ROGELIO E.

RAMOS and ERLINDA RAMOS, in their own behalf and as natural

guardians of the minors, ROMMEL RAMOS, ROY RODERICK RAMOS and RON
RAYMOND RAMOS, petitioners,
vs. COURT OF APPEALS, DELOS SANTOS
MEDICAL CENTER, DR. ORLINO HOSAKA and DRA. PERFECTA GUTIERREZ,
respondents.
G.R. No. 124354 December 29, 1999
Facts:
Sometime in 1985, petitioner Erlinda Ramos, , a 47-year old robust woman sought professional
medical help after experiencing occasional pain due to the presence of stone in her gall bladder.
She was advised to undergo an operation for the removal of a stone in her gall bladder
(cholecystectomy). She was referred to Dr. Hosaka, a surgeon who agreed to perform the
operation on her. The operation was scheduled for June 17, 1985 at 9:00 in the morning at private
respondent De Los Santos Medical Center (DLSMC) Since neither petitioner nor her husband,
petitioner Rogelio knew of any anesthesiologist, Dr. Hosaka recommended to them the services
of Dr. Gutierrez.
Petitioner Erlinda was admitted to the DLSMC the day before the scheduled operation. By 7:30
in the morning of the following day, petitioner Erlinda was already being prepared for operation.
Upon the request of petitioner Erlinda, her sister-in-law Herminda Cruz who was then Dean of
the College of Nursing at the Capitol Medical Center was allowed to accompany her side in the
operating room.
At around 9:30 in the morning, Dr. Hosaka has not yet arrived, Dr. Gutierrez tried to reach him
by phone and thereafter informed Cruz that the operation might be delayed. Erlinda told Cruz,
Mindy inip na inip na ako. Ikuha mo ako ng ibang doctor. Rogelio already wanted to pull out
his wife from the operating room. Dr. Hosaka finally arrived at the hospital at around 12:10 in
the afternoon or more than 3 hours than the scheduled operation. Cruz who was then still inside
the operating room, heard about Dr Hosakas arrival. While she held the hand of Erlinda, Cruz
saw Dr. Gutierrez trying to intubate the patient. Dr Gutierrez uttered, Ang hirap maintubate
nito. Mali yata ang pagkakapasok o lumalaki ang tiyan. Cruz noticed a bluish discoloration of
Erlindas nailbeds on her left hand. She then heard Dr. Hosaka instruct someone to call Dr.
Calderon, another anesthesiologist. When he arrived Dr. Calderon attempted to intubate the
patient. The nailbeds of the patient remained bluish, thus, she was placed in the trendelenberg
positiona position where the head of the patient is placed in a position lower than her feet. At
this point, Cruz went out of the operating room to express her concern to Rogelio that the
operation was not going well.
Cruz quickly rushed back to the operating room and saw that the patient was still in the
trendelenberg position. At almost 3 oclock in the afternoon she saw Erlinda being wheeled to the
ICU. The doctors explained to the petitioner Rogelio that his wife had bronchospasm. Erlinda
stayed in the ICU for a month. She was released from the hospital only four months later or on
November 15, 1985 since the ill-fated operation, Erlinda remained in comatose condition until
she died on August 3, 1999. Petitioner filed with the Regional Trial Court of Quezon city a civil
case for damages against private respondents. After due trial a quo rendered judgment in favor of
petitoners. Essentially, the Court found that private respondents were negligent in the
performance of their duties to Erlinda. However Court of Appeals reversed said decision hence
this petition for certiorari.
Issue: Whether a surgeon, an anaesthesiologist, and a hospital, should be made liable for the
unfortunate comatose condition of a patient scheduled for cholecystectomy

Ruling:
The Hippocratic Oath mandates physicians to give primordial consideration to the health and
welfare of their patients. If a doctor fails to live up to this precept, he is made accountable for his
acts. A mistake, through gross negligence or incompetence or plain human error, may spell the
difference between life and death. In this sense, the doctor plays God on his patient's fate.
Erlinda submitted herself for cholecystectomy and expected a routine general surgery to be
performed on her gall bladder. On that fateful day she delivered her person over to the care,
custody and control of private respondents who exercised complete and exclusive control over
her. At the time of submission, Erlinda was neurologically sound and, except for a few minor
discomforts, was likewise physically fit in mind and body. However, during the administration of
anesthesia and prior to the performance of cholecystectomy she suffered irreparable damage to
her brain. Thus, without undergoing surgery, she went out of the operating room already
decerebrate and totally incapacitated.
Negligence of the Anaesthesiologist
The pre-operative evaluation of a patient prior to the administration of anesthesia is universally
observed to lessen the possibility of anesthetic accidents. 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.
Responsibility of the Surgeon
As the so-called "captain of the ship," it is the surgeon's responsibility to see to it that those under
him perform their task in the proper manner. Respondent Dr. Hosaka's negligence can be found
in his failure to exercise the proper authority in not determining if his anesthesiologist observed
proper anesthesia protocols. In fact, no evidence on record exists to show that respondent Dr.
Hosaka verified if respondent Dra. Gutierrez properly intubated the patient. Furthermore, it does
not escape us that respondent Dr. Hosaka had scheduled another procedure in a different hospital
at the same time as Erlinda's cholecystectomy, and was in fact over three hours late for the
latter's operation. Because of this, he had little or no time to confer with his anesthesiologist
regarding the anesthesia delivery. This indicates that he was remiss in his professional duties
towards his patient. Thus, he shares equal responsibility for the events which resulted in Erlinda's
condition.
Responsibility of the Hospital
When a doctor refers a patient for admission in a hospital, it is the doctor who prescribes the
treatment to be given to said patient. The hospitals obligation is limited to provide the patient
with the preferred room accommodation, the nutritional diet and medication prescribed by the
doctor, the equipment facilities necessary for the treatment of the patient, as well as the hospital
staff.
Wherefore:
1. DLSMC is hereby absolved from liability arising from injury suffered by petitioner Erlinda
Ramos on June 17, 1985
2. Private respondents Dr Orlino Hosaka and Dr Perfecta Gutierrez are herby declared to be
solidary liable for the injury suffered by petitioner and ordered to pay damages a) 1, 325, 000.00
as actual damages b) 2,000,000.00 as moral damages; c.) 100,000.00 as exemplary damages; d.)
100,000.00 as attorneys fees and e.) the costs of the suit.

MARITER MENDOZA vs. ADRIANO CASUMPANG

G.R. No. 197987

March 19, 2012

FACTS:
On February 13, 1993 Josephine underwent hysterectomy and myomectomy that Dr. Mendoza
performed on her at the Iloilo Doctors Hospital. After her operation, Josephine experienced
recurring fever, nausea, and vomiting. Three months after the operation, she noticed while taking
a bath something protruding from her genital. She tried calling Dr. Mendoza to report it but the
latter was unavailable. Josephine instead went to see another physician, Dr. Edna JamandreGumban, who extracted a foul smelling, partially expelled rolled gauze from her cervix.
The discovery of the gauze and the illness she went through prompted Josephine to file a
damage suit against Dr. Mendoza before the RTC of Iloilo City. Because Josephine died before
trial could end, her husband and their children substituted her in the case.
On March 7, 2005 the RTC rendered judgment, finding Dr. Mendoza guilty of neglect that
caused Josephines illness and eventual death and ordering her to pay plaintiffs heirs actual
damages, moral damages, attorneys fees and plus cost of suit.
On motion for reconsideration, however, the RTC reversed itself and dismissed the complaint in
an order dated June 23, 2005.
On appeal, the Court of Appeals (CA) rendered a decision on March 18, 2011, held that Dr.
Mendoza committed a breach of her duty as a physician when a gauze remained in her patients
body after surgery. The CA denied her motion for reconsideration on July 18, 2011, prompting
her to file the present petition.
ISSUE:
Whether or not Dr. Mendoza committed a breach of her duty as a physician when a gauze
remained in her patients body after surgery?
RULING:
A surgical operation is the responsibility of the surgeon performing it. He must personally
ascertain that the counts of instruments and materials used before the surgery and prior to sewing
the patient up have been correctly done. To provide an example to the medical profession and to
stress the need for constant vigilance in attending to a patients health, the award of exemplary
damages in this case is in order.
WHEREFORE, the Court entirely AFFIRMS the decision of the Court of Appeals dated March
18, 2011 with the MODIFICATION ordering petitioner Mariter Mendoza to pay respondents, an
additional P50,000.00 as exemplary damages, additional P30,000.00 as attorneys fees and civil
indemnity arising from death in the amount of P50,000.00.

RICO ROMMEL ATIENZA v BOARD OF MEDICINE and EDITHA SIOSON

G.R. No. 177407 February 9, 2011

FACTS:
Due to her lumbar pains, private respondent Editha Sioson went to Rizal Medical Center
(RMC) for check-up on February 4, 1995. Sometime in 1999, due to the same problem, she was
referred to Dr. Pedro Lantin III of RMC who, accordingly, ordered several diagnostic laboratory
tests. The tests revealed that her right kidney is normal. It was ascertained, however, that her left
kidney is non-functioning and non-visualizing. Thus, she underwent kidney operation in
September, 1999.
On February 18, 2000, private respondents husband, Romeo Sioson (as complainant), filed a
complaint for gross negligence and/or incompetence before the [BOM] against the doctors who
allegedly participated in the fateful kidney operation, namely: Dr. Judd dela Vega, Dr. Pedro
Lantin, III, Dr. Gerardo Antonio Florendo and petitioner Rico Rommel Atienza.
It was alleged in the complaint that the gross negligence and/or incompetence committed by the
said doctors, including petitioner, consists of the removal of private respondents fully functional
right kidney, instead of the left non-functioning and non-visualizing kidney.
The complaint was heard by the [BOM]. After complainant Romeo Sioson presented his
evidence, private respondent Editha Sioson, also named as complainant there, filed her formal
offer of documentary evidence.
The [BOM] denied the motion for reconsideration of petitioner in its Order dated October 8,
2004. It concluded that it should first admit the evidence being offered so that it can determine its
probative value when it decides the case. According to the Board, it can determine whether the
evidence is relevant or not if it will take a look at it through the process of admission.
Disagreeing with the BOM, and as previously adverted to, Atienza filed a petition for certiorari
with the CA, assailing the BOMs Orders which admitted Editha Siosons (Edithas) Formal
Offer of Documentary Evidence. The CA dismissed the petition for certiorari for lack of merit.
ISSUE:
Whether or not the CA committed grave reversible error and decided a question of substance in a
way not in accordance with law and the applicable decisions of the honorable court when it
upheld the admission of incompetent and inadmissible evidence by respondent board, which can
result in the deprivation of professional license.
RULING:
We disagree.
To begin with, it is well-settled that the rules of evidence are not strictly applied in proceedings
before administrative bodies such as the BOM. Although trial courts are enjoined to observe
strict enforcement of the rules of evidence in connection with evidence which may appear to be
of doubtful relevancy, incompetency, or admissibility, we have held that:
It is the safest policy to be liberal, not rejecting them on doubtful or technical grounds, but
admitting them unless plainly irrelevant, immaterial or incompetent, for the reason that their
rejection places them beyond the consideration of the court, if they are thereafter found relevant
or competent; on the other hand, their admission, if they turn out later to be irrelevant or
incompetent, can easily be remedied by completely discarding them or ignoring them.
The rules of evidence are merely the means for ascertaining the truth respecting a matter of
fact.Thus, they likewise provide for some facts which are established and need not be proved,
such as those covered by judicial notice, both mandatory and discretionary. Laws of nature
involving the physical sciences, specifically biology, include the structural make-up and

composition of living things such as human beings. In this case, we may take judicial notice that
Edithas kidneys before, and at the time of, her operation, as with most human beings, were in
their proper anatomical locations.
Finally, these exhibits do not constitute hearsay evidence of the anatomical locations of Edithas
kidneys. To furtherdrive home the point, the anatomical positions, whether left or right, of
Edithas kidneys, and the removal of one or both, may still be established through a belated
ultrasound or x-ray of her abdominal area.
WHEREFORE, the petition is DENIED. The Decision of the Court of Appeals in CA-G.R. SP
No. 87755 is AFFIRMED. Costs against petitioner.

CONCEPCION ILAO-ORETA vs SPOUSES EVA MARIE and BENEDICTO NOEL

RONQUILLO

G.R. No. 172406 October 11, 2007

FACTS:
Respondents, spouses Eva Marie Ronquillo and Noel Benedicto Ronquillo, had not been blessed
with a child despite several years of marriage. They thus consulted petitioner, Dr. Concepcion
Ilao-Oreta, an obstetrician-gynecologist-consultant at the St. Lukes Medical Center where she
was, at the time material to the case, the chief of the Reproductive Endocrinology and Infertility
Section.
Upon Dr. Ilao-Oretas advice, Eva Marie agreed to undergo a laparoscopic procedure whereby a
laparascope would be inserted through the patients abdominal wall to get a direct view of her
internal reproductive organ in order to determine the real cause of her infertility.
Dr. Ilao-Oreta did not arrive at the scheduled time for the procedure, however, and no prior
notice of its cancellationwas received. It turned out that the doctor was on a return flight from
Hawaii to, and arrived at 10:00 p.m. of April 5,1999 in, Manila.
On May 18, 1999, the Ronquillo spouses filed a complaint against Dr. Ilao-Oreta and the St.
Lukes Medical Center for breach of professional and service contract and for damages before
the Regional Trial Court (RTC) of Batangas City. They prayed for the award of actual damages
including alleged loss of income of Noel while accompanying his wife to the hospital, moral
damages, exemplary damages, the costs of litigation, attorneys fees, and other available reliefs
and remedies.
By Decision of March 9, 2001, Branch 84 of the Batangas RTC, finding that the failure of the
doctor to arrive on time was not intentional, awarded Eva Marie only actual damages
On appeal by the spouses, the Court of Appeals, by Decision of April 21, 2006, finding Dr. IlaoOreta grossly negligent, modified the trial courts decision.
Hence, the present Petition for Review.
ISSUE:
Whether or not Dr. Ilao-Oreta is guilty of gross negligence for her failure to arrive at the
scheduled time for the procedure.
RULING:
The records show that before leaving for Hawaii, Dr. Ilao-Oreta left an admitting order with her
secretary for one of the spouses to pick up, apprised Eva Marie of the necessary preparations for
the procedure, and instructed the hospital staff to perform pre-operative treatments. These acts of
the doctor reflect an earnest intention to perform the procedure on the day and time scheduled.
It bears noting that when she was scheduling the date of her performance of the procedure, Dr.
Ilao-Oreta had just gotten married and was preparing for her honeymoon, and it is of common
human knowledge that excitement attends its preparations. Her negligence could then
be partly attributed to human frailty which rules out its characterization as gross.
Dr. Ilao-Oretas negligence not being gross, Ronquillo spouses are not entitled to recover moral
damages. Neither are the spouses entitled to recover exemplary damages in the absence of a
showing that Dr. Ilao-Oreta acted in a wanton, fraudulent, reckless, oppressive or malevolent
manner, nor to award of attorneys fees as, contrary to the finding of the CA that the spouses
were compelled to litigate and incur expenses to protect their interest, the records show that
they did not exert enough efforts to settle the matter before going to court.WHEREFORE, the
petition is GRANTED. The decision appealed from is MODIFIED.
MR. AND MRS. AMADOR C. ONG vs. METROPOLITAN WATER DISTRICT

G.R. No. L-7664

August 29, 1958

FACTS:
In the afternoon of July 5, 1952, at about 1:00 o'clock, Dominador Ong, a 14-year old high
school student and Boy Scout, and his brothers Ruben and Eusebio, went to defendant's
swimming pools. This was not the first time that the three brothers had gone to said natatorium
for they had already been there four or five times before. After paying the requisite admission
fee, they immediately went to one of the small pools where the water was shallow. At about 4:35
p.m., Dominador Ong told his brothers that he was going to the locker room in an adjoining
building to drink a bottle of coke. Upon hearing this, Ruben and Eusebio went to the bigger pool
leaving Dominador in the small pool and so they did not see the latter when he left the pool to
get a bottle of coke. In that afternoon, there were two lifeguards on duty in the pool compound,
namely, Manuel Abao and Mario Villanueva.
Between 4:40 to 4:45 p.m., some boys who were in the pool area informed a bather by the name
of Andres Hagad, Jr., that somebody was swimming under water for quite a long time. Another
boy informed lifeguard Manuel Abao of the same happening and Abao immediately jumped
into the big swimming pool and retrieved the apparently lifeless body of Dominador Ong from
the bottom. Soon after, male nurse Armando Rule came to render assistance, followed by
sanitary inspector Iluminado Vicente who, after being called by phone from the clinic by one of
the security guards, boarded a jeep carrying with him the resuscitator and a medicine kit, and
upon arriving he injected the boy with camphorated oil. After the injection, Vicente left on a jeep
in order to fetch Dr. Ayuyao from the University of the Philippines. Meanwhile, Abao continued
the artificial manual respiration, and when this failed to revive him, they applied the resuscitator
until the two oxygen tanks were exhausted. Not long thereafter, Dr. Ayuyao arrived with another
resuscitator, but the same became of no use because he found the boy already dead. The doctor
ordered that the body be taken to the clinic.
After trial, the lower court found that the action of plaintiffs is untenable and dismissed the
complaint without pronouncement as to costs. Plaintiffs took the case on appeal directly to this
Court because the amount involved exceeds the sum of P50,000.
ISSUE:
Whether the death of minor Dominador Ong can be attributed to the negligence of defendant
and/or its employees so as to entitle plaintiffs to recover damages.
RULING:
There is sufficient evidence to show that appellee has taken all necessary precautions to avoid
danger to the lives of its patrons or prevent accident which may cause their death. Thus, it has
been shown that the swimming pools of appellee are provided with a ring buoy, toy roof, towing
line, oxygen resuscitator and a first aid medicine kit. The bottom of the pools is painted with
black colors so as to insure clear visibility. There is on display in a conspicuous place within the
area certain rules and regulations governing the use of the pools. Appellee employs six lifeguards
who are all trained as they had taken a course for that purpose and were issued certificates of
proficiency. These lifeguards work on schedule prepared by their chief and arranged in such a
way as to have two guards at a time on duty to look after the safety of the bathers. There is a
male nurse and a sanitary inspector with a clinic provided with oxygen resuscitator. And there are
security guards who are available always in case of emergency.
The record also shows that when the body of minor Ong was retrieved from the bottom of the
pool, the employees of appellee did everything possible to bring him back to life. Thus, after he
was placed at the edge of the pool, lifeguard Abao immediately gave him manual artificial
respiration. Soon thereafter, nurse Armando Rule arrived, followed by sanitary inspector
Iluminado Vicente who brought with him an oxygen resuscitator. When they found that the pulse

of the boy was abnormal, the inspector immediately injected him with camphorated oil. When
the manual artificial respiration proved ineffective they applied the oxygen resuscitator until its
contents were exhausted. And while all these efforts were being made, they sent for Dr. Ayuyao
from the University of the Philippines who however came late because upon examining the body
he found him to be already dead. All of the foregoing shows that appellee has done what is
humanly possible under the circumstances to restore life to minor Ong and for that reason it is
unfair to hold it liable for his death.
Since it is not known how minor Ong came into the big swimming pool and it being apparent
that he went there without any companion in violation of one of the regulations of appellee as
regards the use of the pools, and it appearing that lifeguard Abano responded to the call for help
as soon as his attention was called to it and immediately after retrieving the body all efforts at the
disposal of appellee had been put into play in order to bring him back to life, it is clear that there
is no room for the application of the doctrine of last chance now invoked by appellants to impute
liability to appellee.
Wherefore, the decision appealed from being in accordance with law and the evidence, we
hereby affirm the same, without pronouncement as to costs.

OCEAN BUILDERS CONSTRUCTION CORP., and/or DENNIS HAO, vs. SPOUSES

ANTONIO and ANICIA CUBACUB
G.R. No. 150898

April 13, 2011

FACTS:
Bladimir Cubacub was employed as maintenance man by petitioner company Ocean Builders
Construction Corp. at its office in Caloocan City.
On April 9, 1995, Bladimir was afflicted with chicken pox. He was thus advised by petitioner
Dennis Hao, the companys general manager, to rest for three days which he did at the
companys "barracks" where he lives free of charge.
On April 12, 1995, Bladimi asked a co-worker, Ignacio Silangga, to accompany him to his house
in Capas, Tarlac so he could rest. Informed by Silangga of Bladimirs intention, Hao gave
Bladimir P1,000.00 and ordered Silangga to instead bring Bladimir to the nearest hospital.
The hospital did not allow Bladimir to leave the hospital. He was then confined, with Narding
keeping watch over him. The next day, April 13, 1995, a doctor of the hospital informed Narding
that they needed to talk to Bladimirs parents.
At about 8 oclock in the evening of the same day, Bladimirs parents-respondent spouses
Cubacub, with their friend Dr. Hermes Frias, arrived at the Caybiga Hospital and transferred
Bladimir to the Quezon City General Hospital where he was placed in the intensive care unit and
died the following day, April 14, 1995.
The death certificate issued by the QCGH recorded Bladimirs immediate cause of death as
cardio-respiratory arrest and the antecedent cause as pneumonia. On the other hand, the death
certificate issued by Dr. Frias recorded the causes of death as cardiac arrest, multiple organ
system failure, septicemia and chicken pox.
Bladimirs parents-herein respondents later filed on August 17, 1995 before the Tarlac Regional
Trial Court (RTC) at Capas a complaint for damages against petitioners, alleging that Hao was
guilty of negligence which resulted in the deterioration of Bladimirs condition leading to his
death. By Decision of April 14, 1997, Branch 66 of the Tarlac RTC at Capas dismissed the
complaint, holding that Hao was not negligent.
On respondents appeal, the Court of Appeals, by Decision of June 22, 2001, reversed the trial
courts decision, holding that by Haos failure to bring Bladimir to a better-equipped hospital, he
violated Article 161 of the Labor Code
The motion for reconsideration was denied by Resolution of November 26, 2001, hence this
petition.
ISSUE:
Whether or not which of two death certificate is credible.
RULING:
There appears, however, to be no conflict in the two death certificates on the immediate cause of
Bladimirs death since both cite cardio-respiratory arrest due to complications from
pneumonia per QCGH, septicemia and chicken pox per Dr. Frias. In fact, Dr. Frias admitted that
the causes of death in both certificates were the same.
Be that as it may, Dr. Frias could not be considered as Bladimirs attending physician, he having
merely ordered Bladimirs transfer to the QCGH after seeing him at the Caybiga Hospital. He
thereafter left Bladimir to the care of doctors at QCGH, returning to Capas, Tarlac at 4 oclock
the following morning or eight hours after seeing Bladimir. As he himself testified upon cross-

examination, he did not personally attend to Bladimir anymore once the latter was brought to the
ICU at QCGH.
It bears emphasis that a duly-registered death certificate is considered a public document and the
entries therein are presumed correct, unless the party who contests its accuracy can produce
positive evidence establishing otherwise. The QCGH death certificate was received by the City
Civil Registrar on April 17, 1995. Not only was the certificate shown by positive evidence to be
inaccurate. Its credibility, more than that issued by Dr. Frias, becomes more pronounced as note
is taken of the fact that he was not around at the time of death.
In fine, Petitioner Company and its co-petitioner manager Dennis Hao are not guilty of
negligence.1avvphil
WHEREFORE, the petition is GRANTED. The challenged Decision of the Court of Appeals is
REVERSED, and the complaint is hereby DISMISSED.