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TodayisThursday,September08,2016

RepublicofthePhilippines
SUPREMECOURT
Manila
THIRDDIVISION

G.R.No.118231July5,1996
DR.VICTORIAL.BATIQUINandALLANBATIQUIN,petitioners,
vs.
COURTOFAPPEALS,SPOUSESQUEDOD.ACOGIDOandFLOTILDEG.VILLEGAS,respondents.

DAVIDE,JR.,J.:p
Throughout history, patients have consigned their fates and lives to the skill of their doctors. For a breach of this
trust,menhavebeenquicktodemandretribution.Some4,000yearsago,theCodeofHammurabi1 then already
provided:"Ifaphysicianmakeadeepincisionuponamanwithhisbronzelancetandcausetheman'sdeath,oroperateon
the eye socket of a man with his bronze lancet and destroy the man's eyes, they shall cut off his hand." 2Subsequently,
Hippocrates3wrotewhatwastobecomepartofthehealer'soath:"Iwillfollowthatmethodoftreatmentwhichaccordingto
myabilityandjudgment,Iconsiderforthebenefitofmypatients,andabstainfromwhateverisdeleteriousandmischievous..
..WhileIcontinuetokeepthisoathunviolatedmayitbegrantedmetoenjoylifeandpracticetheart,respectedbyallmen
atalltimesbutshouldItrespassandviolatethisoath,maythereversebemylot."Atpresent,theprimaryobjectiveofthe
medicalprofessionifthepreservationoflifeandmaintenanceofthehealthofthepeople.4

Needlesstosaythen,whenaphysicianstraysfromhissacreddutyandendangersinsteadthelifeofhispatient,he
mustbemadetoanswertherefor.Althoughsocietytodaycannotandwillnottoleratethepunishmentmetedoutby
theancients,neitherwillitandthisCourt,asthiscasewouldshow,lettheactgouncondemned.
The petitioners appeal from the decision5 of the Court of Appeals of 11 May 1994 in CAG.R. CV No. 30851, which
reversedthedecision6of21December1990ofBranch30oftheRegionalTrialCourt(RTC)ofNegrosOrientalinCivilCase
No.9492.

Thefacts,asfoundbythetrialcourt,areasfollows:
Dr.BatiquinwasaResidentPhysicianattheNegrosOrientalProvincialHospital,DumagueteCityfrom
January9,1978toSeptember1989.Between1987andSeptember,1989shewasalsotheActg.Head
oftheDepartmentofObstetricsandGynecologyatthesaidHospital.
Mrs.VillegasisamarriedwomanwhosubmittedtoDr.Batiquinforprenatalcareasthelatter'sprivate
patientsometimebeforeSeptember21,1988.
In the morning of September 21, 1988 Dr. Batiquin, with the assistance of Dr. Doris Teresita Sy who
was also a Resident Physician at the same Hospital, C.I. and O.R. Nurse Arlene Diones and some
student nurses performed a simple caesarean section on Mrs. Villegas at the Negros Oriental
ProvincialHospitalandafter45minutesMrs.Villegasdeliveredherfirstchild,RachelAcogido,atabout
11:45 that morning. Thereafter, Plaintiff remained confined at the Hospital until September 27, 1988
duringwhichperiodofconfinementshewasregularlyvisitedbyDr.Batiquin.OnSeptember28,1988
Mrs. Villegas checked out of the Hospital. . . and on that same day she paid Dr. Batiquin, thru the
latter'ssecretary,theamountofP1,500.00as"professionalfee"....
SoonafterleavingtheHospitalMrs.Villegasbegantosufferabdominalpainsandcomplainedofbeing
feverish.Shealsograduallylostherappetite,sosheconsultedDr.Batiquinatthelatter'spolyclinicwho
prescribedforhercertainmedicines...whichshehadbeentakinguptoDecember,1988.

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Inthemeantime,Mrs.VillegaswasgivenaMedicalCertificatebyDr.BatiquinonOctober31,1988...
certifyingtoherphysicalfitnesstoreturntoherworkonNovember7,1988.So,onthesecondweekof
November,1988Mrs.VillegasreturnedtoherworkattheRuralBankofAyungon,NegrosOriental.
The abdominal pains and fever kept on recurring and bothered Mrs. Villegas no end despite the
medications administered by Dr. Batiquin. When the pains became unbearable and she was rapidly
losing weight she consulted Dr. Ma. Salud Kho at the Holy Child's Hospital in Dumaguete City on
January20,1989.
TheevidenceofPlaintiffsshowthatwhenDr.Ma.SaludKhoexaminedMrs.VillegasattheHolyChild's
HospitalonJanuary20,1989shefoundMrs.Villegastobefeverish,paleandwasbreathingfast.Upon
examination she felt an abdominal mass one finger below the umbilicus which she suspected to be
eitheratumoroftheuterusoranovariancyst,eitherofwhichcouldbecancerous.Shehadanxray
takenofMrs.Villegas'chest,abdomenandkidney.ShealsotookbloodtestsofPlaintiff.Abloodcount
showed that Mrs. Villegas had [an] infection inside her abdominal cavity. The results of all those
examinations impelled Dr. Kho to suggest that Mrs. Villegas submit to another surgery to which the
latteragreed.
When Dr. Kho opened the abdomen of Mrs. Villegas she found whitishyellow discharge inside, an
ovariancystoneachoftheleftandrightovarieswhichgaveoutpus,dirtandpusbehindtheuterus,
and a piece of rubber material on the right side of the uterus embedded on [sic] the ovarian cyst, 2
inchesby3/4inchinsize.ThispieceofrubbermaterialwhichDr.Khodescribedasa"foreignbody"
lookedlikeapieceofa"rubberglove"...andwhichis[sic]also"rubberdrainlike"....Itcouldhave
been a torn section of a surgeon's gloves or could have come from other sources. And this foreign
bodywasthecauseoftheinfectionoftheovariesandconsequentlyofallthediscomfortsufferedby
Mrs.VillegasafterherdeliveryonSeptember21,1988.7
ThepieceofrubberallegedlyfoundnearprivaterespondentFlotildeVillegas'suteruswasnotpresentedincourt,
andalthoughDr.Ma.SaludKhoTestifiedthatshesentittoapathologistinCebuCityforexamination,8itwasnot
mentionedinthepathologist'sSurgicalPathologyReport.9

Aside from Dr. Kho's testimony, the evidence which mentioned the piece of rubber are a Medical Certificate,10 a
ProgressRecord,11 an Anesthesia Record,12 a Nurse's Record, 13 and a Physician's Discharge Summary. 14 The trial
court,however,regardedthesedocumentaryevidenceasmerehearsay,"therebeingnoshowingthatthepersonorpersons
who prepared them are deceased or unable to testify on the facts therein stated. . . . Except for the Medical Certificate
(Exhibit"F"),alltheabovedocumentswereallegedlypreparedbypersonsotherthanDr.Kho,andshemerelyaffixedher
signatureonsomeofthemtoexpressheragreementthereto...."15ThetrialcourtalsorefusedtogiveweighttoDr.Kho's
testimonyregardingthesubjectpieceofrubberasDr.Kho"maynothavehadfirsthandknowledge"thereof,16ascouldbe
gleanedfromherstatement,thus:

A...Ihaveheardsomebodythat[sic]says[sic]thereis[sic] a foreign body that goes

withthetissuesbutunluckilyIdon'tknowwheretherubberwas.17
ThetrialcourtdeemedvitalDr.VictoriaBatiquin'stestimonythatwhensheconfrontedDr.Khoregardingthepieceof
rubber,"Dr.Khoansweredthattherewasrubberindeedbutthatshethrewitaway."18Thisstatement,thetrialcourt
noted,wasneverdeniednordisputedbyDr.Kho,leadingittoconclude:

Therearenowtwodifferentversionsonthewhereaboutsofthatoffending"rubber"(1)thatitwas
senttothePathologistinCebuastestifiedtoinCourtbyDr.Khoand(2)thatDr.Khothrewitawayas
toldbyhertoDefendant.ThefailureofthePlaintiffstoreconcilethesetwodifferentversionsserveonly
toweakentheirclaimagainstDefendantBatiquin.19
Alltold,thetrialcourtheldinfavorofthepetitionersherein.
The Court of Appeals reviewed the entirety of Dr. Kho's testimony and, even without admitting the private
respondents' documentary evidence, deemed Dr. Kho's positive testimony to definitely establish that a piece of
rubberwasfoundnearprivaterespondentVillegas'suterus.Thus,theCourtofAppealsreversedthedecisionofthe
trialcourt,holding:
4.ThefaultornegligenceofappelleeDr.Batiquinisestablishedbypreponderanceofevidence.The
trialcourtitselfhadnarratedwhathappenedtoappellantFlotildeafterthecaesareanoperationmade
by appellee doctor. . . . After the second operation, appellant Flotilde became well and healthy.
Appellant Flotilde's troubles were caused by the infection due to the "rubber" that was left inside her
abdomen.Bothappellanttestifiedthataftertheoperationmadebyappelleedoctor,theydidnotgoto
any other doctor until they finally decided to see another doctor in January, 1989 when she was not
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getting any better under the care of appellee Dr. Batiquin. . . . Appellee Dr. Batiquin admitted on the
witnessstandthatshealonedecidedwhentoclosetheoperatingareathatsheexaminedtheportion
she operated on before closing the same. . . Had she exercised due diligence, appellee Dr. Batiquin
wouldhavefoundtherubberandremoveditbeforeclosingtheoperatingarea.20
Theappellatecourtthenruled:
Appellants' evidence show[s] that they paid a total of P17,000.00 [deposit of P7,100.00 (Exh. G1A)
plushospitalandmedicalexpensestogetherwithdoctor'sfeesinthetotalamountP9,900.00(Exhs.G
andG2)]forthesecondoperationthatsavedherlife.
Forthemiseriesappellantsenduredformorethanthree(3)months,duetothenegligenceofappellee
Dr.BatiquintheyareentitledtomoraldamagesintheamountofP100,000.00exemplarydamagesin
theamountofP20,000.00andattorney'sfeesintheamountofP25,000.00.
The fact that appellant Flotilde can no longer bear children because her uterus and ovaries were
removedbyDr.Khoisnottakenintoconsiderationasitisnotshownthattheremovalofsaidorgans
werethedirectresultoftherubberleftbyappelleeDr.Batiquinneartheuterus.Whatisestablishedis
that the rubber left by appellee caused infection, placed the life of appellant Flotilde in jeopardy and
causedappellantfear,worryandanxiety....
WHEREFORE,theappealedjudgment,dismissingthecomplaintfordamagesisREVERSEDandSET
ASIDE.Anotherjudgmentisherebyenteredorderingdefendantsappelleestopayplaintiffsappellants
the amounts of P17,000.00 as and for actual damages P100,000.00 as and for moral damages
P20,000.00asandforexemplarydamagesandP25,000.00asandforattorney'sfeesplusthecosts
oflitigation.
SOORDERED.21
From the above judgment, the petitioners appealed to this Court claiming that the appellate court: (1) committed
graveabuseofdiscretionbyresortingtofindingsoffactnotsupportedbytheevidenceonrecord,and(2)exceeded
its discretion, amounting to lack or excess of jurisdiction, when it gave credence to testimonies punctured with
contradictionsandfalsities.
Theprivaterespondentscommentedthatthepetitionraisedonlyquestionsoffact,whichwerenotproperforreview
bythisCourt.
Whiletheruleisthatonlyquestionsoflawmayberaisedinapetitionforreviewoncertiorari,thereareexceptions,
among which are when the factual findings of the trial court and the appellate court conflict, when the appealed
decisionisclearlycontradictedbytheevidenceonrecord,orwhentheappellatecourtmisapprehendedthefacts.22
Afterdecipheringthecrypticpetition,wefindthatthefocalpointoftheinstantappealistheappreciationofDr.Kho's
testimony. The petitioners contend that the Court of Appeals misappreciated the following portion of Dr. Kho's
testimony:
QWhatisthepurposeoftheexamination?
AJustincase,Iwasjustthinkingatthebackofmymind,justincasethiswouldturnout
to be a medicolegal case, I have heard somebody that [sic] says [sic] there is [sic] a
foreignbodythatgoeswiththetissuesbutunluckilyIdon'tknowwheretherubberwas.It
wasnotintheLab,itwasnotinCebu.23(emphasissupplied)
Thepetitionerspreferthetrialcourt'sinterpretationoftheabovetestimony,i.e.,thatDr.Kho'sknowledgeof
the piece of rubber was based on hearsay. The Court of Appeals, on the other hand, concluded that the
underscored phrase was taken out of context by the trial court. According to the Court of Appeals, the trial
courtshouldhavelikewiseconsideredtheotherportionsofDr.Kho'stestimony,especiallythefollowing:
QSoyoudidactuallyconducttheoperationonher?
AYes,Idid.
QAndwhatwastheresult?
A Opening up her abdomen, there was whitishyellow discharge inside the abdomen,
therewasanovariancystontheleftandsideandtherewasalsoanovariancystonthe
right which, on opening up or freeing it up from the uterus, turned out to be pus. Both
ovaries turned out. . . to have pus. And then, cleaning up the uterus, at the back of the
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uterusitwasverydirty,itwasfullofpus.Andtherewasa[pieceof]rubber,wefounda
[pieceof]rubberontheright
side.24
WeagreewiththeCourtofAppeals.ThephraserelieduponbythetrialcourtdoesnotnegatethefactthatDr.Kho
saw a piece of rubber in private respondent Villegas's abdomen, and that she sent it to a laboratory and then to
CebuCityforexaminationbyapathologist.25 Not even the Pathologist's Report, although devoid of any mention of a
pieceofrubber,couldalterwhatDr.Khosaw.Furthermore,Dr.Kho'sknowledgeofthepieceofrubbercouldnotbebasedon
otherthanfirsthandknowledgefor,assheassertedbeforethetrialcourt:

QButyouaresureyouhaveseen[thepieceofrubber]?
AOhyes.Iwasnottheonlyonewhosawit.26
The petitioners emphasize that the private respondents never reconciled Dr. Kho's testimony with Dr. Batiquin's
claim on the witness stand that when Dr. Batiquin confronted Dr. Kho about the foreign body, the latter said that
therewasapieceofrubberbutthatshethrewitaway.Althoughhearsay,Dr.Batiquin'sclaimwasnotobjectedto,
and hence, the same is admissible 27 but it carries no probative value. 28 Nevertheless, assuming otherwise, Dr.
Batiquin'sstatementcannotbeliethefactthatDr.KhofoundapieceofrubbernearprivaterespondentVillegas'suterus.And
evenifweweretodoubtDr.Khoastowhatshedidtothepieceofrubber,i.e.,whethershethrewitawayorsentittoCebu
City,wearenotjustifiedindistrustingherastoherrecoveryofapieceofrubberfromprivaterespondentVillegas'sabdomen.
Onthisscore,itisperfectlyreasonabletobelievethetestimonyofawitnesswithrespecttosomefactsanddisbelievehis
testimony with respect to other facts. And it has been aptly said that even when a witness is found to have deliberately
falsifiedinsomematerialparticulars,itisnotrequiredthatthewholeofhisuncorroboratedtestimonyberejected,butsuch
portionsthereofdeemedworthyofbeliefmaybecredited.29

It is here worth noting that the trial court paid heed to the following portions of Dr. Batiquin's testimony: that no
rubberdrainwasusedintheoperation,30andthattherewasneitheranytearonDr.Batiquin'sglovesaftertheoperation
nor blood smears on her hands upon removing her gloves.31 Moreover, the trial court pointed out that the absence of a
rubberdrainwascorroboratedbyDr.DorisSy,Dr.Batiquin'sassistantduringtheoperationonprivaterespondentVillegas.32
ButthetrialcourtfailedtorecognizethattheassertionsofDrs.BatiquinandSyweredenialsornegativetestimonies.Well
settledistherulethatpositivetestimonyisstrongerthannegativetestimony.33Ofcourse,asthepetitionersadvocate,such
positivetestimonymustcomefromacrediblesource,whichleadsustothesecondassignederror.

While the petitioners claim that contradictions and falsities punctured Dr. Kho's testimony, a regarding of the said
testimonyrevealsnosuchinfirmityandestablishesDr.Khoasacrediblewitness.Dr.Khowasfrankthroughouther
turnonthewitnessstand.Furthermore,nomotivetostateanyuntruthwaseverimputedagainstDr.Kho,leaving
hertrustworthinessunimpaired.34Thetrialcourt'sfollowingdeclarationshowsthatwhileitwascriticalofthelackofcare
withwhichDr.Khohandledthepieceofrubber,itwasnotpreparedtodoubtDr.Kho'scredibility,thusonlysupportingour
appraisalofDr.Kho'strustworthiness:

Thisisnottosaythatshewaslessthanhonestwhenshetestifiedaboutherfindings,butitcanalsobe
said that she did not take the most appropriate precaution to preserve that "piece of rubber" as an
eloquent evidence of what she would reveal should there be a "legal problem" which she claim[s] to
haveanticipated.35
ConsideringthatwehaveassessedDr.Khotobeacrediblewitness,herpositivetestimony[thatapieceofrubber
was indeed found in private respondent Villega's abdomen] prevails over the negative testimony in favor of the
petitioners.
As such, the rule of res ipsa loquitur comes to fore. This Court has had occasion to delve into the nature and
operationofthisdoctrine:
This doctrine [res ipsa loquitur] is stated thus: "Where the thing which causes injury is shown to be
underthemanagementofthedefendant,andtheaccidentissuchasintheordinarycourseofthings
doesnothappeninthosewhohavethemanagementusepropercare,itaffordsreasonableevidence,
intheabsenceofanexplanationbythedefendant,thattheaccidentarosefromwantofcare."Oras
Black'sLawDictionaryputsit:
Res ipsa loquitur. The thing speaks for itself. Rebuctable presumption or inference that
defendantwasnegligent,whicharisesuponproofthat[the]instrumentalitycausinginjury
wasindefendant'sexclusivecontrol,andthattheaccidentwasonewhichordinarydoes
not happen in absence of negligence. Res ipsa loquitur is [a] rule of evidence whereby
negligence of [the] alleged wrongdoer may be inferred from [the] mere fact that [the]
accidenthappenedprovided[the]characterof[the]accidentandcircumstancesattending
itleadreasonablytobeliefthatin[the]absenceofnegligenceitwouldnothaveoccurred
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and that thing which caused injury is shown to have been under [the] management and
controlof[the]allegedwrongdoer....Under[this]doctrine
...thehappeningofaninjurypermitsaninferenceofnegligencewhereplaintiffproduces
substantial evidence that [the] injury was caused by an agency or instrumentality under
[the] exclusive control and management of defendant, and that the occurrence [sic] was
suchthatintheordinarycourseofthingswouldnothappenifreasonablecarehadbeen
used.
xxxxxxxxx
Thedoctrineof[r]esipsaloquiturasaruleofevidenceispeculiartothelawofnegligence
whichrecognizesthatprimafacienegligencemaybeestablishedwithoutdirectproofand
furnishes a substitute for specific proof of negligence. The doctrine is not a rule of
substantivelaw,butmerelyamodeofprooforamereproceduralconvenience.Therule,
whenapplicabletothefactsandcircumstancesofaparticularcase,isnotintendedtoand
does not dispense with the requirement of proof of culpable negligence on the party
charged. It merely determines and regulates what shall be primafacie evidence thereof
and facilitates the burden of plaintiff of proving a breach of the duty of due care. The
doctrine can be invoked when and only when, under the circumstances involved, direct
evidenceisabsentandnotreadilyavailable.36
In the instant case, all the requisites for recourse to the doctrine are present. First, the entire proceedings of the
caesareansectionwereundertheexclusivecontrolofDr.Batiquin.Inthislight,theprivaterespondentswerebereft
of direct evidence as to the actual culprit or the exact cause of the foreign object finding its way into private
respondentVillegas'sbody,which,needlesstosay,doesnotoccurunlessthroughtheintersectionofnegligence.
Second,sinceasidefromthecaesareansection,privaterespondentVillegasunderwentnootheroperationwhich
couldhavecausedtheoffendingpieceofrubbertoappearinheruterus,itstandstoreasonthatsuchcouldonly
havebeenabyproductofthecaesareansectionperformedbyDr.Batiquin.Thepetitioners,inthisregard,failedto
overcome the presumption of negligence arising from resort to the doctrine of res ipsa loquitur. Dr. Batiquin is
thereforeliablefornegligentlyleavingbehindapieceofrubberinprivaterespondentVillegas'sabdomenandforall
theadverseeffectsthereof.
Asafinalword,thisCourtreiteratesitsrecognitionofthevitalrolethemedicalprofessionplaysinthelivesofthe
people,37andtheState'scompellinginteresttoenactmeasurestoprotectthepublicfrom"thepotentiallydeadlyeffectsof
incompetenceandignoranceinthosewhowouldundertaketotreatourbodiesandmindsfordiseaseortrauma."38Indeed,
aphysicianisboundtoservetheinterestofhispatients"withthegreatestofsolicitude,givingthemalwayshisbesttalent
and skill." 39 Through her tortious conduct, the petitioner endangered the life of Flotilde Villegas, in violation of her
profession's rigid ethical code and in contravention of the legal standards set forth for professionals, in general, 40 and
membersofthemedicalprofession,41inparticular.

WHEREFORE,thechallengeddecisionof11May1994oftheCourtofAppealsinCAG.R.CVNo.30851ishereby
AFFIRMEDintoto.
Costsagainstthepetitioners.
SOORDERED.
Narvasa,C.J.,Melo,FranciscoandPanganiban,JJ.,concur.
Footnotes
1ImplementedinBabylon,ca.2250B.C.
2SeeL.J.REGAN,DOCTORANDPATIENTANDTHELAW,2d.ed.[1949],34.
3460377B.C.
4P.SOLIS,MEDICALJURISPRUDENCE[1988ed.],5.
5Appendix"A"ofPetitionRollo,1222.PerAustriaMartinez,M.A.,J.,withMarigomen,A.,andReyes,R.
JJ.,concurring.
6OriginalRecords(OR),260272.PerJudgeEnriqueC.Garrovillo.
7OR,261264.
8TSN,12July1990,49.
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9Id.,5051.
10OR,132.
11Id.,135137.
12Id.,138.
13Id.,139140.
14Id.,141.
15Id.,268.
16Id.,266.
17TSN,12July1990,49.
18OR,269.
19Id.
20Rollo,20.
21Id.,21.
22 Remalante vs. Tibe, 158 SCRA 138, 145 [1988] Medina vs. Asistio, 191 SCRA 218, 223224 [1990]
Borillo vs. Court of Appeals, 209 SCRA 130, 140141 [1992] Director of Lands vs. Intermediate Appellate
Court,209SCRA214,221[1992]Margollesvs.CourtofAppeals,230SCRA97,106[1994].
23TSN,12July1990,49.
24TSN,12July1990,9.
25Id.,1049.
26TSN,12July1990,10.
27RICARDOJ.FRANCISCO,Evidence,255[1993].
28Peoplevs.Laurente,G.R.No.116734,29March1996,at24,citationsomitted.
29Peoplevs.Ducay,225SCRA1,14[1993]Peoplevs.Caeja,235SCRA328,337[1994].
30TSN,31August1990,20.
31Id.,21.
32TSN,10September1990,5.
33Peoplevs.Antonio,233SCRA283,299[1994].
34 See People vs. De Leon, 245 SCRA 538, 545 [1995] People vs. Malunes, 247 SCRA 317, 326327
[1995].
35OR,267.
36Layuganvs.IntermediateAppellateCourt,167SCRA363,376377[1988].SeediscussionsinMartinez
vs.VanBuskirk,18Phil.79,8586[1910]Africavs.Caltex(Phil.)Inc.,16SCRA448,454456[1966]F.F.
CruzandCo.,Inc.vs.CourtofAppeals,164SCRA731,736[1988].
37DepartmentofEducation,Culture,andSportsvs.SanDiego,180SCRA533,538[1989].
38Tablarinvs.Gutierrez,152SCRA730,743,[1987].
39Section3,Article1,1960CodeofEthicsoftheMedicalProfessioninthePhilippines,ascitedinCarillovs.
People,229SCRA386,396[1994].
40CulionIce,Fish&Elec.Co.vs.Phil.MotorsCorporation,55Phil.129133[1930].
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41 Stevenson vs. Yates, 208 SW 820 [1919] Kennedy vs. Parrott, 90 SE 2d 754 [1956] DeLaughter vs.
Womack,164So2d762[1994]Hillvs.Stewart,209So2d809[1968].
TheLawphilProjectArellanoLawFoundation

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