Dela Torre v Imbuido o Dr.
Norma, however, provided no details
G.R. No. 192973, September 9, 2014 | Reyes, J. | by R. Leal or its purpose and the doctor who would
perform it.
Doctrine: o At around 3:00 p.m. on February 12,
Medical malpractice or medical negligence, is that 1992, Carmen had her second operation.
type of claim which a victim has available to him or Dr. Norma informed Pedrito that
her to redress a wrong committed by a medical "everything was going on fine with his
professional which has caused bodily harm. wife.”
The condition of Carmen worsened and on
In order to successfully pursue such a claim, a
February 13, 1992, she vomited dark red blood. At
patient, or his or her, "must prove that a health
9:30 p.m. on the same day, Carmen died.
care provider, either failed to do something which
a reasonably prudent health care provider would Death Cert: the immediate cause of Carmen’s
have done, or that he or she did something that a death was "cardio-respiratory arrest secondary to
reasonably prudent provider would not have done; cerebro vascular accident, hypertension and
and that failure or action caused injury to the chronic nephritis induced by pregnancy."
patient.
An autopsy Report prepared by Dr. Richard
As the Court held in Spouses Flores v. Spouses Patilano (Dr. Patilano), Medico-Legal Officer-
Pineda, et al., the critical and clinching factor in a Designate of Olongapo City, however, provided
medical negligence case is proof of the causal that the cause of Carmen’s death was "shock due
to peritonitis, severe, with multiple intestinal
connection between the negligence and the
adhesions; Status post Caesarian Section and
injuries.
Exploratory Laparotomy."
A verdict in a malpractice action cannot be based Pedrito claimed in his complaint that the
on speculation or conjecture. Causation must be respondents "failed to exercise the degree of
proven within a reasonable medical probability diligence required of them" as members of the
based upon competent expert testimony, which medical profession, and were "negligent for
the Court finds absent in the case at bar. practicing surgery on Carmen in the most
unskilled, ignorant and cruel manner.”
FACTS & Recit Summary:
The case stemmed from a complaint for damages Herein respondents argued that they "observed
filed by Pedrito Dela Torre (Pedrito), against herein the required standard of medical care in attending
respondents Dr. Arturo Imbuido and Dr. Norma to the needs of Carmen."
Imbuido (Dr. Norma) and Dr. Nestor Pasamba (Dr.
Nestor) (Respondents). A caesarian section operation became necessary.
No unusual events were observed during the
At around 3:00 p.m. on February 3, 1992, Carmen course of Carmen’s caesarian section operation.
Castillo Dela Torre (Carmen), wife of Pedrito, was
brought to the hospital’s operating room for her The second surgery, however, became necessary
caesarian section operation. due to suspected intestinal obstruction and
adhesions.
By 5:30 p.m. of the same day, Pedrito was
informed of his wife’s delivery of a baby boy. The respondents included in their answer a
counterclaim for P48,515.58 as unpaid hospital
In the morning of February 4, 1992, Carmen charges, professional fees and medicines,
experienced abdominal pain and difficulty in P3,000,000.00 for moral damages, P1,500,000.00
urinating. She was diagnosed to be suffering from for exemplary damages, and attorney’s fees.
urinary tract infection (UTI), and was prescribed
medications by Dr. Norma. At the trial, Pedrito presented the testimony of Dr.
Patilano.
On February 10, 1992, Pedrito noticed that
Carmen’s stomach was getting bigger, but Dr. Dr. Patilano claimed that peritonitis could have
Norma dismissed the patient’s condition as mere been prevented through proper medical
flatulence (kabag). When Carmen’s stomach still procedures and medicines. He also stated that if
grew bigger despite medications, Dr. Norma the cause of Carmen’s death was actually cerebro-
advised Pedrito of the possibility of a second vascular accident, there would have been ruptured
operation on Carmen. blood vessels and blood clot in her head; but there
were none in Carmen’s case.
Among those who testified to refute Pedrito’s specialization and competence to testify on the
claim was Dr. Nestor. He claimed that when degree of care, skill and diligence needed for the
Carmen was referred to him on February 3, 1992, treatment of Carmen's case.
she was in full term uterine pregnancy, with pre- o Considering that it was not duly
eclampsia, fetal distress and active labor pains. established that Dr. Patilano practiced
o A caesarian section operation became and was an expert in the fields that
necessary to terminate the pregnancy for involved Carmen's condition, he could not
her safety. Carmen was ready to go home have accurately identified the said degree
four days after giving birth, but was of care, skill, diligence and the medical
advised by the doctors to stay more procedures that should have been applied
because of her persistent hypertension. by her attending physicians.
o The second surgery performed on Carmen o Similarly, such duty, degree of care, skill
was necessary after she showed and diligence were not sufficiently
symptoms of intestinal obstruction. Both established in this case because the
Carmen and Pedrito gave their written testimony of Dr. Patilano was based solely
consent to this second procedure. on the results of his autopsy on the
cadaver of Carmen. His study and
Regional Trial Court (RTC) of Olongapo City, Branch assessment were restricted by limitations
75, rendered its Decision in favor of Pedrito. that denied his full evaluation of Carmen's
case.
Respondents appealed to the CA. The CA rendered o Judging from his testimony, Dr. Patilano
its Decision reversing and setting aside the did not even take full consideration of the
decision of the RTC. medical history of Carmen’s actual health
o For the appellate court, it was not condition at the time of hospital
established that the respondents failed to admission, and her condition as it
exercise the degree of diligence required progressed while she was being
of them by their profession as doctors. monitored and treated by the
o The CA also granted the respondents’ respondents.
counterclaim for the amount of P o For lack of sufficient information on
48,515.58 Carmen's health condition while still alive,
Dr. Patilano could not have fully
Hence, this petition for review on certiorari. evaluated the suitability of the
respondents' decisions in handling
ISSUE: WON respondents should be held liable for the Carmen's medical condition as it turned
death of Carmen – NO. critical.
o Dr. Nestor, a surgeon, possessed the
Lucas, et al. v. Tuaño that in medical negligence reasonable degree of learning, skill and
cases, there is a physician-patient relationship experience required by his profession for
between the doctor and the victim- four essential the treatment of Carmen. The
elements must be established by the plaintiff, respondents also emphasized that Dr.
namely: (1) duty; (2) breach; (3) injury; and (4) Nestor had his training and experience in
proximate causation. surgery and obstetrics since 1970.
o All four elements must be present in Without sufficient proof from the
order to find the physician negligent claimant on a different degree of care,
skill and diligence that should be
It is settled that a physician’s duty to his patient expected from the respondents, it could
relates to his exercise of the degree of care, skill not be said with certainty that a breach
and diligence which physicians in the same was actually committed.
general neighborhood, and in the same general o Moreover, while Dr. Patilano opined that
line of practice, ordinarily possess and exercise in Carmen died of peritonitis which could be
like cases. There is breach of this duty when the due to the poor state of the hospital
patient is injured in body or in health. equipment and medical supplies used
during her operation, there was no
Proof of this breach rests upon the testimony of an sufficient proof that any such fault
expert witness. actually attended the surgery of Carmen,
caused her illness and resulted in her
To justify an award of damages, the negligence of death.
the doctor must be established to be the o Dr. Patilano, did not comply with the basic
proximate cause of the injury autopsy procedure when he examined
the cadaver of Carmen. Dr. Patilano did
For the trial court to give weight to Dr. Patilano's not appear to have thoroughly examined
report, it was necessary to show first Dr. Patilano's Carmen's vital organs such as her heart,
lungs, uterus and brain during the
autopsy. His findings were then
inconclusive on the issue of the actual
cause of Carmen's death, and the claim of
negligence allegedly committed by the
respondents.
The CA's award of P48,515.58 is sustained,
considering that among the parties' stipulations
during the pre-trial indicated: That at the time of
the death of the patient Carmen, there was an
unpaid balance for hospital bills, professional fees
and other expenses in the amount of P48,515.58,
incurred by plaintiff when the patient was confined
at said hospital from February 3 to 13, 1992.
RULING:
WHEREFORE, the petition is DENIED. The Decision dated
December 15, 2009 and Resolution dated July 27, 2010 of
the Court of Appeals in CA-G.R. CV No. 78534 are
AFFIRMED.
