly, witnesses need not know the names of the malefactors so long as they recognize their faces.
What is imperative is that the witnesses are positive as to the perpetrators physical identification from the
witnesses own personal knowledge, as is obtaining in this case.[38] It is the natural reaction of victims of criminal
violence to strive to see the appearance of their assailants and to observe the manner in which the crime was
committed. Most often, the face and body movements of the assailant create an impression which cannot easily
be erased from their memory.

While witnesses may differ in their recollections of an incident, it does not necessarily follow from their
disagreement that all of them should be disbelieved as liars and their testimonies completely discarded as
worthless.[41] As long as the mass of testimony jibes on material points, the slight clashing statements neither
dilute the witnesses credibility nor the veracity of their testimony,[42] for indeed, such inconsistencies are but
natural and even enhance credibility as these discrepancies indicate that the responses are honest and
unrehearsed.[43]
Witnesses cannot be expected to remember all the details of the harrowing event which unfolded before their
eyes. Minor discrepancies might be found in their testimony, but they do not damage the essential integrity of the
evidence in its material whole, nor should they reflect adversely on the witness credibility as they erase suspicion
that the same was perjured.

The trial court is correct in disregarding appellants defense of alibi and denial. For the defense of alibi to prosper,
the accused must prove not only that he was at some other place at the time of the commission of the crime but
also that it was physically impossible for him to be at the locus delicti or within its immediate vicinity.[45] Apart
from testifying with respect to the distance of their houses from that of the victims, appellants were unable to
explain and show that it was physically impossible for them to be at the scene of the crime.
Abdominal Injury
Mahawan v. CA
G.R. No. 176609 2008

FACTS:
On 5 October 1996, at about 9:30 p.m., Paradero was tending her store when petitioner arrived and asked her for
a bottle of beer. She told petitioner that there was no more beer. When she was about to open the refrigerator in
the store to show petitioner that there was really no more beer, petitioner sneaked inside the store. She closed the
refrigerator and faced petitioner. Suddenly, petitioner pulled out a gun (caliber .38 revolver) and shot her on the
left chest. She retreated and fell on the ground. As petitioner moved closer to her, she grabbed a kitchen knife
nearby to defend herself. Petitioner shot Paradero again but the bullet this time merely grazed her left earlobe.
Petitioner snatched the kitchen knife from her hand and fled the store.

She also underwent a surgical operation on her colon (large intestine), liver and diaphragm as these vital organs
were hit by the trajectory of the bullet. Dr. Guardiario performed the said treatment and operation.

Defence’s version: On 5 October 1996, at around 9:30 p.m., petitioner went to Paradero's store to buy cigarettes.
Upon arriving there, he saw Paradero standing near the store's door. He asked Paradero if he could buy
cigarettes. Paradero replied in a loud voice that she did not have any stock of cigarettes. Suddenly, Paradero,
then holding a knife, went out of the store and approached him. Paradero tried to stab him with the knife but he
parried the thrust. He and Paradero grappled for possession of the knife causing him injury on the left finger. He
did let go of Paradero. The latter, however, attacked him again with the knife. This time he was slightly hit by the
knife on the stomach. He drew his firearm and shot Paradero who, upon being hit by the bullet, slumped on the
ground. He took Paradero's knife and went home.

ISSUE:
Whether he should be acquitted on the grounds of self-defense

RULING:
NO, the elements of self-defense is absent
The subsequent disposition of the RTC implies that although the prosecution failed to show by sufficient evidence
that it was petitioner who first attacked Paradero, the defense likewise failed to establish that unlawful aggression
on the part of Paradero preceded petitioner's attack on her. This, in effect, means that petitioner failed to
discharge his burden of proving with clear and convincing evidence that there was unlawful aggression on the
part of Paradero.
Paradero testified that on the night of the incident, petitioner went to her store and asked for a bottle of beer.
When she told petitioner that there was no more beer, the latter entered her store, confronted her, and shot her
with a gun. There is nothing in the foregoing which evinces unlawful aggression on the part of Paradero. What is
clear is that petitioner was the aggressor during the incident. We have carefully examined the testimony of
Paradero and found it to be credible and trustworthy. She testified in a clear and consistent manner during the
trial.
On the other hand, petitioner narrated that when he went to Paradero's store to buy cigarettes, the latter replied in
a loud voice that she did not have any stock of cigarettes. Paradero, then holding a knife, suddenly went out of
the store and attacked him. This testimony does not inspire belief. It is inconsistent with logic and human
experience that after Paradero told petitioner that there were no more cigarettes, Paradero would thereafter
immediately attack petitioner. Precisely, there was no reason for Paradero to be angry and thereupon assault
petitioner. It was petitioner who had more reason to be angry and attack Paradero, because the latter had told him
in a loud voice that there were no more cigarettes.
In stark contrast, Paradero sustained a gunshot wound on the left chest. The trajectory of the bullet hit and
seriously injured her liver, colon and diaphragm. This caused her to undergo two surgical operations. She also
sustained wounds on her left forearm, right wrist and left earlobe. Based on the foregoing, it is difficult to believe
that Paradero was the unlawful aggressor.
In the case at bar, there was no reason or necessity for petitioner to shoot Paradero with a gun. Paradero was
merely tending her store and did not attack or place in danger the life of petitioner during the incident. Even if we
are to adopt petitioner's version of the incident, his act of shooting Paradero would not also be a reasonable and
necessary means of repelling the aggression allegedly initiated by Paradero. In addition, petitioner was armed
with a gun while Paradero supposedly held a knife. Petitioner should have fired a warning shot first to ward off
Paradero or, if the latter persisted in attacking, fired a shot at a non-vital portion of her body in order to disable her
instead of shooting her instantly in the chest. Further, when Paradero allegedly approached and tried to stab him,
petitioner was not trapped or cornered in a specific area such that he had no way out. He testified that he and
Paradero were outside the store during the incident. He could have run away and called the neighbors or police
for help. In short, petitioner had other less harmful options than to shoot Paradero. Indeed, petitioner's act failed to
pass the test of reasonableness of the means employed in preventing or repelling an unlawful aggression.
Dr. Guardiario testified that the injury on Paradero's colon was fatal and would have caused her death were it not
for the timely medical attention given her.41 The seriousness of Paradero's injuries was also shown by the fact
that she was confined and operated on twice in different hospitals for the wound sustained in the colon. Verily, the
foregoing circumstances clearly manifest intent to kill on the part of petitioner.
Cardio-Respiratory Physiology
Ramos v. CA
G.R. No. 124354 April 11,2002

FACTS:
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.

ISSUE:
Whether the Surgeon, Anesthesiologist, and the Hospital is guilty for damages

RULING:
YES, they are all guilty for damages
Res ipsa loquitur is a Latin phrase which literally means the thing or the transaction speaks for itself. The phrase
res ipsa loquitur 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.[13] Where the thing which caused
the injury complained of is shown to be under the management of the defendant or his servants and the accident
is such as in ordinary course of things does not happen if those who have its management or control use proper
care, it affords reasonable evidence, in the absence of explanation by the defendant, that the accident arose from
or was caused by the defendants want of care.[14]

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
defendant who is charged with negligence.[15] 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.[16] Hence, res ipsa loquitur is applied in conjunction with the doctrine of
common knowledge.

However, much has been said that res ipsa loquitur is not a rule of substantive law and, as such, does not create
or constitute an independent or separate ground of liability.[17] Instead, it is considered as merely evidentiary or in
the nature of a procedural rule.[18] It is regarded as a mode of proof, or a mere procedural convenience since it
furnishes a substitute for, and relieves a plaintiff of, the burden of producing specific proof of negligence.[19] In
other words, mere invocation and application of the doctrine does not dispense with the requirement of proof of
negligence. It is simply a step in the process of such proof, permitting the plaintiff to present along with the proof
of the accident, enough of the attending circumstances to invoke the doctrine, creating an inference or
presumption of negligence, and to thereby place on the defendant the burden of going forward with the proof.[20]
Still, before resort to the doctrine may be allowed, the following requisites must be satisfactorily shown:
1. The accident is of a kind which ordinarily does not occur in the absence of someones negligence;
2. It is caused by an instrumentality within the exclusive control of the defendant or defendants; and
3. The possibility of contributing conduct which would make the plaintiff responsible is eliminated.

Although generally, expert medical testimony is relied upon in malpractice suits to prove that a physician has done
a negligent act or that he has deviated from the standard medical procedure, when the doctrine of res ipsa
loquitur is availed by the plaintiff, the need for expert medical testimony is dispensed with because the injury itself
provides the proof of negligence.[27] The reason is that the general rule on the necessity of expert testimony
applies only to such matters clearly within the domain of medical science, and not to matters that are within the
common knowledge of mankind which may be testified to by anyone familiar with the facts.[28] Ordinarily, only
physicians and surgeons of skill and experience are competent to testify as to whether a patient has been treated
or operated upon with a reasonable degree of skill and care.

However, testimony as to the statements and acts of physicians and surgeons, external appearances, and
manifest conditions which are observable by any one may be given by non-expert witnesses.[29] Hence, in cases
where the res ipsa loquitur is applicable, the court is permitted to find a physician negligent upon proper proof of
injury to the patient, without the aid of expert testimony, where the court from its fund of common knowledge can
determine the proper standard of care.[30] Where common knowledge and experience teach that a resulting
injury would not have occurred to the patient if due care had been exercised, an inference of negligence may be
drawn giving rise to an application of the doctrine of res ipsa loquitur without medical evidence, which is ordinarily
required to show not only what occurred but how and why it occurred.[31] When the doctrine is appropriate, all
that the patient must do is prove a nexus between the particular act or omission complained of and the injury
sustained while under the custody and management of the defendant without need to produce expert medical
testimony to establish the standard of care. Resort to res ipsa loquitur is allowed because there is no other way,
under usual and ordinary conditions, by which the patient can obtain redress for injury suffered by him.

It is generally restricted to situations in malpractice cases where a layman is able to say, as a matter of common
knowledge and observation, that the consequences of professional care were not as such as would ordinarily
have followed if due care had been exercised.[37] A distinction must be made between the failure to secure
results, and the occurrence of something more unusual and not ordinarily found if the service or treatment
rendered followed the usual procedure of those skilled in that particular practice. It must be conceded that the
doctrine of res ipsa loquitur can have no application in a suit against a physician or surgeon which involves the
merits of a diagnosis or of a scientific treatment.[38] The physician or surgeon is not required at his peril to explain
why any particular diagnosis was not correct, or why any particular scientific treatment did not produce the
desired result.

Considering that a sound and unaffected member of the body (the brain) is injured or destroyed while the patient
is unconscious and under the immediate and exclusive control of the physicians, we hold that a practical
administration of justice dictates the application of res ipsa loquitur. Upon these facts and under these
circumstances the Court would be able to say, as a matter of common knowledge and observation, if negligence
attended the management and care of the patient. Moreover, the liability of the physicians and the hospital in this
case is not predicated upon an alleged failure to secure the desired results of an operation nor on an alleged lack
of skill in the diagnosis or treatment as in fact no operation or treatment was ever performed on Erlinda. Thus,
upon all these initial determination a case is made out for the application of the doctrine of res ipsa loquitur.

On Proximate Cause: Scientific studies point out that intubation problems are responsible for one-third (1/3) of
deaths and serious injuries associated with anesthesia.[69] Nevertheless, ninety-eight percent (98%) or the vast
majority of difficult intubations may be anticipated by performing a thorough evaluation of the patients airway prior
to the operation.[70] As stated beforehand, respondent Dra. Gutierrez failed to observe the proper pre-operative
protocol which could have prevented this unfortunate incident. Had appropriate diligence and reasonable care
been used in the pre-operative evaluation, respondent physician could have been much more prepared to meet
the contingency brought about by the perceived anatomic variations in the patients neck and oral area, defects
which would have been easily overcome by a prior knowledge of those variations together with a change in
technique.[71] In other words, an experienced anesthesiologist, adequately alerted by a thorough pre-operative
evaluation, would have had little difficulty going around the short neck and protruding teeth.[72] Having failed to
observe common medical standards in pre-operative management and intubation, respondent Dra. Gutierrez
negligence resulted in cerebral anoxia and eventual coma of Erlinda.

In Re Anesthesiologist: With regard to Dra. Gutierrez, we find her negligent in the care of Erlinda during the
anesthesia phase. As borne by the records, respondent Dra. Gutierrez failed to properly intubate the patient. This
fact was attested to by Prof. Herminda Cruz, Dean of the Capitol Medical Center School of Nursing and
petitioner's sister-in-law, who was in the operating room right beside the patient when the tragic event occurred.

The pre-operative evaluation of a patient prior to the administration of anesthesia is universally observed to
lessen the possibility of anesthetic accidents. Pre-operative evaluation and preparation for anesthesia begins
when the anesthesiologist reviews the patients medical records and visits with the patient, traditionally, the day
before elective surgery.[53] It includes taking the patients medical history, review of current drug therapy, physical
examination and interpretation of laboratory data.
In the case at bar, respondent Dra. Gutierrez admitted that she saw Erlinda for the first time on the day of the
operation itself, on 17 June 1985. Before this date, no prior consultations with, or pre-operative evaluation of
Erlinda was done by her. Until the day of the operation, respondent Dra. Gutierrez was unaware of the
physiological make-up and needs of Erlinda. She was likewise not properly informed of the possible difficulties
she would face during the administration of anesthesia to Erlinda. Respondent Dra. Gutierrez act of seeing her
patient for the first time only an hour before the scheduled operative procedure was, therefore, an act of
exceptional negligence and professional irresponsibility. The measures cautioning prudence and vigilance in
dealing with human lives lie at the core of the physicians centuries-old Hippocratic Oath. Her failure to follow this
medical procedure is, therefore, a clear indicia of her negligence.

Elective procedures, on the other hand, are operative procedures that can wait for days, weeks or even months.
Hence, in these cases, the anesthesiologist possesses the luxury of time to make a proper assessment, including
the time to be at the patient's bedside to do a proper interview and clinical evaluation. There is ample time to
explain the method of anesthesia, the drugs to be used, and their possible hazards for purposes of informed
consent. Usually, the pre-operative assessment is conducted at least one day before the intended surgery, when
the patient is relaxed and cooperative. Erlindas case was elective and this was known to respondent Dra.
Gutierrez. Thus, she had all the time to make a thorough evaluation of Erlindas case prior to the operation and
prepare her for anesthesia. However, she never saw the patient at the bedside. She herself admitted that she had
seen petitioner only in the operating room, and only on the actual date of the cholecystectomy. She negligently
failed to take advantage of this important opportunity. As such, her attempt to exculpate herself must fail.
Medico-legal Aspects Physical Injuries:
A. Medico-legal classification of wounds
Stab Wound
People v. Camano
G.R. No. L- 36662-63 July 30,1982
FACTS:
On February 17, 1970, in the barrio of Nato, Municipality of Sagñay, Province of Camarines Sur, between the
hours of four and five o'clock in the afternoon, after the accused had been drinking liquor, he stabbed twice the
victim Godofredo Pascua with a bolo while the latter was walking alone along the barrio street almost infront of
the store of one Socorro Buates.
The victim, Godofredo Pascua, sustained two mortal wounds for which he died instantaneously, described by Dr.
Constancio A. Tan, Municipal Health Officer, of Sagñay Camarines Sur, in his Autopsy Report (Exhibit "A", pp. 5,
Record Crim. Case No. T-21) as follows:
NATURE OF WOUNDS UPON AUTOPSY: WOUND STAB - three (3) inches long at left side, three (3) inches
below left axilla, a little bit posteriorly, cutting the skin, subcutaneous tissues, muscles one (1) rib, pleura of left
lung, pericardium, penetrating the ventricles of the heart, Media stinum, the right lung and exit to the right chest.
One inch opening.
After hacking and stabbing to death Godofredo Pascua, the accused proceeded to the seashore of the barrio, and
on finding Mariano Buenaflor leaning at the gate of the fence of his house, in a kneeling position, with both arms
on top of the fence, and his head stooping down hacked the latter with the same bolo, first on the head, and after
the victim fell and rolled to the ground, after said blow, he continued hacking him, until he lay prostrate on the
ground, face up, when the accused gave him a final thrust of the bolo at the left side of the chest above the nipple
running and penetrating to the right side a little posteriorly and superiorly with an exit at the back, of one (1) inch
opening, (Exhibit B) causing instant death.

NATURE OF WOUNDS UPON AUTOPSY: (1) WOUND STAB, Two (2) inches long at the left side of chest above
the nipple, running to the right side a little posteriorly and superiorly with an exit at the back of one (1) inch
opening. Penetrating the skin, subcutaneous tissues, pericardium the auricles of the heart, the left lung towards
the right side of back. (2) WOUND STAB at sternum one and one-half (1-1/2) inches deep three-fourth (3/4) inch
long penetrating the skin and the sternum. (3) WOUND STAB left side of neck three-fourth (3/4) inch long one and
one-half (1-1/2) inches deep. (4) WOUND HACKED, cutting left ear and bone four (4) inches long. (5) WOUND
HACKED, left leg three (3) inches long cutting skin and bone of anterior side. (6) WOUND INCISED left palm two
(2) inches long. (7) WOUND STAB, one (1) inch long two (2) inches deep at the back near spinal column. (8)
WOUND HACKED, two (2) inches long at dome of head cutting skin and bone.

CAUSE OF DEATH - Wound number one (1) causing instant death due to severe hemorrhage from the heart."
Out of the eight (8) wounds, two (2) are mortal wounds, namely wound Number one (1) and wound Number Three
(3)
Defense’s version: His version of the incident is that in the early morning of February 17, 1970, he was fishing in
the open sea. He went ashore at about 7:00 o'clock in the morning and was met by Mariano Buenaflor who, upon
seeing that he had a big catch, demanded a percentage. for the fishery commission. When he refused to give
what was asked, Buenaflor remarked that he was hard-headed.

While he was standing in the yard of his house, Mariano Buenaflor, Godofredo Pascua, Gorio Carable, Jesus
Carable, Tomas Carable, Abelardo Bolaye, Amado Payago, and Loreto Payago, who were drinking at the store of
Socorro Buates, went to him and Godofredo Pascua, without any provocation whatsoever, boxed him. He
recounted what happened next: "I defend myself but inspite of that I was hit on my upper arm.

"When I met Godofredo Pascua he was on the act of boloing me but I was able to take hold of his hands and I
was able to grab the bolo. After I have taken the bolo from Godofredo Pascua, all I know is that he fell on the
ground and the rest of the group except Mariano Buenaflor run away after seeing that Godofredo Pascua fell
already on the ground. Mariano Buenaflor approached me having also a bolo then immediately when we meet
each other I boloed him and when he has wounded he run away and when he was running away I run after him.
After I have boloed Mariano Buenaflor he run away so I run after him because I know that he has a gun and if he
reach home he will get that gun and he might shoot me." 5 Mariano Buenaflor was hit on the head.

ISSUE:
Whether the crime should be downgraded to homicide

RULING:
NO, the crime is murder for the presence of treachery
The autopsy report, 11 showed that the point of entry of the stab wound inflicted upon Pascua was three (3)
inches long and three (3) inches below the left armpit, a little bit posteriorly or toward the hinder end of the body;
and the point of exit was the right chest, one (1) inch Iateral to the right nipple with a one (1) inch opening. If the
deceased was stabbed while he was facing his assailant, as claimed by counsel for the accused, the entrance
wound would have been in the front part of the body, and its exit wound, if any, would be at the back. The trial
court, therefore, did not commit an error in finding that the deceased Godofredo Pascua was assaulted from
behind.

With respect to Mariano Buenaflor, the evidence shows that he was attacked while in a kneeling position, with his
arms on top of the gate of the fence surrounding his hut and his head was "stooping down." 12 He was hacked on
the head, causing him to fall to the ground, and then successively hacked and stabbed without respite, as he lay
on the ground, until he died. The attack was also sudden, unexpected, and lethal, such as to disable and
incapacitate the victim from putting up any defense.
 Stab Wound

PEOPLE OF THE PHILIPPINES, plaintiff-appellee, vs. BERNARDINO DOMANTAY, @ JUNIOR OTOT,

accused-appellant.
G.R. No. 130612. May 11, 1999

Facts:
The body of Jennifer Domantay (6 years old) was found in a bamboo grove at around four o'clock in the afternoon
of October 17,1996. Her body bore stab wounds. The medical examination conducted by Dr. Ma. Fe Letecia
Macaranas showed that Jennifer died of multiple organ failure and hypovolemic shock secondary to 38 stab
wounds at the back. The doctor did not found any laceration or signs of inflammation of the outer and inner labia
and vaginal walls of the victims genitalia, although the vaginal canal easily admitted the little finger with minimal
resistance. Noting possible commision of acts of lasciviousness, Dr. Macaranas recommended an autopsy by a
medico-legal expert of the NBI.

Police investigation pointed Bernardino Domantay, a cousin of the victim's grandfather, as the lone suspect. That
when he was picked up by the police for questioning, he confessed to the killing of Jennifer, He also disclosed
that he had given the fatal weapon used, a bayonet, to Elsa and jorge Casingal (his aunt and uncle).

A complaint for murder was filed against him. October 25, 1996, Dr. Ronald Bandonill, medico-legal expert of the
NBI, performed an autospy on the embalmed body of Jennifer, wherein he found that after examining the genitalia
of the victim the hymen had been completely laceration on the right side. Due to the report of the medico-legal,
the complaint against Bernardino was amended to rape with homicide.

Information filed: "That on or about the 17th day of October, 1996, in the afternoon, in barangay Guilig,
Municipality of Malasiqui, province of Pangasinan, Philippines and within the jurisdiction of this Honorable Court,
the above-named accused, with lewd design and armed with a bayonnete, did then and there, wilfully, unlawfully
and feloniously have sexual intercourse with Jennifer Domantay, a minor of 6 years old against her will and
consent, and on the same occasion, the said accused with intent to kill, then and there, wilfully, unlawfully and
feloniously stab with the use of a bayonnete, the said Jennifer Domantay, inflicting upon her multiple stab wounds,
which resulted to her death, to the damage and prejudice of her heirs."

During trial, seven witnesses where presented.

Edward Domantay testified that Bernardino and his two brothers-in-law (Jaime and Daudencio) had a round of
drinks, while he (Edward was across tending to some pigeons). Edward later joined the group, and that
Bernardino who had too much to drink said that he "will massacre somebody here and they will cry and cry".
Edward saw that tucked on the left side of Bernardino is a bayonet without a cover. (it was not the first time that
he carried it, it was usually with him)

Jiezl Domantay testified that she saw Bernardino and Jennifer walking towards the bamboo grove at about 2 in
the afternoon, while she was playing with other children.

Lorenzo Domantay corroborated Jiezl's testimony and said that he saw Bernardino about 30 meters away from
the spot where Jennifer's body was found and appeared to be restless and worried.

Prosecution witness Joselito Mejia (tricycle driver) said that Bernardino asked him to take him to Malasiqui
(place) at once, he noticed Bernardino was nervous and afraid. That he later changed his mind and alighted near
the Mormons church outside Malasiqui.

The prosecution also presented SPO1 Antonio Espinoza and Celso Manuel, who testified that on separate
occasions, Bernardino confessed of killing Jennifer, on with Espinoza when he was questioned by the latter and
another with Manuel when he interviewed Bernardino when he was detained in the municipal jail (Manuel was a
radio reporter).

Dr. Bandonill, NBI Medico-legal testified that Jennifer died as a result of numerous stab wounds on her back with
the average of 6 inches, and opined that the wounds were probably caused by a pointed sharp-edged instrument.
He noted contusions on the forehead, neck and breast bone of the victim. he found laceration on the right side of
the hymen was caused within 24 hours of her death. He added that the genital area shows signs of inflammation.

Accused Bernardino denied the allegations against him.

Trial court found Bernardino guilty as charged.

Issue: WON the trial court erred in convicting him despite the failure of the prosecution to prove his guilt beyond
reasonable doubt.

Ruling: Yes. There is no sufficient evidence to hold Bernardino guilty of raping Jennifer Domantay.

Hymenal laceration is not necessary to prove rape, neither does its presence prove its commission. As held in
People v. Ulili, a medical certificate or the testimony of the physician is presented not to prove that the victim was
raped but to show that the latter had lost her virginity. Consequently, standing alone, a physicians finding that the
hymen of the alleged victim was lacerated does not prove rape. It is only when this is corroborated by other
evidence proving carnal knowledge that rape may be deemed to have been established.

This conclusion is based on the medically accepted fact that a hymenal tear may be caused by objects other than
the male sex organ or may arise from other causes.Dr. Bandonill himself admitted this. He testified that the right
side of the victims hymen had been completely lacerated while the surrounding genital area showed signs of
inflammation.He opined that the laceration had been inflicted within 24 hours of the victims death and that the
inflammation was due to a trauma in that area.When asked by the private prosecutor whether the lacerations of
the hymen could have been caused by the insertion of a male organ he said this was possible. But he also said
when questioned by the defense that the lacerations could have been caused by something blunt other than the
male organ.

To be sure, this Court has sustained a number of convictions for rape with homicide based on purely
circumstantial evidence. In those instances, however, the prosecution was able to present other tell-tale signs of
rape such as the location and description of the victims clothings, especially her undergarments, the position of
the body when found and the like.

In People v. Macalino, for instance, the Court affirmed a conviction for the rape of a two year-old child on the basis
of circumstantial evidence:
The Court notes that the testimony or medical opinion of Dr. Gajardo that the fresh laceration had been produced
by sexual intercourse is corroborated by the testimony given by complainant Elizabeth that when she rushed
upstairs upon hearing her daughter suddenly cry out, she found appellant Macalino beside the child buttoning his
own pants and that she found some sticky fluid on the childs buttocks and some blood on her private part.

In contrast, in the case at bar, there is no circumstantial evidence from which to infer that accused-appellant
sexually abused the victim. The only circumstance from which such inference might be made is that accused-
appellant was seen with the victim walking toward the place where the girls body was found. Maybe he raped the
girl. Maybe he did not. Maybe he simply inserted a blunt object into her organ, thus causing the lacerations in the
hymen. Otherwise, there is no circumstance from which it might reasonably be inferred that he abused her, e.g.,
that he was zipping up his pants, that there was spermatozoa in the girls vaginal canal.

The very autopsy report of Dr. Bandonill militates against the finding of rape.

Considering the relative physical positions of the accused and the victim in crimes of rape, the usual location of
the external bodily injuries of the victim is on the face, neck, and anterior portion of her body. Although it is not
unnatural to find contusions on the posterior side, these are usually caused by the downward pressure on the
victims body during the sexual assault. It is unquestionably different when, as in this case, all the stab wounds
(except for a minor cut in the lower left leg) had their entry points at the back running from the upper left shoulder
to the lower right buttocks.
It is noteworthy that the deceased was fully clothed in blue shorts and white shirt when her body was brought to
her parents house immediately after it was found.Furthermore, there is a huge bloodstain in the back portion of
her shorts.This must be because she was wearing this piece of clothing when the stab wounds were inflicted or
immediately thereafter, thus allowing the blood to seep into her shorts to such an extent. As accused-appellant
would naturally have to pull down the girls lower garments in order to consummate the rape, then, he must have,
regardless of when the stab wounds were inflicted, pulled up the victims shorts and undergarments after the
alleged rape, otherwise, the victims shorts would not have been stained so extensively. Again, this is contrary to
ordinary human experience.

Even assuming that Jennifer had been raped, there is no sufficient proof that it was accused-appellant who had
raped her. He did not confess to having raped the victim.
 B. Documentation of Injuries
Rape without medical certificate
PEOPLE OF THE PHILIPPINES, appellee, vs. EDDIE BASITE, appellant.
G.R. No. 150382. October 2, 2003

Facts:
On September 1, 1996, Sonia Pa-ay was on her way to her parents home in Tinoc, Ifugao to get her allowance.
As she was walking she met Eddie Basite who walking the opposite way. A few seconds later she saw Eddie
following her, and when he reached her, he held her with both hands and told her to go down with him. Due to her
resistance, Eddie pulled out a knife and threatened to stab her. Eddie then accused undressed himself and
forcibly removed Sonias pants and underwear. He placed himself on top of her, inserted his penis into her vagina
and made a push and pull movement. Sonia felt pain in her vagina. She resisted but the accused threatened to
stab her. When he was through with the sexual assault, he warned her not to relate the incident to anyone or else
he would stab her. Sonia pleaded with the accused to allow her to go home. Upon seeing that he had laid down
his knife beside her head while he was putting on his clothes, Sonia grabbed the knife and stabbed him on the left
shoulder. Wounded, he ran away.

Sonia tried to put her clothes on but lost her balance and rolled down the cliff and loss consciousness. When she
recovered she decided to continue her way home. Along the way she met some soldiers who offered to
accompany her. While on their way they met four men, one of whom turned out to be Eddie's brother, he then
proposed to go back to the place where she was raped. The brother then asked Sonia to go with him to see
Eddie, but she refused. As she was walking home, she met her uncle Nazario and other relative and narrated her
ordeal to them. They then proceeded to the police station where they reported the incident and filed the
complaint. As they were passing through Bot-oan on their way to Abatan they saw Eddie alighting from a yellow
Ford Fiera. He appeared to have injured his right hand. Nazario approached himand held him by the shoulder and
told him to go with them to Abatan. Eddie pushed Nazarios arm and ran away. Nazario and his companions gave
chase and caught up with Eddie.

At the police station, Sonia was advised to undergo medical examination. She went to the Abatan Emergency
Hospital for the physical examination, and to the Lutheran Hospital for the laboratory tests. She was issued a
medical certificate. The following day, 3 September 1996, Sonia filed her Sworn Statement and a criminal
complaint was formally lodged with the Fiscals Office against Eddie Basite.

On 2 October 1996 an Information for Rape was filed against the accused who pleaded not guilty when arraigned.

The prosecution presented Dr. Relante Raper of the Abatan Emergency Hospital who testified on the medical
findings he made upon examination of Sonia Pa-ay. When Sonia presented herself for examination, Dr. Raper
observed that her clothes were muddy. He found mud on her right breast and on her pubic hair. There were
multiple healing scratches and contusions on her arms, legs and inner thighs which could have been caused by
the application of an external force or the impact of a fall. Internal examination revealed that there were no
lacerations, scratches or bleeding on the perineal area and her hymen was intact. The vagina admitted one (1)
finger with difficulty. A whitish mucoid discharge found over the labia minora was sent to the Lutheran Hospital for
microscopy. Examination of the discharge yielded negative for sperm. Dr. Raper clarified that it was possible,
even for a married woman, to have an intact hymen since there are some hymen that are very elastic

Eddie denied having raped Sonia. To support his defense, he presented two (2) witnesses, Lidot Lacbao and Dr.
Ronald Bandonill.
Lidot Lacbao recalled that in the early morning of 2 September 1996 he received complainant Sonia Pa-ay in his
home and offered her camote to eat. The girl was limping. She had scratches on her arms and legs and her
clothes were muddy. The girl told him that she had slept in the forest and that she met a man who accosted her
but that she stabbed him. Lidot asked her if she had been raped. She replied that she had not been raped since
she stabbed the man and if she did not, he would have done something to her.

Dr. Ronald Bandonill of the NBI-CAR, Baguio City, as an expert witness to dispute the findings of prosecution
witness Dr. Relante Raper. Based on Dr. Rapers findings that there was no bleeding or scratches inside the
genitalia and that the injuries were only outside the genital area and on the upper and lower extremities of Sonia,
Dr. Bandonill opined that there was no insertion into the vagina and there was no physical contact or sexual
intercourse. Otherwise, the genital area would have shown signs of trauma such as inflammation, redness,
swelling and even bleeding if the hymen was the type that was easily lacerated. Dr. Bandonill added that the
Medico-Legal Certificate issued by Dr. Raper was incomplete and incomprehensive and not compatible with
standard Medico-Legal Reports of the NBI in rape cases.
The trial court agreed with Dr. Bandonill that the Medico-Legal Certificate issued by Dr. Raper was insufficient to
conclude that sexual intercourse actually took place, since it failed to indicate whether the labia and vagina of
private complainant were thoroughly examined to determine sexual contact. However, it still found the accused
guilty beyond reasonable doubt of the crime charged based on Sonias spontaneous, forthright and positive
testimony identifying the accused as the person who raped her.

Eddie Basite appealed, arguing that the trial court already entertained reasonable doubt as to his guilt when it
ruled that the Medico-Legal Certificate issued by Dr. Raper was incomprehensive and inconclusive as to the
occurrence of sexual contact between him and Sonia.

Issue:
WON The trial court allegedly erred in not taking these testimonies into consideration and relying solely on the
declarations of Sonia, and in disregarding Dr. Bandonills expert testimony, especially in view of its ruling that the
Medico-Legal Certificate was inadequate to prove the alleged sexual intercourse.

Ruling:
No. In rape offenses, the lone testimony of the complainant, if credible, straightforward, convincing and otherwise
consistent with human nature and the ordinary course of things, may stand to convict the accused. The credibility
of the complainants testimony is of utmost significance. In this case the trial court gave credence and full
probative weight to the testimony of Sonia Pa-ay.

Sonia Pa-ay testified in a categorical, straightforward and consistent manner. As observed by the trial court, she
tearfully narrated the details of the sexual abuse she suffered at the hands of accused-appellant and the
circumstances leading and subsequent thereto. She unwaveringly and positively identified Eddie Basite as her
defiler without any purpose other than to seek justice for the crime committed against her. Accused-appellant
failed to impute any motive against complainant that would tarnish her credibility at the witness stand.

Accused-appellant harps on the fact that the trial court discounted the Medico-Legal Certificate issued by Dr.
Raper. This allegedly shows reasonable doubt as to the fact of sexual intercourse between accused-appellant and
private complainant. On this matter, jurisprudence holds that even without a medical examination, the accused
may still be convicted of rape as long as the testimony of the complainant meets the test of credibility and
resolutely points to the accused as the author of the crime. A medical certificate is not indispensable to prove
rape. That the trial court considered Dr. Bandonills expert testimony to rule on the sufficiency of the Medico-Legal
Certificate issued by Dr. Raper does not mean that the court a quo doubted accused-appellants guilt. The trial
court merely used Dr. Bandonills testimony to determine for itself if that Medico-Legal Certificate would
satisfactorily show the results of a complete and thorough physical examination of Sonia Pa-ay, consistent with
the physical examinations being conducted by the NBI and Dr. Bandonill.
 Medical Evidence is only corroborative

People of the Philippines v Jimmy Alverio

G.R. No. 194259 March 16, 2011

Facts:
On or about June 3, 2002 AAA was on her way to her grandmother's house from the benefit dance when Jimmy
Alverio, her cousin, got hold of her and dragged her to the back of the barangay hall where she was raped
(Alverio was armed with a knife and used it to poke the side of AAA). Trial court found Alverio to be guilty beyond
reasonable doubt, which was affirmed by the appellate court.

Issue:
WON trial court erred in finding Alverio to guilty beyond reasonable doubt.

Ruling:
No. Supreme Court held that in cases involving the prosecution for forcible rape corroboration of the victims
testimony is not a necessary condition to a conviction for rape where the victims testimony is credible, or clear
and convincing or sufficient to prove the elements of the offense beyond a reasonable doubt. As such, appellate
courts generally do not disturb the findings of the trial court with regard to the assessment of the credibility of
witnesses, the reason being that the trial court has the unique opportunity to observe the witnesses first hand and
note their demeanor, conduct and attitude under grilling examination. More importantly, courts generally give full
credence to the testimony of a complainant for rape, especially one who is only a minor.

The exceptions to this rule are when the trial courts findings of facts and conclusions are not supported by the
evidence on record, or when certain facts of substance and value likely to change the outcome of the case have
been overlooked by the lower court, or when the assailed decision is based on a misapprehension of facts.
However, the court finds none of these exceptions present in the instant case.

In addition, Alverio submits that although the medical certificate was presented as evidence, its contents were
never testified to by the signatory himself and, as such, cannot be considered as corroborative of the claim of the
victim that she was raped.

Such argument, however, cannot prosper. Medical evidence is dispensable and merely corroborative in proving
the crime of rape. Besides, a medical certificate is not even necessary to prove the crime of rape. he gravamen of
rape is carnal knowledge of a woman through force and intimidation.

The elements needed to prove the crime of rape under paragraph 1(a) of Article 266-A of the Revised Penal Code
are: (1) the offender is a man; (2) the offender had carnal knowledge of a woman; and (3) the act is accomplished
by using force or intimidation. All these elements were sufficiently proved by the prosecution. The testimony of
AAA overwhelmingly proves that Alverio raped her with the use of force and intimidation.

Furthermore, Alverios defense of alibi cannot stand versus the positive identification of AAA. Nothing is
more settled in criminal law jurisprudence than the rule that alibi and denial cannot prevail over the
positive and categorical testimony and identification of the accused by the complainant
 Medical Evidence is only corroborative

People of the Philippines v Neil B. Colorado

G.R. No. 200791 November 14, 2012

Facts:
AAA was the second to the youngest of 12 twelve siblings and Neil Colorado was an older brother who lived with
her, their parents and 2 other brothers. AAA testified that sometime in December 2002, her parents attended a
wedding leaving her, Neil and two other brothers in the house. When their parents had not yet arrived home, Neil
committed the dastardly act against AAA, she was 12 at that time while Neil was 24. The same night, Neil raped
AAA twice more, unmindful of the presence of the other brothers in the same room sleeping. He had threatened
AAA with a knife.

In trial, AAA disclosed that neil had raped her back when she was 9 and that she was also raped by another
brother, DDD and a brother-in-law.

A Medico-Legal certificate was prepared by Dr. Ma Teresa Sanchez:

Internal Exam Finding:
-Nonparous Introitus
-Hymenal lacerations at 6 o'clock position with bleeding
-Vagina admits 2 fingers with slight resistance
-Uterus small
-(+)bleeding

When Neil testified, he denied of raping AAA and claimed that he stayed with another sister at another house.

RTC found Neil Colorado guilty beyond reasonable doubt for qualified rape and such was affirmed by the Court of
Appeals.

Issue:
WON Neil was guilty of qualified rape

Ruling;
Yes. Both the RTC and CA correctly ruled on the concurrence of the following elements of qualified rape: 1. that
the victim is a female over 12 years but under 18 years of age, 2. that the offender is a parent, ascendant,
stepparent, guardian or relative by consanguinity or affinity within the third civil degree, or the common-law
spouse of the parent of the victim and 3. that the offense had carnal knowledge of the victim either through force,
threat or intimidation or when she is deprived of reason or is otherwise unconscious or by means of fraudelent
machinations or grave abuse of authority.

The age of AAA was undisputed, a certified true/xerox copy of hee Certificate of Live Birth was produced. There
was also no dispute that Neil Colorado is her full-blood brother. As to the third element, despite the denial of Neil
Colorado, the Supreme Court take due consideration of the trial court's finding of the fact, its assessment of AAA's
credibility, her testimony and the manner by which her statement were relayed.

"AAA testified directly and categorically how she was raped by the accused ... the testimony of AAA is simple,
candid, straightforward and consistent on material points detailing every single bestial act of her brother in
ravishing her".

even the failure of AAA on identifying the exact date of the commission of the crime, it is inconsequential to the
conviction of Colorado. In rape cases, the date of commission is not an essential element of the offense, what is
material is the occurence - a fact sufficiently established given AAA's and her testimony;s credibility.

Neil Colorado also questions the weight of Dr. Sanchez's medico-legal certificate, arguing that AAA's hymenal
lacerations could have resulted from the sexual aggressions of DDD and their brother-in-law. Such contention
however deserves no consideration, given that results of an offended party's medical examination are merely
corroborative in character.

As explained by the Court in People v. Balonzo, a medical certificate is not necessary to prove the commission of
rape, as even a medical examination of the victim is not indispensable in a prosecution for rape. Expert testimony
is merely corroborative in character and not essential to conviction. An accused can still be convicted of rape on
the basis of the sole testimony of the private complainant.
Furthermore, laceration of the hymen, even if considered the most telling and irrefutable physical evidence of
sexual assault, is not always essential to establish the consummation of the crime of rape. In the context that is
used in the RPC, “carnal knowledge,” unlike its ordinary connotation of sexual intercourse, does not necessarily
require that the vagina be penetrated or that the hymen be ruptured.Thus, even granting that AAA’s lacerations
were not caused by Colorado, the latter could still be declared guilty of rape, after it was established that he
succeeded in having carnal knowledge of the victim.
 Notarized medical certificate

UNION MOTOR CORPORATION, petitioner, vs. NATIONAL LABOR RELATIONS COMMISSION and
ALEJANDRO A. ETIS, respondents.
[G.R. No. 159738. December 9, 2004]

Facts:
Alejandro Etis was hired by Union Motor Corp as an automotive mechanic at the service department. During his
employment he was awarded the Top Technician of the month (May 1995) and Technician of the Year (1995).

September 22, 1997, Etis made a phone call to the company nurse, Rosa Dela Cruz, telling her that he had to
take a sick leave due to an unbearable toothache. The following day he again called to inform her that he can't go
to work because he still had to consult a doctor. When he was referred to a dentist, Dr. Rodolfo Pamor, he was
scheduled for a tooth extraction. Upon management instruction, a company security guard visited Etis and
confirmed that he was ill. The tooth extraction was rescheduled to October 4,1997. because the inflammation had
not subsided.

October 2, 1997 Union Motors issued an Inter Office Memorandum, terminating the services of Etis for having
incurred more than five days of consecutive absences without proper notification (it was considered as
abandonment of office).

After Etis had his tooth extracted and recovered, he reported for work but was denied entry and was informed
about his termination. Etis first sought the help of the union but the complaint filed by the union was dismissed by
the NCMB. Hence Etis filed a complaint for illegal dismissal against Union Motors, alleging that he was dismissed
without just and legal basis. The Labor Arbiter ruled that the respondent’s failure to report for work for ten (10)
days without an approved leave of absence was equivalent to gross neglect of duty, and that his claim that he had
been absent due to severe toothache leading to a tooth extraction was unsubstantiated. The Labor Arbiter
stressed that unnotarized medical certificates were self-serving and had no probative weight.

NLRC reversed the LA decision, stating the Etis' successive absences was known to the management. That the
medical certificates issued by the doctor and dentist who attended to him substantiated the latter's medical
problem. It also declared that the lack of notarization of the said certificates was not a valid justification for their
rejection as evidence. (this ruling was upheld by the Court of Appeals)

Issue:
WON Lower court (and CA) erred in giving much evidentiary weight to the medical certificate submitted by the
private respondent.

Ruling:
No.
SC noted that the company rules do not require that the notice of an employee’s absence and the reasons
therefor be in writing and for such notice to be given to any specific office and/or employee of the petitioner.
Hence, the notice may be verbal; it is enough then that an officer or employee of the petitioner, competent and
responsible enough to receive such notice for and in behalf of the petitioner, was informed of such absence and
the corresponding reason.
The evidence on record shows that the respondent informed the petitioner of his illness through the company
nurse. The security guard who was dispatched by the petitioner to verify the information received by the company
nurse, confirmed the respondent’s illness.

While the records do not reveal that the respondent filed the required leave of absence for the period during which
he suffered from a toothache, he immediately reported for work upon recovery, armed with medical certificates to
attest to the cause of his absence. The respondent could not have anticipated the cause of his illness, thus, to
require prior approval would be unreasonable. While it is true that the petitioner had objected to the veracity of the
medical certificates because of lack of notarization, it has been said that verification of documents is not
necessary in order that the said documents could be considered as substantial evidence. The medical certificates
were properly signed by the physicians; hence, they bear all the earmarks of regularity in their issuance and are
entitled to full probative weight.