SUBJECT OUTLINE BY Atty.

Judy Anne Yuki Yulo

A. Legal medicine - branch of medicine that deals with the application of medical knowledge to the purposes of law
and in the administration of justice.
Forensic medicine - application of medical science to elucidate
legal problems.
Medical jurisprudence - deals with the aspect of law and legal concepts in relation with the practice of medicine
Why do we need to study Legal Medicine and Medical Jurisprudence?
B. RULES OF COURT: RULE 138 ATTORNEYS AND ADMISSION TO BAR Section 5.
Section 5. Additional requirements for other applicants. All applicants for admission other than those
referred to in the two-preceding section shall, before being admitted to the examination, satisfactorily show that they
have regularly studied law for four years, and successfully completed all prescribed courses, in a law school or
university, officially approved and recognized by the Secretary of Education. The affidavit of the candidate,
accompanied by a certificate from the university or school of law, shall be filed as evidence of such facts, and further
evidence may be required by the court.
No applicant shall be admitted to the bar examinations unless he has satisfactorily completed the following courses in a
law school or university duly recognized by the government: civil law, commercial law, remedial law, criminal law,
public and private international law, political law, labor and social legislation, medical jurisprudence, taxation and legal
ethics.
C. CONSTITUTION ARTICLE 12 NATIONAL ECONOMY and PATRIMONY Section 14.
Section 14.The sustained development of a reservoir of national talents consisting of Filipino scientists, entrepreneurs,
professionals, managers, high-level technical manpower and skilled workers and craftsmen in all fields shall be
promoted by the State. The State shall encourage appropriate technology and regulate its transfer for the national benefit.
The practice of all professions in the Philippines shall be limited to Filipino citizens, save in cases prescribed by law.
D. REPUBLIC ACT No. 2382 : THE MEDICAL ACT OF 1959
ARTICLE II Section 6
Section 6.Minimum required courses.Students seeking admission to the medical course must have a bachelor of science
or bachelor of arts degree or their equivalent and must have taken in four years the following subjects with their
corresponding number of units:
Twelve units of Spanish shall be required pursuant to Republic Act Numbered Seven hundred nine; but commencing
Unit Zoology and Botany 15
English 12 Physics 8
Latin 3 Chemistry 21
Mathematics, including Accounting and Statistics 9 Library Science 1
Philosophy, including Psychology and Logic 12 Humanities and Social Sciences 12
with the academic year nineteen hundred sixty to nineteen hundred sixty-one, twenty-four units of Spanish shall be
required pursuant to Republic Act Numbered Eighteen hundred and eighty-one as cultural, social and nationalistic
studies.
Provided, That the following students may be permitted to complete the aforesaid preparatory medical course in shorter
periods as follows:
(a) Students whose general average is below eighty-five per cent but without any grade of failure or condition
may be allowed to pursue and finish the course in three academic years and the intervening summer sessions;
and
(b) Students whose general average is eighty-five per cent or over may be permitted to finish the course in three
academic years by allowing them to take each semester the overload permitted to bright students under existing
regulations of the Bureau of Private Schools.
Provided, That upon failure to maintain the general average of eighty-five per cent, students under (b) shall automatically
revert to the category of students under (a) and those under (a), upon having any grade of failure or condition, shall
automatically revert to the category of students required to pursue the preparatory course in four years mentioned above.
The medical course shall be at least five years, including not less than eleven rotating internship in an approved hospital,
and shall consist of the following subjects:
Anatomy,Physiology,Biochemistry and Nutrition,Pharmacology,Microbiology,Parasitology,Medicine and
Therapeutics,GenycologyOpthalmology, Otology, Rhinology and LaryngologyPediatricsObstetricsSurgery
Preventive Medicine and Public Health Legal Medicine, including Medical Jurisprudence and Ethics.
SUBJECT OUTLINE BY Atty.Judy Anne Yuki Yulo
ARTICLE III Section8,9,10,11,12,22,23,24,25,26,27
ARTICLE IIITHE BOARD OF MEDICAL EXAMINERS; REGISTRATION OF PHYSICIANS
Section 8.Prerequisite to the practice of medicine.No person shall engage in the practice of medicine in the Philippines
unless he is at least twenty-one years of age, has satisfactorily passed the corresponding Board Examination, and is a holder
of a valid Certificate of Registration duly issued to him by the Board of Medical Examiners.
Section 9.Candidates for board examination.Candidates for Board examinations shall have the following qualifications:
(1) He shall be a citizen of the Philippines or a citizen of any foreign country who has submitted competent and
conclusive documentary evidence, confirmed by the Department of Foreign Affairs, showing that his country's
existing laws permit citizens of the Philippines to practice medicine under the same rules and regulations governing
citizens thereof;
(2) He shall be of good moral character, showing for this purpose certificate of civil status;
(3) He shall be of sound mind;
(4) He shall not have been convicted by a court of competent jurisdiction of any offense involving moral turpitude;
and
(5) He shall be a holder of the degree of Doctor of Medicine or its equivalent, conferred by a college of medicine
duly recognized by the Department of Education.
Section 10.Acts constituting practice of medicine.A person shall be considered as engaged in the practice of medicine (a)
who shall, for compensation, fee, salary or reward in any form, paid to him directly or through another, or even without the
same, physical examine any person, and diagnose, treat, operate or prescribe any remedy for any human disease, injury,
deformity, physical, mental or physical condition or any ailment, real or imaginary, regardless of the nature of the remedy
or treatment administered, prescribed or recommended; or (b) who shall, by means of signs, cards, advertisements, written
or printed matter, or through the radio, television or any other means of communication, either offer or undertake by any
means or method to diagnose, treat, operate or prescribe any remedy for any human disease, injury, deformity, physical,
mental or physical condition; or (c) who shall use the title M.D. after his name.
Section 11.Exemptions.The preceding section shall not be construed to affect (a) any medical student duly enrolled in an
approved medical college or school under training, serving without any professional fee in any government or private
hospital, provided that he renders such service under the direct supervision and control of a registered physician; (b) any
legally registered dentist engaged exclusively in the practice of dentistry; (c) any duly registered masseur or physiotherapist,
provided that he applies massage or other physical means upon written order or prescription of a duly registered physician,
or provided that such application of massage or physical means shall be limited to physical or muscular development; (d)
any duly registered optometrist who mechanically fits or sells lenses, artificial eyes, limbs or other similar appliances or
who is engaged in the mechanical examination of eyes for the purpose of constructing or adjusting eye glasses, spectacles
and lenses; (e) any person who renders any service gratuitously in cases of emergency, or in places where the services of a
duly registered physician, nurse or midwife are not available; (f) any person who administers or recommends any household
remedy as per classification of existing Pharmacy Laws; and (g) any psychologist or mental hygienist in the performance
of his duties, provided such performance is done in conjunction with a duly registered physician.
Section 12.Limited practice without any certificate of registration.Certificates of registration shall not be required of the
following persons:
(a) Physicians and surgeons from other countries called in consultation only and exclusively in specific and definite
cases, or those attached to international bodies or organization assigned to perform certain definite work in the
Philippines provided they shall limit their practice to the specific work assigned to them and provided further they
shall secure a previous authorization from the Board of Medical Examiners.
(b) Commissioned medical officers of the United States armed forces stationed in the Philippines while rendering
service as such only for the members of the said armed forces and within the limit of their own respective territorial
jurisdiction.
(c) Foreign physicians employed as exchange professors in special branches of medicine or surgery whose service
may in the discretion of the Board of Medical Education, be necessary.
(d) Medical students who have completed the first four years of medical course, graduates of medicine and
registered nurses who may be given limited and special authorization by the Secretary of Health to render medical
services during epidemics or national emergencies whenever the services of duly registered physicians are not
available. Such authorization shall automatically cease when the epidemic or national emergency is declared
terminated by the Secretary of Health.
Section 13.The Board of Medical Examiners, its composition and duties.The Board of Medical Examiners shall be
composed of six members to be appointed by the President of the Philippines from a confidential list of not more than
twelve names approved and submitted by the executive council of the Philippine Medical Association, after due
consultation with other medical associations, during the months of April and October of each year. The chairman of the
Board shall be elected from among themselves by the member at a meeting called for the purpose. The President of the
Philippines shall fill any vacancy that may occur during any examination from the list of names submitted by the Philippine
Medical Association in accordance with the provisions of this Act.
No examiner shall handle the examinations in more than four subjects or groups of subjects as hereinafter provided. The
distribution of subject to each member shall be agreed upon at a meeting called by the chairman for the purpose. The
examination papers shall be under the custody of the Commissioner of Civil Service or his duly authorized representative,
and shall be distributed to each member of the Board who shall correct, grade, and sign, and submit them to the said
Commissioner within one hundred twenty days from the date of the termination of the examinations.
A final meeting of the Board for the deliberation and approval of the grades shall be called by the Commissioner of Civil
Service immediately after receipt of the records from the members of the Board of Medical Examiners. The secretary of
the Board shall submit to the President of the Philippines for approval the names of the successful candidates as having
been duly qualified for licensure in alphabetical order, without stating the ratings obtained by each.
Section 14.Qualifications of examiners.No person shall be appointed a member of the Board of Medical Examiners unless
he or she (1) is a natural-born citizen of the Philippines, (2) is a duly registered physician in the Philippines, (3) has been
in the practice of medicine for at least ten years, (4) is of good moral character and of recognized standing in the medical
profession, (5) is not a member of the faculty of any medical school and has no pecuniary interest, directly or indirectly, in
any college of medicine or in any institution where any branch of medicine is taught, at the time of his
appointment:Provided, That of the six members to be appointed, not more than two shall be graduates of the same institution
and not more than three shall be government physicians.
Section 15.Tenure of office and compensation of members.The members of the Board of Medical Examiners shall hold
office for one year:Provided, That any member may be reappointed for not more than one year. Each member shall receive
as compensation ten pesos for each candidate examined for registration as physician, and five pesos for each candidate
examined in the preliminary or final physician examination.
The President of the Philippines, upon the recommendation of the Commissioner of Civil Service , after due investigation,
may remove any member of the Board of Medical Examiners for neglect of duty, incompetency, or unprofessional or
dishonorable conduct.
Section 16.Executive Officer and Secretary of the Board.The Secretary of the Boards of Examiners appointed in accordance
with section ten of Act Numbered Four thousand seven, as amended, shall also be the secretary of the Board of Medical
Examiners, who shall keep all the records, including examination papers, and the minutes of the deliberations of the Board.
He shall also keep a register of all persons to whom certificates of registration has been granted; set forth the name, sec,
age, and place of birth of each, place of business, post office address, the name of the medical college or university from
which he graduated or in which he had studied, together with time spent in the study of the profession elsewhere, the name
of the country where the institution is located which had granted to him the degree or certificate of attendance upon clinic
and all lectures in medicine and surgery, and all other degrees granted to him from institutions of learning. He shall keep
an up-to-date registration book of all duly registered physicians in the Philippines. He shall furnish copies of all examination
questions and ratings in each subject of the respective candidates in the physicians examination, one month after the release
of the list of successful examinees, to the deans of the different colleges of medicine exclusively for the information and
guidance of the faculties thereof. This report shall be considered as restricted information. Any school which violates this
rule shall be deprived of such privilege. The secretary of the Board shall likewise keep a record of all registered medical
students. He shall keep all the records and proceedings, and issue and receive all papers in connection with any and all
complaints presented to the Board.
Section 17.Rules and regulations.The Board of Medical Examiners, with the approval of the Commissioner of Civil
Service, shall promulgate such rules and regulations as may be necessary for the proper conduct of the examinations,
correction of examination papers, and registration of physicians. The Commissioner shall supervise each Board
examination and enforce the said rules and regulations. These rules and regulations shall take effect fifteen days after the
date of their publication in the Official Gazette and shall not be changed within sixty days immediately before any
examination. Such rules and regulations shall be printed and distributed for the information and guidance of all concerned.
Section 18.Dates of examinations.The Board of Medical Examiners shall give examinations for the registration of
physicians, one in May and one in November every year, in the City of Manila or any of its suburbs after giving not less
than ten days' notice to each candidate who had filed his name and address with the secretary of the Board.
Section 19.Fees.The secretary of the Board, under the supervision of the Commissioner of Civil Service, shall collect from
each candidate the following fees:
For registration as medical student P 5.00 For preliminary or final examination 40.00
For complete physician examination 75.00 For registration as physician 20.00
All fees paid as provided herein shall accrue to the funds of the Board of Medical Examiners and be expended for the
payment of the compensation of the members thereof. No fees other than those provided herein shall be paid to the Board.
Section 20.Issuance of Certificate of Registration, grounds for refusal of same.The Commissioner of Civil Service and the
secretary of the Board of Medical Examiners shall sign jointly and issue certificates of registration to those who have
satisfactorily complied with the requirements of the Board. They shall not issue a certificate of registration to any candidate
who has been convicted by a court of competent jurisdiction of any criminal offense involving moral turpitude, or has been
found guilty of immoral or dishonorable conduct after he due investigation by the Board of Medical Examiners, or has been
declared to be of unsound mind.
Section 21.Scope of examination.The examination for the registration of physicians shall consist of the following subjects:
(1) Anatomy and Histology, (2) Physiology, (3) Biochemistry, (4) Microbiology and Parasitology, (5) Pharcology and
Therapeutics, (6) Pathology, (7) Medicine, (8) Obstetrics and Gynecology, (9) Pediatrics and Nutrition, (10) Surgery and
Opthalmology, Otolaryngology and Rhinology, (11) Preventive Medicine and Public Health, and (12) Legal Medicine,
Ethics and Medical Jurisprudence:Provided,however, That the examination questions in each subject or group of subject
shall at least be ten in number:Provided, further, That the examination questions in Medicine shall include at least three
from the following branches: Infectious diseases, Neurology, Dermatology, Allergy, Endocrinology and Cardio-Vascular
diseases:Provided,finally, That the examination questions in Surgery shall include at least four questions from the
following: Opthalmology, Otology, Rhinology, Laryngology, Orthopedic Surgery and Anesthesiology.
The questions shall be the same for all applicants. All answers must be written either in English or Spanish. No name of
the examinee shall appear in the examination paper but the examiners shall devise a system whereby each applicant can be
identified by number only.

3
In order that a candidate may be deemed to have passed his examination successfully he must have obtained a general
average of seventy-five per cent without a grade lower than sixty-five per cent in Medicine, Pediatrics and Nutrition,
Obstetrics and Gynecology, and Preventive Medicine and Public Health, and no grade lower than fifty per cent in the rest
of the subjects.
The preliminary examinations shall comprise of the following subjects:
(1) Gross Anatomy and Histology
(2) Physiology
(3) Biochemistry
(4) Microbiology and Parasitology
Section 22.Administrative investigations. In addition to the functions provided for in the preceding sections, the
Board of Medical Examiners shall perform the following duties: (1) to administer oath to physicians who qualified
in the examination; (2) to study the conditions affecting the practice of medicine in all parts of the Philippines; (3)
to exercise the powers conferred upon it by this article with the view of maintaining the ethical and professional
standards of the medical profession; (4) to subpoena or subpoena duces tecum witnesses for all purposes required
in the discharge of its duties; and (5) to promulgate, with the approval of the Commissioner of Civil Service, such
rules and regulations as it may deem necessary for the performance of its duties in harmony with the provisions of
this Act and necessary for the proper practice of medicine in the Philippines.
Administrative investigations may be conducted by not less than four members of the Board of Medical Examiners;
otherwise the proceedings shall be considered void. The existing rules of evidence shall be observed during all
administrative investigations. The Board may disapprove applications for examination or registration, reprimand erring
physicians, or suspend or revoke registration certificates, if the respondents are found guilty after due investigations.
Section 23.Procedure and rules.Within five days after the filling of written charges under oath, the respondent physician
shall be furnished a copy thereof, without requiring him or her to answer the same, and the Board shall conduct the
investigation within five days after the receipt of such copy by the respondent. The investigation shall be completed as soon
as practicable.
Section 24.Grounds for reprimand, suspension or revocation of registration certificate.Any of the following shall be
sufficient ground for reprimanding a physician, or for suspending or revoking a certificate of registration as physician:
(1) Conviction by a court of competent jurisdiction of any criminal offense involving moral turpitude;
(2) Immoral or dishonorable conduct;
(3) Insanity;
(4) Fraud in the acquisition of the certificate of registration;
(5) Gross negligence, ignorance or incompetence in the practice of his or her profession resulting in an injury to or
death of the patient;
(6) Addiction to alcoholic beverages or to any habit forming drug rendering him or her incompetent to practice his
or her profession, or to any form of gambling;
(7) False or extravagant or unethical advertisements wherein other things than his name, profession, limitation of
practice, clinic hours, office and home address, are mentioned.
(8) Performance of or aiding in any criminal abortion;
(9) Knowingly issuing any false medical certificate;
(10) Issuing any statement or spreading any news or rumor which is derogatory to the character and reputation of
another physician without justifiable motive;
(11) Aiding or acting as a dummy of an unqualified or unregistered person to practice medicine;
(12) Violation of any provision of the Code of Ethics as approved by the Philippine Medical Association.
Refusal of a physician to attend a patient in danger of death is not a sufficient ground for revocation or suspension of his
registration certificate if there is a risk to the physician's life.
Section 25.Rights of respondents.The respondent physician shall be entitled to be represented by counsel or be heard by
himself or herself, to have a speedy and public hearing, to confront and to cross-examine witnesses against him or her, and
to all other rights guaranteed by the Constitution and provided for in the Rules of Court.
Section 26.Appeal from judgment.The decision of the Board of Medical Examiners shall automatically become final thirty
days after the date of its promulgation unless the respondent, during the same period, has appealed to the Commissioner of
Civil Service and later to the Office of the President of the Philippines. If the final decision is not satisfactory, the respondent
may ask for a review of the case, or may file in court a petition forcertiorari.
Section 27.Reinstatement.After two years, the Board may order the reinstatement of any physicians whose certificate of
registration has been revoked, if the respondent has acted in an exemplary manner in the community wherein he resides
and has not committed any illegal, immoral or dishonorable act.
ARTICLE IV Section 28,29.
ARTICLE IVPENAL AND OTHER PROVISIONS
Section 28.Penalties.Any person found guilty of "illegal practice of medicine" shall be punished by a fine of not less than
one thousand pesos nor more than ten thousand pesos with subsidiary imprisonment in case of insolvency, or by
imprisonment of not less than one year nor more than five years, or by both such fine and imprisonment, in the discretion
of the court.
Section 29.Injunctions.The Board of Medical Examiners may file an action to enjoin any person illegally practicing
medicine from the performance of any act constituting practice of medicine if the case so warrants until the necessary
certificate therefore is secured. Any such person who, after having been so enjoined, continues in the illegal practice of
medicine shall be punished for contempt of court. The said injunction shall not relieve the person practicing medicine
without certificate of registration from criminal prosecution and punishment as provided in the preceding section.
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Section 30.Appropriation.To carry out the provisions of this Act, there is hereby appropriated, out of any funds in the
National Treasury not otherwise appropriated, the sum of twenty thousand pesos.
Section 31.Repealing clause.All Acts, executive orders, administrative orders, rules and regulations, or parts thereof
inconsistent with the provisions of this Act are repealed or modified accordingly.
Section 32.Effectivity.This Act shall take effect upon its approval:Provided, That if it is approved during the time when
examinations for physicians are held, it shall take effect immediately after the said examinations:Provided, further, That
section six of this Act shall take effect at the beginning of the academic year nineteen hundred sixty to nineteen hundred
sixty-one, and the first paragraph of section seven shall take effect four years thereafter.
E. ILLEGAL OR UNAUTHORIZED PRACTICE OF MEDICINE VS MEDICAL MALPRACTICE
ILLEGAL OR UNAUTHORIZED PRACTICE OF MEDICINE - Every act having as its object to diagnose or treat any
deficiency in the health of a human being constitutes the practice of medicine.
MEDICAL MALPRACTICE -is professional negligence by act or omission by a health care provider in which the treatment
provided falls below the accepted standard of practice in the medical community and causes injury or death to the patient,
with most cases involving medical error.
F. DOCTRINES
1. Doctrine of Vicarious Liability / Imputed Negligence / Doctrine of Respondeat Superior
1.1Doctrine of vicarious liability.A legal doctrine that assigns liability for an injury to a person who did not cause
the injury but who has a particular legal relationship to the person who did act negligently. Also referred to
as Imputednegligence.
1.2Imputed negligence results in vicarious liability, where the principal is responsible for the acts of his agents.
For example
o Employers have vicarious liability for the actions of their employees. If an employee injures someone in
the course of employment, then it doesn't matter whether the employer could have done anything to prevent
itthe employer will be held liable regardless.
o Other instances of imputed negligence are through the effect of the family purpose doctrine that holds
parents responsible for the negligent acts of their children, or the dram shop law, which holds the seller of
alcoholic beverages liable for drunken patrons. If a patron drives after drinking at a tavern, and
subsequently kills or injures someone with his vehicle, then the tavern owner can be held liable.
1.3Doctrine of respondeat superior Lat.Let the master answer. A legal doctrinewhich states that, in many
circumstances, an employeris responsible for the actions of employees performed within the course of their
employment.
2. Doctrine of Contributory Negligence or Doctrine of Common Fault
2.1Doctrine of Common Fault
- It has been defined as conduct on the part of the plaintiff or injured party, contributing as a legal cause to the harm
he has suffered, which falls below the standard which he is required to conform to his own protection.
- It is the act or omission amounting to want of care on the part of the complaining party which, concurring with
the defendants negligence, is the proximate cause of the injury.
Art. 2179, Civil Code
When the plaintiffs own negligence was the immediate and proximate cause of his injury, he cannot recover
damages. But if his negligence was only contributory, the immediate and proximate cause of injury being the
defendants lack of due care, the plaintiff may recover damages, but the court may mitigate the damages to be
awarded.
In quasi-delicts, the contributory negligence of the plaintiff shall reduce the damages that he may recover.
Some Instances where there is contributory negligence:
1. Failure to give the physician an accurate history;
2. Failure to follow the treatment recommended by the physician;
3. Leaving the hospital against the advice of the physician;
4. Failure to seek further medical assistance if symptoms persist.
3. Doctrine of Ostensible Agent or Doctrine of Apparent Authority
(Ostensible- stated or appearing to be true, but not necessarily so.)
3.1Apparent authority refers to "the power to affect the legal relations of another person by transactions with
third persons, professedly as agent for the other, arising from and in accordance with the others
manifestations to such third persons - Professional Services, Inc. vs. Agana, G.R. No. 126297, 31 January 2007
4. Borrowed Servant Doctrine
Ordinarily, resident physicians, nurses and other personnel of the hospital are employees or servants of the hospital;
In some instances, they are under the temporary supervision and control of another other than their employer while
performing their duties;
By fiction of law, they are deemed borrowed from the hospital by someone and for any wrongful act committed by
them during the period, their temporary employer must be held liable for the discharge of their acts and duties;
In the determination whether one is a borrowed servant, it is necessary that he is not only subjected to the control
of another with regard to the work done and the manner of performing it but also that the work to be done is for the
benefit of the temporary employer.
5. Captain of the Ship Doctrine is the legal doctrine which holds that, during an operation in an operating room, a surgeon
of record is liable for all actions conducted in the course of the operation.
6. Doctrine of Res Ipsa Loquitur or Doctrine of Common Knowledge
- The thing speaks for itself; nature of the wrongful act or injury is suggestive of negligence.
5
 - General rule: expert testimony is necessary to prove that a physician has done a negligent act or that has
deviated from the standard of medical practice.
Requisites of Res Ipsa Loquitor Doctrine:
1. The accident must be of a kind which ordinarily does not occur in the absence of someones negligence;
2. It must be caused by an agency or instrumentality within the exclusive control of the defendant;
3. It must not have been due to any voluntary action or contribution on the part of the plaintiff.
Some cases wherein the Doctrine of Res Ipsa Loquitor has been applied:
1. Objects left in the patients body at the time of caesarian section;
2. Injury to a healthy part of the body;
3. Removal of a wrong part of the body when another part was intended;
4. Infection resulting from unsterilized instruments;
5. Failure to take radiographs to diagnose a possible fracture;
Instances where the Doctrine of Res Ipsa Loquitor does not apply:
1. Where the Doctrine of Calculated Risk is applicable;
When an accepted method of medical treatment involves hazards, which may produce injurious results
regardless of the care exercised by the physician.
2. Bad Result Rule;
3. Honest Errors of judgment as to Appropriate Procedure;
4. Mistake in the Diagnosis.
- In most medical malpractice suits, there is a necessity for a physician to give his expert medical opinion to
prove whether acts or omissions constitute medical negligence. This doctrine has been regarded as rule of sympathy to
counteract the conspiracy of silence
According to one of the most distinguished jurist(Canada), Justice Mignault:
the practice of medicine and surgery is indispensable to humanity and should not be fettered by rules and
responsibility so strict as to exact an infallibility on the part of the physician which he does not possess.
we would be doing a disservice to the community at large if we were to impose liabilities on hospitals and
doctors for everything that goes wrong. Doctors would be led to think more of their own safety than the good of the
patients. Initiative would be stiffed and confidence shaken.
7. Doctrine of Assumption of Risk
Predicated upon knowledge and informed consent, anyone who voluntarily assumes the risk of injury from a known
danger, if injured, is barred from recovery.
violenti non fit injuria, which means that a person who assents and was injured is not regarded in law to be
injured
8. Doctrine of Last Clear Chance / Doctrine of Discovered Peril / Doctrine of Supervening
Negligence / Humanitarian Doctrine / Doctrine of Last Clear Chance A physician who has the last clear chance
of avoiding damage or injury but negligently fails to do is liable.
- It implies thought, appreciation, mental direction and lapse of sufficient time to effectually act upon impulse to
save the life or prevent injury to another.
Example
it was he who had the sufficient opportunity to avoid the accident after noticing the danger.
It applied to auto accidents, a typical case of last clear chance would be when one driver drifts over the
center line, and this action was noted by an on-coming driver who proceeds without taking simple evasive
action, crashes into the first driver, and is thus liable for the injuries to the first driver who was over the
line
Doctrine of Discovered Peril The doctrine [holding] that where both parties are negligent, but the negligent act of
one is appreciably later in time than that of the other, or when it is impossible to determine whose fault or negligence
should be attributed to the incident, the one who had the last clear opportunity to avoid the impending harm and
failed to do so is chargeable with the consequences thereof. [See Picart v. Smith, 37 Phil. 809].
Doctrine of Supervening Negligence Doctrine of supervening negligence.Also Doctrine of discovered peril. The
doctrine x x x to the effect that where both parties are negligent, but the negligent act of one is appreciably later in
time than that of the other, or when it is impossible to determine whose fault or negligence should be attributed to
the incident, the one who had the last clear opportunity to avoid the impending harm and failed to do so is
chargeable with the consequences thereof. [Picart v. Smith, 37 Phil. 809]. [A]n antecedent negligence of a person
does not preclude the recovery of damages for supervening negligence of, or bar a defense against the liability
sought by, another if the latter, who had the last fair chance, could have avoided the impending harm by the exercise
of due diligence. [Pantranco North Express, Inc. v. Baesa, 179 SCRA 384].
Humanitarian Doctrine- Doctrine of last clear chance. Also, known as the Doctrine of discovered peril or the
Humanitarian doctrine. A doctrine in the law of torts which states that the contributory negligence of the party
injured will not defeat the claim for damages if it is shown that the defendant might, by the exercise of reasonable
care and prudence, have avoided the consequences of the negligence of the injured party. In such cases, the person
who had the last clear chance to avoid the mishap is considered in law solely responsible for the consequences
thereof. [Ong v. Metropolitan Water District, 104 Phil. 405 (1958)].See Last clear chance doctrine.

9. Doctrine of Foreseeability

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 A physician cannot be held accountable for negligence if the injury sustained by the patient is on account of
unforeseen conditions but if a physician fails to ascertain the condition of the patient for want of the requisite skill
and training is answerable for the injury sustained by the patient if injury resulted thereto.
A physician owes duty of care to all persons who are foreseeably endangered by his conduct, with respect to the
risk which make the conduct unreasonably dangerous.
G. CASES
Name: 1.Carillo vs. People of the PhilippinesG.R. No. 86890, January 21, 1994
Facts Catherine had suffered from an overdose of, or an adverse reaction to, anesthesia, particularly the
arbitrary administration of Nubain, a pain killer, without benefit of prior weighing of the patient's body
mass, which weight determines the dosage of Nubain which can safely be given to a patient.
This condition triggered off a heart attack as a post-operative complication, depriving Catherine's brain
of oxygen, leading to the brain's haemorrhage. The Court of Appeals identified such cardiac arrest as
the immediate cause of Catherine's death.
Issue WON Dr. Carillo and Dr.Madrid breach their duty of being physician that constitute a criminal act
punishable under the Revised Penal Code (RPC) and other special penal laws provided?
Held/Rati Yes, Dr Carillo and Dr Madrid are guilty with simple negligence resulting to homicide.
o: It is the duty of a physician has been said to include the duty to serve the interest of his patient with the
greatest of solicitude, giving them always his best talent and skill.
The critical importance for present purposes is not so much the identification of the "true cause" or "real
cause" of Catherine's death but rather the set of circumstances which both the trial court and the
Court of Appeals found constituted simple (as distinguished from reckless) negligence on the part
of the two accused Dr. Madrid and Dr. Carillo leading to the death of Catherine.
Doctrine: simple negligence, penalized under what is now Article 365 of the Revised Penal Code, is
defined as "a mere lack of prevision in a situation where either the threatened harm is not
immediate or the danger not openly visible."

Name: 2.Batiquin v. CA G.R. No. 118231, July 5, 1996

NATURE Petition for review of the decision of the Court of Appeals
Facts Simple cesarean section on Mrs. Villegas was done under the exclusive control of Dr. Batiquin.The
abdominal pains and fever kept on recurring and bothered Mrs. Villegas no end and despite the
medications administered by Dr. Batiquin. When the pains become unbearable and she was rapidly
losing weight she consulted Dr. Ma. Salud Kho.
Dr. Kho opened the abdomen of Mrs. Villegas she found whitish-yellow discharge inside, an ovarian
cyst on each of the left and right ovaries which gave out pus, dirt and pus behind the uterus, and a piece
of rubber materials on the right side of the uterus embedded on [sic] the ovarian cyst, 2 inches by 3/4
inch in size. This piece of rubber material which Dr. Kho described as a "foreign body" looked like a
piece of a "rubber glove"
Issue WON Dr. Batiquin is negligent?
Held/Rati YES, Dr Batiquin is negligent in performing a simple cesarean to Mrs Villegas.
o: Throughout history, people have consigned their fates and lives to the skill of their doctors. To the
medical profession, society entrusts the sacred duty of preserving the virtues of life and good health.
Hence, only the most qualified individuals should engage in this profession.
Doctrine Medical Negligence

Name: 3.Garcia-Rueda v. Office of the City Prosecutor

NATURE May this Court review the findings of the Office of the Ombudsman?
Facts Florencio V. Rueda, husband of petitioner Leonila Garcia-Rueda, underwent surgical operation at the
UST hospital for the removal of a stone blocking his ureter. He was attended by Dr. Domingo Antonio,
Jr. who was the surgeon, while Dr. Erlinda Balatbat-Reyes was the anaesthesiologist. Six hours after
the surgery, however, Florencio died of complications of unknown cause," according to officials of the
UST Hospital.
Issue Whether or not expert testimony is necessary to prove the negligent act of the respondent?
Held/Rati Yes, in accepting a case, a doctor in effect represents that, having the needed training and skill possessed
o: by physicians and surgeons practicing in the same field, he will employ such training, care and skill in
the treatment of his patients. He therefore has a duty to use at least the same level of care that any other
reasonably competent doctor would use to treat condition under the same circumstances.
It is in this aspect of medical malpractice that expert testimony is essential to establish not only the
standard of care of the profession but also that the physicians conduct in the treatment and care falls
below such standard. Further, inasmuch as the causes of the injuries involved in malpractice actions are
determinable only in the light of scientific knowledge, it has been recognized that expert testimony is
usually necessary to support the conclusion as to causation
doctrine What is a probable cause?
Probable cause has been defined as the existence of such fact and circumstances as would excite the
belief,
1. in a reasonable mind,
7
 2. acting on the facts within the knowledge of the prosecution,
3. that the person charged was guilty of the crime for which he was prosecuted
finding of probable cause does not require an inquiry into whether there is sufficient evidence to procure
a conviction. It is enough that it is believed that the act or omission complained of constitutes the offense
charged
Proximate cause is defined as that cause, which, in natural and continuous sequence, unbroken by any
efficient intervening cause, produces the injury, and without which the result would not have
occurred. And more comprehensively, the proximate legal cause is that acting first and producing the
injury, either immediately or by setting other events in motion, all constituting a natural and continuous
chain of events, each having a close causal connection with its immediate predecessor, the final event
in the chain immediately effecting the injury as a natural and probable result of the cause which first
acted, under such circumstances that the person responsible for the first event should, as an ordinary
prudent and intelligent person, have reasonable ground to expect at the moment of his act or default that
an injury to some person might probably result therefrom
Elements of medical malpractice
the erring physician or surgeon who generally bears liability for damages suffered by virtue of art. 2176
of the Civil Code. His liability is predicated upon the concurrence of the four (4) elements of an
actionable malpractice: duty, breach, injury, and proximate causation.

Name: 4.Cruz v. CA G.R. No. 122445. November 18, 1997

Facts Lydia was examined by the petitioner who found a Myoma in her uterus, and scheduled her for a
hysterectomy operation on March 23, 1991. Rowena and her mother slept in the clinic on the evening
of March 22, 1991 as the latter was to be operated on the next day at 1pm. Later, without the knowledge
of Lydias relatives, she was decided by the doctors to be transferred to San Pablo District Hospital
where she was supposed to be re-operated. After Lydia experienced shocks, she died.
Issue Whether or not Dr Cruz has been negligent which caused the death of Lydia Umali?
Held/Rati Yes. Whether or not a physician has committed an inexcusable lack of precaution in the treatment of
o: his patient to be determined according to the standard of care observed by other members of the
profession in good standing under similar circumstances bearing in mind the advanced state of the
profession at the time of treatment or the present state of medical science.
doctrine It is in this aspect of medical malpractice that expert testimony is essential to establish not only the
standard of care of the profession but also that the physicians conduct in the treatment and care falls
below such standard.

Name: 5.Ramos v. CA, DSMC G.R. No. 124354 December 29, 1999
Facts Erlinda Ramos: 47-year old robust woman who underwent an operation for the removal of a stone in
her gall bladder. She had passed a series of examinations, which indicated she was fit for surgery.After
the surgery, Erlina was diagnosed to be suffering from diffuse cerebral parenchymal damage and that
the petitioner alleged that this was due to lack of oxygen supply to Erlindas brain which resulted from
the intubation.
Issue Whether or not the doctors and the hospital are liable for damages against petitioner for the result
to Erlinda of the said operation?
Held/Rati Yes. The private respondents were unable to disprove the presumption of negligence on their part in the
o: care of Erlinda and their negligence was the proximate case of her piteous condition.
doctrine Doctrine of respondeat superior Lat.Let the master answer. A legal doctrinewhich states that, in
many circumstances, an employer is responsible for the actions of employees performed within the
course of their employment.

Name: 6.Reyes v. Sisters of Mercy Hospital G.R. No. 130547 October 3, 2000
Facts Five days before his death on January 8, 1987, Jorge had been suffering from a recurring fever with
chills. After he failed to get relief from some home medication he was taking, which consisted of
analgesic, antipyretic, and antibiotics, he decided to see the doctor.
Issue Whether the court erred that the doctrine of res ipsa loquitur is not applicable
Held/Rati NO, in this case, while it is true that the patient died just a few hours after professional medical assistance
o: was rendered, there is really nothing unusual or extraordinary about his death. Prior to his admission,
the patient already had recurring fevers and chills for five days unrelieved by the analgesic, antipyretic,
and antibiotics given him by his wife. This shows that he had been suffering from a serious illness and
professional medical help came too late for him.
doctrine doctrine of res ipsa loquitur is not applicable
Medical Malpractice Defined
- failure of a physician to apply to his practice of medicine that degree of care and skill which is
ordinarily employed by the profession generally, under similar conditions, and in like surrounding
circumstances
Elements of Medical Malpractice duty the existence of a physician-patient relationship
breach of duty injury caused
8
causal connection between the breach of duty and the injury caused
Evidentiary Rule
TWO-PRONGED EVIDENCE:
evidence of the recognized standards
the physician negligently departed from these standards
EXPERT TESTIMONY ESSENTIAL:
In the present case, there is no doubt that a physician-patient relationship existed between respondent
doctors and Jorge Reyes. Respondents were thus duty-bound to use at least the same level of care that
any reasonably competent doctor would use to treat a condition under the same circumstances. It is
breach of this duty which constitutes actionable malpractice. As to this aspect of medical malpractice,
the determination of the reasonable level of care and the breach thereof, expert testimony is essential.
Inasmuch as the causes of the injuries involved in malpractice actions are determinable only in the light
of scientific knowledge, it has been recognized that expert testimony is usually necessary to support the
conclusion as to causation. (Reyes vs. Sisters of Mercy Hospital, supra)
EXCEPTION:
There is a case when expert testimony may be dispensed with, and that is under the doctrine of res ipsa
loquitur. As held in Ramos v. Court of Appeals:
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 loquitor is availed by the plaintiff, the need for expert medical testimony is
dispensed with because the injury itself provides the proof of negligence. 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. 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. 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. 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. 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 loquitor 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. (Reyes vs. Sisters of Mercy Hospital, supra)
Standard of Diligence Required
- the standard of care in the locality (Locality Rule)
- a physician is not liable for error in judgment (Error in Judgment Rule), provided he applied
reasonable skill and care
STANDARD OF DILIGENCE REQUIRED:
Indeed, the standard contemplated is not what is actually the average merit among all known
practitioners from the best to the worst and from the most to the least experienced, but the reasonable
average merit among the ordinarily good physicians.
STANDARD IS NOT EXTRAORDINARY DILIGENCE:
The standard of extraordinary diligence is peculiar to common carriers. The Civil Code provides: "Art.
1733. Common carriers, from the nature of their business and for reasons of public policy, are bound to
observe extraordinary diligence in the vigilance over the goods and for the safety of the passengers
transported by them, according to the circumstances of each case. . . ."
The practice of medicine is a profession engaged in only by qualified individuals. It is a right earned
through years of education, training, and by first obtaining a license from the state through professional
board examinations. Such license may, at any time and for cause, be revoked by the government. In
addition to state regulation, the conduct of doctors is also strictly governed by the Hippocratic Oath, an
ancient code of discipline and ethical rules which doctors have imposed upon themselves in recognition
and acceptance of their great responsibility to society. Given these safeguards, there is no need to
expressly require of doctors the observance of extraordinary diligence. As it is now, the practice of
medicine is already conditioned upon the highest degree of diligence. And, as we have already noted,
the standard contemplated for doctors is simply the reasonable average merit among ordinarily good
physicians. That is reasonable diligence for doctors or, as the Court of Appeals called it, the reasonable
skill and competence . . . that a physician in the same or similar locality . . . should apply. (Reyes vs.
Sisters of Mercy Hospital, supra)
Responsibility of the Hospital
Ramos vs. CA, G.R. No. 124354, Dec. 29, 1999
9
 RESPONSIBILITY OF THE HOSPITAL:
The unique practice (among private hospitals) of filling up specialist staff with attending and visiting
"consultants," who are allegedly not hospital employees, presents problems in apportioning
responsibility for negligence in medical malpractice cases. However, the difficulty is only more apparent
than real.
In the first place, hospitals exercise significant control in the hiring and firing of consultants and in the
conduct of their work within the hospital premises. Doctors who apply for "consultant" slots, visiting or
attending, are required to submit proof of completion of residency, their educational qualifications;
generally, evidence of accreditation by the appropriate board (diplomate), evidence of fellowship in
most cases, and references. These requirements are carefully scrutinized by members of the hospital
administration or by a review committee set up by the hospital who either accept or reject the
application. This is particularly true with respondent hospital.
After a physician is accepted, either as a visiting or attending consultant, he is normally required to
attend clinico-pathological conferences, conduct bedside rounds for clerks, interns and residents,
moderate grand rounds and patient audits and perform other tasks and responsibilities, for the privilege
of being able to maintain a clinic in the hospital, and/or for the privilege of admitting patients into the
hospital. In addition to these, the physician's performance as a specialist is generally evaluated by a peer
review committee on the basis of mortality and morbidity statistics, and feedback from patients, nurses,
interns and residents. A consultant remiss in his duties, or a consultant who regularly falls short of the
minimum standards acceptable to the hospital or its peer review committee, is normally politely
terminated.
In other words, private hospitals, hire, fire and exercise real control over their attending and visiting
"consultant" staff. While "consultants" are not, technically employees, a point which respondent hospital
asserts in denying all responsibility for the patient's condition, the control exercised, the hiring, and the
right to terminate consultants all fulfill the important hallmarks of an employer-employee relationship,
with the exception of the payment of wages. In assessing whether such a relationship in fact exists, the
control test is determining. Accordingly, on the basis of the foregoing, we rule that for the purpose of
allocating responsibility in medical negligence cases, an employer-employee relationship in effect exists
between hospitals and their attending and visiting physicians. This being the case, the question now
arises as to whether or not respondent hospital is solidarily liable with respondent doctors for petitioner's
condition.

Name: 7.Ruez Jr. v. Dr. Jurado, A.M. No. 2005-08-SC, December 9, 2005
Facts Ruez, Jr. filed a letter-complaint with the Office of the Chief Justice regarding the alleged lack of
attention given to his father by Dr. Jurado. Specifically, he claims that Dr. Jurado merely advised his
father to go to the hospital and then allowed him to travel to Manila Doctors Hospital despite the
availability of an ambulance at the disposal of the clinic. Ruez, Jr. submits that his father would not
have suffered a stroke if not for the neglect of Dr. Jurado.
Issue whether, given the accepted facts, there is cause to hold Dr. Jurado administratively liable. Atty.
Candelaria is satisfied that Dr. Jurado provided Ruez, Sr. proper treatment inside the clinic?
Held/Ratio: the Court finds no reason to hold Dr. Jurado liable for simple neglect of duty, and, therefore,
DISMISSESthe complaint for lack of merit. As recommended by Atty. Eden T. Candelaria, Deputy
Clerk of Court and Chief of Administrative Services, Dr. Prudencio Banzon, Senior Staff Officer,
Medical and Dental Services, isDIRECTEDto prepare a flexi-time schedule for all doctors and nurses
in the clinic to further develop its capability to provide immediate and proper attention in emergency
medical situations, and to submit the same to Atty. Candelaria in 30 days from receipt of a copy of
this decision which should be served upon him forthwith.
doctrine neglect of duty, misconduct or negligence.

Name: 8.Nogales v. Capitol Medical Center G.R. No. 142625, December 19, 2006
Facts Upon Corazons admission at the CMC, Rogelio Nogales (Rogelio) executed and signed the Consent
on Admission and Agreement and Admission Agreement. Corazon was then brought to the labor
room of the CMC. Corazon died at 9:15 a.m. The cause of death was hemorrhage, post partum.
Issue Whether CMC is vicariously liable for the negligence of Dr. Estrada as its attending independent-
contractor physician considering that facts of the instant case.
Held/Ratio: Yes. In general, a hospital is not liable for the negligence of an independent contractor-physician. There
is, however an exception to this principle. The hospital may be liable if the physician is the ostensible
agent of the hospital. This exception is also known as the doctrine of apparent authority.
doctrine Under the doctrine of apparent authority a hospital can be held vicariously liable for the negligent acts
of a physician providing care at the hospital, regardless of whether the physician is an independent
contractor, unless the patient knows, or should have known, that the physician is an independent
contractor.
For a hospital to be liable under the doctrine of apparent authority, a plaintiff must show that
1.) the hospital, or its agent, acted in a manner that would lead a reasonable person to conclude that
the individual who was alleged to be negligent was an employee or agent of the hospital;

10
 2.) Where the acts of the agent create the appearance of authority, the plaintiff must also prove that the
hospital had knowledge of and acquired in them; and
3.) the plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent with ordinary
care and prudence.
Two Factors to consider:
1) An inquiry onwhether the hospital acted in a manner which would lead a reasonable person to
conclude that the individual who was alleged to be negligent was an employee or agent of the
hospital. The hospital need not make express representations to the patient that the treating
physician is an employee of the hospital; rather a representation may be general and implied.
2) An inquiry on whether the plaintiff acted in reliance upon the conduct of the hospital or its
agent, consistent with ordinary care and prudence.
Application of these factors to this case:
1) CMC impliedly held out Estrada as a member of its medical staff.
a) CMC granted staff privileges to Dr. Estrada. CMC extended its medical staff and facilities to
Dr. Estrada.
b) CMC made Rogelio sign consent forms printed on CMC letterhead. These forms did not
indicate that he was an independent contractor-physician. No one from CMC informed the
Spouses
c) Dr. Estrada's referral of Corazon's profuse vaginal bleeding to Dr. Espinola, who was then
the Head of the Obstetrics and Gynecology Department of CMC, gave the impression that
Dr. Estrada as a member of CMC's medical staff was collaborating with other CMCemployed
specialists in treating Corazon.
2) Rogelio testified that he and his wife specifically chose Dr. Estrada to handle Corazon's delivery
not only because of their friend's recommendation, but more importantly because of Dr.
Estrada's "connection with a reputable hospital, the CMC." In other words, Dr. Estrada's
relationship with CMC played a significant role in the Spouses Nogales' decision in accepting Dr.
Estrada's services
Borrowed servant doctrine provides that once a surgeon enters the operating room and takes charge
of the acts or omissions of operating room personnel and any negligence associated with each acts or
omissions are imputable to the surgeon, while the assisting physicians and nurses may be employed by
the hospital, or engaged by the patient, they normally become the temporary servants or agents of the
surgeon in charge while the operation is in progress, and liability may be imposed upon the surgeon for
their negligent acts under the doctrine of respondeat superior.

Name: 9.PSI v Agana G.R. No. 126297 January 31, 2007

NATURE three consolidated petitions for review on certiorar
Facts On April 4, 1984, Natividad Agana was rushed to the Medical City General Hospital because of
difficulty of bowel movement and bloody anal discharge. After a series of medical examinations,
Dr. Miguel Ampil diagnosed her to be suffering from Cancer of the sigmoid. On April 11, 1984,
Dr. Ampil assisted by the medical staff of the Medical City Hospital performed an Anterior
resection surgery on Natividad. He found that the malignancy on her sigmoid area had spread on
her left ovary, necessitating the removal of certain portions of it. Thus, Dr. Ampil obtained the
consent of Natividads husband, Enrique Agana, to permit Dr. Juan Fuentes to perform
hysterectomy on her. After Dr. Fuentes had completed the hysterectomy, Dr. Ampil took over,
completed the operation and closed the incision after searching for the missing 2 gauzes as
indicated by the assisting nurses but failed to locate it. After a couple of days, Natividad
complained of excruciating pains in her anal region but Dr. Ampil said it is a natural consequence
of the operation/surgery and recommended that she consult an oncologist to examine the cancerous
nodes which were not removed during the operation. Natividad and her husband went to the US to
seek further treatment and she was declared free from cancer. A piece of gauze portruding from
Natividads vagina was found by her daughter which was then removed by hand by Dr. Ampil and
assured that the pains will vanished. However, it didnt. The pains intensified prompting Natividad
to seek treatment at the Polymedic General Hospital. While confined there, Dr. Ramon Guttierez
detected the presence of another foreign object in her vagina a foul smelling gauze measuring
1.5 inches in width which badly infected her vagina. A recto-vaginal fistula had forced stool to
excrete through her vagina. Another surgical operation was needed to remedy the damage.
Issue Whether or not Dr. Ampil and Fuentes are liable for medical malpractice and the PSI for
damages due to the negligence of the said doctors.
Held/Ratio: Yes. No. Yes. An operation requiring the placing of sponges in the incision is not complete until
the sponges are properly removed and it is settled that the leaving of sponges or other foreign
substances in the wound after the incision has been closed is at least prima facie negligence by the
operating surgeon. To put it simply, such act is considered so inconsistent with due care as to raise
inference of negligence. There are even legions of authorities to the effect that such act is
negligence per se.
This is a clear case of medical malpractice or more appropriately, medical negligence. To
successfully pursue this kind of case, a patient must only prove that a health care provider either
11
 failed to do something which a reasonably prudent health care provider would have done, or that
he did something that a reasonably prudent provider would not have done; and that failure or action
caused injury to the patient. Simply puts the elements are duty, breach, injury, and proximate
causation. Dr. Ampil, as the lead surgeon, had the duty to remove all foreign objects, such as
gauzes, from Natividads body before closure of the incision. When he failed to do so, it was his
duty to inform Natividad about it. Dr. Ampil breached both duties. Such breach caused injury to
Natividad, necessitating her further examination by American doctors and another surgery. That
Dr. Ampils negligence is the proximate cause of Natividads injury could be traced from his act
of closing the incision despite the information given by the attending nurses that 2 pieces of gauze
were still missing. That they were later on extracted from Natividads vagina established the causal
link between Dr. Ampils negligence and the injury. And what further aggravated such injury was
his deliberate concealment of this missing gauzes from the knowledge of Natividad and her family.
The requisites for the applicability of the doctrine of res ipsa liquitor are:
1. Occurrence of an injury;
2. The thing which caused the injury was under the control and management of the defendant;
3. The occurrence was such that in the ordinary course of things would not have happened if
those who had control or management used proper care, and;
4. The absence of explanation by the defendant
Of the foregoing, the most instrumental is the Control and management of the thing which caused
the injury.
Under the Captain of the ship rule, the operating surgeon is the person in complete charge of the
surgery room and all personnel connected with the operation.
The knowledge of any of the staff of Medical City constitutes knowledge of PSI.
The doctrine of corporate responsibility, has the duty to see that it meets the standards of
responsibilities for the care of patients. Such duty includes the proper supervision of the members
of its medical staff. The hospital accordingly has the duty to make a reasonable effort to monitor
and over see the treatment prescribed and administered by the physician practicing in its premises.

Name: 10 Cantre vs Sps Go G.R. No. 160889 April 27, 2007

NATURE review on certiorari
Facts Petitioner Dr. Milagros L. Cantre is a specialist in obstetrics and gynecology at the Dr. Jesus Delgado
memorial Hospital. She was the attending physician of respondent Nora Go, who was admitted at
the said hospital on April 19, 1992. At 1:30am of April 20, 1992, Nora gave birth to her fourth child,
a baby boy. However, at around 3:30am Nora suffered profuse bleeding insider her womb due to
some parts of the placenta were not completely expelled from her womb after delivery consequently,
Nora suffered hypovolemic shock, resulting in a drop in her blood pressure to 40/0. Petitioner said
the assisting resident physician performed various medical procedures to stop the bleeding and to
restore Noras blood pressure. Her blood pressure was frequently monitored with the use of a
sphygmamometer. While petitioner was massaging Noras uterus for it to contract and stop bleeding,
she ordered a drop light to warm Nora and her baby. Nora remained unconscious until she recovered.
While in the recovery room, her husband, respondent John David Z. Go noticed a fresh gasping
wound 2 1/2 x 3 1/2 in the inner portion of her left arm, close to the armpit. He asked the nurses
what caused the injury. He was informed, it was a burn. An investigation was filed by Noras
husband and found out from the petitioner that it was caused by the blood pressure cuff, however,
this was contrary to the findings from a medico-legal report which stated that it was indeed a burn
and that a drop light when placed near a skin for about 10mins could cause such burn. Nora was
referred to a plastic surgeon from the hospital and skin grafting was done on her and scar revision
but both still left a mark on Noras arm compelling the respondent spouse to file a complaint for
damages against petitioner.
Issue Whether or not petitioner is liable for the injury referred by Nora.
Held/Ratio: Yes. The Hippocratic oath mandates physicians to give primordial consideration to the well-being
of their patients. If a doctor fails to live up to his precept, he is accountable for his acts. This is
notwithstanding, courts face a unique restraint in adjudicating medical negligence cases because
physicians are not guardians of care and they never set out to intentionally cause injury to their
patients. However, intent is immaterial in negligence cases because where negligence exist and is
proven, it automatically gives the injured a right to reparation for the damage caused.
In cases, involving medical negligence, the doctrine of res ipsa liquitor allows the mere existence of
an injury to justify a presumption of negligence on the part of the person who controls the instrument
causing the injury, provided that the following requisites concur:
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;
3) The possibility of contributing conduct which would make the plaintiff responsible is
eliminated
All of these three requisites were present in the case at bar.

12
 Under the the captain of the ship doctrine, the surgeon in charge of the operation is liable for the
negligence of his assistants during the time when those are under the surgeons control.
doctrine res ipsa loquitu

Name: 11.Ilao-Oreta vs. Sps. Ronquillo G.R. No. 160889 April 27, 2007
NATURE petition for Review
Facts Respondent 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 and chief of the Reproductive Endocrinology and
Infertility Section at the St. Lukes Medical Center. Dr. Ilao-Oreta advised Eva Marie to undergo a
laparoscopic procedure whereby a laparascope would be inserted through the patientsabdominalwall
to get adirect viewof her internal reproductive organ in order to determine the real cause of her
infertility.
The procedure was scheduled on April 5, 1999 at 2:00 p.m. to be performed by Dr. Ilao-Oreta.
Eva Marie, accompanied by Noel, checked in at the St. Lukes Medical Center and underwent pre-
operative procedures including the administration of intravenous fluid and enema. However, Dr. Ilao-
Oreta did not arrive at the scheduled time for the procedure and no prior notice of
itscancellationwasreceived. 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.
Issue Whether or not Dr. Ilao-Oreta is guilty of gross negligence for her failure to arrive at the scheduled
time for the procedure?
Held/Ratio: 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 nonhuman knowledge
that excitement attends its preparations. Her negligence could then be partly attributed to human
frailty which rules out mischaracterizations gross.

Name: 12.Sps. Flores vs. Sps. Pineda G.R. No. 158996 November 2008
NATURE petition involves a medical negligence case that was elevated to this Court through an appeal
bycertiorariunder Rule 45 of the Rules of Court.
Facts Teresita Pineda consulted her townmate Dr. Fredelicto Flores regarding her medical condition,
complaining about general body weakness, loss of appetite, frequent urination and thirst, and on-
and-off vaginal bleeding. After interviewing Teresita, Dr. Fredelicto advised her to go to United
Doctors Medical Center (UDMC) in Quezon City for a general check-up the following week but
the former did not. As for her other symptoms, he suspected that Teresita might be suffering from
diabetes and told her to continue her medications. When her conditions persisted, she went to
UDMC where Dr. Fredelictor check-up her and ordered her admission and further indicate on call
D&C operation to be performed by his wife, Dra. Felicisima Flores, an Ob-Gyne. Laboratory tests
were done on Teresita including internal vaginal examination, however, only the blood sugar and
CBC results came out prior to operation which indicated of diabetes. D&C operations were still
done and thereafter, Dra. Felicisima advised her that she can go home and continue to rest at home
but Teresita opted otherwise. Two days after the operation, her condition worsened prompting
further test to be done which resulted that Teresita have diabetes melitus type II. Insulin was
administered but it might arrived late, she died.
Issue Whether or not spouses petitioners are liable for medical negligence.
Held/Ratio: Yes. A medical negligence case is a type of claim to redress a wrong committed by a medical
professional, that caused a bodily harm to or the death of a patient. There are four elements involved
in a medical negligence case, namely: duty, breach, injury, and proximate cause.
Duty refers to the standard of behavior which imposes restrictions on ones conduct. The standard
in turn refers to the amount of competence associated with the proper discharge of the profession.
A physician is expected to use at least the same level of case that any other reasonably competent
doctor would use under the same circumstances. Breach of duty occurs when the physician fails to
comply with those professional standards. If injury results to the patient as a result of this breach,
the physician is answerable for negligence.
If a patient suffers from some disability that increases the magnitude of risk to him, that disability
must be taken into account as long as it is or should have been known to the physician.
Stress, whether physical or emotional, is a factor that can aggravate diabetes; a D&C operation is
a form of physical stress. Dr. Mendoza explained how surgical stress can aggravate the patients
hyperglycemia: when stress occurs, the diabetics body, especially the autonomic system, reacts by
secreting hormones which are counter-regulatory; she can have prolonged hyperglycemia which,
if unchecked, could lead to death. Medical lecture further explains that if the blood sugar has
become very high, the patient becomes comatose (diabetic coma). When this happens over several
days, the body uses its own fats to produce energy, and the result is high level of waste products in
the blood and urine.
These findings leads us to the conclusion that the decision to proceed with the D&C operation
notwithstanding Teresitas hyperglycemia and without adequately preparing her for the procedure,
13
 was contrary to the standards observed by the medical profession. Deviation from this standard
amounted to a breach of duty which resulted in the patients death. Due to this negligent conduct,
liability must attach to the petitioner spouses.
doctrine Medical Negligence is a wrong committed by a medical professional causing harm or death to a
patient.
The elements of which are: duty, breach, injury and proximate causation.
Duty: Standard behavior which imposes restrictions on ones conduct (the amount of competence
associated with the proper discharge of a profession)
Breach: When physician fails to comply with these professional standards. If injury results from
this, he is liable for negligence.
It must be proven that:
1) Physician either failed to do something which a reasonably prudent health care provider would
have done, or did something a reasonably prudent provider would not have done.
2) This failure or action caused injury to the patient. (best shown through expert testimony) In this
case:
1) Felicisima did not even check on her patient or talk to her before the operation (I think the SC is
wrong here, because the case was an emergency and usually someone else does it for them but
then again, thats just me 2) The spouses were not able to prove that the bleeding was life-
threatening. Dr. Flores should not have made the decision to operate on her because he was not an
expert in the field of gynecology.

Name: 13.Lasam vs. Sps. Ramolete G.R. No. 159132 December 8, 2008
NATURE Petition for Review onCertiorariunder Rule 45
Facts On July 28, 1994, respondent 3 months pregnant Editha Ramolete was brought to Lorma Medical
Center (LMC) in San Fernando, La Union due to vaginal bleeding upon advise of petitioner related
via telephone, Editha was admitted to the LMC on the same day. A pelvic sonogram was then
conducted on Editha revealing the fetus weak cardiac pulsation. The following day, Editha repeat
pelvic sonogram showed that aside from the fetus weak cardiac pulsation, no fetal movement was
also appreciated. Due to persistent and profuse vaginal bleeding, petitioner advised her to undergo
a D&C procedure. She was discharged the following day. On September 16, 1994, Editha was
once gain brought at the LMC, as she was suffering from vomiting ans severe abdominal pains.
Editha was attended by Drs. Dela Cruz, Mayo and Komiya. Dr. Mayo allegedly informed Editha
that there was a dead fetus in the latters womb, after Editha went laparectomy, she was found to
have massive intra abdominal hemorrhage and ruptured uterus. Thus, she had to go hysterectomy
and as a result no more chance to bear a child.
Issue Whether or not petitioner is liable for medical malpractice.
Held/Ratio: No. Medical malpractice is a particular form of negligence which consists in the failure of a
physician or surgeon to apply to his practice of medicine that degree of care and skill which is
ordinarily employed by the profession generally under similar conditions, and in like surrounding
circumstances. In order to successfully pursue such a claim, a patient must prove that the
physician or surgeon either failed to do something which a reasonably prudent physician or
surgeon would not have done, and that the failure or action caused injury to the patient.
There are four elements involved in medical negligence cases: duty, breach, injury, and proximate
cause..
A physician-patient relationship was created when Editha employed the services of the petitioner.
As Edithas physician, petitioner was duty-bound to use at least the same level of care that any
reasonably competent doctor would use to treat a condition under the same circumstances. The
breach of these professional duties of skill and care, or their improper performance by a physician
surgeon, whereby the patients injured in body or in health, constitutes actionable malpractice, as
to this aspect of medical malpractice, the determination of the reasonable level of care and the
breach thereof, expert testimony is essential. Further, in as much as the causes of the injuries
involved in malpractice actions are determinable only in the light of scientific knowledge, it has
been recognized that expert testimony is usually necessary to suspect the conclusion as to
causation.
It is undisputed that Editha did not return for follow-up evaluation, in defiance of the petitioners
advice. This is as found out is the proximate cause of the injury she sustained.
doctrine Medical malpractice is a particular form of negligence which consists in the failure of a physician
or surgeon to apply use at least the same level of care that any reasonably competent doctor would
use to treat a condition under the same circumstances. As to this aspect of medical malpractice,
the determination of the reasonable level of care and the breach thereof, expert testimony is
essential. Further, inasmuch as the causes of the injuries involved in malpractice actions are
determinable only in the light of scientific knowledge, it has been recognized that expert testimony
is usually necessary to support the conclusion as to causation. All told, doctors are protected by a
special rule of law. They are not guarantors of care. They are not insurers against mishaps or

14
 unusual consequences specially so if the patient herself did not exercise the proper diligence
required to avoid the injury.

NAME 14.Lucas vs Tuao G.R. No. 178763 April 21, 2009

NATURE petition for review oncertiorari[1]under Rule 45 of the Revised Rules of Court
FACTS ometime in 1988, petitioner Peter Paul Patrick Lucas contracted "sore eyes" in his right eye. Upon
consultation with Dr. Tuano, Peter narrated that it has been 9 days since the problem with his right
eye began, and that he was already taking Maxitrol to address the eye problem. According to Dr.
Tuano, he performed "ocular routine examination" on Peter's eyes, wherein: 1. a cross examination
Peter's eyes and their surrounding area was made, and 2. Peter's visual acuity were taken, 3. Peter's
eyes were palpated to check the intraocular pressure of each; 4. the mortility of Peter's eyes were
observed, and 5. the ophthalmoscopy on Peter's eyes was used.
On that particular consultation, Dr. Tuano diagnosed that Peter was suffering from conjunctivitis
or sore eyes. He then prescribed Spersacet C-eye drops for Peter and told the latter to return for
follow-up after one week.
As instructed, Peter returned and Dr. Tuano discovered that the right eye developed Epidemic
Kerato Conjunctivitis, EKC, a viral infection. To address the problem, Dr. Tuano prescribed
Maxitrol, for a dosage of 6 times a day.
However, the EKC was getting worse yet Dr. Tuano still continued on advising the use of Maxittrol,
despite Peter's discovery of the inscribed warning written in its label.
Upon examination, Dr. Tuano noted the hardness in Peter's right eye and discovered that the tension
in Peter's right eye was 39.0 Hg. Since the tension was way over the normal IOP which only ranged
from 10.0 Hg to 21.0 Hg, Dr. Tuano then ordered him to immediately discontinue the use of
Maxitrol and prescribed to the latter Diamox and Normoglaucon instead. He also required Peter to
go for a daily check-up in order for the former to closely monitor the pressure of the latter' eyes.
During one of Peter's regular follow-ups, Dr. Tuano noted the recurrence of EKC in Peter's right
eye. Thus, he referred Peter to Dr. Manuel Agulto, M.D., another opthalmologist specializing in
glaucoma treatment.
Eventually, Peter, in claiming to have "steroid-induced glaucoma" and blaming Dr. Tuano for the
same, filed a civil complaint for damages against Dr. Tuano. In their complaint, petitioners averred
that as the direct consequence of Peter's prolonged use of Maxitrol, he suffered from steroid-
induced glaucoma which caused the elevation of his intra-ocular pressure, which caused the
impairment of his vision which may lead to total blindness.
In rebutting petitioner's claim, Dr. Tuano asserted that the treatment made by him more than three
years ago has no causal connection to Peter's glaucoma. He further explained that 'drug-induced
glaucoma is temporary and curable, steroids have the side effect of increasing intraocular pressure.
Steroids are prescribed to treat Epidemic Kerato Conjunctivitis or EKC which is an infiltration of
the cornea as a result of conjunctivitis or sore eyes'. Hence, the steroid treatment of Peter's EKC
caused the steroid-induced glaucoma.
RTC Ruling
The RTC dismissed the Civil Case for insufficiency of evidence, opining that petitioners failed to
prove by preponderance of evidence that Dr. Tuano was negligent in his treatment of Peter's
condition. The trial court reasoned hat the recognized standards of the medical community has not
been established in thiss case, much less has causation been established to render Dr. Tuano liable.
Further, absence of any medical evidence to the contrary, the RTC ruled that it cannot accept
petitioner's claim that the use of steroid is the proximate cause of the damage sustained by Peter's
eye. Court of Appeals Ruling
The CA faulted petitioners because they failed to present any medical expert to testify that Dr.
Tuano's prescription of Maxitrol and Blephamide for the treatment of EKC on petiitioner's right
eye was not proper and that his palpation of Peter's right eye was not enough to detect adverse
reaction to steroid.
During the trial in CA, Peter testified that Dr. Manuel Agulto told him that he should not have used
steroid for the treatment of EKC or that he should have used it only for two weeks, as EKC iss only
a viral infection which will cure in tself. However, Dr. Agulto was not presented by petitioners as
a witness to confirm what he allegedly told Peter and therefore, the latter's testimony is hearsay.
Under Rule 130, Section 36 of the Rules of Court, a witness can testify only to those facts which
he knows of and his own personal knowledge. Familiar and fundamental is the rule that hearsay
testimony is inadmissible as evidence.
Petitioner's Motion for Reconsideration was denied by resolution, hence, this appeal.
ISSUE Did the petitioners failed to prove by preponderance of evidence their claim for damages against
Dr. Tuano?
HELD: Court Ruling:
Only questions of law may be raised under Rule 45 of the Rules of Court as this court is not a trier
of facts.

15
 The said issue constitutes a question of fact, as the Supreme Court is asked to revisit anew the
factual findings of the RTC and the CA. While this general rule admits of certain exceptions, such
as the circumstance when the finding of fact of the Court of Appeals is premised on the supposed
absence of evidence, but is contradicted by the evidence on record.
The fact of want of competence or diligence is evidentiary in nature, the veracity of which can best
be passed upon after a full-blown trial for it is virtually impossible to ascertain the merits of a
medical negligence case without extensive investigation, research, evaluation and consultation with
the medical experts.
Petitioner's position in sum is that Peter's glaucoma is the direct result of Dr. Tuano's negligence in
his improper administration of the drug Maxitrol. Clearly, the present controversy is a classic
illustration of a medical negligence case against a physician based on the latter's professional
negligence. In this type of suit, the patient or his heirs, in order to prevail, is required to prove by
is required to prove by preponderance of evidence that the physician failed to exercise that degree
of skill, care and learning possessed by other persons in the same profession; and that as a proximate
result of such faiure, the patient or his heirs suffered damages.
For lack of a specific law geared towards the type of negligence committed by members of the
medical profession, such claim for damages is almost always anchored on the alleged violation of
Article 2176 of the Civil Code which states that "whoever by act or omission, causes damage to
another, there being no fault or negligence, is obliged to pay for the damage done. Such fault or
negligence, is there is no pre-existing contractual relation between the parties is called quasi-delict.
In medical negligence cases, the four essential elements are the following: 1. duty 2. breach 3.
injury 4. proximate cause, which must be established by the plaintiffs.
In order that there may be a recovery for an injury, it must be shown that the injury for which the
recovery is sought must be the legitimate consequence of the wrong done, the connection between
the negligence and the injury must be a direct and natural sequence of events, unbroken by
intervening efficient causes.
Criminal Law- Proximate cause: It is the cause, which is the natural and continuous sequence,
unbroken by any efficient intervening cause, produces the injury, and without which the result
would not have occurred. That is, the negligence must be the proximate cause of the injury.
Just as with the elements of duty and breach of the same, in order to establish the proximate cause
by preponderance of evidence, the patient must similarly use expert testimony, because the question
of whether the alleged professional negligence caused the patient's injury is generally one for
specialized expert knowledge beyond the ken of the average layperson; using the specialized
knowledge and training of his field, the expert's role is to present to the court a realistic assessment
of the likelihood that the physician's alleged negligence caused the patient's injury.
In this case, Dr. Tuano was able to clearly explain what is only required of ophthalmologists, in
cases such as Peter's is the conduct of standard tests/ procedures known as "ocular routine
examination" composed of five (5) test procedures, specifically: gross examination of the eyes and
the surrounding area, taking of the visual acuity of the patient, checking the intraocular pressure of
the patient, checking the motility of the eyes--and he did all those tests every time Peter went to
see him for follow-up consultation and/or check-up.
Even if we are to assume that Dr. Tuano committed negligent acts in his treatment of Peter's
condition, the causal connection between Dr. Tuano's supposed negligence and Peter's injury still
needed to be established. The critical and clinching factor in a medical negligence case is proof of
the causal connection between the negligence which the evidence established and the plaintiff's
injuries.
Civil procedure, burden of proof: In civil cases, the party having the burden of proof must establish
his case by a preponderance of evidence, or evidence which is more convincing to the court as
worthy of belief than that which is offered in opposition thereto. The party having the burden of
proof must establish his case by a preponderance of evidence or "evidence which is of greater
weight or more convincing that that which is offered in opposition to it; in the last analysis, it means
the probability of truth.
It seems basic that what constitutes proper medical treatment is a medical question that should have
been presented to experts. If no standard is established through expert medical witnesses, then
courts have no standard by which to gauge the basic issue of breach by the physician or surgeon.
The RTC, Court of Appeals and even the Supreme Court; could not be expected to determine on
its own what medical technique should have been utilized for a certain disease or injury. Absent
expert medical opinion, the courts would be dangerously engaging in speculations.
DOCTRINE In a medical negligence suit, the patient or his heirs, in order to prevail, is required to prove
bypreponderance of evidence that the physician failed to exercise that degree of skill, care,
andlearning possessed by other persons in the same profession; and that as a proximate result ofsuch
failure, the patient or his heirs suered damages.There is breach of duty of care, skill and diligence,
or the improper performance of such duty, bythe attending physician when the patient is injured in
body or in health constitutes the actionablemalpractice.

16
Name: 15. Dr. Li vs. Sps. Soliman G.R. No. 165279 June 7, 2011
Facts On July 7, 1993, respondents 11 year old daughter, Angelica Soliman underwent a biopsy of the mass
located in her lower extremity at the St. Lukes Medical Center (SLMC). Results showed that Angelica
was suffering from osteosaucoma, ostiobiostic type, a high-grade (highly malignant) cancer of the
bone which usually affects teenage children. Following this diagnosis, Angelicas right leg was
amputated by Dr. Tamayo in order to remove the tumor. As a adjuvant treatment to eliminate any
remaining cancer cells, and hence minimizing the chances of recurrence and prevent the decease from
spreading to other parts of the patients body, chemotherapy was suggested by Dr. Tamayo and
referred Angelica to another doctor at SLMC, herein petitioner Dr. Rubi Li, a medical oncologist.
On July 23, 1993, petitioner saw the respondents at the hospital after Angelicas surgery and
discussed with them Angelicas condition. Petitioner told respondents that Angelica should be given
2-3 weeks to recover from the operation before starting the chemotherapy. Respondents were
apprehensive due to financial constraints as Reynaldo earns only from P70,000-150,000 a year from
his jewelry and watching repair business. Petitioner, however, assured them not to worry about her
professional fee and told them to just save up for medicines to be used.
As the chemotherapy session started, day by day, Angelica experience worsening condition and other
physical effect on the body such as discoloration, nausea, and vomiting.
Petitioner claimed, that she explained to respondents that even when a tumor is removed, there are
still small lesions undetectable to the naked eye and that adjuvant chemotherapy is needed to clean
out the small lesions in order to lessen the chance of cancer to recur. She did not give the respondents
any assurance that chemotherapy will cure Angelicas cancer. During these consultations with
respondents, she explained the following side effects of chemotherapy treatment to respondents:
1.) Falling hair; 2.) nausea and vomiting 3.) loss of appetite;

4.) low count of WBC, RBC, 5.) low count of WBC, RBC, 6) possible sterility due to the
and platelets; and platelets; effects on Angelicas ovary;

7.) Damage to kidney and darkening of the skin

heart; especially when exposed to
sunlight.
She actually talked to the respondents four times, once at the hospital after the surgery, twice at her
clinic and fourth when Angelicas mother called her through long distance. This was disputed by
respondents who countered that petitioner gave them assurance that there is 95% chance of healing
for Angelica if she undergoes chemotherapy and that the only side effects were nausea, vomiting and
hair loss. Those were the only side effects of chemotherapy mentioned by petitioner.
Issue Whether or not petitioner committed medical malpractice.
Held/Ratio: No. The type of lawsuit which has been called medical malpractice or more appropriately, medical
negligence, is that type of claim which a victim has available to him or her to redress a wrong
committed by a medical professional which has caused bodily harm. In order to successfully pursue
such claim, a patient must prove that a health care provider in most cases a physician, either failed to
do something which a reasonably prudent health care provider would have done or that he or she did
something that a reasonably health care provider would not have done; and that failure or action
caused injury to the patient.
Medical negligence cases are best proved by opinions of expert witnesses belonging in the same
general neighborhood and in the same general line of practice as defendant physician or surgeon. The
deference of courts to the expert opinion of qualified physicians stems from the formers realization
that the latter possess unusual technical skills which layman in most instances are incapable of
intelligently evaluating, hence the indispensability of expert testimonies.
The doctrine of informed consent within the context of physician-patient relationships goes as far
back into english common law. As early as 1767, doctors were charged with the tort of battery if they
have not gained the consent of their patients prior to performing a surgery or procedure. In the United
States, the seminal case was Schoendorff vs Society of New York Hospital which involved unwanted
treatment performed by a doctor. Justice Bejamin Cardozo oft-quoted opinion upheld the basic right
of a patient to give consent to any medical procedure or treatment; every human being of adult year
and sound mind has a right to determine what shall be done with his own body; and a surgeon who
performs an operation without his patients consent commits an assault, for which he is liable in
damages. From a purely ethical norm, informed consent evolved into a general principle of law that
a physician has a duty to disclose what a reasonably prudent physician in the medical community in
the exercise of reasonable care would disclose to his patient as to whatever grave risk of injury might
be incurred from a proposed course of treatment, so that a patient, exercising ordinary care for her
own welfare and faced with a choice of undergoing the proposed treatment, as alternative treatment,
or none at all, may intelligently exercise his judgement by reasonably balancing the probable risk
against the probable benefits.
There are four essential elements a plaintiff must proved in a malpractice action based upon the
doctrine of informed consent: 1.) the physician had a duty to disclose material risks; 2.) he failed to

17
 disclose or inadequately disclosed those risks; 3.) as a direct and proximate result of the failure to
disclose, the patient consented to treatment she otherwise would not have consented to; and 4.)
plaintiff was injured by the proposed treatment. The gravamen in an informed consent requires the
plaintiff to point to significant undisclosed information relating to the treatment which could have
altered her decision to undergo it.
Examining the evidence, we hold that there was adequate disclosure of material risks inherent in
chemotherapy procedure performed with the consent of Angelicas parents. Respondents could not
have been unaware in the course of initial treatment and amputation of Angelicas lower extremity
that her immune system was already weak on account of the malignant tumor in her knee. When
petitioner informed the respondents beforehand of the side effects of chemotherapy which includes
lowered counts of white and red blood cells, decrease in blood platelets, possible kidney or heart
damage and skin darkening, there is reasonable expectation on the part of the doctor that the
respondents understood very well that the severity of these side effects will not be the same for all
patients undergoing the procedure. In other words, by the nature of the disease itself, each patients
reaction to the chemical agents even with pre-treatment laboratory tests cannot be precisely
determined by the physician. That death can possibly result from complications of the treatment or
the underlying cancer itself, immediately or sometime after the administration of chemotherapy
drugs, is a risk that cannot be ruled out, as with most other major medical procedures, but such
conclusion can be reasonably drawn from the general side effects of chemotherapy already disclosed.
doctrine The doctrine of informed consent within the context of physician patient relationships goes far back
into English common law

Name: 16.Atienza vs. Board of Medicine G.R. No. 177407 February 9, 2011
NATURE petition for review oncertiorariunder Rule 45 of the Rules of Co
Facts due to her Lumbar parts, 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. This, she underwent kidney operation in 1999, September. On
February 18, 2000, private respondents husband Romeo Sioson, filed a complaint for gross negligence
and/or incompetence before the board of medicine against the doctors who allegedly participated in the
fateful kidney operation. 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. Among the
evidence presented are certified photocopy of the results of the ultrasound and X-ray conducted to
Editha with the interpretation that both of her kidneys are in their proper anatomical location.
Issue Whether or not the doctors who conducted the kidney operation are liable for gross negligence despite
the evidence presented were mere photocopies.
Held/Rati Yes. To begin with, it is a well settled rule that the rules of evidence are not strictly applied in
o: proceedings before administrative bodies such as the Board of Medicine. 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.

Name: 17.Dr. Jarcia and Bastan vs. People G.R. No. 187926 February 15, 2012
NATURE petition for review under Rule 45 of the Rules of Court
Facts Belinda Santiago lodged a complaint with the National Bureau of Investigation (NBI) against the
petitioners, Dr. Emanuel Jarcia and Dr. Marilou Bastan, for their alleged neglect of professional duty
which caused her son, Roy Alfonso Santiago, to suffer physical injuries. Upon investigation, the NBI
found that Roy Jr. was hit by a taxicab; that he was rushed to the Manila Doctors Hospital for an
emergency medical treatment; that an X-ray of the victims ankle was ordered; that the X-ray result
showed no fracture as read by Dr. Jarcia; that Dr. Bastan entered the emergency room and, after
conducting her own examination of the victim, informed Mrs. Santiago that since it was only the ankle
that was hit there was no need to examine the upper leg; that 11 days later, Roy developed fever, swelling
of the right leg and misalignment of the right foot; that Mrs. Santiago brought him back to the hospital;
and that the x-ray revealed a right mid-tibial fracture and a linear hairline fracture in the shaft of the
bone. A complaint for reckless imprudence resulting physical injuries was filed against the petitioners
for the alleged misconduct in the handling of the illness of Roy.
Issue Whether or not the petitioners failed to exercise the degree of care expected of them as doctors and are
liable for negligence to the private respondent.
Held/ Yes. The doctrine ofres ipsa liquitoras a rule of evidence is unusual to the law of negligence which
recognizes thatprima facienegligencce may be established without direct proof and furnishes a substitute
for specific proof of negligence. The doctrine however, is not a rule of substantive law, but merely a
18
 mode of proof or a mere procedural convenience the rule when applicable to the facts and circumstances
of a given case, is not meant to and does not dispense with the requirement of proof of culpable
negligence on the party charged. It merely determines and regulates what shall beprima facieevidence
thereof and helps the plaintiff in proving a breach of duty. The doctrine can be invoked when and only
when, under the circumstances involved, direct evidence is absolute and not readily available.
doctrine he requisites for the application of the doctrine of res ipsa liquitor are:
1.The accident was of a kind which does not ordinarily occur unless someone is negligent;
2.The instrumentality or agency which caused the injury was under the exclusive control of the person
in charge; and
3.The injury suffered must not have been due to any voluntary action or contribution of the person
injured.
Negligence is defined as the failure to observe for the protection of the interests of another person that
degree of care, precaution and vigilance which the circumstances justly demand whereby such other
person suffers injury.
Reckless imprudence consists of voluntarily doing or failing to do, without malice, an act from which
material damage results by reason of an inexcusable lack of precaution on the part of the person
performing or failing to perform such act.
In failing to perform an extensive medical examination to determine the extent of Roys injuries, Dr.
Jarcia and Dr. Bastan were remiss of their duties as members of the medical profession. Assuming for
the sake of argument that they did not have the capacity to make such thorough evaluation at that stage
they should have referred the patient to another doctor with sufficient training and experience instead
of assuring him and his mother that everything was all right.

Name: 18.DR. CERENO, and ZAFE vs. CA G.R. No. 167366, September 26, 2012
NATURE petition for review under Rule 45 of the Rules of Court
Facts (Raymond), a victim of a stabbing incident, was rushed to the Bicol Regional Medical Center
(BRMC). Drs. Zafe and Cereno, were busy operating on gunshot victim Charles Maluluy-on.
Assisting them in the said operation was Dr. Rosalina Tatad (Dr. Tatad), who was the only senior
anesthesiologist on duty at BRMC that night. Just before the operation on Maluluy-on was finished,
another emergency case involving Lilia Aguila, a woman who was giving birth to triplets, was
brought to the operating room.
Raymond died due to massive loss of blood.
Issue Whether or not Drs. Zafe and Cereno are guilty of gross negligence in the performance of their
duties?
Held/Ratio: YES The type of lawsuit which has been called medical malpractice or, more appropriately, medical
negligence, is that type of claim which a victim has available to him or her to redress a wrong
committed by a medical professional which has caused bodily harm. In order to successfully pursue
such a claim, a patient must prove that a health care provider, in most cases a physician, either failed
to do something which a reasonably prudent health care provider would have done, or that he or
she did something that a reasonably prudent provider would not have done; and that the failure or
action caused injury to the patient.

Name: 19.DR. LUMANTAS vs. CALAPIZ G.R. No. 163753, January 15, 2014
Facts Spouses Hilario Calapiz, Jr. and Herlita Calapiz brought their 8-year-old son, Hanz Calapiz (Hanz), to
the Misamis Occidental Provincial Hospital, Oroquieta City, for an emergency appendectomy. Hanz
was attended to by the petitioner, who suggested to the parents that Hanz also undergo circumcision at
no added cost to spare him the pain. With the parents consent, the petitioner performed the coronal type
of circumcision on Hanz after his appendectomy. On the following day, Hanz complained of pain in his
penis, which exhibited blisters
Issue Whether the CA erred in affirming the petitioners civil liability despite his acquittal of the crime of
reckless imprudence resulting in serious physical injuries.
Held/ NO.It is automatic that every person criminally liable for a felony is also civilly liable.

Name: 20.DR. ANTONIO P. CABUGAO vs. PEOPLE OF THE PHILIPPINES G.R. No. 163879 July
30, 2014
NATURE Court are appeals via Rule 45
Facts DR. ANTONIO P.CABUGAO and DR. CLENIO YNZON, being then the attending physicians of one
RODOLFO PALMA, JR., a minor 10 years old, confederating and acting jointly with one another, did,
then and there, willfully, unlawfully and feloniously fail through negligence, carelessness and
imprudence to perform immediate operation upon their patient, RODOLFO PALMA, JR. of acute
appendicitis, when they, the said physicians, should have been done so considering that examinations
conducted upon their patient Rodolfo Palma, Jr. seriously manifest todo so, causing by such negligence,
carelessness, and imprudence the victim, RODOLFO PALMA JR., to die due to:
19
 "CARDIORESPIRATORY ARREST, METABOLIC ENCEPHALOPATHY, SEPTICEMIA (ACUTE
APPENDICITIS), CEREBRAL ANEURYSM RUPTURED
Issue whether or not petitioners' conviction of the crime of reckless imprudence resulting in homicide, arising
from an alleged medical malpractice, is supported by the evidence on record.
Held Yes Worth noting is that the assigned errors are actually factual in nature, which as a general rule,
findings of fact of the trial court and the Court of Appeals are binding and conclusive upon this Court,
and we will not normally disturb such factual findings unless the findings of the court are palpably
unsupported by the evidence on record or unless the judgment itself is based on misapprehension of
facts. In the instant case, we find the need to make certain exception.

Name: 21.DR. NOEL CASUMPANG vs. CORTEJO G.R. No. 171127, March 11, 2015
Facts Mrs. Jesusa Cortejo brought her 11-year old son, Edmer Cortejo (Edmer), to the Emergency Room of
the San Juan de Dios Hospital (SJDH) because of difficulty in breathing, chest pain, stomach pain,
and fever
Issue 1Whether or not the petitioning doctors had committed inexcusable lack of precaution in diagnosing
and in treating the patient
2.Whether or not the petitioner hospital is solidarity liable with the petitioning doctors;
3.Whether or not there is a causal connection between the petitioners' negligent act/omission and the
patient's resulting death;
Held/Ratio: 1. The doctor committed inexcusable lack of precaution in diagnosing and treating the patient.
2. The respondent submits that SJDH should not only be held vicariously liable for the petitioning
doctors' negligence but also for its own negligence. He claims that SJDH fell short of its duty of
providing its patients with the necessary facilities and equipment as shown by the following
circumstances:
(a) SJDH was not equipped with proper paging system;
(b) The number of its doctors is not proportionate to the number of patients;
(c) SJDH was not equipped with a bronchoscope;
(d) When Edmer's oxygen was removed, the medical staff did not immediately provide him with
portable oxygen;
(e) When Edmer was about to be transferred to another hospital, SJDH's was not ready and had no
driver; and
(f) Despite Edmer's critical condition, there was no doctor attending to him from 5:30 p.m. of April
22, to 9:00 a.m. of April 23, 1988.
SJDH on the other hand disclaims liability by claiming that the petitioning doctors are not its
employees but are mere consultants and independent contractors. We affirm the hospital's liability not
on the basis of Article 2180 of the Civil Code, but on the basis of the doctrine of apparent authority
or agency by estoppel.
3.The Causation Between Dr.Casumpang's Negligent Act/Omission, and the Patient's Resulting
Death was Adequately Proven

Name: 22.DR. JAIME T. CRUZ v. DR. AGAS, JR., G.R. No. 171217 G.R. No. 204095, June 15, 2015
Facts in his Complaint-Affidavit5for Serious Physical Injuries through Reckless Imprudence and Medical
Malpractice against Dr. Agas, Dr. Cruz alleged, among others, that sometime in May 2003, he engaged
the services of St. Lukes Medical Center (SLMC)for a medical check-up; that after being admitted in
SLMC on May 28, 2003,he underwent stool, urine, blood, and other body fluid tests conducted by the
employees and doctors of the said hospital; that on May 29, 2003, he was sent to the Gastro-Enterology
Department for a scheduled gastroscopy and colonoscopy; that because the specialist assigned to
perform the procedure was nowhere to be found, he gave the colonoscopy results to the attending female
anesthesiologist for the information and consideration of the assigned specialist; that, thereafter, he was
sedated and the endoscopic examination was carried out; that when he regained consciousness, he felt
that something went wrong during the procedure because he felt dizzy, had cold clammy perspiration
and experienced breathing difficulty; that he could not stand or sit upright because he felt so exhausted
and so much pain in his abdomen; that when he was about to urinate in the comfort room, he collapsed;
that he tried to consult the specialist who performed the colonoscopy but he was nowhere to be found;
and that his cardiologist, Dra. Agnes Del Rosario, was able to observe his critical condition and
immediately referred him to the surgical department which suspected that he had hemorrhage in his
abdomen and advised him to undergo an emergency surgical operation.
Issue Whether or not probable cause exists to charge Dr. Agas with Serious Physical Injuries through Reckless
Imprudence and Medical Malpractice.
Held Non-interference with Executive Determination of Probable Cause in Preliminary Investigations
Under the doctrine of separation of powers, courts have no right to directly decide on matters over which
full discretionary authority has been delegated to the Executive Branch of the Government, or to
substitute their own judgment for that of the Executive Branch, represented in this case by the
Department of Justice. The settled policy is that the courts will not interfere with the executive
determination of probable cause for the purpose of filing an Information, in the absence of grave abuse
20
 of discretion. That abuse of discretion must be so patent and gross as to amount to an evasion of a
positive duty or a virtual refusal to perform a duty enjoined by law or to act at all in contemplation of
law, such as where the power is exercised in an arbitrary and despotic manner by reason of passion or
hostility.

Name: 23.PEDRITO DELA TORRE vs. DR. ARTURO IMBUIDO G.R. No. 192973 September 29,
2014
Facts At around 3:00pm of February 3, 1992, Carmen was brought to Divine Spirit General Hospitals
operating room for her caesarian section operation, which was to be performed by Dr. Nestor. By
5:30pm, of the same day, Pedrito was informed by his wifes delivery of a baby boy. In the early
morning of February 4, 1992, Carmen experienced abdominal pains and difficulty in urinating. She
was diagnosed to be suffering from urinary tract infection (UTI), and was prescribed medication by
Dr. Norma. On February 10, 1992, Pedrito noticed that Carmens stomach was getting bigger, but
Dr. Norma dismissed the patients condition as mere fratulence. When Carmens stomach still grow
bigger despite medications, Dr. Norma advised Pedrito of the possibility of a second operation on
Carmen. Dr. Norma, however, provided no details on its purpose and the doctor who would perform
it. At around 3:00pm on February 12, 1992 Carmen had her second operation. Later in the evening,
Dr. Norma informed Pedrito that everything was going on fine with his wife. The condition of
Carmen, however, did not improve. It instead worsened that on February 13, 1992, she vomited dark
red blood. At 9:30pm of the same day, Carmen died. Per her death certificate upon information
provided by the hospital, the immediate cause of Carmens death was cardio-respiratory arrest
secondary to cerebro vascular accident, hypertension and chronic nephritis induced by pregnancy.
An autopsy report prepared by Dr. Partilano, medico-legal officer designate of Olongapo City,
however, provided that the cause of Carmens death was shock due to peritonitis severe with multiple
intestinal adhesions; status post caesarian section and exploratory laparotomy. Pedrito claimed in his
complaint that the respondents failed to exercise the degree of diligence required of them as members
of the medical profession, and were negligent for practicing surgery on Carmen in the most unskilled,
ignorant, and cruel manner.
Issue Whether or not respondents were liable for medical malpractice that resulted to Carmens death.
Held/Ratio: No. Medical malpractice or, more appropriately, medical negligence, is that type of claim which a
victim has available to him or her to redress a wrong committed by a medical professional which has
caused bodily harm. In order to successfully pursue such a claim, a patient, or his or her family as in
this case, must prove that healthcare provider, in most cases, a physician, either failed to do
something which a reasonably prudent health care provider would have done, or that he or she did
something that a reasonably prudent provider would not have done; and that failure or action caused
injury to the patient.
Four essential elements must be established namely: 1.) duty; 2.) breach; 3.) injury and 4.) proximate
causation. All four elements must be present in order to find the physician negligent and thus, liable
for damages.
For the trial court to give weight to Dr. Partilanos report, it was necessary to show first Dr.
Partilanos specialization and competence to testify on the degree of care, skill and diligence needed
for the treatment of Carmens case. Considering that it was not duly established that Dr. Partilano
practiced and was an expert on the fields that involved Carmens condition, he could not have
accurately identified the said degree of care, skill and diligence and the medical procedure, that
should have been applied.

Name: 24.Rosit vs. DDH G.R. No. 210445 December 7, 2015

fact - The ultimate issue for our resolution is whether the appellate court correctly absolved Dr. Gestuvo
from liability.
Issue Whether or not an expert witness is necessary as theres ipsa loquiturdoctrine is applicable.
Held A medical negligence case is a type of claim to redress a wrong committed by a medical professional,
that has caused bodily harm to or the death of a patient.There are four elements involved in a medical
negligence case, namely: duty, breach, injury, and proximate causation.
A medical negligence case is a type of claim to redress a wrong committed by a medical professional,
that has caused bodily harm to or the death of a patient.There are four elements involved in a medical
negligence case, namely: duty, breach, injury, and proximate causation.

Name: 25.Solidum et al vs. People G.R. No. 192123 March 10, 2014
Facts Gerald Albert Gercayo was born on June 2, 1992 with an imperforate anus. Two days after his birth,
Gerald under went colostomy, a surgical procedure to bring one end of the large intestine out through
the abdominal walls, enabling him to excrete through a colostomy bag attached to the side of his
body. On May 17, 1995, Gerald was admitted at the Ospital ng Maynila for a pull-through operation.
Dr. Leandro Resurreccionheaded the surgical team, and was assisted by Dr. Joselito Lucerio,
Dr.Donatella Valeria and Dr. Joseph Tibio. The anesthesiologist included Drs. Abella, Razon and
Solidum. During the operation, Gerald experienced bradycardia and went into a coma. His coma
21
 lasted for two weeks , but he regained consciousness only after a month. He could no longer see,
hear, or move. A complaint for reckless imprudence resulting in serious physical injuries were filed
by Geralds parents against the team of doctors alleging that there was failure in monitoring the
anesthesia administered to Gerald.
Issue Whether or not petitioner is liable for medical negligence.
Held/Ratio: No. Negligence is defined as the failure to observe for the protection of the interests of another person
that degree of care, precaution, and vigilance that the circumstances justly demand, whereby such
other person suffers injury. Reckless imprudence, on the other hand, consists of voluntarily doing or
failing to do, without malice, an act from which material damage results by reason of an inexcusable
lack of precaution on the part of the person to perform or failing to perform such act.
doctrine In order to allow resort to the doctrine, therefore, the following essential requisites must first be
satisfied, to wit: (1) the accident was of a kind that does not ordinarily occur unless someone is
negligent; (2) the instrumentality or agency that caused the injury was under the exclusive control of
the person charged; and (3) the injury suffered must not have been due to any voluntary action or
contribution of the person injured.
H. REASONABLE OR JUSTIFIABLE RELIANCE
Justifiable reliance represents the core to any charge of misrepresentation and nondisclosure, as it represents the
specific standard to which a representative relationship can be ascertained to the point of legal responsibility. Justifiable
reliance, simply put, indicates the extent to which one can be held to have relied on the representations of another.
justifiable reliance, and its basis on materiality, forms a key part when determining whether misrepresentation or
nondisclosure has occurred. If the product guarantees a material promise, then an individual is entitled to expect that the
product will fulfill that promise, in the form of justifiable reliance.
If the product does not fulfill that obligation, either because the seller or creator misrepresented its ability, or failed
to disclose an element that would prevent it from fulfilling that promise then they have not adhered to the promise of
justifiable reliance. Under tort law, if that failure of justifiable reliance on the part of the seller has led to a loss on the part
of the buyer, then they are able to hold the seller responsible for that loss (even if that loss represents something as small
as a refund on the purchase).
I.GOOD SAMARITAN ACT
Providingfirst aidin an emergency is very crucial. Certain injuries or illness may be life threatening if not provided
with care in just a few minutes. However, there are certain restrictions that may cause thefirst aiderto think twice in
providing care in an emergency. Aside from the lack of knowledge... there is also the fear of getting sued.
Lets face it, nobody is obligated to provide care in an emergency when no legal duty exists... However, we do need
to consider that providing care to someone most especially if there is a threat to life is very much satisfying and fulfilling.
Once youprovide care, there is already the risk of getting sued. However there is a law that provides protection to
that person.
The Good Samaritan Law - this law generally provides protection to off duty personnel providing first aid. But
remember that there is no such thing as complete protection. So it is important that a person should know what they are.
The Good Samaritan Law applies when the rescuer is:
acting in good faith
acting in anemergency
acting with no guilt or misconduct
acting without compensation
So there you are. Remember this the moment you provide care. Also remember that there is no substitute to proper
first aid training.
As you provide care, it is also important to obtain consent. Consent is necessary prior to providing care. Consent can be:
Expressed- this is usually when a person is conscious and is in the right age to decide. It can be given verbally or by gesture.
Implied Consent- this applies to any person that is unconscious, as well as to children and those who are mentally
incompetent.
Lastly, do not forget that once you have provided care, do not leave the victim until help arrives or until another person
capable of providing care has taken over. That person could be another first aider, a medical doctor, health care provider or
the emergency medical services.
Laws vary from country to country and state to state
Please be advised that Law vary from country to country and state to state. In some cases, only the emergency care
services personnel are allowed to provide care. It is very important to know and be aware of specific laws governing
emergency care in your area.
It is also important to know the right firstsince doing the wrong thing may add more injury to the victim of accident.
Find out more about first aid and learn how to provide. Who knows the life you save may be your own.
J. PHYSICIAN-PATIENT CONFIDENTIALITY PRIVILEGE COMMUNICATION
RULE 130 Section 24. (c), Section 27
Section 24. Disqualification by reason of privileged communication. The following persons cannot testify as to matters
learned in confidence in the following cases:
(c) A person authorized to practice medicine, surgery or obstetrics cannot in a civil case, without the consent of the
patient, be examined as to any advice or treatment given by him or any information which he may have acquired
in attending such patient in a professional capacity, which information was necessary to enable him to act in
capacity, and which would blacken the reputation of the patient;

22
Section 27. Offer of compromise not admissible. In civil cases, an offer of compromise is not an admission of any
liability, and is not admissible in evidence against the offeror.
In criminal cases, except those involving quasi-offenses (criminal negligence) or those allowed by law to be compromised,
an offer of compromised by the accused may be received in evidence as an implied admission of guilt.
A plea of guilty later withdrawn, or an unaccepted offer of a plea of guilty to lesser offense, is not admissible in evidence
against the accused who made the plea or offer.
An offer to pay or the payment of medical, hospital or other expenses occasioned by an injury is not admissible in evidence
as proof of civil or criminal liability for the injury. (24a)
K. DEFENSES:
1) Standard Negligence Defenses - Medical malpractice is a form of negligence, therefore many of the defenses allowed
against general negligence claims are also viable against malpractice claims.
a) For example, a doctor may argue that his care was in line with the standards upheld in the medical profession, or
that the patients injuries werent the result of a medical error. While disproving an element of negligence is one
of the most common defenses to medical malpractice, there are a number of other defenses that may apply as well.
2) Contributory Negligence - Oftentimes, medical professionals arent the only ones to blame for an injury. If a medical
professional can show that the injury would not have occurred had it not been for a negligent act by the patient, he or
she may have a valid defense against a malpractice claim.
a) For example, if a patient mixed prescriptions against the doctors orders or failed to disclose key elements of his
or her medical history, the doctor may be off the hook for any injuries that result..
3) Respectable Minority Principle Within the medical field there are a number of ways to treat diseases and aliments.
Some ways happen to be more controversial than others, and in the past, have opened up doctors to malpractice medical
lawsuits. However, more recent legislature has sought to protect treatments that doctors can use within their scope of
employment, allowing them not to be subjected to frivolous malpractice medical lawsuits.
a) For example a neurosurgeon who treated a patient for cerebral vascular disease with PREMARIN (Wyeth
Pharmaceuticals, Philadelphia, PA). The plaintiff sued doctor due to the side effects of breast enlargement and loss
of libido and stated that doctor was the only neurosurgeon out of nine in Nashville that used PREMARIN for
cerebral vascular disease.
4) Good Samaritan Laws - Many states have Good Samaritan laws, shielding individuals who come to the aid of those
in medical distress. Doctors, nurses, and other medical professionals are often specifically included in such laws. That
means if a doctor aids someone in an emergency situation, he or she will be protected from civil liability should anything
go wrong during the rescue. Generally, however, a medical professional who voluntarily aids someone owes that person
the same duty of care and treatment as that of a reasonably competent physician under the same or similar
circumstances.
a) For example, physician pulls over at the scene of an accident and, through a sense of civic responsibility, delivers
health care.
5) Statute of Limitations State laws place time limits on when an action can be brought for medical malpractice. Some
states have adopted the discovery rule, which holds that the statute of limitations period doesnt begin until an injury
is actually discovered. If the medical professional can show that the patient discovered the injury at a certain point and
that the statute of limitations has since run, the case may be dismissed.
Common Defenses in Medical Malpractice Lawsuit Cases
a. The doctors deviation from standard of care D.The patient failed to treat the condition or made the
did not lead to, worsen or contribute to the condition worse.
patients injuries or damages. E.The patient failed to provide pertinent information to the
b. The patient was negligent. If the patients doctor.
negligence is proven to have caused the injuries F.Another medical provider or doctor caused the injuries.
and resultant damages, the patient will be
unable to recover damages in the claim.
c. The patient gave informed consent, assuming
the risk of the complications or side effects he
or she experienced.
Rejection of Expert Testimony
An Experts Qualifications. (SEE TABLE below)
Reliability of an Experts Opinion.
Reduction or Elimination of Damages
Absence of Causation.
DEMANDED
FROM EVERY
TYPES DUTIES Qualifications DISQUALIFICATION
MEDICAL
WITNESS.

23
 It is the duty of
every physician
when called upon
MEDICAL by the judicial
WITNESS AND authorities, to assist . 1. That he
THE COURT in the must be
administration of
justice on matters absolutely
which are medico- honest and
legal in character unbiased in his
1. The person must
testimony.
he should only have the organ and the
power of perception. 2. That he has
be allowed to 2. The perceptions
ORDINARY state the facts 1. Those with the real
gathered by his organs
WITNESS
which come to of sense can be unsound mind. expert
imparted to others.
his own 3. He does not fall in knowledge
perception any of the exceptions 2. Children of of the
in the Rules of Court
tender age and subject on
1.That the fact to be inferior which he is
proven is one
requiring expert capacity testifying.
knowledge incapable of 3. That he
2.That the witness is receiving studied
really an expert.
(a) the experts correct thoroughly the
scientific, technical, impressions of case in which
He is allowed or other specialized the facts when he expects to
to give knowledge will help
the trier of fact to they are testify and
inference, understand the examined prepared
EXPERT deduction, evidence or to himself to look
WITNESS conclusion or determine a fact in
issue; up the opinion
opinion from (b) the testimony is and statement
the facts based on sufficient held by
presented to facts or data;
(c) the testimony is authorities and
him the product of others who
reliable principles have written
and methods; and
(d) the expert has on the subject.
reliably applied the
principles and
methods to the facts
of the case.

Privileged communication: Requisites of the privileged information between the

Physician and his Patient
(a) the privilege is claimed in a civil case; 1. That the privilege is claimed in a civil case.
(b) the person against whom the privilege is claimed is 2. That the person against whom the privilege is claimed
one duly authorized to practice medicine, surgery or is one duly authorized to practice medicine, surgery or
obstetrics; obstetrics.
(c) such person acquired the information while he was 3. That the physician acquired information while was
attending to the patient in his professional capacity; attending the patient in his professional capacity.
(d) the information was necessary to enable him to act in 4. That the information is confidential, if disclose will
that capacity; and, blacken the character of the
patient

24
 (e) the information was confidential and, if disclosed,
would blacken the reputation (formerly character) of the
patient.

As a rule, it is not admissible: Grounds for Requisites for its admissibility

admissibility
1.It is hard to determine whether 1Necessity The declaration must concern the cause and
the original declarant is 2Trustworthiness surrounding circumstances of the declarants death.
irresponsible. 2. That at the time the declarant was made, the
2.Depreciation of the truth of the declarant was under the consciousness of impending
statement on the process of death.
repetition. 3. That the declarant is a competent witness.
3.Opportunity for the commission 4. That the declarant is offered in a criminal case for
of fraud. homicide, murder or parricide in which the declarant is
the victim.

Factors to be considered in determining the weight of Duties of a physician with regards to Dying
a dying declaration: declaration

1. The trustworthiness of the physician who reported the 1. Physician must observe patient of feeling of impending
declaration. death and advise the importance in making of such
2. The capacity of the declarant at the time of making the declaration
declaration to 2. Observe carefully the mental condition of the patient.
accurately remember the past. 3. Physician immediately write down what patients
3. The capacity of the declarant to tell what he statements.
remembered. 4. He must avoid leading questions.
4. Factors which may influence the declarant in making a 5. If the case is long standing, he may inform any officer
declaration. of the law to take down the dying declaration.
6. The Physician must produce the statement taken and
not to judge by himself the relevant points of
admissibility.
.
Prescription of crimes art 71 RPC penalties ARTICLE 71. Fine. The fine shall be considered as the last of all the
principal penalties listed in the preceding article.
Art. 1146. The following actions must be instituted within four years:
(1) Upon an injury to the rights of the plaintiff;
(2) Upon a quasi-delict;
BORROWED SERVANT DOCTRINE- A principle under which the party usually liable for a persons actionse.g., a
hospital which has employed a particular nurseis absolved of responsibility when that 'borrowed servant' is asked to do
somethinge.g., by a surgeonwhich is outside of the bounds of hospital policy.
L. RA 8504 ARTICLE VI Sec. 30, 31, 32, 33, 34
ARTICLE VI CONFIDENTIALITY
Sec. 30.Medical confidentiality. All health professionals, medical instructors, workers, employers, recruitment agencies,
insurance companies, data encoders, and other custodians of any medical record, file, data, or test results are directed to
strictly observe confidentiality in the handling of all medical information, particularly the identity and status of persons
with HIV.
Section 31.Exceptions to the mandate of confidentiality. Medical confidentiality shall not be considered breached in the
following cases:
(a) when complying with reportorial requirements in conjunction with the AIDSWATCH programs provided in
Sec. 27 of this Act;
(b) when informing other health workers directly involved or about to be involved in the treatment or care of a
person with HIV/AIDS: Provided, That such treatment or care carry the risk of HIV transmission: Provided, further,
That such workers shall be obliged to maintain the shared medical confidentiality;
(c) when responding to a subpoena duces tecum and subpoena ad testificandum issued by a Court with jurisdiction
over a legal proceeding where the main issue is the HIV status of an individual:Provided,That the confidential
medical record shall be properly sealed by its lawful custodian after being double-checked for accuracy by the head
of the office or department, hand delivered, and personally opened by the judge:Provided, further,That the judicial
proceedings be held in executive session.
Section 32.Release of HIV/AIDS test results. All results of HIV/AIDS testing shall be confidential and shall be released
only to the following persons:
(a) the person who submitted himself/herself to such test;
(b) either parent of a minor child who has been tested;
(c) a legal guardian in the case of insane persons or orphans;

25
 (d) a person authorized to receive such results in conjunction with the AIDSWATCH program as provided in Sec.
27 of this Act;
(e) a justice of the Court of Appeals or the Supreme Court, as provided under subSec. (c) of this Act and in
accordance with the provision of Sec. 16 hereof.
Section 33.Penalties for violations of confidentiality. Any violation of medical confidentiality as provided in Sec.s 30
and 32 of this Act shall suffer the penalty of imprisonment for six (6) months to four (4) years, without prejudice to
administrative sanctions such as fines and suspension or revocation of the violator's license to practice his/her profession,
as well as the cancellation or withdrawal of the license to operate any business entity and the accreditation of hospitals,
laboratories or clinics.
Section 34.Disclosure to sexual partners. Any person with HIV is obliged to disclose his/her HIV status and health
condition to his/her spouse or sexual partner at the earliest opportune time.
M. STANDARD OF CARE
How is the Standard of Care Determined?
Standard of careis the only degree of prudence and caution required of an individual who is under aduty of care.
A standard of careis a medical or psychological treatment guideline, and can be general or specific. It specifies appropriate
treatment based on scientific evidence and collaboration between medical and/or psychological professionals involved in
the treatment of a given condition.
1. Degree of ability by other physicians in the same locality.
2. Degree of care, attention, diligence or vigilance exercised by those physicians in the application of their skills.
3. Special or extraordinary for specialist.
National Standard of Care the diligence is determined on what is applicable on a national standard basis Locality
Rule the standard of care is measured by the degree of care in the locality
Respectable Minority Rule (refer to page 24)
Modified locality rule
similar locality rule diligence is determined when the other physicians in the locality or similar locality
could have acted the same way socio economic similarities or geographical proximity
Customary Care Accepted Medical Standards of Care
Customary defined: according to the customs or usual 1.Standard of care means the degree of care and skill of the
practices associated with a particular society, place, or set of average health care provider who practices the providers
circumstances. specialty, taking into account the medical knowledge that is
available to the physician.
2.Another way to describe the term is that the standard of care
is based on the customary practices of the average physician,
i.e., what the average physician would customarily or
typically do in similar circumstances.
Customary solution works on the standard of applying a Advanced pharmaceutical then again, includes the usage and
solitary or in mix of ways to deal with treat, analyze, application wellbeing science, biomedical examination and
counteract diseases and keep up prosperity through cutting edge therapeutic innovation in the analysis, treatment
wellbeing hones or methodologies that use information and and aversion of maladies.
convictions utilizing plants, creature, spirits, manual
systems.
Sample
back rub and activities. anesthesia
Prescription of medicine
Experimental is every now and again the system that is being works under the guideline of exactness, accuracy, direness
used. and speediness where no room for give and take is permitted
Conventional solution uses herbalism or the utilization of with regards to sparing lives. For sure, speedy and precise
plants or herbs, choices are imperative to life.

Cause-in-fact is determined by the "but for" test:

Proximate Cause
the DOCTRINE of Proximate Cause -continuous and natural sequence, unbroken by an efficient cause producing the
injury and without which the result would not have occurred.
Conditions that must be complied with in the determination of the proximate cause:
1. Direct physical connection between the wrongful act and the injury. -unsterile
2. Wrongful act must not be too remote from the development of the injury.
3. The result must be the natural and probable consequences of the cause.
DOCTRINE of Efficient Independent Intervening Cause:= may mitigate the damage to be rewarded.

26
CAUSATION-DIFFERENCE BET BUT FOR TEST AND SUBSTANTIAL FACTOR TEST
The but-for test and the substantial factor test are alternative tests that courts often use to determine whether the defendant
was the cause in fact of the plaintiffs injury.
CAUSATION-DIFFERENCE BET BUT FOR TEST SUBSTANTIAL FACTOR TEST
Would the plaintiff have suffered the injury if defendant hadnt acted if a defendant works in a factory and
carelessly? develops cancer, he might allege that the
cancer resulted from asbestos poisoning
1. Concurrent causes. Where two separate acts of negligence combine 1.Under that standard, a cause in fact is
to cause an injury to a third party, each actor is liable. something that is a substantial factor in
1.1. For example, a construction worker negligently leaves the bringing about the injury. The substantial
cover off a manhole, and a careless driver negligently clips factor standard generally produces the
a pedestrian, forcing the pedestrian to fall into the open same results as does the but for rule of
manhole. Both the construction worker and the careless driver causation which states that a defendants
are equally liable for the injury to the pedestrian. conduct is a cause of the injury if the
1.1.1. This example obeys the but for test. The injury could injury would not have occurred but for
have been avoided by the elimination of either act of that conduct. The substantial factor
negligence, thus each is a but for cause of the injury. standard, however, has been embraced as
2. Sufficient combined causes. Where an injury results from two a clearer rule of causationone which
separate acts of negligence, either of which would have been subsumes the but for test while reaching
sufficient to cause the injury, both actors are liable. beyond it to satisfactorily address other
2.1. For example, two campers in different parts of the woods situations, such as those involving
negligently leave their campfires unattended. A forest independent or concurrent causes in fact.
fire results, but the same amount of property damage would 2.it is a relatively broad one, requiring
have resulted from either fire. Both campers are equally liable only that the contribution of the individual
for all damage. cause be more than negligible or
2.2. Two parties have acted negligently, but only one causes an theoretical. Thus, a force which plays
injury to a third party, the burden shifts to the negligent parties only an infinitesimal or theoretical
to prove that they were not the cause of the injury. part in bringing about injury, damage, or
2.3. In that case, two hunters negligently fired their shotguns in the loss is not a substantial factor, but a very
direction of their guide, and a pellet lodged in his eye. Because minor force that does because harm is a
it was impossible to tell which hunter fired the shot that caused substantial factor. This rule honors the
the injury, the court held both hunters liable. principle of comparative fault
3. Market share evidence. Injury or illness is occasioned by
a fungible product made by all the manufacturers joined together in
a lawsuit. The injury or illness is due to a design hazard, with each
having been found to have sold the same type of product in a manner
that made it unreasonably dangerous, there is inability to identify the
specific manufacturer of the product or products that brought about
the Plaintiffs injury or illness and there are enough manufacturers
of the fungible product joined in the lawsuit, to represent a
substantial share of the market. Any damages would then be divided
according to the market share ratio.
4. Since but-for causation is very easy to show and does not
assign culpability (but for the rain, you would not have crashed your
car the rain is not morally or legally culpable but still constitutes a
cause), there is a second test used to determine if an action is close
enough to a harm in a "chain of events" to be a legally culpable cause
of the harm. This test is called proximate cause.

N. CASES:
Name: CHAN vs. CHAN N. G.R. No. 179786 July 24, 2013
Facts Josielene osielene Lara Chan (Josielene) filed before the Regional Trial Court (RTC) of Makati City,
Branch 144 a petition for the declaration of nullity of her marriage to respondent Johnny Chan (Johnny),
the dissolution of their conjugal partnership of gains, and the award of custody of their children to her.
Josielene claimed that Johnny failed to care for and support his family and that a psychiatrist diagnosed
him as mentally deficient due to incessant drinking and excessive use of prohibited drugs. Indeed, she
had convinced him to undergo hospital confinement for detoxification and rehabilitation. ohnny resisted
the action, claiming that it was Josielene who failed in her wifely duties. To save their marriage, he
agreed to marriage counseling but when he and Josielene got to the hospital, two men forcibly held him
by both arms while another gave him an injection. The marriage relations got worse when the police
temporarily detained Josielene for an unrelated crime and released her only after the case against her
ended. By then, their marriage relationship could no longer be repaired.
Issue Whether or not the CA erred in ruling that the trial court correctly denied the issuance of a subpoena
duces tecum covering Johnnys hospital records on the ground that these are covered by the privileged
character of the physician-patient communication?

27
Held Josielene requested the issuance of a subpoena duces tecum covering the hospital records of Johnnys
confinement, which records she wanted to present in court as evidence in support of her action to have
their marriage declared a nullity. Respondent Johnny resisted her request for subpoena, however,
invoking the privileged character of those records. He cites Section 24(c), Rule 130 of the Rules of
Evidence which reads:SEC. 24. Disqualification by reason of privileged communication. The
following persons cannot testify as to matters learned in confidence in the following casesc) A
person authorized to practice medicine, surgery or obstetrics cannot in a civil case, without the consent
of the patient, be examined as to any advice or treatment given by him or any information which he
may have acquired in attending such patient in a professional capacity, which information was
necessary to enable him to act in that capacity, and which would blacken the reputation of the
patient.The physician-patient privileged communication rule essentially means that a physician who
gets information while professionally attending a patient cannot in a civil case be examined without
the patients consent as to any facts which would blacken the latters reputation. This rule is intended
to encourage the patient to open up to the physician, relate to him the history of his ailment, and give
him access to his body, enabling the physician to make a correct diagnosis of that ailment and provide
the appropriate cure. Any fear that a physician could be compelled in the future to come to court and
narrate all that had transpired between him and the patient might prompt the latter to clam up, thus
putting his own health at great risk.

Name: KROHN vs.COURT OF APPEALS and KROHN, JR., G.R. No. 108854 June 14, 1994
Facts Ma. Paz Fernandez Krohn, invoking the rule on privileged communication between physician and
patient, seeks to enjoin her husband from disclosing the contents of the report.
Issue Whether or not the evidence offered by Edgar may be admitted?
Held/Rati Petitioner's discourse while exhaustive is however misplaced.
o: Lim v Court of Appeals
clearly lays down the requisites in order that the privilege may be successfully invoked: (a) the privilege
is claimed in civil case; (b) the person against whom the privilege is claimed is one duly authorized to
practice medicine, surgery or obstetrics; (c) such person acquired the information while he was attending
to the patient in his professional capacity; (d) the information was necessary to enable him to act in that
capacity; and, (e) the information was confidential and, if disclosed, would blacken the
reputation(formerly character) of the patient

Name: NELLY LIM v. THE COURT OF APPEALS G.R. No. 91114. September 25, 1992
Facts November 25, 1987 Juan Sim filed with Pangasinan RTC a petition for annulment based on
Art 36, alleging that Nelly Lim (petitioner) is suffering from schizophrenia before, during and after
marriage and until the present
January 11, 989 Sim announced he will present Dr Lydia Acampado (psychiatrist) as a witness
on January 25, 1989
Petitioner opposed on the grounds that the testimony sought to be elicited from the witness is
privileged since Dr Acampado had examined Lim in a professional capacity and had diagnosed her with
schizophrenia. Subpoena was issued on January 12, 1989
January 24, 1989 petitioner filed urgent motion to quash subpoena and suspend proceedings.
Overruled
Respondent claimed that Dr Acampado will be presented as expert witness and would not testify
on any information acquired while attending to the petitioner as doctor.
March 3, 1989 petitioner filed with CA petition for certiorari and prohibition but was denied
on September 18, 1989 on the ground that petitioner failed to establish the confidential nature of the
testimony obtained from Dr Acampado
Issue Whether Dr Acampado can be presented as expert witness in testifying schizophrenia in case where
petitioner is her client?
Held/Rati In order for patient-doctor privilege can be claimed, the following requisites must concur:
o: 1. Privilege claimed is in a civil case
2. The person against whom the privilege is claimed is one duly authorized to practice medicine
3. Such person acquired the information while he was attending to the patient in his professional
capacity
4. The information was necessary for him to enable him to act in that capacity
These requisites must concur with the 4 fundamental conditions necessary for invoking doctor-patient
confidentiality:
1. The communications must originate in a confidence that they will not be disclosed
2. Element of confidentiality must be essential to the full and satisfactory maintenance of the
relation between the parties
3. The relation must be one which the opinion of the community ought to be sedulously fostered
4. The injury that would inure to the relation by the disclosure of the communications must greater
than the benefit thereby gain for correct disposal of litigation

28
 O. RPC
Art. 174, 175, 259, 347, 365
Section Five.-Falsification of medical certificates, certificates of merit or services and the like.
Article 174.False medical certificates, false certificates of merits or service, etc.- The penalties ofarresto mayorin its
maximum period to prision correccional in its minimum period and a fine not to exceedP1,000 pesos shall be imposed
upon:
1. Any physician or surgeon who, in connection, with the practice of his profession, shall issue a false certificate;
and
2. Any public officer who shall issue a false certificate of merit of service, good conduct or similar circumstances.
The penalty ofarresto mayorshall be imposed upon any private person who shall falsify a certificate falling within the
classes mentioned in the two preceding subdivisions.
SAMPLE Issuing a false medical certificate by a physician or surgeon
a). The contents are not true in that the person was never examined; or that he actually had no illness; or that the
illness is not as serious as stated in the certificate; or that the period of confinement or rest is not as stated therein.
b)the patient who altered the period of days of confinement.
The act of knowingly using said false certificates
Article 175.Using false certificates.- The penalty ofarresto menorshall be imposed upon any one who shall knowingly use
any of the false certificates mentioned in the next preceding article.
Examples: false seals, false branding instruments
Article 259.Abortion practiced by a physician or midwife and dispensing of abortives.- The penalties provided in Article
256 shall be imposed in its maximum period, respectively, upon any physician or midwife who, taking advantage of their
scientific knowledge or skill, shall cause an abortion or assist in causing the same.
Any pharmacist who, without the proper prescription from a physician, shall dispense any abortive shall sufferarresto
mayorand a fine not exceeding 1,000 pesos.
SIMULATION OF BIRTHS AND USURPATION OF CIVIL STATUS
Article 347.Simulation of births, substitution of one child for another and concealment or abandonment of a legitimate
child.- The simulation of births and the substitution of one child for another shall be punished by prision mayor and a fine
of not exceeding 1,000 pesos.
The same penalties shall be imposed upon any person who shall conceal or abandon any legitimate child with intent to
cause such child to lose its civil status.
Any physician or surgeon or public officer who, in violation of the duties of his profession or office, shall cooperate in the
execution of any of the crimes mentioned in the two next preceding paragraphs, shall suffer the penalties therein prescribed
and also the penalty of temporary special disqualification.
CRIMINAL NEGLIGENCE
Article 365.Imprudence and negligence.- Any person who, by reckless imprudence, shall commit any act which, had it
been intentional, would constitute a grave felony, shall suffer the penalty ofarresto mayorin its maximum period to prision
correccional in its medium period; if it would have constituted a less grave felony, the penalty ofarresto mayorin its
minimum and medium periods shall be imposed; if it would have constituted a light felony, the penalty ofarresto menorin
its maximum period shall be imposed.
Any person who, by simple imprudence or negligence, shall commit an act which would otherwise constitute a grave felony,
shall suffer the penalty ofarresto mayorin its medium and maximum periods; if it would have constituted a less serious
felony, the penalty ofarresto mayorin its minimum period shall be imposed.
When the execution of the act covered by this article shall have only resulted in damage to the property of another, the
offender shall be punished by a fine ranging from an amount equal to the value of said damages to three times such value,
but which shall in no case be less than twenty-five pesos.
A fine not exceeding two hundred pesos and censure shall be imposed upon any person who, by simple imprudence or
negligence, shall cause some wrong which, if done maliciously, would have constituted a light felony.
In the imposition of these penalties, the court shall exercise their sound discretion, without regard to the rules prescribed in
Article sixty-four.
The provisions contained in this article shall not be applicable:
1. When the penalty provided for the offense is equal to or lower than those provided in the first two paragraphs of
this article, in which case the court shall impose the penalty next lower in degree than that which should be imposed
in the period which they may deem proper to apply.
2. When, by imprudence or negligence and with violation of the Automobile Law, to death of a person shall be
caused, in which case the defendant shall be punished by prision correccional in its medium and maximum periods.
Reckless imprudence consists in voluntary, but without malice, doing or falling to do an act from which material damage
results by reason of inexcusable lack of precaution on the part of the person performing of failing to perform such act,
taking into consideration his employment or occupation, degree of intelligence, physical condition and other circumstances
regarding persons, time and place.
Simple imprudence consists in the lack of precaution displayed in those cases in which the damage impending to be caused
is not immediate nor the danger clearly manifest.
The penalty next higher in degree to those provided for in this article shall be imposed upon the offender who fails to lend
on the spot to the injured parties such help as may be in this hand to give. (As amended by R.A. 1790, approved June 21,
1957).
P. RA 9165 Comprehensive Dangerous Drugs Act of 2002 -(KINDLY REFER TO RPC CODAL)

29
Republic Act No. 7170 January 7, 1992AN ACT AUTHORIZING THE LEGACY OR DONATION OF ALL
OR PART OF A HUMAN BODY AFTER DEATH FOR SPECIFIED PURPOSES
Be it enacted by the Senate and House of Representatives of the Philippines in Congress assembled::
Section 1.Title. This Act shall be known as the"Organ Donation Act of 1991".
Section 2.Definition of Terms. As used in this Act the following terms shall mean:
(a) "Organ Bank Storage Facility" - a facility licensed, accredited or approved under the law for storage of
human bodies or parts thereof.
(b) "Decedent" - a deceased individual, and includes a still-born infant or fetus.
(c) "Testator" - an individual who makes a legacy of all or part of his body.
(d) "Donor" - an individual authorized under this Act to donate all or part of the body of a
decedent.1awphilalf
(e) "Hospital" - a hospital licensed, accredited or approval under the law, and includes, a hospital operated
by the Government.
(f) "Part" - includes transplantable organs, tissues, eyes, bones, arteries, blood, other fluids and other portions
of the human body.
(g) "Person" - an individual, corporation, estate, trust, partnership, association, the Government or any of its
subdivisions, agencies or instrumentalities, including government-owned or -controlled corporations; or any
other legal entity.
(h) "Physician" or "Surgeon" - a physician or surgeon licensed or authorized to practice medicine under the
laws of the Republic of the Philippines.
(i) "Immediate Family" of the decedent - the persons enumerated in Section 4(a) of this Act.
(j) "Death" - the irreversible cessation of circulatory and respiratory functions or the irreversible cessation of
all functions of the entire brain, including the brain stem. A person shall be medically and legally dead if
either:1awphilalf
(1) In the opinion of the attending physician, based on the acceptable standards of medical practice,
there is an absence of natural respiratory and cardiac functions and, attempts at resuscitation would
not be successful in restoring those functions. In this case, death shall be deemed to have occurred at
the time these functions ceased; or
(2) In the opinion of the consulting physician, concurred in by the attending physician, that on the
basis of acceptable standards of medical practice, there is an irreversible cessation of all brain
functions; and considering the absence of such functions, further attempts at resuscitation or
continued supportive maintenance would not be successful in resorting such natural functions. In this
case, death shall be deemed to have occurred at the time when these conditions first appeared.
The death of the person shall be determined in accordance with the acceptable standards of medical practice and shall
be diagnosed separately by the attending physician and another consulting physician, both of whom must be
appropriately qualified and suitably experienced in the care of such parties. The death shall be recorded in the patient's
medical record.
Section 3.Person Who May Execute A Legacy. Any individual, at least eighteen (18) years of age and of sound
mind, may give by way of legacy, to take effect after his death, all or part of his body for any purpose specified in
Section 6 hereof.
Section 4.Person Who May Execute a Donation.
(a) Any of the following, person, in the order of property stated hereunder, in the absence of actual notice of
contrary intentions by the decedent or actual notice of opposition by a member of the immediate family of
the decedent, may donate all or any part of the decedent's body for any purpose specified in Section 6 hereof:
(1) Spouse;
(2) Son or daughter of legal age;
(3) Either parent;
(4) Brother or sister of legal age; or
(5) Guardian over the person of the decedent at the time of his death.
(b) The persons authorized by sub-section (a) of this Section may make the donation after or immediately
before death.
Section 5.Examination of Human Body or Part Thereof. A legacy of donation of all or part of a human body
authorizes any examination necessary to assure medical acceptability of the legacy or donation for the purpose(s)
intended.
For purposes of this Act, an autopsy shall be conducted on the cadaver of accident, trauma, or other medico-legal
cases immediately after the pronouncement of death, to determine qualified and healthy human organs for
transplantation and/or in furtherance of medical science.
Section 6.Persons Who May Become Legatees or Donees. The following persons may become legatees or donees
of human bodies or parts thereof for any of the purposes stated hereunder:
(a) Any hospital, physician or surgeon - For medical or dental education, research, advancement of medical
or dental science, therapy or transplantation;
(b) Any accredited medical or dental school, college or university - For education, research, advancement of
medical or dental science, or therapy;
(c) Any organ bank storage facility - For medical or dental education, research, therapy, or transplantation;
and
(d) Any specified individual - For therapy or transplantation needed by him.
30
Section 7.Duty of Hospitals. A hospital authorized to receive organ donations or to conduct transplantation shall
train qualified personnel and their staff to handle the task of introducing the organ donation program in a humane and
delicate manner to the relatives of the donor-decedent enumerated in Section 4 hereof. The hospital shall accomplish
the necessary form or document as proof of compliance with the above requirement.
Section 8.Manner of Executing a Legacy.
(a) Legacy of all or part of the human body under Section 3 hereof may be made by will. The legacy becomes
effective upon the death of the testator without waiting for probate of the will. If the will is not probated, or
if it is declared invalid for testamentary purposes, the legacy, to the extent that it was executed in good faith,
is nevertheless valid and effective.
(b) A legacy of all or part of the human body under Section 3 hereof may also be made in any document other
than a will. The legacy becomes effective upon death of the testator and shall be respected by and binding
upon his executor or administrator, heirs, assigns, successors-in-interest and all members of the family. The
document, which may be a card or any paper designed to be carried on a person, must be signed by the testator
in the presence of two witnesses who must sign the document in his presence. If the testator cannot sign, the
document may be signed for him at his discretion and in his presence, in the presence of two witnesses who
must, likewise, sign the document in the presence of the testator. Delivery of the document of legacy during
the testator's lifetime is not necessary to make the legacy valid.
(c) The legacy may be made to a specified legatee or without specifying a legatee. If the legacy is made to a
specified legatee who is not available at the time and place of the testator's death, the attending physician or
surgeon, in the absence of any expressed indication that the testator desired otherwise, may accept the legacy
as legatee. If the legacy does not specify a legatee, the legacy may be accepted by the attending physician or
surgeon as legatee upon or following the testator's death. The physician who becomes a legatee under this
subsection shall not participate in the procedures for removing or transplanting a part or parts of the body of
the decedent.
(d) The testator may designate in his will, card or other document, the surgeon or physician who will carry
out the appropriate procedures. In the absence of a designation, or if the designee is not available, the legatee
or other persons authorized to accept the legacy may authorize any surgeon or physician for the purpose.
Section 9.Manner of Executing a Donation. Any donation by a person authorized under subsection (a) of Section
4 hereof shall be sufficient if it complies with the formalities of a donation of a movable property.
In the absence of any of the persons specified under Section 4 hereof and in the absence of any document of organ
donation, the physician in charge of the patient, the head of the hospital or a designated officer of the hospital who
has custody of the body of the deceased classified as accident, trauma, or other medico-legal cases, may authorize in
a public document the removal from such body for the purpose of transplantation of the organ to the body of a living
person: Provided, That the physician, head of hospital or officer designated by the hospital for this purpose has exerted
reasonable efforts, within forty-eight (48) hours, to locate the nearest relative listed in Section 4 hereof or guardian
of the decedent at the time of death.
In all donations, the death of a person from whose body an organ will be removed after his death for the purpose of
transplantation to a living person, shall be diagnosed separately and certified by two (2) qualified physicians neither
of whom should be:
(a) A member of the team of medical practitioners who will effect the removal of the organ from the body;
nor
(b) The physician attending to the receipt of the organ to be removed; nor
(c) The head of hospital or the designated officer authorizing the removal of the organ.
Section 10.Person(s) Authorized to Remove Transplantable Organs. Only authorized medical practitioners in a
hospital shall remove and/or transplant any organ which is authorized to be removed and/or transplanted pursuant to
Section 5 hereof.
Section 11.Delivery of Document of Legacy or Donation. If the legacy or donation is made to a specified legatee
or donee, the will, card or other document, or an executed copy thereof, may be delivered by the testator or donor, or
is authorized representative, to the legatee or donee to expedite the appropriate procedures immediately after death.
The will, card or other document, or an executed copy thereof, may be deposited in any hospital or organ bank storage
facility that accepts it for safekeeping or for facilitation or procedures after death. On the request of any interested
party upon or after the testator's death, the person in possession shall produce the document of legacy or donation for
verification.
Section 12.Amendment or Revocation of Legacy or Donation.
a) If he will, card or other document, or an executed copy thereof, has been delivered to a specific legatee or
donee, the testator or donor may amend or revoke the legacy or donation either by:
(1) The execution and delivery to the legatee or donee of a signed statement to that effect; or
(2) An oral statement to that effect made in the presence of two other persons and communicated to
the legatee or donee; or
(3) A statement to that effect during a terminal illness or injury addressed to an attending physician
and communicated to the legatee or donee; or
(4) A signed card or document to that effect found on the person or effects of the testator or donor.
(b) Any will, card or other document, or an executed copy thereof, which has not been delivered to the legatee
or donee may be revoked by the testator or donor in the manner provided in subsection (a) of this Section or
by destruction, cancellation or mutilation of the document and all executed copies thereof.

31
 Any legacy made by a will may also be amended or revoked in the manner provided for amendment or
revocation of wills, or as provided in subsection (a) of this Section.
Section 13.Rights and Duties After Death.
(a) The legatee or donee may accept or reject the legacy or donation as the case may be. If the legacy of
donation is of a part of the body, the legatee or donee, upon the death of the testator and prior to embalming,
shall effect the removal of the part, avoiding unnecessary mutilation. After removal of the part, custody of
the remainder of the body vests in the surviving spouse, next of kin or other persons under obligation to
dispose of the body of the decedent.
(b) Any person who acts in good faith in accordance with the terms of this Act shall not be liable for damages
in any civil action or subject to prosecution in any criminal proceeding of this Act.
Section 14.International Sharing of Human Organs or Tissues. Sharing of human organs or tissues shall be made
only through exchange programs duly approved by the Department of Health: Provided, That foreign organ or tissue
bank storage facilities and similar establishments grant reciprocal rights to their Philippine counterparts to draw
organs or tissues at any time.
Section 15.Information Drive. In order that the public will obtain the maximum benefits from this Act, the
Department of Health, in cooperation with institutions, such as the National Kidney Institute, civic and non-
government health organizations and other health related agencies, involved in the donation and transplantation of
human organs, shall undertake a public information program.
The Secretary of Health shall endeavor to persuade all health professionals, both government and private, to make an
appeal for human organ donation.
Section 16.Rules and Regulations. The Secretary of Health, after consultation with all health professionals, both
government and private, and non-government health organizations shall promulgate such rules and regulations as
may be necessary or proper to implement this Act.
Section 17.Repealing Clause. All laws, decrees, ordinances, rules and regulations, executive or administrative
orders, and other presidential issuance inconsistent with this Act, are hereby repealed, amended or modified
accordingly.
Section 18.Separability Clause. The provisions of this Act are hereby deemed separable. If any provision hereof
should be declared invalid or unconstitutional, the remaining provisions shall remain in full force and effect.
Section 19.Effectivity. This Act shall take effect after fifteen (15) days following its publication in the Official
Gazette or at least two (2) newspapers of general circulation.
Approved: January 7, 1992

AN ACT TO ADVANCE CORNEAL TRANSPLANTATION IN THE PHILIPPINES, AMENDING FOR THE

PURPOSE REPUBLIC ACT NUMBERED SEVEN THOUSAND ONE HUNDRED AND SEVENTY (R. A. NO.
7170), OTHERWISE KNOWN AS THE ORGAN DONATION ACT OF 1991
[REPUBLIC ACT NO. 7885]
AN ACT TO ADVANCE CORNEAL TRANSPLANTATION IN THE PHILIPPINES, AMENDING FOR THE
PURPOSE REPUBLIC ACT NUMBERED SEVEN THOUSAND ONE HUNDRED AND SEVENTY (R. A. NO.
7170), OTHERWISE KNOWN AS THE ORGAN DONATION ACT OF 1991
Be it enacted by the Senate and House of Representatives of the Philippines in Congress assembled:
SECTION 1. Section 9 of Republic Act No. 7170 is hereby amended to read as follows:
SEC. 9. Manner of Executing a Donation. Any donation by a person authorizing under subsection (a) of Section 4 hereof
shall be sufficient if it complies with the formalities of a donation of a movable property.
In the absence of any persons specified under Section 4 hereof and in the absence of any document of organ donation, the
physician in charge of the patient, the head of the hospital or a designated officer of the hospital who has custody of the
body of the deceased classified as accident, trauma, or other medico-legal cases, may authorize in a public document the
removal from such body for the purpose of transplantation of the organ to the body of a living person: Provided, That the
physician, head of the hospital or officer designated by the hospital for this purpose has exerted reasonable efforts, within
forty-eight (48) hours, to locate the nearest relative listed in Section 4 hereof or guardian of the decedent at the time of
death: Provided, however, That the said physician, head or designated officer of the hospital, or the medico-legal officer of
any government agency which has custody of such body may authorize the removal of the cornea or corneas of the decedent
within twelve (12) hours after death and upon the request of qualified legatees or donees for the sole purpose of
transplantation: Provided, That such removal of the cornea or corneas will not interfere with any subsequent investigation
or alter the post-mortem facial appearance of the decedent by such means as placing eye caps after the said cornea or
corneas have been removed.
In all donations, the death of a person from whose body and organ will be removed after his death for the purpose of
transplantation to a living person, shall be diagnosed separately and certified by two (2) qualified physicians neither of
whom shall be:
(a) A member of the team of medical practitioners who will effect the removal of the organ from the body, nor
(b) The physician attending to recipient of the organ to be removed; nor
(c) The head of hospital or the designated officer authorizing the removal of the organ.
SEC. 2. Section 10 of Republic Act No. 7170 is also amended to read as follows:
SEC. 10. Person(s) Authorized to Remove and Transplant Organs and Tissues. Only authorized medical practitioners
in a hospital shall remove and/or transplant any organ which is authorized to be removed and/or transplanted pursuant to
Section 5 hereof: Provided, however, that the removal of corneal tissues shall be performed only by ophthalmic surgeons

32
and ophthalmic technicians trained in the methodology of such procedure and duly certified by the accredited National
Association of Ophthalmologists.
SEC. 3. The implementing rules and regulations of Republic Act No. 7170 shall be amended accordingly by the Secretary
of Health, in consultation with professional health groups and non-government health organizations, to make it consistent
with the provisions of this Act.
SEC. 4. The provisions of this Act are hereby declared separable, and in the event any such provisions is declared
unconstitutional, the other provisions not affected thereby shall remain in force and effect.
SEC. 5. All other laws, decrees, executive orders, administrative orders, rules and regulations or parts thereof which are
inconsistent with the provisions of this Act are hereby repealed, amended or modified accordingly.
Q. DR. FILOTEO A. ALANO vs. ZENAIDA MAGUD-LOGMAO G.R. No. 175540 April 7, 2014
NAME DR. FILOTEO A. ALANO vs. ZENAIDA MAGUD-LOGMAO G.R. No. 175540 April 7, 2014
FACT At around 9:50pm of March 1, 1988, Arnelito Logmao then 18 y/o, was brought to the East Avenue
Medical Center (EAMC) in Quezon City by two sidewalk vendors, who allegedly saw the former fall
from the overpass near the Farmers Market in Cubao, Quezon City. The patients data sheet identified
the patient as Angelito Lugmoso of Boni Ave., Mandaluyong. However, the clinical abstract prepared
by Dr. Paterno F. Cabrera, the surgical resident on-duty at the emergency room of EAMC, stated the
patient is Angelito Logmao. Dr. Cabrera reported that Logmao was drowsy with alcoholic breath, was
conscious and coherent; that the skull x-ray showed no fracture; that at around 4:30am of March 2,
1988, Logmao developed generalized seizures and was managed by the neuro-surgeon resident on-duty;
that the condition of Logmao progressively deteriorated and he was intubated and ambu-bagging
support was provided; that admission to the ICU and mechanical ventilation support became necessary,
but there was no vacancy at the ICU and all the ventilation units were being used by other patients; that
a resident physician of NKTI, who was rotating at EAMC, suggested that Logmao be transferred to
NKTI; and that after arrangements were made, Logamo was transferred to NKTI at 10:10am. At the
NKTI, the name Angelito Logmao was recorded as Angelito Lugmoso. Lugmoso was immediately
attended to and given the necessary medical treatment. As Lugmoso had no relatives around, Jennifer
Misa, transplant coordinator was asked to locate his family by enlisting police and media assistance.
Dr. Enrique Ona, chairman of the Department of Surgery, observed that severity of the brain injury of
Lugmoso manifested symptoms of brain death. He requested the laboratory section to conduct tissue
typing and tissue cross-matching examination, so that should Lugmoso expire despite the necessary
care and medical management and he would be found to be a suitable organ donor and his family would
consent to organ donation, the organs thus donated could be detached and transplanted promptly to any
compatible beneficiary. The identity of Lugmoso was verified by Misa from EAMC and she was
furnished the patients data sheet. She then contacted several radio and television stations to request for
air time for the purpose of locating the family of Angelito Lugmoso of Boni Ave., Mandaluyong who
was confined at NKTI with severe head injury after allegedly falling from the Cubao overpass, as well
as police station no. 5 Eastern Police District. Lugmoso was pronounced brain dead on March 3, 1988
7:00am. Two hours later, Dr. Ona was informed that EEG recording exhibited a flat tracing thereby
confirming his brain death. He was found to be a suitable donor of the heart, kidneys, pancreas, and
liver, and after the extensive search, no relatives were found. Dr. Ona then requested the removal of the
specific organs of Lugmoso from the herein petitioners, Dr. Alano, the director of NKTI who thereafter
issued a memorandum stating that only after the requirements of RA 349 as amended by PD 856 was
complied, they can remove the specified organs of Lugmoso. Lugmosos remains was brought at La
Funeraria Oro. A press release made by NKTI announcing a double organ transplant led to the findings
of the relatives of Lugmoso.
ISSUE Whether or not the removal of Lugmosos organs were valid.
HELD Yes. The internal organs of the deceased were removed only after he had been declared brain dead; thus
the emotional pain suffered by respondent due to the death of her son cannot be in any way be attributed
to petitioner. Neither can the court find evidence or second to show that respondents emotional
suffering at the sight of the pitful state in which she found her sons lifeless body be categorically
attributed to petitioners conduct.
Thus, there can be no cavil that petitioners employed reasonable means to disseminate notifications
intended to reach the relatives of the deceased. The only question that remains pertains to the sufficiency
of time allotted for notices to reach the relatives of the deceased.
If respondent failed to immediately receive notice of her sons death because the notices did not properly
state the name or identity of the deceased, fault cannot be laid at petitioners door. The trial and appellate
courts found that it was the EAMC, who recorded the wrong information regarding the deceaseds
identity to NKTI. The NKTI could not have obtained the information about his name from the patient,
because as found by the lower courts, the deceased was already unconscious by the time he was brought
to NKTI.

R. REPUBLIC ACT NO. 4226 - AN ACT REQUIRING THE LICENSURE OF ALL HOSPITALS IN THE
PHILIPPINES AND AUTHORIZING THE BUREAU OF MEDICAL SERVICES TO SERVE AS THE
LICENSING AGENCY
Section 1. This Act shall also be known as the Hospital Licensure Act.
33
Sec. 2. Definitions. As used in this Act
(a) 'Hospital' means a place devoted primarily to the maintenance and operation of facilities for the diagnosis,
treatment and care of individuals suffering from illness, disease, injury or deformity, or in need of obstetrical or
other medical and nursing care. The term 'hospital shall also be construed as any institution, building or place where
there are installed beds, or cribs, or bassinets for twenty-four-hour use or longer by patients in the treatment of
diseases, diseased-conditions, injuries, deformities, or abnormal physical and mental states, maternity cases, and all
institutions such as those for convalescence, sanitarial or sanitarial care, infirmities, nurseries, dispensaries and such
other names by which they may designated.
(b) 'Government hospital' means a hospital operated and maintained either partially or wholly by the national,
provincial, municipal or city government or other political subdivision, or by any department, division, board or
other agency thereof.
(c) 'Private hospital' means one which is privately owned, established and operated with funds raised or contributed
through donations, or by private capital or other means, by private individuals, association, corporation, religious
organization, firm, company or joint stock association.
(d) 'Clinic' means a place in which patients avail of medical consultations or treatments on an out-patient basis.
However, any clinic or dispensary where there is at least six beds or cribs or bassinets installed for twenty-four-hour
use by patients shall be construed to fall within the definition of a hospital as described in this Act.
(e) 'Licensee' is the person or persons granted a license to operate and maintain a hospital according to an approved
minimum standard.
Sec. 3. Construction Permit. No hospital, government or private, shall be constructed unless plans have been
approved and construction permit issued by the licensing agency as defined in this Act.
Sec. 4. Registration and license. No hospital shall operate or be opened to the public unless it shall have been
registered and a license for its operation obtained from the licensing agency provided in this Act.
Sec. 5. Licensing Agency. For purposes of setting standards in hospital construction and operation, the Bureau
of Medical Services in addition to its present duties shall act as the licensing agency. The Secretary of Health shall
reorganize this Bureau to include a staff of hospital architects, hospital administrators, sanitary engineers and such
personnel as may be necessary to carry out the purposes of this Act without necessarily increasing the present
personnel strength of this Bureau.
Sec. 6. Powers and duties of the licensing agency. The Bureau of Medical Services, or the licensing agency
shall have the following powers and duties:
a. To conduct an ocular survey of all existing hospitals in the Philippines, government or private, with a view to
determine their fitness to operate considering their facilities and physical plant.
b. To prescribe standard plans for government hospital plants in consultation with the Division of Architecture,
Bureau of Public Works.
c. To approve plans for hospital plants, government or private, and to issue permits or authority to construct
hospitals in accordance with the provisions of this Act.
d. To keep a permanent register of approved hospitals or those issued licenses to operate indicating the name of
the hospital, address or location, type of hospital, name of the director or administrator, ownership, number of
authorized beds and bassinets and such other pertinent data as may be necessary.
e. To grant licenses for the operation and maintenance of hospitals or revoke the same in accordance with the
provisions of this Act.
f. To make periodic inspection of all hospitals so as to check compliance with rules and regulations legally
promulgated or with the provisions of this Act and to make recommendations to directors or administrators of
hospitals for the correction of defects found during such inspections.
g. To publish yearly a list of all approved hospitals indicating the name, location, type, authorized beds, and name
of the director or administrator.
h. To submit yearly reports to the Secretary of Health, the Speaker of the House of Representatives, the President
of the Senate and the chairmen and members of the Committees on Health of both Houses of Congress, such reports
to include a list of approved hospitals indicating the name of the hospital, location, bed capacity and name of the
director or administrator and make recommendations on hospital needs or requirements for hospital service in certain
communities that do not enjoy such hospital services.
Sec. 7. Filing of Application for Construction Permit. Application for a permit to construct a hospital shall be
submitted to the Office of the Director, Bureau of Medical Services in a form prescribed by the latter and
accompanied by a plan of the hospital plant proposed to be constructed. The application shall state the name of the
hospital, ownership, number of beds proposed to be operated, location and type of hospital to be constructed.
Sec. 8. Minimum Standards of Construction. In order that a permit to construct a hospital can be issued the
hospital plan shall provide sufficient bed space for the hospital bed capacity proposed, a laboratory room, an
operating room, including work rooms for sterilization, anesthesia preparation, etc., an X-ray or radiology room,
pharmacy, dispensary or out-patient department, delivery room, isolation rooms, autopsy room or morgue, sufficient
quarters for residents, nurses, attendants and helpers and sufficient number of toilet facilities.
Wards shall be constructed such that segregation of the sexes is observed and as far as practicable classified as to
the type of cases to be confined.
Sec. 9. Application for Registration and Issuance of License. Application for registration of a hospital and for
the issuance of a license for its operation and maintenance shall be filed with the Bureau of Medical Services on a

34
 form prescribed by it. Registration may be made and license issued upon compliance with the provisions of Section
eight hereof and the rules and regulations prescribed by the licensing agency pursuant to the provisions of this Act.
SECTION 10. Inspection. Permit to construct a hospital or a major portion thereof and license to operate and
maintain the same shall be issued by the licensing agency only after a representative of the licensing agency has
conducted an ocular inspection and certified that the applicant has satisfactorily complied with requisites prescribed
in this Act. The license to operate and maintain a hospital shall be renewed every year upon payment of the prescribed
fees.
SECTION 11. Revocation of License. The licensing agency may suspend or revoke a license already issued for
any of the following grounds: (a) repeated violation by the licensee of any provision of this Act or of any other
existing law; (b) repeated violation of rules and regulations prescribed in the implementation of this Act; or (c)
repeated failure to make necessary corrections or adjustments required by the licensing agency in the improvement
of facilities and services.
SECTION 12. Hearing. Any person, association, corporation, or any other private entity who has been refused
a license to operate and maintain a hospital or whose license for such hospital has been suspended or revoked shall
be entitled to an administrative hearing to be conducted by the Secretary of Health and his two undersecretaries to
determine the justifiability of such denial, suspension or revocation of the license: provided, that the licensee may
resort to the courts, as in other cases provided by law.
SECTION 13. Separate Licenses Required. Separate licenses shall be required for hospitals or branches thereof
maintained in separate premises, even though they are operated under the same management: provided, however,
that separate licenses shall not be required for separate buildings in the same compound: provided, further, that
permits for construction or alteration of buildings within the same compound shall also be secured from the licensing
agency to determine compliance with standards and requirements herein authorized.
SECTION 14. License not transferable. License for the operation of hospitals shall not be transferable. The
licensing agency shall be notified of any change in ownership, change of name of the hospital, and transfer of location
and in the latter case, an application for a new license should be submitted.
SECTION 15. Rules and Regulations. The Bureau of Medical Services acting as a licensing agency and subject
to the approval of the Secretary of Health, shall promulgate rules and regulations to implement the provisions of this
Act.
SECTION 16. Classification of Hospitals. The licensing agency shall study and adopt a system of classifying
hospitals in the Philippines as to: (1) general or special; (2) hospital services capabilities; (3) size or bed capacity
and (4) class of hospital whether training or not.
SECTION 17. Fees. Each applicant for a permit to construct a hospital shall pay the amount of five pesos as
permit fee. A registration fee of five pesos and an annual license fee of ten pesos shall likewise be collected for each
hospital and for each approved license: provided, that a government hospital shall be exempt from the payment of
such fees. The amount herein collected shall be officially receipted by the licensing agency and shall constitute as a
revolving fund for the use of the licensing agency.
SECTION 18. Penalties. Any person, partnership, association, or corporation who establishes, operates,
conducts, manages or maintains a hospital or hospital clinic within the meaning of this Act without first obtaining a
license as provided for in this Act or violates any provision hereof shall be guilty of a misdemeanor, and upon
conviction thereof shall be liable to a fine of not more than five hundred pesos for the first offense and not more than
one thousand pesos for each subsequent offense, and each day that the hospital shall operate after the first conviction
shall be considered a subsequent offense.
SECTION 19. Repeal. Any law or laws or parts thereof inconsistent with the provisions of this Act are hereby
repealed.
Sec. 20. Effectivity. This Act shall take effect upon its approval.
S. REPUBLIC ACT NO. 9439 April 27, 2007
AN ACT PROHIBITING THE DETENTION OF PATIENTS IN HOSPITALS AND MEDICAL CLINICS
ON GROUNDS OF NONPAYMENT OF HOSPITAL BILLS OR MEDICAL EXPENSES
Be it enacted by the Senate and House of Representatives of the Philippines in Congress assembled:
SECTION 1.It shall be unlawful for any hospital or medical clinic in the country to detain or to otherwise cause,
directly or indirectly, the detention of patients who have fully or partially recovered or have been adequately attended
to or who may have died, for reasons of nonpayment in part or in full of hospital bills or medical expenses.
SEC. 2.Patients who have fully or partially recovered and who already wish to leave the hospital or medical clinic
but are financially incapable to settle, in part or in full, their hospitalization expenses, including professional fees and
medicines, shall be allowed to leave the hospital or medical clinic, with a right to demand the issuance of the
corresponding medical certificate and other pertinent papers required for the release of the patient from the hospital
or medical clinic upon the execution of a promissory note covering the unpaid obligation. The promissory note shall
be secured by either a mortgage or by a guarantee of a co-maker, who will be jointly and severally liable with the
patient for the unpaid obligation. In the case of a deceased patient, the corresponding death certificate and other
documents required for interment and other purposes shall be released to any of his surviving relatives requesting for
the same:Provided, however, That patients who stayed in private rooms shall not be covered by this Act.
SEC. 3.Any officer or employee of the hospital or medical clinic responsible for releasing patients, who violates the
provisions of this Act shall be punished by a fine of not less than Twenty thousand pesos (P20,000.00), but not more
than Fifty thousand pesos (P50,000.00), or imprisonment of not less than one month, but not more than six months,
or both such fine and imprisonment, at the discretion of the proper court.
35
 SEC. 4.The Department of Health shall promulgate the necessary rules and regulations to carry out the provisions of
this Act.
SEC. 5.If any provision of this Act is declared void and unconstitutional the remaining provisions hereof not affected
thereby shall remain in full force and effect.
SEC. 6.All laws, decrees, orders, rules and regulations or part thereof inconsistent with this Act are hereby repealed
or amended accordingly.
SEC. 7.This Act shall take effect fifteen (15) days after its publication in two national newspapers of general
circulation.
Approved,
T. Republic Act No. 8344 August 25, 1997
Republic Act No. 8344 August 25, 1997
AN ACT PENALIZING THE REFUSAL OF HOSPITALS AND MEDICAL CLINICS TO ADMINISTER
APPROPRIATE INITIAL MEDICAL TREATMENT AND SUPPORT IN EMERGENCY OR SERIOUS
CASES, AMENDING FOR THE PURPOSE BATAS PAMBANSA BILANG 702, OTHERWISE KNOWN
AS "AN ACT PROHIBITING THE DEMAND OF DEPOSITS OR ADVANCE PAYMENTS FOR THE
CONFINEMENT OR TREATMENT OF PATIENTS IN HOSPITALS AND MEDICAL CLINICS IN
CERTAIN CASES"
Be it enacted by the Senate and House of Representatives of the Philippines in Congress assembled::
Section 1.Section 1 ofBatas Pambansa Bilang 702is hereby amended to read as follows:
"SECTION 1. In emergency or serious cases, it shall be unlawful for any proprietor, president, director,
manager or any other officer, and/or medical practitioner or employee of a hospital or medical clinic to
request, solicit, demand or accept any deposit or any other form of advance payment as a prerequisite for
confinement or medical treatment of a patient in such hospital or medical clinic or to refuse to administer
medical treatment and support as dictated by good practice of medicine to prevent death or permanent
disability: Provided, That by reason of inadequacy of the medical capabilities of the hospital or medical clinic,
the attending physician may transfer the patient to a facility where the appropriate care can be given, after
the patient or his next of kin consents to said transfer and after the receiving hospital or medical clinic agrees
to the transfer: Provided, however, That when the patient is unconscious, incapable of giving consent and/or
unaccompanied, the physician can transfer the patient even without his consent: Provided, further, That such
transfer shall be done only after necessary emergency treatment and support have been administered to
stabilize the patient and after it has been established that such transfer entails less risks than the patient's
continued confinement: Provided, furthermore, That no hospital or clinic, after being informed of the medical
indications for such transfer, shall refuse to receive the patient nor demand from the patient or his next of kin
any deposit or advance payment: Provided, finally, That strict compliance with the foregoing procedure on
transfer shall not be construed as a refusal made punishable by this Act."
Section 2.Section 2 of Batas Pambansa Bilang 702 is hereby deleted and in place thereof, new sections 2, 3 and 4
are added, to read as follows:
"SEC. 2. For purposes of this Act, the following definitions shall govern:
"(a) 'Emergency' - a condition or state of a patient wherein based on the objective findings of a
prudent medical officer on duty for the day there is immediate danger and where delay in initial
support and treatment may cause loss of life or cause permanent disability to the patient.
"(b) 'Serious case' - refers to a condition of a patient characterized by gravity or danger wherein based
on the objective findings of a prudent medical officer on duty for the day when left unattended to,
may cause loss of life or cause permanent disability to the patient.
"(c) 'Confinement' - a state of being admitted in a hospital or medical clinic for medical observation,
diagnosis, testing, and treatment consistent with the capability and available facilities of the hospital
or clinic.
"(d) 'Hospital' - a facility devoted primarily to the diagnosis, treatment and care of individuals
suffering from illness, disease, injury or deformity, or in need of obstetrical or other medical and
nursing care. It shall also be construed as any institution, building or place where there are facilities
and personnel for the continued and prolonged care of patients.
"(e) 'Emergency treatment and support' - any medical or surgical measure within the capability of the
hospital or medical clinic that is administered by qualified health care professionals to prevent the
death or permanent disability of a patient.
"(f) 'Medical clinic' - a place in which patients can avail of medical consultation or treatment on an
outpatient basis.
"(g) 'Permanent disability' - a condition of physical disability as defined under Article 192-C and
Article 193-B and C of Presidential Decree No 442; as amended, otherwise known as the Labor Code
of the Philippines.
"(h) 'Stabilize' - the provision of necessary care until such time that the patient may be discharged or
transferred to another hospital or clinic with a reasonable probability that no physical deterioration
would result from or occur during such discharge or transfer.
"SEC. 3. After the hospital or medical clinic mentioned above shall have administered medical treatment and
support, it may cause the transfer of the patient to an appropriate hospital consistent with the needs of the
patient, preferably to a government hospital, specially in the case of poor or indigent patients.

36
 "SEC. 4. Any official, medical practitioner or employee of the hospital or medical clinic who violates the
provisions of this Act shall, upon conviction by final judgment, be punished by imprisonment of not less than
six (6) months and one (1) day but not more than two (2) years and four (4) months, or a fine of not less than
Twenty thousand pesos (P20,000.00), but not more than One hundred thousand pesos (P100,000.00) or both,
at the discretion of the court: Provided, however, That if such violation was committed pursuant to an
established policy of the hospital or clinic or upon instruction of its management, the director or officer of
such hospital or clinic responsible for the formulation and implementation of such policy shall, upon
conviction by final judgment, suffer imprisonment of four (4) to six (6) years, or a fine of not less than One
hundred thousand pesos (P100,000.00), but not more than Five hundred thousand pesos (P500,000.00) or
both, at the discretion of the court."
Section 3.Section 3 of Batas Pambansa Bilang 702 is hereby repealed.
Section 4.Section 4 of Batas Pambansa Bilang 702 shall become Section 5 thereof and shall be amended to read as
follows:
"SEC. 5. The Department of Health shall promulgate the necessary rules and regulations to carry out the
provisions of this Act."
Section 5.This Act shall take effect fifteen (15) days after its publication in two (2) national newspapers of general
circulation.

RULES AND REGULATIONS OF REPUBLIC ACT NO. 8344,

OTHERWISE KNOWN AS "AN ACT PENALIZING THE REFUSAL OF HOSPITALS AND MEDICAL
CLINICS TO ADMINISTER APPROPRIATE INITIAL MEDICAL TREATMENT AND SUPPORT IN
EMERGENCY OR SERIOUS CASES, AMENDING FOR THE PURPOSE BATAS PAMBANSA BILANG
702, OTHERWISE KNOWN AS AN ACT PROHIBITING THE DEMAND OF DEPOSITS OR ADVANCE
PAYMENTS FOR THE CONFINEMENT OR TREATMENT OF PATIENTS IN HOSPITALS AND
MEDICAL CLINICS IN CERTAIN CASES"
WHEREAS, the Tenth Congress of the Republic of the Philippines enacted Republic Act No. 8344 on June 05, 1997;
WHEREAS, the President of the Republic of the Philippines signed into law R.A. 8344 on August 25, 1997;
WHEREAS, under Section 5 of R.A. 8344, the Department of Health (DOH) is mandated to promulgate the necessary
rules and regulations to carry out the provisions of the aforementioned law.
NOW THEREFORE, pursuant to the provisions of R.A. 8344 authorizing the Department of Health to promulgate
the necessary rules and regulations, the following are hereby issued:
1. Section 1 of said Act provides: "In emergency or serious cases, it shall be unlawful for any proprietor,
president, director, manager or any other officer, and/or medical practitioner or employee of a hospital or
medical clinic to request, solicit, demand or accept any deposit or any other form of advance payment as a
prerequisite for confinement or medical treatment of a patient in such hospital or medical clinic or to refuse
to administer medical treatment and support as dictated by good practice of medicine to prevent death or
permanent disability: Provided, That by reason of inadequacy of the medical capabilities of the hospital or
medical clinic, the attending physician may transfer the patient to a facility where appropriate care can be
given, after the patient or his next of kin consents to said transfer: Provided, however, That when the patient
is unconscious, incapable of giving consent and/or unaccompanied, the physician can transfer the patient
even without his consent, Provided, further, That such transfer shall be done only after the necessary
emergency treatment and support have been administered to stabilize the patient and after it has been
established that such transfer entails less risks than the patient's continued confinement: Provided, finally,
That strict compliance with the foregoing procedure on transfer shall not be construed as a refusal made
punishable by this Act."
2. For the purpose of implementing the above, the following definitions are provided:
2.1 Emergency - A condition or state of patient wherein based on the objective findings of a prudent
medical officer on duty for the day there is immediate danger and where delay in initial support and
treatment may cause loss of life or cause permanent disability to the patient.
2.2 Serious Case - refers to a condition of a patient characterized by gravity or danger wherein based
on the objective findings of a prudent medical officer on duty for the day when left unattended to,
may cause loss of life or cause permanent disability to the patient.
2.3 Confinement - a state of being admitted in a hospital or medical clinic for medical observation,
diagnosis, testing, and treatment consistent with the capability and available facilities of the hospital
or clinic.
2.4 Hospital - a facility devoted primarily to the diagnosis, treatment and care of individuals or other
medical and nursing care. It shall also be construed as any institution, building or place where there
are facilities and personnel for the continued and prolonged care of patients. The hospital shall be
duly licensed by the Bureau of Licensing and Regulation of the DOH.
2.5 Emergency Treatment and Support - any medical or surgical measure within the capability of a
hospital or medical clinic that is administer by qualified health care professionals to prevent the death
or permanent disability of a patient. (In determining the capability of a hospital or clinic, the standards
and the classification of these facilities set by the DOH Bureau of Licensing and Regulation shall be
used).

37
 2.6 Medical Clinic - a place in which patients can avail of medical consultation or treatment on an
outpatient basis.
2.7 Permanent Disability - a condition of physical disability as defined under Article 192-C and
Article 193-B and C of Presidential Decree No. 442, as amended, otherwise known as the Labor
Code of the Philippines.
2.8 Stabilize - the provision of necessary care until such time that the patient may be discharged or
transferred to another hospital or clinic with a reasonable probability that no physical deterioration
would result from or occur during such discharge or transfer.
3. Transfer of Patients - Section 3 of R.A. 8344 provides: "After the hospital or medical clinic mentioned
above shall have administered medical treatment and consistent with the needs of the patients preferably to a
government hospital, specially in the case of poor or indigent patients."
3.1 The transferring and receiving hospital, shall be as much as practicable, be within ten (10)
kilometer radius of each other.
3.2 The transfer of patients contemplated under this Act shall at all times be properly documented.
3.3 Hospitals may require a deposit or advance payment when the patient is no longer under the state
of emergency and he/she refuses to be transferred.
4. All hospitals shall use a Uniform Discharge/Transfer Slip for cases covered by RA 8344 which shall
include the following information:
4.1 Admission Form of transferring hospital.
4.2 Transfer Form of Transferring Hospital, to include but not necessarily limited to the following
information:
4.2.1 Vital signs
4.2.2 Name of Attending Physician
4.2.3 Treatment given to patient
4.2.4 Name of receiving hospital
4.2.5 Name of contact person and approving official at receiving hospital
4.2.6 Consent of the patient or companion. In case of an unaccompanied minor or patient,
they may be transferred without consent provided that the provisions of Section 1 of RA
8344 is strictly observed.
The hospital shall endeavor to use all forms of media to contact the next of kin of the
unaccompanied minor or patient.
4.2.7 In case of refusal of transfer, the name of the hospital, the name(s) of persons who
refused and the reason(s) for the refusal.
A copy of the Uniform Discharge/Transfer Slip is hereto attached as Annex A*.
5. Penal Provisions - any official, medical practitioner or employee of the hospital or medical clinic who
violates the provisions of RA 8344 shall, upon conviction by final judgment, be punished by imprisonment
of not less than six (6) months and one (1) day but not more than two (2) years and four months, or a fine of
not less than Twenty Thousand Pesos (P20,000.00) but not more than One Hundred Thousand Pesos
(P100,000.00) or both at the discretion of the court: Provided, however, That if such violation was committed
pursuant to an established policy of the hospital or clinic or upon instruction of its management, the director
or officer of such hospital or clinic responsible for the formulation and imprisonment of four (4) to six (6)
years, or a fine of not less than One Hundred Thousand Pesos (P100,000.00), but not more than Five Hundred
Thousand Pesos (P500,000.00) or both, at the discretion of the court.
6. In order to demonstrate compliance with the Act's provisions, all hospitals and medical clinics are
instructed to institute the following measures:
6.1 A copy of the law and this implementing rules and regulations should be displayed prominently
at hospital emergency rooms, hospital admission, counters and medical clinic premises.
6.2 Hospital and clinic managers shall establish billing and collection procedure for treatment or
confinement of emergency and serious cases which shall not commence until the essential
appropriate treatment of such cases has been completed.
6.3 Hospital and clinic managers shall instruct their personnel to provide prompt and immediate
medical attention to emergency and serious cases without any prior requirements for payment or
deposit.
6.4 It is clarified that the law and this administrative order covers only the provision of medical and
surgical goods and services, and do not cover the provision of non-medical amenities which have
nothing to do with the treatment of the emergency or serious case. The provisions of and payment
for these non-medical amenities shall be subject to appropriate institutional business practice.
6.5 Alleged violations of the Act and this Order may be reported to the Bureau of Licensing and
Regulations, Office for Standards and Regulations, Department of Health, Sta. Cruz, Manila, or to
the nearest Regional Health Office which shall immediately conduct a fact-finding investigation. The
findings shall be referred to the appropriate fiscal for criminal prosecution. Persons convicted of
violation shall be punished in accordance with the Act.
6.6 At the instance of the Bureau of Licensing and Regulation, Administrative proceedings may also
be pursued against erring clinics or hospitals that could lead to either suspension or revocation of
appropriate licenses.

38
 These Rules and Regulations shall take effect fifteen (15) days after publication in the Official Gazette or in a
newspaper of general circulation.

U. REPUBLIC ACT NO. 6615 - AN ACT REQUIRING GOVERNMENT AND PRIVATE HOSPITALS
AND CLINICS TO EXTEND MEDICAL ASSISTANCE IN EMERGENCY CASES
Section 1. All government and private hospitals or clinic duly licensed to operate as such are hereby required to
render immediate emergency medical assistance and to provide facilities and medicine within its capabilities to
patients in emergency cases who are in danger of dying and/or who may have suffered serious physical injuries.
Sec. 2. The expenses and losses of earnings incurred by a private hospital of clinic for medicines, facilities and
services beyond first aid extended to emergency cases as required herein, and not to exceed fifty thousand pesos per
year, shall be deductible expenses and losses for income tax purposes which may be carried over for a period of five
years, any provision of law or regulation to the contrary notwithstanding.
Sec. 3. Any hospital director, administrator, officer-in-charge or physician in the hospital, medical center or clinic,
who shall refuse or fail without good cause to render the appropriate assistance pursuant to the requirements of section
one after said case had been brought to his attention, or any nurse, midwife or medical attendant who shall refuse to
extend the appropriate assistance, subject to existing rules, or neglect to notify or call a physician shall be punished
by imprisonment of one month and one day to one year and one day, and a fine of three hundred pesos to one thousand
pesos, without prejudice to the provisions of Republic Act Numbered Twenty-three hundred eighty-two in the case
of physicians.
In the case of Government hospitals, the imposition of the penalty upon the person or persons guilty of the violations
shall be without prejudice to the administrative action that might be proper.
In the case of private hospitals, aside from the imposition of penalty upon the person or persons guilty of the
violations, the license of the hospital to operate shall, whenever justified, be suspended or revoked.
Sec. 4. Subject to the approval of the Secretary of Health, the Bureau of Medical Services shall promulgate the
necessary rules and regulations to carry out the provisions of this Act.
Sec. 5. Any law or laws or parts thereof inconsistent with the provisions of this Act is hereby repealed.
Sec. 6. This Act shall take effect upon its approval
V. CASES:
Name: MANILA DOCTORS HOSPITAL vs SO UN CHUA and TY G.R. No. 150355 July 31, 2006
Facts When her mother and sister were confined at the Manila Doctors Hospital in Manila, incurring the
total hospital bill of P1,075,592.95. Vicky issued seven postdated checks to secure payment of the
obligation. Upon presentment for payment, however, the checks bounced. Despite demand to pay,
the Vicky failed to pay the face value of the checks, hence, the hospital sued her for violation of BP
22. In her defense, Vicky alleged that her issuance of the checks was due to an uncontrollable fear
of a greater injury. She was forced to issue the checks to obtain release of her mother who was
treated inhumanely and harshly treated, and would not be discharged unless the the bills are
paid. Her mother was deprived of room facilities, such as the air-condition unit, refrigerator and
television set, and subject to inconveniences such as the cutting off of the telephone line, late
delivery of her mothers food and refusal to change the latters gown and bedsheets. She also
bewailed the hospitals suspending medical treatment of her mother. Because of the inhumane and
debasing treatment, her mother contemplated suicide if she would not be discharged from the
hospital. She was forced to sign the promissory note, open an account with Metrobank, and issue
the checks so her mother could be immediately discharged.After trial, the court rendered a decision
finding Vicky guilty of BP 22. On appeal, the CA rejected her claim of involuntariness in the
issuance of the checks and the hospitals knowledge of her checking accounts lack of funds. It held
that B.P. 22 makes the mere act of issuing a worthless check punishable as a special offense, it
being a malum prohibitum. What the law punishes is the issuance of a bouncing check and not the
purpose for which it was issued nor the terms and conditions relating to its issuance. Invoking the
case of Vaca vs CA, the CA imposed the penalty of fine instead of a prison term.
Issue
Held/Ratio: We find the petition to be without merit and accordingly sustain Tys conviction.Well-settled is the
rule that the factual findings and conclusions of the trial court and the Court of Appeals are entitled
to great weight and respect, and will not be disturbed on appeal in the absence of any clear showing
that the trial court overlooked certain facts or circumstances which would substantially affect the
disposition of the case.1 Jurisdiction of this Court over cases elevated from the Court of Appeals is
limited to reviewing or revising errors of law ascribed to the Court of Appeals whose factual
findings are conclusive, and carry even more weight when said court affirms the findings of the trial
court, absent any showing that the findings are totally devoid of support in the record or that they
are so glaringly erroneous as to constitute serious abuse of discretion.2 In the instant case, the Court
discerns no compelling reason to reverse the factual findings arrived at by the trial court and
affirmed by the Court of Appeals.

Name: FELIX MARQUEZ vs. BOM G.R. No. L-24119 August 8, 1925
Facts It appears that petitioner is a graduate of the Chicago Medical College, having received the degree of
M.D. from said institution on June 8, of the year 1922. No question appears to have been made by the
39
 respondents with respect to the petitioner's qualifications of the physician's examinations in other
respects, but they have denied him admission to the examinations on the grounds that the Chicago
Medical College, where the petitioner was graduated, has been classified as a Class C medical college
by the National Medical State Board of the United States. For this reason the respondents, in accordance
with the regulations of the board now in effect, have denied the requisite standing to said institution and
excluded petitioner.
Issue whether a medical institution is "a reputable medical school," in the sense intended by the law, is vested
in the Board of Medical Examiners, and although the action taken by them may conceivably, in isolated
cases, result in hardship, nevertheless the interests of the public require that the board should be free to
exercise its judgment and discretion without reference to the effect of the determination of the question
in particular instances.
Held: there can in the nature of things be no vested right in an existing law, which would preclude its change
or repeal. No one who has commenced preparation in a particular institution has any inchoate right on
account of that fact. If the law were otherwise upon this point, it would be impossible for the Board of
Medical Examiners to give effect to the knowledge which they from time to time acquire as to the
standing of medical schools; and an intending physician, upon matriculating in a particular college,
takes upon himself the risk of changes that may be made in the standing of the institution by the board.

NAME DECS vs. SAN DIEGO and JUDGE DIZON-CAPULONG G.R. No. 144681 June 21, 2004
FACTS Respondent San Diego has flunked the NMAT (National Medical Admission Test) three times. When
he applied to take again, petitioner rejected his application based on the three-flunk-rule. He then
filed a petition before the RTC on the ground of due process and equal protection and challenging
the constitutionality of the order. The petition was granted by the RTC therefore this petition.
ISSUE : Whether or not the NMAT three-flunk-rule order is valid and constitutional.
HELD Yes. It is the right and responsibility of the State to insure that the medical profession is not infiltrated
by incompetents to whom patients may unwarily entrust their lives and health. The method employed
by the challenged regulation is not irrelevant to the purpose of the law nor is it arbitrary or oppressive.
The right to quality education is not absolute. The Constitution provides that every citizen has the
right to choose a profession or course of study, subject to fair, reasonable and equitable admission
and academic requirements. It is not enough to simply invoke the right to quality education as a
guarantee of the Constitution but one must show that he is entitled to it because of his preparation
and promise. Petition was granted and the RTC ruling was reversed.

NAME PRC vs. DE GUZMAN et al G.R. No. 88259 August 10, 1989
FACTS The respondents are all graduates of the Fatima College of Medicine, Valenzuela City, Metro
Manila. They passed the Physician Licensure Examination conducted in February 1993 by the
Board of Medicine (Board). Petitioner Professional Regulation Commission (PRC) then released
their names as successful examinees in the medical licensure examination. Shortly thereafter,
the Board observed that the grades of the seventy-nine successful examinees from Fatima
College in the two most difficult subjects in the medical licensure exam, Biochemistry (Bio-
Chem) and Obstetrics and Gynecology (OB-Gyne), were unusually and exceptionally high.
Eleven Fatima examinees scored 100% in Bio-Chem and ten got 100% in OB-Gyne, another
eleven got 99% in Bio-Chem, and twenty-one scored 99% in OB-Gyne.
For its part, the NBI found that the questionable passing rate of Fatima examinees in the [1993]
Physician Examination leads to the conclusion that the Fatima examinees gained early access to
the test questions.
ISSUE Was the act pursuant to R.A. 2382 a valid exercise of police power
HELD Yes, it is true that this Court has upheld the constitutional right of every citizen to select a
profession or course of study subject to a fair, reasonable, and equitable admission and academic
requirements. But like all rights and freedoms guaranteed by the Charter, their exercise may be
so regulated pursuant to the police power of the State to safeguard health, morals, peace,
education, order, safety, and general welfare of the people. Thus, persons who desire to engage
in the learned professions requiring scientific or technical knowledge may be required to take an
examination as a prerequisite to engaging in their chosen careers.

Name: THE BOARD OF MEDICAL EDUCATION vs. ALFONSO, G.R. No. 8825 August 10, 1989
Facts Petitioners BME, the government agency which supervises and regulates thecountrys medical
colleges, Sec. Quisimbing, chairman of the Department of Education, Culture and Sports prayed for a
writ of certiorari to nullify the order of herein Respondent Judge Alfonso in Civil case No. 1385
restraining the enforcement of Pet. Order of closure of Philippine Muslim-Christian College of
Medicine Foundation Inc(the college). -The college was founded on 1981 for the purpose of producing
physicians who will emancipate Muslim citizens from age-old attitudes of health. -However, because
of the unstable peace and order situation in Mindanao, the college was established in Antipolo, Rizal,
given a temporary permit to operate instead of the originally proposed location in Zamboanga City.
Antipolo was adopted as its permanent site and the name was changed to Rizal College of Medicine.
40
 -In 1985, DECS & BME authorized the Commission on Medical Education to conduct a study of all
Medical Schools in the Philippines. -The report showed that the college fell very much short of the
minimum standards set for medical schools. Further, the team of inspectors cited the ff. Grounds
among others: (a)the College was not fulfilling its purpose due inappropriate location (b)lack of
university affiliation for balance humanistic and scientific education (c)absence of philosophy based
hospitals for students training
(d)more than 60% of the college faculty did not teach full time -The school disputed these findings
as biased and discriminatory and requested BME to send another team of doctors for re-evaluation.
2nd team confirmed the previous findings and recommended the phase-out of the school. -There were
third and fourth evaluations but the college failed both and was rendered inadequate in all aspects. -
The DECS recommended the college for closure but somehow the college succeeded to have the Board
form yet another team of inspectors but although the findings show that there were major efforts to
improve the college, it is still rendered inadequate and recommended for closure w/ provisions to
disperse its students to other medical schools. -Mr. Victor Sumulong(chairman of BOT), upon learning
the same proposed a gradual phase-out so as not to dislocate the students and minimized financial
losses ALLOWED to operate until May 1989. -The college appealed the decision to the OP, but the
Executive Secretary found no reason to disturb the contested decisio
AFFIRMED! -The college filed civil case No. 1385 applying for a writ of preliminary injunction to
restrain its implementation APPROVED! (by Judge Alfonso holding that there were no evidence
supporting the findings in the June 18, 1988 report, and that contrary to the findings, the laboratory
and library areas were big enough and operations in the base hospital was going smoothly.) -Thus, the
present petition.
Issue WON Judge Alfonso acted with grave abuse of discretion in substituting his judgment to for the
members/evaluators.
Held/Ratio: YES! It is well-settled doctrine that courts of justice should not generally interfere with purely
administrative and discretionary functions; that courts having no supervisory power over the
proceedings and actions of the administrative departments of the government; involving the exercise
of judgment and findings of facts, because by reason of their special knowledge and expertise over
matters falling under their jurisdiction, the latter are in a better position to pass judgment on such
matters and their findings of facts in that regard are generally accorded respect, if not finality, by the
courts.There are, to be sure, exceptions to this general rule but none of them obtains in this case

Name: PMA vs. BOM and TORRES G.R. No. L-25135 September 21, 1968
Facts The Board of Medical Examiners and Jose Ma. Torres, to annul a resolution of the former and a
certificate issued by the same authorizing the latter to practice medicine in the Philippines without
examination.The facts are not disputed. Jose Ma. Torres hereinafter referred to as respondent is a
Spanish subject and a member of the Missionary Sons of the Immaculate Heart of Mary, otherwise
known as the Claretian Missionaries. Having graduated from the University of Barcelona, Spain, with
the degree of Licentiate in Medicine and Surgery, he is entitled, under the laws of Spain, to practice
medicine and surgery throughout the territory thereof.On January 21, 1955, respondent was granted
special authority to practice medicine in Lamitan, Basilan City, where he resides, pursuant to Section
771(e) of the Revised Administrative Code reading:SEC. 771. Persons exempt from registration.
Registration shall not be required of the following classes of persons: . . .(e) In cases of epidemic or in
municipalities where there is no legally qualified practicing physician, or when the circumstances
require it, in the interest of the public health, the Director of Health may issue special authorizations, to
all medical students who have completed the first three years of their studies, or to persons who have
qualified in medicine, and to graduate or registered nurses, who may request it.this authority was
revoked, on November 8, 1960, by the then Secretary of Health, upon the ground that "the conditions
under which it was granted no longer obtained in Lamitan Basilan City, there being enough practising
physicians in that locality.
Issue
Held

Name: TABLARIN vs. GUTIERREZ G.R. No. 78164 July 31, 1987
Facts Teresita Tablarin, Ma. Luz Ciriaco, Ma. Nimfa B. Rovira, and Evangelina S. Labao sought admission into
colleges or schools of medicine for the school year 1987-1988. However, they either did not take or did not
successfully take the National Medical Admission Test (NMAT) required by the Board of Medical Education
and administered by the Center for Educational Measurement (CEM). On 5 March 1987, Tablarin, et. al., in
behalf of applicants for admission into the Medical Colleges who have not taken up or successfully hurdled
the NMAT, filed with the Regional Trial Court (RTC), National Capital Judicial Region, a Petition for
Declaratory Judgment and Prohibition with a prayer for Temporary Restraining Order (TRO) and
Preliminary Injunction, to enjoin the Secretary of Education, Culture and Sports, the Board of Medical
Education and the Center for Educational Measurement from enforcing Section 5 (a) and (f) of Republic Act
2382, as amended, and MECS Order 52 (series of 1985), dated 23 August 1985 [which established a uniform
admission test (NMAT) as an additional requirement for issuance of a certificate of eligibility for admission
into medical schools of the Philippines, beginning with the school year 1986-1987] and from requiring the
41
 taking and passing of the NMAT as a condition for securing certificates of eligibility for admission, from
proceeding with accepting applications for taking the NMAT and from administering the NMAT as
scheduled on 26 April 1987 and in the future. After hearing on the petition for issuance of preliminary
injunction, the trial court denied said petition on 20 April 1987. The NMAT was conducted and administered
as previously scheduled. Tablarin, et. al. accordingly filed a Special Civil Action for Certiorari with the
Supreme Court to set aside the Order of the RTC judge denying the petition for issuance of a writ of
preliminary injunction.
Issue Whether NMAT requirement for admission to medical colleges contravenes the Constitutional guarantee for
the accessibility of education to all, and whether such regulation is invalid and/or unconstitutional.
Held No. Republic Act 2382, as amended by Republic Acts 4224 and 5946, known as the Medical Act of 1959
defines its basic objectives to govern (a) the standardization and regulation of medical education; (b) the
examination for registration of physicians; and (c) the supervision, control and regulation of the practice of
medicine in the Philippines. The Statute created a Board of Medical Education and prescribed certain
minimum requirements for applicants to medical schools.

Name: BOARD OF MEDICINE vs YASUYUKI OTA, G.R. No. 166097 July 14, 2008
Facts Yasuyuki Ota (respondent) is a Japanese national, married to a Filipina,
- who has continuously resided in the Phil. for more than 10 years.
- He graduated from Bicol Christian College of Medicine on April 21, 1991 with a degree of
Doctor of Medicine
- After successfully completing a one-year post graduate internship training at
the Jose Reyes Memorial Medical Center, he filed an application to take the medical board
examinations in order to obtain a medical license.
In spite of all these, the Board of Medicine (Board) of the PRC, in a letter dated March 8,
1993,denied respondent's request for a license to practice medicine in the Phil.
Issue Did the CA commit a reversible error in finding that Respondent had established the existence of
reciprocity in the practice of medicine between the Phil and Japan?
Held/Rati In fine, the only matter being questioned by petitioners is the alleged failure of respondent to prove that
o: there is reciprocity between the laws of Japan and the Philippines in admitting foreigners into the
practice of medicine. Respondent has satisfactorily complied with the said requirement and the CA has
not committed any reversible error in rendering its Decision dated November 16, 2004 and Resolution
dated October 19, 2003.
WHEREFORE, the petition is hereby DENIED for lack of merit.

W. RPC PHYSICAL INJURIES Art. 262, 263, 264, 265, 266

Physical Injuries
ARTICLE 262. Mutilation. The penalty of reclusin temporal to reclusin perpetua shall be imposed upon any person
who shall intentionally mutilate another by depriving him, either totally or partially, of some essential organ for
reproduction.
Any other intentional mutilation shall be punished by prisin mayor in its medium and maximum periods.
article 263. Serious Physical Injuries. Any person who shall wound, beat, or assault another, shall be guilty of the crime
of serious physical injuries and shall suffer:
1. The penalty of prisin mayor, if in consequence of the physical injuries inflicted, the injured person shall become insane,
imbecile, impotent, or blind;
2. The penalty of prisin correccional in its medium and maximum periods, if in consequence of the physical injuries
inflicted, the person injured shall have lost the use of speech or the power to hear or to smell, or shall have lost an eye, a
hand, a foot, an arm, or a leg or shall have lost the use of any such member, or shall have become incapacitated for the
work in which he was theretofore habitually engaged;
3. The penalty of prisin correccional in its minimum and medium periods, if in consequence of the physical injuries
inflicted, the person injured shall have become deformed, or shall have lost any other part of his body, or shall have lost
the use thereof, or shall have been ill or incapacitated for the performance of the work in which he was habitually engaged
for a period of more than ninety days;
4. The penalty of arresto mayor in its maximum period to prisin correccional in its minimum period, if the physical injuries
inflicted shall have caused the illness or incapacity for labor of the injured person for more than thirty days.
If the offense shall have been committed against any of the persons enumerated in article 246, or with attendance of any of
the circumstances mentioned in article 248, the case covered by subdivision number 1 of this article shall be punished by
reclusin temporal in its medium and maximum periods; the case covered by subdivision number 2 by prisin correccional
in its maximum period to prisin mayor in its minimum period; the case covered by subdivision number 3 by prisin
correccional in its medium and maximum periods; and the case covered by subdivision number 4 by prisin correccional
in its minimum and medium periods.
The provisions of the preceding paragraph shall not be applicable to a parent who shall inflict physical injuries upon his
child by excessive chastisement.
ARTICLE 264. Administering Injurious Substances or Beverages. The penalties established by the next preceding
article shall be applicable in the respective cases to any person who, without intent to kill, shall inflict upon another any

42
serious physical injury, by knowingly administering to him any injurious substances or beverages or by taking advantage
of his weakness of mind or credulity.
ARTICLE 265. Less Serious Physical Injuries. Any person who shall inflict upon another physical injuries not described
in the preceding articles, but which shall incapacitate the offended party for labor for ten days or more, or shall require
medical attendance for the same period, shall be guilty of less serious physical injuries and shall suffer the penalty of arresto
mayor.
Whenever less serious physical injuries shall have been inflicted with the manifest intent to insult or offend the injured
person, or under circumstances adding ignominy to the offense, in addition to the penalty of arresto mayor, a fine not
exceeding 500 pesos shall be imposed.
Any less serious physical injuries inflicted upon the offenders parents, ascendants, guardians, curators, teachers, or persons
of rank, or persons in authority, shall be punished by prisin correccional in its minimum and medium periods, provided
that, in the case of persons in authority, the deed does not constitute the crime of assault upon such persons.
ARTICLE 266. Slight Physical Injuries and Maltreatment. The crime of slight physical injuries shall be punished:
1. By arresto menor when the offender has inflicted physical injuries which shall incapacitate the offended party for labor
from one to nine days, or shall require medical attendance during the same period.
2. By arresto menor or a fine not exceeding 200 pesos and censure when the offender has caused physical injuries which
do not prevent the offended party from engaging in his habitual work nor require medical attendance.
3. By arresto menor in its minimum period or a fine not exceeding 50 pesos when the offender shall ill-treat another by
deed without causing any injury.
X. CASES:
PEOPLE OF THE PHILIPPINES vs. BULING G.R. No. L-13315 April 27, 1960
Appeal from a judgment of the Court of First Instance of Leyte, Hon. Gaudencio Cloribel, presiding, finding the accused
Buenaventura Buling guilty of serious physical injuries and sentencing him to imprisonment of four months of arresto
mayor, as minimum, to one year of prision correccional, as maximum, and to indemnify the offended party.
The following uncontroverted facts appear in the record: On December 7, 1956, the accused was charged in the Justice of
the Peace Court of Cabalian, Leyte, with the crime of less serious physical injuries for having inflicted wounds on
complaining witness Isidro Balaba, which according to the complaint would "require, medical attendance for a period from
10 to 15 days and will incapacitate the said Isidro Balaba from the performance of his customary labors for the game period
of time." The accused pleaded guilty to the complaint and was on December 8, 1957 found guilty of the crime charged and
sentenced to 1 month and 1 day of arresto mayor and to pay damages to the offended party in the sum of P20.00, with
subsidiary imprisonment in case of insolvency. On the same day he began to serve his sentence and has fully served the
same.
However, Balaba's injuries did not heal within the period estimated, and so on February 20, 1957, the Provincial Fiscal
filed an information against the accused before the Court of First Instance of Leyte, charging him of serious physical
injuries. The information alleges that the wounds inflicted by the accused on Isidro Balaba require medical attendance and
incapacitated him for a period of from 1 months to 2 months. After trial the accused was found guilty of serious
physical injuries and sentenced in the manner indicated in first paragraph hereof. This is the decision now sough to be set
aside and reversed in this appeal.
The only question for resolution by this Court whether the prosecution and conviction of Balaba for less serious physical
injuries is a bar to the second prosecution for serious physical injuries.
Two conflicting doctrines on double jeopardy have been enunciated by this Court, one in the cases of People vs. Tarok, 73
Phil., 260 and People vs. Villasis, 81 Phil., 881, and the other, in the cases of Melo vs. People, 85 Phil., 766,
People vs. Manolong, 85 Phil., 829 and People vs. Petilla, 92 Phil., 395. But in Melo vs. People, supra, we expressly
repealed our ruling in the case of People vs. Tarok, supra, and followed in the case of People vs. Villasis, supra. In the
Melo vs. People case, we stated the ruling to be that:
. . . Stating it in another form, the rule is that "where after the first prosecution a new fact supervenes for which the defendant
is responsible, which changes the character of the offense and, together with the facts existing at the time, constitutes a new
and distinct offense" (15 Am. Jur., 66), the accused cannot be said to be in second jeopardy if indicted for the new offense.
(85 Phil., 769-770).
Do the facts in the case at bar justify the application of the new ruling? In other words, has a new fact supervened, like
death in the case of Melo vs. People, which changes the character of the offense into one which was not in existence at the
time the case for less serious physical injuries was filed? We do not believe that a new fact supervened, or that a new fact
has come into existence. What happened is that the first physician that examined the wounds of the offended party certified
on December 10, 1956 that the injury was as follows: "wound, incised, wrist lateral, right, 3/4 inch long, sutured" and that
the same would take from 10 to 15 days to heal and incapacitated (the wounded man) for the same period of time from his
usual work (Exh. 3). It was on the basis of this certificate that on December 8, 1956, defendant-appellant was found guilty
of less serious physical injuries and sentenced to imprisonment of 1 month and 1 day of arresto mayor, etc.
But on January 18, 1957, another physician examined the offended party, taking an X-ray picture of the arm of the offended
party which had been wounded. The examination discloses, according to the physician, the following injuries:
Old stab wound 4 inches long. With infection, distal end arm, right. X-ray plate finding after one month and 12 days
Fracture old oblique, incomplete distal end, radius right, with slight calus. (Exh. "E").
and the certification is to the effect that treatment will take from 1 months to 2 months barring complications.
Counsel for the appellant claims that no fact had supervened in the case at bar, as a result of which another offense had
been ommitted. It is argued that the injury and the condition thereof was the same when the first examination was made on
December 10, 1956, as when the examination was made on January 18, 1957, and that if any new fact had been disclosed

43
in the latter examination failure of this new fact to be disclosed in the previous examination may be attributed to the
incompetence on the part of the examining physician. We find much reason in this argument. What happened is no X-ray
examination of the wounded hand was made during the first examination, which was merely superficial. The physician
who made the first examination could not have seen the fracture at the distal end of the right arm, and this could only be
apparent or visible by X-ray photography.
Under the circumstances above indicated, we are inclined to agree with the contention made on behalf of appellant that no
new supervening fact has existed or occurred, which has transformed the offense from less serious physical injuries to
serious physical injuries.
But the Solicitor General cites the case of People vs. Manolong, supra, and argues that our ruling in said case should apply
to the case at bar, for the reason that in the said case the first crime with which the accused was charged was less serious
physical injuries and the second one was serious physical injuries and yet we held that there was no jeopardy. We have
carefully examined this case and have found that the first examination made of the offended party showed injuries which
would take from 20 to 30 days to heal, whereas the subsequent examination disclosed that the wound of the offended party
would require medical attendance and incapacitate him for labor for a period of 90 days, "causing deformity and the loss
of the use of said member". No finding was made in the first examination that the injuries had caused deformity and the
loss of the use of the right hand. As nothing was mentioned in the first medical certificate about the deformity and the loss
of the use of the right hand, we presume that such fact was not apparent or could not have been discernible at the time the
first examination was made. The course (not the length), of the healing of an injury may not be determined before hand; it
can only be definitely known after the period of healing has ended. That is the reason why the court considered that there
was a supervening fact occurring since the filing of the original information.
But such circumstances do not exist in the case at bar. If the X-ray examination discloses the existence of a fracture on
January 17, 1957, that fracture must have existed when the first examination was made on December 10, 1956. There is,
therefore, no now or supervening fact that could be said to have developed or arisen since the filing of the original action,
which would justify the application of the ruling enunciated by us in the cases of Melo vs. People and People vs. Manolong,
supra. We attribute the new finding of fracture, which evidently lengthened the period of healing of the wound, to the very
superficial and inconclusive examination made on December 10, 1956. Had an X-ray examination taken at the time, the
fracture would have certainly been disclosed. The wound causing the delay in healing was already in existence at the time
of the first examination, but said delay was caused by the very superficial examination then made. As we have stated, we
find therefore that no supervening fact had occurred which justifies the application of the rule in the case of Melo vs.
People and People vs. Manolong, for which reason we are constrained to apply the general rule of double jeopardy.
We take this opportunity to invite the attention of the prosecuting officers that before filing informations for physical
injuries, thorough physical and medical examinations of the injuries should first be made to avoid instances, like the present,
where by reason of the important Constitutional provision of double jeopardy, the accused can not be held to answer for
the graver offense committed.
The decision appealed from is hereby reversed. The judgment of conviction is set aside and the defendant-appellant
acquitted of the charge of serious physical injuries. Without costs.
Paras, C.J., Bengzon, Montemayor, Bautista Angelo, Concepcion, Endencia, Barrera and Gutierrez David, JJ., concur.

PEOPLE OF THE PHILIPPINES vs. YORAC G.R. No. L-29270 November 23, 1971
The constitutional right not to be put twice in jeopardy for the same offense 1 was the basis for a motion to quash filed by
the accused, now appellee, Rodrigo Yorac. He was prosecuted for frustrated murder arising allegedly from having assaulted,
attacked, and hit with a piece of wood the offended party, for which he had been previously tried and sentenced for slight
physical injuries, his plea being one of guilt. The later information for frustrated murder was based on a second medical
certificate after the lapse of one week from the former previously given by the same physician who, apparently, was much
more thorough the second time, to the effect that the victim did suffer a greater injury than was at first ascertained. The
lower court, presided by the Honorable Judge Nestor B. Alampay, considering that there was no, supervening fact that
would negate the defense of double jeopardy, sustained the motion to quash in an order of June 21, 1968. The People
appealed. As the order complained of is, fully supported by the latest authoritative ruling of this Tribunal, People v.
Buling, 2we have to affirm.
In the brief for the People of the Philippines, it was shown that the accused Yorac was charged with slight physical injuries
before the City Court of Bacolod, the offended party being a certain Lam Hock who, according to the medical certificate
issued in April 10, 1968 by a Dr. Rogelio Zulueta, a resident physician of the Occidental Negros Provincial Hospital, was
confined "since April 8, 1968 up to the present time for head injury." 3 Then came a plea of guilty by the accused on April
16, 1968 resulting in his being penalized to suffer ten days of arresto menor. He started serving his sentence forthwith. On
April 18, 1968, the provincial fiscal filed an information, this time in the Court of First Instance of Negros Occidental,
charging the same defendant with frustrated murder arising from the same act against the aforesaid victim Lam Hock upon
another medical certificate dated April 17, 1968 issued by the same Dr. Zulueta. In the medical certificate of April 17,
1968, it was made to appear that the confinement of the offended party in the hospital was the result of: "1. Contusion with
lacerated wound 4 inches parieto-occipital region scalp mid portion. 2. Cerebral concussion, moderately severe,
secondary." 4 Moreover, it further contained a statement that the X-ray finding did not yield any "radiographic evidence of
fracture." The healing period barring complications, was declared to be from eighteen to twenty-one days. 5
Afterwards, a motion to quash was filed by the accused on June 10, 1968 on the ground that, having been previously
convicted of slight physical injuries by the City Court of Bacolod and having already served the penalty imposed on him
for the very same offense, the prosecution for frustrated murder arising out of the same act committed against the same

44
offended party, the crime of slight physical injuries necessarily being included in that of frustrated murder, he would be
placed in second jeopardy if indicted for the new offense. 6 In its well-reasoned resolution of June 21, 1968 granting the
motion to quash and ordering the dismissal of a criminal case for frustrated murder against the accused, Judge Alampay
relied on People v. Buling which, in his opinion, was squarely applicable as "nothing in the later medical certificate
[indicated] that a new or supervening fact had developed or arisen since the time of the filing of the original action" against
the accused. A motion for reconsideration being unavailing, an appeal was elevated to us.
As succinctly set forth in the brief of the People of the Philippines: "The sole issue in this case is whether the defendant,
who had already been convicted of slight physical injuries before the City Court of Bacolod for injuries inflicted upon Lam
Hock, and had served sentence therefore, may be prosecuted anew for frustrated murder for the same act committed against
the same person." 7 The position taken by the appellant is in the affirmative but, as indicated at the outset, the controlling
force of People v. Buling would preclude us from reversing the resolution of Judge Alampay.
1. The Constitution, to repeat, is quite explicit: "No person shall be twice put in jeopardy of punishment for the same
offense. As Justice Laurel made clear in an address as delegate before the Constitutional Convention, such a provision finds
its origin" from the days when sanguinary punishments were frequently resorted to by despots." 9A defendant in a criminal
case should therefore, according to him, be adjudged either guilty or not guilty and thereafter left alone in peace, in the
latter case the State being precluded from taking an appeal. 10 It is in that sense that the right against being twice put in
jeopardy is considered as possessing many features in common with the rule of finality in civil cases. For the accused is
given assurance that the matter is closed, enabling him to plan his, future accordingly, protecting him from continued
distress, not to mention saving both him and the state from the expenses incident to redundant litigation. There is likewise
the observation that this constitutional guarantee helps to equalize the adversary capabilities of two grossly mismatched
litigants, a poor and impecunious defendant hardly in a position to keep on shouldering the costs of a suit.
Then, as a member of the Supreme Court, Justice Laurel had the first opportunity to give meaning to what, under the
Constitution, should be considered "the same offense." In the case of People v. Tarok, decided in 1941, 11 the then
comparatively new Rules of Court in its Section 9 of Rule 113 speaks of a bar to another prosecution for the offense charged
after a defendant shall have been convicted or acquitted or the case against him dismissed or otherwise terminated without
his express consent, "or for any attempt to commit the same or frustration thereof or for, any offense which necessarily
includes or is necessarily included in the offense charged in the former complaint or information." 12
In the Tarok case, the conviction for parricide of the accused was sought to be set aside, as previously he had been indicted
for the crime of serious physical injuries, to which he had pleaded guilty. He was sentenced and was actually incarcerated
by virtue of such penalty imposed. The offended party was his wife whom he hacked with bolo, his ire being aroused by
certain, remarks made her. While he was thus serving sentence, the victim died resulting in the new prosecution for parricide
of which he was convicted. On appeal to this Court, it was decided over the dissents of the then Justice Moran and Justice
Diaz that the offense of serious physical injury of which he was found guilty being included in parricide his previous
conviction was a bar to such subsequent prosecution for the more serious crime. The lower court judgement of conviction
was thus reversed. According to Justice Laurel who spoke for the Court: "To our mind, the principle embodied in the New
Rules of Court is a clear expression of selection of rule amidst conflicting theories. We take the position that when we
amended section 26 of General Orders No. 58 by providing that the conviction or acquittal of the defendant or the dismissal
of the case shall be a bar to another prosecution for any offense not only necessarily therein included but which necessarily
includes the offense charged in the former complaint or information, we meant what we have, in plain language, stated. We
certainly did not mean to engage in the simple, play of words." 13
2. Such a ruling was however re-examined and set aside in Melo v. People, 14 where it was held that an accused who pleaded
guilty to the offense of frustrated homicide, the offended party thereafter dying in the evening of the same day, could not
rely on a plea of double jeopardy if, as a result thereof, the information was amended to charge him with homicide. 15 As
was clarified in the opinion of this Court through the then Chief Justice Moran, one of the dissenters in the Tarok case:
"This rule of identity does not apply, however, when the second offense was not in existence at the time of the first
prosecution, for the simple reason that in such case there is no possibility for the accused, during the first prosecution, to
be convicted for an offense that was then inexistent. Thus, where the accused was charged with physical injuries and after
conviction the injured person dies, the charge for homicide against the same accused does not put him twice in
jeopardy." 16 Stated differently, if after the first prosecution "a new fact supervenes on which defendant may be held liable,
resulting in altering the character of the crime and giving rise to a new and distinct offense, "the accused cannot be said to
be in second jeopardy if indicted for the new offense." 17 It is noteworthy, however, that in the Melo ruling, there was a
reiteration of what was so emphatically asserted by Justice Laurel in the Tarok case in these words: "As the Government
cannot begin with the highest, and then down step by step, bringing the man into jeopardy for every dereliction included
therein, neither can it begin the lowest and ascend to the highest with precisely the same result." 18
3. There is then the indispensable requirement of the existence of "a new fact [which] supervenes for which the defendant
is responsible" changing the character of the crime imputed to him and together with the facts existing previously
constituting a new and distinct offense. The conclusion reached in People v. Buling, 19 the latest case in point relied upon
by Judge Alampay in the resolution no appeal, was thus, predictable. As set forth in the opinion of Justice Labrador in the
case, there was a medical certification that the wounds for which the accused Buenaventura as first prosecuted for less
serious physical injuries would require medical attendance from a period of from ten days to fifteen days. He pleaded guilty
and on December 8, 1956, sentenced by the Justice of the Peace of Cabalian Leyte, to one month and one day of arresto
mayor. He started serving his sentence on the same day. On January 18, 1957, however, another physician examined the
offended party and with the use of an X-ray apparatus, certified that he did suffer a fracture requiring a treatment of from
one and one-half months to two and one half months, barring complications. As a result, on February 20, 1957, an
information was filed against the same accused, this time before the Court of First Instance of Leyte, charging him with
serious physical injuries. He stood trial and was found guilty of such an offense and sentenced to imprisonment of four
45
months of arresto mayor as minimum to one year of prision correccional as maximum. On appeal to this Court, his
invocation of the defense of double jeopardy struck a responsive chord, and he was acquitted.
4. The opinion of Justice Labrador explained with clarity why the constitutional right against being put twice in jeopardy
was a bar to the second prosecution. Thus: "If the X-ray examination discloses the existence of a fracture on January 17,
1957, that fracture must have existed when the first examination was made on December 10, 1956. There is therefore, no
view or supervening fact that could be said to have developed or arisen since the filing of the original action, which would
justify the application of the ruling enunciated by us in the cases if Melo vs. People and People vs. Manolong ... . We
attribute the new finding of fracture, which evidently lengthened the period of healing of the wound, to the very superficial
and inconclusive examination made on December 10, 1956. Had an X-ray examination been taken at the time, the fracture
would have certainly been disclosed. The wound causing the delay in healing was already in existence at the time of the
first examination, but said delay was, caused by the very superficial examination then made. As we have stated, we find
therefore that no supervening fact had occurred which justifies the application of the rule in the case of Melo vs.
People and People vs. Manolong for which reason we are constrained to apply the general rule of double jeopardy." 20 It is
quite apparent, in the light of the foregoing, why the lower court, submitting to the compulsion of the Buling decision, had
to sustain the motion to quash and to dismiss the information against appellee Yorac. No error could therefore be rightfully
imputed to it.
WHEREFORE, the resolution of June 21, 1968 of Judge Nestor B. Alampay granting the motion to quash, ordering the
dismissal of the case and the immediate release of the appellee Rodrigo Yorac, is affirmed. Without costs.

Name: PEOPLE vs. ADIL and FAMA, JR. G.R. No. L-41863 April 22, 1977
Facts On April 12, 1975, Fama Jr., attacked Viajar by throwing a piece of stone upon his right cheek,
inflicting physical injuries which would require medical attendance for a period from 5 to 9 days
barring complication as per medical certificate of the physician. A criminal complaint for slight
physical injuries was filed against Fama Jr. on April 15, 1975, docketed as Case No. 3335. Meanwhile,
Viajar filed another complaint on July 28, 1975, docketed as Case No. 5241, for the same instance of
throwing a stone but this time for serious physical injuries because it left permanent scar and
deformation on his right face. The first case proceeded and Fama Jr. pleaded not guilty during
arraignment. After several postponements by the prosecution, Fama Jr.successfully sought dismissal
of the first criminal case invoking the constitutional right to speedy trial. Fama Jr. now moves for the
dismissal of the second case on the ground of double jeopardy.
Issue Whether or not the additional allegation of deformity in the information in Case No. 5241 constitutes
a supervening element which should take this case out of the rule of identity resulting in double
jeopardy
Held/Ratio: YES.
This rule of identity does not apply when the second offense was not in existence at the time of the
first prosecution, for the simple reason that in such case there is no possibility for the accused during
the first prosecution, to be convicted for an offense that was then inexistent Thus, where the accused
was charged with physical injuries and after conviction the injured dies, the charge of homicide
against the same accused does not put him twice in jeopardy.

[Here], when the complaint was filed on April 15, 1975, only three days had passed since the incident
in which the injuries were sustained took place, and there were yet no indications of a graver injury
or consequence to be suffered by said offended party. Evidently, it was only later, after Case No. 3335
had already been filed and the wound on the face of Viajar had already healed, that the alleged
deformity became apparent. In other words, in the peculiar circumstances of this case, the plea of
double jeopardy of private respondent Fama Jr., cannot hold.

Name: ENRILE AND ENRILE vs. MANALASTAS G.R. No. 166414 October 22, 2014
Facts The mauling incident involving neighbors end up with filing of criminal case in the MTC for frustrated
homicide and less serious physical injuries. Petitioners moved for the reconsideration of the joint
resolution, arguing that the complainants had not presented proof of their having been given medical
attention lasting 10 days or longer, thereby rendering their charges of less serious physical injuries
dismissible; and that the two cases for less serious physical injuries, being necessarily related to the case
of frustrated homicide still pending in the Office of the Provincial Prosecutor, should not be governed
by the Rules on Summary Procedure. The MTC denied the petitioners motion for reconsideration
because the grounds of the motion had already been discussed and passed upon in the resolution sought
to be reconsidered; and because the cases were governed by the Rules on Summary Procedure, which
prohibited the motion for reconsideration. Thereafter, the petitioners presented a manifestation with
motion to quash and a motion for the deferment of the arraignment. The MTC denied the motion to
quash, and ruled that the cases for less serious physical injuries were covered by the rules on ordinary
procedure; and reiterated the arraignment previously scheduled.

Unsatisfied, the petitioners commenced a special civil action for certiorari assailing the order of the MTC
in the RTC. RTC Judge Manalastas dismissed the petition for certiorari. The petitioners moved for the
reconsideration, but the RTC denied their motion.

46
 The petitioners next went to the CA via a petition for certiorari and prohibition to nullify the orders issued
by the RTC, averring grave abuse of discretion amounting to lack or excess of jurisdiction. They urged
the dismissal of the criminal cases on the same grounds they advanced in the RTC. The CA dismissed
the petition for certiorari and prohibition for being the wrong remedy.
Issue Is the presentation of medical certificates that will show the number of days rendered for medication
essential during filing of complaint, considering the complaints were filed two (2) months after the
alleged incident?
Held/Ratio: [T]he presentation of the medical certificates to prove the duration of the victims need for medical
attendance or of their incapacity should take place only at the trial, not before or during the preliminary
investigation. According to Cinco v. Sandiganbayan, the preliminary investigation, which is the occasion
for the submission of the parties respective affidavits, counter-affidavits and evidence to buttress their
separate allegations, is merely inquisitorial, and is often the only means of discovering whether a person
may be reasonably charged with a crime, to enable the prosecutor to prepare the information. It is not yet
a trial on the merits, for its only purpose is to determine whether a crime has been committed and whether
there is probable cause to believe that the accused is guilty thereof. The scope of the investigation does
not approximate that of a trial before the court; hence, what is required is only that the evidence be
sufficient to establish probable cause that the accused committed the crime charged, not that all
reasonable doubt of the guilt of the accused be removed.

PEOPLE vs MAPALO G.R. No. 172608 February 6, 2007

THIRD DIVISION

PEOPLE OF THE PHILIPPINES, G.R. No. 172608

Plaintiff-Appellee,
Present:

YNARES-SANTIAGO, J.,
Chairperson,
- versus - AUSTRIA-MARTINEZ,
CALLEJO, SR., and
CHICO-NAZARIO, JJ.

Promulgated:
BERNARD MAPALO,
Accused-Appellant. February 6, 2007
x- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -x

DECISION

CHICO-NAZARIO, J.:

In its Decision[1] dated 27 October 2004, the Regional Trial Court (RTC), Branch 32 of Agoo, La Union, in Criminal Case
No. A-2871, found appellant Bernard Mapalo guilty beyond reasonable doubt of the crime of Murder, and imposed upon
him the penalty of reclusion perpetua. On appeal, the Court of Appeals rendered a Decision[2] dated 21 November 2005,
modifying the Decision of the RTC, and finding Bernard Mapalo guilty beyond reasonable doubt of the crime of Frustrated
Murder.

The Indictments

Appellant, together with Peter Doe, John Doe and Peter Doe, Jr., was charged before the RTC of Agoo, La Union
with the crime of Murder, said to have been committed as follows:

That on or about the 13th day of February, 1994, in the Municipality of Aringay, Province of La Union,
Philippines, and within the jurisdiction of this Honorable Court, the above-named accused, with intent to
kill and being then armed with lead pipes and bladed weapons and conspiring, confederating and mutually
helping each other, did then and there by means of treachery and with evident premeditation and taking
advantage of their superior strength, wil[l]fully, unlawfully and feloniously attack, assault and use personal
violence on one Manuel Piamonte y Ugay by clubbing him with the said pipes and stabbing him several

47
 times with the said bladed weapons, and thereby inflicting on the aforenamed victim fatal injuries which
were the direct and immediate cause of his death, to the damage and prejudice of his heirs.

Contrary to law.[3]

The RTC ordered the issuance of a warrant of arrest for the apprehension of the appellant. No bail was
recommended.[4] When the case was called, appellant filed a Motion for Reinvestigation and Bail, which was granted.

On 27 March 1995, 3rd Assistant Provincial Prosecutor Manuel S. Oliva filed a Motion to Admit Amended
Information and for the Issuance of Warrant of Arrest for the Apprehension of the Other Accused,[5] alleging that a
reinvestigation was conducted and a prima facie case was found against the other accused. It was prayed that an amended
information be admitted and a warrant of arrest be issued for the apprehension of Alejandro Fajardo, Jr., Jimmy Frigillana,
and Rolando Mapalo alias Lando. Finding the Motion to be well-taken, the RTC issued an Order,[6] dated 27 April 1995,
admitting the Amended Information, viz:

The undersigned Assistant Provincial Prosecutor accuses BERNARD MAPALO, ALEJANDRO

FAJARDO, JR., JIMMY FRIGILLANA and ROLANDO MAPALO alias Lando of the crime of
MURDER, committed as follows:

That on or about the 13th day of February, 1994, in the Municipality of Aringay, Province of La
Union, Philippines, and within the jurisdiction of this Honorable Court, the abovenamed accused, with
intent to kill and being then armed with lead pipe and bladed weapons and conspiring, confederating and
mutually helping each other, did then and there by means of treachery and with evident premeditation and
taking advantage of their superior strength, wil[l]fully, unlawfully and feloniously attack, assault and use
personal violence on one Manuel Piamonte y Ugay by clubbing him with the said pipe and stabbing him
several times with the said bladed weapons, and thereby inflicting on the aforenamed victim fatal injuries
which were the direct and immediate cause of his death, to the damage and prejudice of his heirs.[7]

Consequently, a warrant of arrest was issued for the apprehension of Alejandro Fajardo, Jr., Jimmy Frigillana, and
Rolando Mapalo alias Lando. Only Alejandro Fajardo, Jr. was apprehended; the other two remain at large.

On arraignment, appellant pleaded not guilty.[8] Thereafter, trial on the merits commenced.

After the prosecution had rested its case, Alejandro Fajardo, Jr. filed a Demurrer to Evidence which was granted
by the RTC, in its Order[9] dated 5 November 1998, on the ground that the prosecution did not present any evidence against
him. Thus, only accused Bernard Mapalo proceeded to present his evidence. He was eventually found guilty.

The Case for the Prosecution

The prosecution presented Calixto Garcia (Garcia) as its lone eyewitness.

Garcia testified that on 12 February 1994, a pre-Valentine dance was held in Sitio Baracbac, Brgy. Sta. Cecilia in
Aringay, La Union. He watched the dance, along with the appellant and Jimmy Frigillana.[10] In the early morning of 13
February 1994, at around 3:00 a.m., a fight erupted between Manuel Piamonte (Piamonte) and the group of Lando
Mapalo,[11] Jimmy Frigillana, and the appellant.[12]

Garcia further testified that he witnessed the fight from a distance of more or less five (5) meters. He claimed that
he could see the incident very clearly because of the light at the dancing hall.[13] He saw the appellant club Piamonte with
a lead pipe from behind, hitting him on the right side of the head.[14] The pipe was one and a half (1 and ) feet in length, and
one and a half (1 and ) inches in diameter.[15] At that time when the appellant struck Piamonte with a lead pipe, he saw
Jimmy Frigillana and Lando Mapalo standing in front of Piamonte. Later, he saw the dead body of Piamonte, which had
suffered multiple stab wounds.[16] He saw stab wounds on the left and right parts of the abdomen, and below the left breast,
as well as small wounds on the front part of his left hip.[17] Garcia disclosed that he neither witnessed how Piamonte was
stabbed, nor did he see the act of stabbing Piamonte.[18] He does not know who stabbed the latter.[19] It was only when
Piamontes shirt was removed when he saw stab wounds on the formers dead body.[20]
The Case for the Defense

Appellant testified that in the evening of 13 February 1994,[21] at around 9:00 p.m., he, along with his wife, Caridad
Mapalo, entertained several guests at their residence, namely, Crispin Calderon, Noel Cordero, Ruel Mercado, and Rolando
Mapalo.[22] They drank wine.[23] Appellant knew that there was a Valentines Day dance celebration at the dance hall, located
northeast of his house at a distance of about 20-30 meters.[24] At 12:30 a.m., after his guests had left the house, he went to
sleep.[25] At 3:00 a.m., his wife woke him up and was informed that somebody had been stabbed. He said he came to know
that Piamonte was the person who was stabbed.[26] He added that he planned to go out of the house, but his wife prevented
him from doing so.[27] He, thereafter, returned to his room, and went back to sleep.[28]
48
 Corroborating the appellants defense of denial and alibi, his wife, Caridad Mapalo, narrated that on 13 February
1994[29] at 8:00 p.m., she served brandy to her husband and their guests at their residence. The celebration finished at
around 12:00 midnight.[30] Thereafter, she and her husband went to sleep, while their guests proceeded to the dance
hall. At 3:00 a.m., she awoke because of a commotion from the dance hall.[31] She described that the dance hall is around
60 to 70 meters, southwest of their residence.[32] She went outside of their house, and along with her sister-in-law, Marissa
Dapit, proceeded to the edge of the dancing hall.[33] She claimed that her husband did not go out and just stayed at their
house.[34] She explained that she and Marissa Dapit went out to see or to know the name of the person who died at the
commotion.[35] At the dancing hall, she saw the body of Piamonte, lying face down.[36]

The Ruling of the RTC

After trial, the RTC rendered a Decision, dated 27 October 2004, finding appellant guilty beyond reasonable doubt
of the crime of Murder.

It ruled that appellants defense of alibi cannot prevail over the positive identification of the lone eyewitness. As
emphasized by the RTC, per admission of appellant, the distance between his house and the dancing hall is only 20 to 30
meters, more or less. There was no physical impossibility for the appellant to be present at the scene of the crime. Moreover,
it found Garcias testimony to be consistent and uncontradicted. On the other hand, the RTC considered the testimony of
Caridad Mapalo as defying the natural course of human reaction and experience. The RTC found it strange that it was only
Caridad Mapalo who was awakened by the commotion, while the appellant remained asleep. Learning of the same, Caridad
Mapalo exposed herself to danger by proceeding to the dance hall to see what the commotion was all about without even
informing her husband. The RTC conjectured that Caridad Mapalo proceeded to the dance hall not to see what the
commotion was all about, but because she was informed that her husband was involved in a fight.[37]

Further, the RTC ruled that conspiracy was established by the prosecution. According to the RTC, the appellant
was clearly identified by Garcia as the one who struck Piamonte on the head with a lead pipe, which alone is sufficient
manifestation of a concerted, common and united design with the other accused to commit an unlawful and felonious
act. The fact that the medical certificate shows the cause of death as stab wounds was deemed by the RTC as immaterial,
in view of the presence of conspiracy. The RTC also appreciated the attendance of abuse of superior strength as a qualifying
circumstance, on the rationalization that the perpetrators were armed with bladed weapons and a lead pipe that were out of
proportion to the unarmed Piamonte.

The decretal portion of the RTC Decision states:

WHEREFORE, the accused BERNARD MAPALO is hereby found Guilty beyond reasonable
doubt of the crime of MURDER and is sentenced to suffer the penalty of RECLUSION PERPETUA.

Further, the accused is ordered to pay the heirs of Manuel Piamonte the amount of Twelve
Thousand Seven Hundred Pesos (P12,700.00) as actual damages. Fifty Thousand Pesos (P50,000.00) as
civil indemnity for the death of Piamonte and Fifty Thousand Pesos (P50,000.00) as moral damages.[38]

The Ruling of the Court of Appeals

Before the appellate court, appellant challenged the credibility of the prosecutions lone eyewitness. Appellant
similarly assailed the ruling of the RTC on the ground that it erred in convicting him despite the failure of the prosecution
to prove his guilt beyond reasonable doubt.[39]

The Court of Appeals found no adequate reason to disturb the findings of the RTC in weighing the testimony of
Garcia. It did not find significant the alleged inconsistencies in Garcias affidavits as executed before the investigating police
and the prosecutor.[40] The appellate court did not accept the appellants defense of alibi. The positive identification of the
prosecution witness which was consistent and categorical, and shown to be without ill-motive, has discredited appellants
defense.

The Court of Appeals, however, found reason to modify the findings of the RTC. It convicted the appellant of
frustrated murder only. It was not convinced that the evidence on record established conspiracy among the appellant and
his co-accused. The appellate court rationalized that while the evidence shows that Piamonte sustained stab wounds which
caused his death,[41] the appellant was never identified as the one who inflicted the stab wounds on the deceased. According
to the appellate court, the prosecutions evidence only established that the appellant clubbed Piamonte with a lead
pipe. However, the prosecutions witness did not see the stabbing. He was not able to describe the particular acts which
caused Piamontes death. Hence, it cannot be inferred from the account of the witness that the appellant and his co-accused
came to an agreement to commit a felony, or that they decided to commit the same, by concerted acts. [42] The Court of
Appeals made the following observations:

49
 In the first place, the killing was the result of a fight that erupted suddenly during the Valentine
dance, which discourages the conclusion that the killing was planned. Also, the witness did not see any
stabbing.He did not see anyone else perform any act of stabbing or hitting, other than the appellant
delivering blows with a lead pipe on the victim. There is no proof, therefore, of any concerted action or
common design to kill the victim that could be the basis for a finding of conspiracy among several
malefactors. Because of this, it could not be said that conspiracy was proven attendant beyond reasonable
doubt.[43]

In the absence of a conspiracy, the Court of Appeals said that the appellant could only be held liable for the
consequences of his own criminal act. It ruled that when the appellant hit Piamonte in the head with the lead pipe, he
performed all the acts that would have brought about the death of the victim.[44] Piamontes death however was due to some
other supervening cause, independent of the appellants will.[45]

The fallo of the Court of Appeals Decision reads, viz:

WHEREFORE, premises considered, the lower courts Decision is hereby MODIFIED, in that the
accused-appellant Bernard Mapalo is hereby found guilty beyond reasonable doubt of the crime of
Frustrated Murder. Accused-appellant is hereby sentenced to 8 years and 1 day of prision mayor, as
minimum to 14 years, 8 months and 1 day of reclusion temporal, as maximum.

Further, the accused is ordered to pay the heirs of Manuel Piamonte[,] the amount of Twenty Five
Thousand Pesos (P25,000.00) as temperate damages, Thirty Thousand Pesos (P30,000.00) as civil
indemnity and Thirty Thousand Pesos (P30,000.00) as moral damages pursuant to prevailing
jurisprudence. (People v. Pacana, 345 SCRA 72 [2000]; People v. Givera, 349 SCRA 513 [2001]).[46]

The Issues

Appellant contends that:

I
THE COURT OF APPEALS GRAVELY ERRED IN CONVICTING THE ACCUSED-APPELLANT
DESPITE FAILURE OF THE PROSECUTION TO IDENTIFY THE ACCUSED-APPELLANT IN
OPEN COURT; and

II
ASSUMING THAT THE ACCUSED-APPELLANT IS GUILTY, THE COURT OF APPEALS
GRAVELY ERRED IN CONVICTING HIM OF FRUSTRATED MURDER INSTEAD OF
FRUSTRATED HOMICIDE.[47]

The Ruling of the Court

In support of the first assignment of error, appellant raises, for the first time, the defense that the witness for the
prosecution failed to positively identify him during the trial proceedings. Citing People v. Galera[48] and People v.
Hatton,[49] appellant submits that the prosecution failed to discharge its first duty, which is the identification of the accused
as the author of the crime charged.[50] Witness Garcia did not identify the appellant in open court.

Appellant further posits that Garcia did not deny drinking gin at around 9:00 p.m. on 13 February 1994 until 3:00
a.m. of the following day. Garcia was then intoxicated if he had been drinking hard liquor continuously for six hours. At
such point, he can no longer positively determine a persons identity. It is argued that the foregoing circumstances create
doubts as to the identity of the appellant as one of the perpetrators of the crime.

We first tackle the issue on the lack of in-court identification.

True that on the matter of identification, the Court in Hatton said:

More importantly, the accused-appellant was not positively identified in court. True, his name was referred
to by both Basierto and Ongue in their respective direct testimonies. However, he was not identified in
Court.The failure of the prosecution witness to positively identify the assailant in court is fatal to the
prosecutions cause. Pre-trial identification is not sufficient.[51]
50
 Verily, the records are bereft of proof that there was in-court identification by the witness Garcia of the
appellant. Indeed, Garcia did not point to the appellant in the courtroom. Such fact can be gleaned from the pertinent portion
of the transcript of stenographic notes of the trial, reproduced hereunder, as follows:

Direct-examination by Prosecutor Rudio

of the witness Calixto Garcia

Q Do you know the accused Bernard Mapalo?

A I know, sir.

Q If that accused is inside the courtroom now will you please stand up and point to him if he is inside the
courtroom?

A No, he is not around.

COURT:

Q Was he notified for (sic) todays hearing?

INTERPRETER:
Yes, he signed, sir.

COURT: O R D E R:
It appears that the accused Bernard Mapalo was being notified for (sic) todays hearing and his wife
came to Court and informed the Honorable Court that her husband could not come to Court because he is
sick.[52]

The same testimony, however, conspicuously reveals that there was no identification in open court of the appellant
because said appellant was not present at the time, despite notice, as according to his wife, he was sick.

In a later case, this Court clarified that a physical courtroom identification is essential only when there is a question
or doubt on whether the one alleged to have committed the crime is the same person who is charged in the information and
subject of the trial. In People v. Quezada,[53] this Court expounded, thus:

We do not see the absolute need for complainant to point to appellant in open court as her
attacker. While positive identification by a witness is required by the law to convict an accused, it need not
always be by means of a physical courtroom identification. As the court held in People v. Paglinawan:

x x x. Although it is routine procedure for witnesses to point out the accused in open court by way
of identification, the fact that the witness x x x did not do so in this case was because the public prosecutor
failed to ask her to point out appellant, hence such omission does not in any way affect or diminish the
truth or weight of her testimony.

In-court identification of the offender is essential only when there is a question or doubt on whether
the one alleged to have committed the crime is the same person who is charged in the information and
subject of the trial. This is especially true in cases wherein the identity of the accused, who is a stranger to
the prosecution witnesses, is dubitable. In the present case, however, there is no doubt at all that the rapist
is the same individual mentioned in the Informations and described by the victim during the trial.
(Emphasis supplied.)[54]

We do not find herein a case where there is a question or doubt as to whether the one alleged to have committed
the crime is the same person charged in the information and subject of the trial.In fact, appellant never denied that he is the
person indicted in the Information, and subject of the proceedings. His denial is that he did not participate in the commission
of the crime. Hence, in-court identification is not indispensable in the case at bar.
We are convinced that the identity of the appellant was sufficiently established by the evidence on record.

The appellant is not a stranger to the witness Garcia. The identity of the appellant to Garcia does not appear to be
controvertible. In fact, appellant himself admits that he and Garcia are friends.Thus:
51
 Cross-examination by Prosecutor Lachica
of [appellant] Bernard Mapalo

Q Mr. Witness you said that you were informed by your counsel a while ago that a certain Calixto Garcia
testified against you in this case did I get you right?

A Yes, sir.

Q And this Calixto Garica is a resident of the same Barangay as you are?

A Yes, sir.

Q In fact this Calixto Garcia is an acquaintance of yours?

A Yes, sir.

Q He is considered a friend?

A Yes, sir I consider him as such.

Q Prior to the incident which happened sometime on February 13, 1994, you have never quarreled with
this Calixto Garcia?

A No, sir.

Q Even after that incident that happened on February 13, 1994 you never quarreled with Calixto Garcia?

A No, sir.

Q You know that this Calixto Garcia is not a relative of Piamonte the victim in this case?

A I do not know whether he is a relative of the victim or not.

Q You know for a fact that Calixto Garcia executed a statement before the police pointing to you or
pointing to you as the assailant of Paimonte did you come to know that?

A No, sir.
Q You said that you know Calixto Garcia your friend according to you, did you confront him when he testified
against you in court?

A No, sir.

Q You did not tell your friend that he was mistaken in identifying you as the assailant of Piamonte, correct?

A No, sir. [55]

The proper identification of the appellant is further bolstered by the fact that appellants wife, Caridad Mapalo
corroborated the testimony that the witness Garcia is a family friend of the spouses. Thus:

Cross examination of Caridad Mapalo

by Prosecutor Lachica

Q Do you know a certain Calixto Garcia?

A Yes, sir.

Q He is your Barangay mate?

A Yes, sir.

Q His house is closed to your house, correct?

A Far, sir.

52
 Q But he is staying within your barangay which is Sta. Cecilia?

A Yes, sir.

Q This Calixto Garcia whom you know is a friend of your family, correct?

A Yes, sir.

Q In fact, your family have (sic) never quarreled with Calixto Garcia?

A None, sir.

Q Prior to the filing of this case, you know that Calixto Garcia being a friend will not falsify his testimony
regarding your husband?

A Yes, sir.

ATTY. RIMANDO:
Objection, your honor.

COURT:
Objection overruled.

PROSECUTOR LACHICA:

Q Until now, this Calixto Garcia is your friend?

A Yes, sir.

PROSECUTOR LACHICA:
That would be all for the witness.

RE-DIRECT EXAMINATION BY ATTY. RIMANDO:

Q This Calixto Garcia was your guest in that evening in your residence?

A No, sir.

Q Is your family close with (sic) this Calixto Garcia?

A Yes, sir.[56]

Moreover, we do not find herein the presence of factors[57] that could cause the witness Garcia to misidentify the
appellant. In People v. Limpangog,[58] this Court enumerated several other known causes of misidentification, viz:

x x x Known causes of misidentification have been identified as follows:

Identification testimony has at least three components. First, witnessing a crime, whether as a
victim or a bystander, involves perception of an event actually occurring. Second, the witness must
memorize details of the event. Third, the witness must be able to recall and communicate
accurately. Dangers of unreliability in eyewitness testimony arise at each of these three stages, for
whenever people attempt to acquire, retain, and retrieve information accurately, they are limited by normal
human fallibilities and suggestive influences.[59]

There is no question that the witness Garcia was at a close range of merely five meters more or less from the scene of the
incident.[60] Neither can it be said that the illumination was poor. The dancing hall was lighted.[61] No improper motive was
attributed to the witness Garcia for testifying against the appellant. Moreover, witness Garcia is familiar not only to
appellant. Garcia was also familiar with the deceased, Piamonte. Witness Garcia, in his testimony, referred to Piamonte as
his third cousin.[62]

On appellants submission that it is doubtful if witness Garcia can still have positively identified him as one of the
perpetrators of the crime considering that the former admitted to drinking hard liquor from 9:00 p.m. on 13 February 1994
until 3:00 a.m. of the following day, we are not convinced that the same can overthrow the trial courts evaluation of Garcias
testimony. Beyond appellants bare allegations, no evidence whatsoever was produced to show that Garcia suffered from
53
such a level of intoxication as to impair his facility and disable him to identify appellant. In the case of People v. Dee,[63] the
credibility of the surviving victim therein as witness was disputed because he was under the influence of liquor at the time
of the incident. In Dee, the witness was even found positive for alcoholic breath, but the Court ruled that such fact does not
necessarily prevent him from making a positive identification of his attackers, especially since his level of intoxication was
not shown to impair his faculties. The credibility of the witness therein was not made to suffer on that score alone.[64]

The foregoing material considerations, taken together with the fact that witness Garcia and the appellant are not
strangers to each other, satisfy us that the danger of Garcia misidentifying the appellant does not exist. Where the
prosecution eyewitness was familiar with both victim and accused, and where the locus criminis afforded good visibility,
and where no improper motive can be attributed to the witness for testifying against the accused, his version of the story
deserves much weight.[65]

Hence, we do not find any reason to depart from the general rule that the conclusions of the trial court on the
credibility of witnesses deserve great respect, viz:

The assessment of the credibility of witness and their testimony is a matter best undertaken by the trial
court because of its unique opportunity to observe the witnesses firsthand; and to note their demeanor,
conduct and attitude under examination. Its findings on such matters are binding and conclusive on
appellate courts unless some facts or circumstances of weight and substance have been overlooked,
misapprehended or misinterpreted.[66]

Appellants defense of alibi and denial cannot stand in the face of the positive identification of the accused. We have
unfailingly held that alibi and denial being inherently weak cannot prevail over the positive identification of the accused as
the perpetrator of the crime.[67] It is facile to fabricate and difficult to disprove, and is generally rejected.[68]

For the defense of alibi to prosper, it must be shown with clear and convincing evidence that at the time of the commission
of the crime charged, the accused is in a place other than the situs of the crime such that it was physically impossible for
him to have been at the situs criminis when the crime was committed.[69]

In the case at bar, appellant was not successful in invoking the defense of alibi. Appellant insists that he was sleeping at his
residence at the time when the incident occurred. The RTC and the Court of Appeals consistently found that the distance
between appellants residence and the dance hall, or the situs criminis, is 20 to 30 meters, more or less.[70] Such a distance
is negligible. In fact, appellants wife testified that from their residence, she could see the people dancing at the hall.[71] It
was not highly impossible for the appellant to be physically present at the dancing hall at the time of the occurrence of the
incident. We, therefore, reject appellants defense of alibi.

We shall now determine the criminal liability of the appellant.

To reiterate, the RTC, in convicting the appellant guilty beyond reasonable doubt of the crime of murder, proceeded from
a rationalization that there was conspiracy among appellant and his co-accused. It also appreciated the attendance of abuse
of superior strength to qualify the crime to Murder.

The Court of Appeals was unable to agree with the RTC. It found that the conspiracy was not proven beyond reasonable
doubt. It ruled that the witness Garcia admitted to not being able to see the stabbing. He could only attest to the clubbing
of the victim by appellant with a lead pipe. No proof was shown as to the concerted action of the malefactors of their
common design to kill. It, thus, modified the RTCs conviction, and, instead, found appellant guilty of frustrated murder.

The Amended Information charged the appellant and his co-accused with conspiracy in killing Piamonte.

Conspiracy exists when two or more persons come to an agreement concerning the commission of a felony and
decide to commit it.[72] Conspiracy as a basis for conviction must rest on nothing less than a moral certainty.[73] Considering
the far-reaching consequences of criminal conspiracy, the same degree of proof necessary in establishing the crime is
required to support the attendance thereof, i.e., it must be shown to exist as clearly and convincingly as the commission of
the offense itself.[74] Thus, it has been held that neither joint nor simultaneous actions is per sesufficient proof of
conspiracy.[75]

We are, further, guided by the following pronouncement of the Court:

For conspiracy to exist, the participants must agree to the commission of the felony and decide to commit
it, which agreement may be deduced from the mode and manner of the commission of the offense or
inferred from the acts that point to joint purpose and design, concerted action and community of intent.
x x x.[76]

54
 While conspiracy need not be established by direct evidence, it is, nonetheless, required that it be proved by clear
and convincing evidence by showing a series of acts done by each of the accused in concert and in pursuance of the common
unlawful purpose.[77]

There is a want of evidence to show the concerted acts of the appellant and his co-accused in pursuing a common design -
to kill the deceased, Piamonte. The sole eyewitness for the prosecution, Garcia, was categorical and precise in declaring
that he did not see the act of stabbing Piamonte, nor the manner in which Piamonte was stabbed. He later learned that
Piamonte died from stab wounds when he saw the latters dead body covered with stab wounds. The cause of death of
Piamonte, as found by the RTC and the Court of Appeals,[78] and as borne by the records, is multiple stab wounds.[79] It
was, thus, incumbent on the part of the prosecution to prove beyond reasonable doubt that the appellant and his co-accused
acted in concert with a unity of purpose to kill Piamonte. They must show to the satisfaction of this Court the appellants
overt act in pursuance or furtherance of the complicity.[80] They must show that appellants act of striking Piamonte with a
pipe was an intentional participation in the transaction with a view to the furtherance of the common design and purpose. [81]

The prosecution was unable to show, either by direct or indirect evidence, proof of the agreement among the
appellant and his co-accused to warrant conspiracy as a basis for appellants conviction. No evidence was even adduced to
show implied conspiracy. Nothing has been shown that the appellant and his co-accused were aimed by their acts towards
the accomplishment of the same unlawful object, each doing a part so that their combined acts, though apparently
independent of each other were, in fact, connected and cooperative, indicating a closeness of personal association and a
concurrence of sentiment.[82]

This complete absence of evidence on the part of the prosecution to show the conduct of the appellant and his co-
accused, disclosing a common understanding among them relative to the commission of the offense, [83] is fatal to the
prosecution. The prosecutions witness could not testify on the manner by which the deceased Piamonte was stabbed,
precisely because by his own admission, he did not see the stabbing. No account of the stabbing which caused the death of
the deceased Piamonte was ever given nor shown. Unfortunately, no account of how Piamonte died was ever given, except
for the established fact that he died due to stabbing. The appellants act of holding a lead pipe and hitting the deceased in
the head was not shown to be in furtherance of the common design of killing the deceased. What transpired during the
stabbing of the victim, which is material to proving the fact of conspiracy, is, regrettably, left merely to speculation. This
Court must neither conjecture nor surmise that a conspiracy existed. The rule is clear that the guilt of the accused must be
proved with moral certainty.[84] All doubts should be resolved in favor of the accused. Thus, the time honored principle in
criminal law that if the inculpatory facts are capable of two or more explanations, one consistent with the innocence of the
accused and the other with his guilt, the Court should adopt that which is more favorable to the accused for then the evidence
does not fulfill the test of moral certainty.[85]

Liability of the Accused Bernard Mapalo

There being no conspiracy, the liability of the appellant will revolve around his individual participation in the
event.[86]

In the case of Li v. People,[87] a street fight ensued resulting in the death of the victim therein. No conspiracy was
proven beyond reasonable doubt. The liability of the accused Li who was shown to have struck the victims right arm with
a baseball bat, resulting in a contusion was, thus, determined by the Court in the following manner:

The only injury attributable to Li is the contusion on the victims right arm that resulted from Li
striking [the victim] Arugay with a baseball bat. In view of the victims supervening death from injuries
which cannot be attributed to Li beyond reasonable doubt, the effects of the contusion caused by Li are not
mortal or at least lie entirely in the realm of speculation. When there is no evidence of actual incapacity of
the offended party for labor or of the required medical attendance, the offense is only slight physical
injuries, penalized as follows:

xxxx

The duration of the penalty of arresto menor is from one day to thirty days. The felony of slight
physical injuries is necessarily included in the homicide charges. Since the Information against Li states
that among the means employed to commit the felonious act was the use of the baseball bat, conviction on
the lesser offense or slight physical injuries is proper. There being no aggravating or mitigating
circumstances established, the imposition of the penalty in its medium period is warranted. Li was
convicted by the RTC on January 5, 1994. Having long served more than the imposable penalty, Li is
entitled to immediate release unless, of course, he is being lawfully detained for another cause.[88]

In the case at bar, no injury was shown to be attributable to the appellant. The only medical evidence that appears on records
is the deceased Piamontes death certificate,[89] which indicates that the cause of death is massive hypovolemia[90] secondary
to multiple stab wounds. The factual findings of the RTC and the Court of Appeals coincide to show that the cause of death
of Piamonte is multiple stab wounds. Nothing has been shown otherwise. Other than the presence of multiple stab wounds,
55
no other type of injury on the deceased was established. No contusions or injury on the head of the victim or anywhere else
in his body caused by a lead pipe was shown. The witness Garcia, in his testimony, merely pointed to stab wounds on the
different parts of the body of the deceased.[91] No proof on the injury that was sustained by the deceased that can be
attributable to appellants act was demonstrated. No other physical evidence was proffered.[92]

We cannot convict appellant of Attempted or Frustrated Murder or Homicide. The principal and essential element of
attempted or frustrated homicide or murder is the assailants intent to take the life of the person attacked.[93] Such intent
must be proved clearly and convincingly, so as to exclude reasonable doubt thereof.[94] Intent to kill may be proved by
evidence of: (a) motive; (b) the nature or number of weapons used in the commission of the crime; (c) the nature and
number of wounds inflicted on the victim; (d) the manner the crime was committed; and (e) words uttered by the offender
at the time the injuries are inflicted by him on the victim.[95]

In the case at bar, no motive on the part of appellant to kill Piamonte was shown either prior or subsequent to the
incident. Nor can such intent to kill be inferred from his acts. It bears reiterating that no injury on the body of the deceased
was attributed to the appellants act of hitting the victim with a lead pipe. On the nature of the weapon used, the lead pipe
was described by Garcia as one and a half feet in length, and one and a half inches in diameter. The relevant testimony of
Garcia on the incident follows:

Q Now you said that Bernard Mapalo clubbed this Manuel Piamonte. He clubbed him from
behind?

A Yes, sir.

Q And what did he use in clubbing the victim, is it lead pipe?

A Yes, sir.

Q How long is that lead pipe?

A Around this length. (Witness demonstrated 1 1/2 feet).

Q And how wide is the diameter?

A 1 inches.

Q What part of his body was hit?

A Right side of the head, sir. (Witness showing the right side of his head.)[96]

Homicidal intent must be evidenced by the acts that, at the time of their execution, are unmistakably calculated to
produce the death of the victim by adequate means.[97] We cannot infer intent to kill from the appellants act of hitting
Piamonte in the head with a lead pipe. In the first place, wounds were not shown to have been inflicted because of the
act. Secondly, absent proof of circumstances to show the intent to kill beyond reasonable doubt, this Court cannot declare
that the same was attendant.

When the offender shall ill-treat another by deed without causing any injury, and without causing dishonor, the
offense is Maltreatment under Article 266,[98] par. 3 of the Revised Penal Code.It was beyond reasonable doubt that by
hitting Piamonte, appellant ill-treated the latter, without causing any injury. As we have earlier stated, no proof of injury
was offered. Maltreatment is necessarily included in Murder, which is the offense charged in the Information. Thus:

ART. 266. Slight physical injuries and maltreatment. The crime of slight physical injuries shall be
punished:
xxxx
3. By arresto menor in its minimum period or a fine not exceeding 50 pesos when the offender shall ill-
treat another by deed without causing any injury.
The duration of the penalty of arresto menor in its minimum period is 1 day to 10 days.
WHEREFORE, the Decision of the Court of Appeals, dated 21 November 2005, in CA-G.R. CR HC No. 00408
is MODIFIED. Appellant Bernard Mapalo is ACQUITTED of the charge of MURDER for lack of evidence beyond
reasonable doubt. He is found GUILTY of the crime of MALTREATMENT, as defined and punished by Article 266,
par. 3 of the Revised Penal Code. He is accordingly sentenced to suffer the penalty of imprisonment of arresto menor of
10 days. Considering that appellant has been incarcerated since 2004, which is well-beyond the period of the penalty herein
imposed, the Director of the Bureau of Prisons is ordered to cause appellants IMMEDIATE RELEASE, unless appellant
is being lawfully held for another cause, and to inform this Court, within five (5) days from receipt of this Decision, of the
compliance therewith.
[21]
There appears to be a confusion on the date. The incident transpired from the evening of 12 February 1994 to early
morning of 13 February 1994.
56
[57]
People v. Pineda, G.R. No. 141644, 27 May 2004, 429 SCRA 478, 503, citing PATRICK M. WALL, EYE-WITNESS
IDENTIFICACATION IN CRIMINAL CASES 74 (1965), thus:

A well-known authority in eyewitness identification made a list of 12 danger signals that exist independently of the
identification procedures investigators use. These signals give warning that the identification may be erroneous
even though the method used is proper. The list is not exhaustive. The facts of a particular case may contain a
warning not in the list. The list is as follows:

(1) the witness originally stated that he could not identify anyone;
(2) the identifying witness knew the accused before the crime, but made no accusation against him
when questioned by the police;
(3) a serious discrepancy exists between the identifying witness original description and the actual
description of the accused;
(4) before identifying the accused at the trial, the witness erroneously identified some other person;
(5) other witnesses to the crime fail to identify the accused;
(6) before trial, the witness sees the accused but fails to identify him;
(7) before the commission of the crime, the witness had limited opportunity to see the accused;
(8) the witness and the person identified are of different racial groups;
(9) during his original observation of the perpetrator of the crime, the witness was unaware that a
crime was involved;
(10) a considerable time elapsed between the witness view of the criminal and his identification of
the accused;
(11) several persons committed the crime; and
(12) the witness fails to make a positive trial identification.
[78]
We quote with approval the following observation made by the Court of Appeals, to wit:
The prosecutions sole eyewitness was incapable, or for some reason reticent, to identify who inflicted the fatal stab
wounds. He also failed to describe the particular acts that caused the victim to sustain the stab
wounds that were the proximate cause of his death. In fact, by his own admission, he had concluded
that the victim was stabbed several times because he saw the stab wounds after the killing occurred,
when the victim was already dead. (Rollo, p. 7.)
[79]
Records, p. 386.
[80]
People v. Bisda, 454 Phil. 194, 217-218 (2003).
[81]
Id. at 218.
[82]
Id. at 217.
[83]
People v. Garalde, 401 Phil. 174, 213 (2000).
[84]
People v. Garillo, 446 Phil. 163, 180 (2003).
[85]
People v. Duma, 230 Phil. 1, 17 (1986).
[86]
People v. Macatana, G.R. No. L-57061, 9 May 1988, 161 SCRA 235, 240.
[87]
G.R. No. 127962, 14 April 2004, 427 SCRA 217.
[88]
Id. at 235-236.
[89]
Records, p. 4.
[90]
Blood loss; See Harrisons Principles of Internal Medicine, (12th Ed., 1991), p. 233.
[91]
TSN, 15 July 1996, pp. 14-15; TSN, 9 October 1996, p. 6.
[92]
While it appears that 2nd Assistant Provincial Prosecutor Gloria D. Catbagan of the Office of the Provincial Prosecutor
in Agoo, La Union sent a Letter of Request to the Branch Clerk of Court, RTC, Branch 32 of Agoo, La Union that
a subpoena be issued to Dr. Armando Avena of RHU, Aringay La Union to bring the death certificate of the
deceased Piamonte and to testify thereon on 23 April 1998, nothing appears on record with regard to the testimony
or the appearance of the aforesaid Dr. Armando Avena in court.; See Records, p. 205.
[93]
People v. Catbagan, G.R. Nos. 149430-32, 23 February 2004, 423 SCRA 535, 566.
[94]
Id.
[95]
People v. Caballero, 448 Phil. 514, 534 (2003).
[96]
TSN, 15 July 1996, p. 14.
[97]
Supra note 91 at 566.
[98]
Art. 266 of the Revised Penal Code, provides:
ART. 266. Slight physical injuries and maltreatment. The crime of slight physical injuries shall be
punished:
1. By arresto menor when the offender has inflicted physical injuries which shall incapacitate the offended
party for labor from one to nine days, or shall require medical attendance during the same period;
2. By arresto menor or a fine not exceeding 200 pesos and censure when the offender has caused physical
injuries which do not prevent the offended party from engaging in his habitual work nor require medical
attendance.
3.By arresto menor in its minimum period or a fine not exceeding 50 pesos when the offender shall ill-
treat another by deed without causing injury.

Name: MUPAS vs. PEOPLE G.R. No. 172834 February 6, 2008

57
Facts Petitioners JUN and GIL (aka Bajno) MUPAS were found guilty of frustrated homicide in
Criminal Case No. 2314 in the Decision dated 22 November 2002 rendered by the Regional Trial
Court of Malaoan, La Union.

The prosecution presented three witnesses, namely: Rogelio Murao (Rogelio - victim), Flaviano
Murao (Flaviano) and Dr. Arsenio B. Martinez (Dr. Martinez).

Rogelio testified that at around 7:30 in the morning of 18 February 1993, he was walking to school
with his companion Eduardo Murao, Jr. when Jun suddenly stopped and stabbed him using a 29-
inch Batangas knife. Meantime, Banjo bodily restrained him but luckily Rogelio was able to avoid
the blow. Next, Banjo and Jun hurled stones at him and hit him on the leg while Rogelio was
running eastward. Rogelio then flagged down a motorized tricycle but the two assailants continued
to pursue him. While inside the tricycle, Banjo held Rogelio by his neck and punched him while
Jun stabbed him several times. Then, Rogelio alighted from the tricycle and ran home. Afterwards,
his father and mother accompanied him to the hospital. There, Dr. Martinez attended to Rogelio,
and found that the wounds may take TWO WEEKS to HEAL.

Prior to the incident, Rogelio recalled that in January of the same year, he had a misunderstanding
with Jun where he and the latter hurled invectives at each other. Rogelio suspected that this event
gave rise to the subject incident.

Jun and Gil were found guilty as charged and the judgment of conviction was elevated to the Court
of Appeals.

Before the Court of Appeals, Jun and Gil argued that the trial court erred in: (1) finding Gil guilty
of the crime charged despite the prosecutions failure to prove his guilt beyond reasonable doubt;
and (2) finding Jun guilty of the crime of frustrated homicide instead of physical injuries only. The
convictions were however affirmed.
Issue Is the affirmation of the conviction for frustrated homicide proper?
Held/Ratio: No. The trial court solely hinged its judgment of conviction on the victim Rogelios lone and
uncorroborated testimony. While it is true that the testimony of one witness is sufficient to sustain
a conviction if such testimony establishes the guilt of the accused beyond reasonable doubt, the
Court rules in this case that the testimony of one witness in this case is not sufficient for this
purpose. It appears then that Rogelio had at his disposal many witnesses who could have supported
his allegations but curiously and without any explanation, none of these so-called witnesses were
presented. It is thus Rogelios word against the attestations of others. Such omission already raises
a reasonable doubt as to the guilt of the petitioners.

Assuming that Gil alias Banjo had any participation, there is likewise no evidence that he or Jun
had intent to kill Rogelio. Intent to kill is the principal element of homicide or murder, in whatever
stage of commission. Such intent must be proved in a clear and evident manner to exclude every
possible doubt as to the homicidal intent of the aggressor.

Although it can be fairly assumed that the injuries suffered by Rogelio were sustained during the
fistfight, it is not conclusive that the same were inflicted purposely to kill him. For one, if Jun in
fact had been carrying a bolo with intent of killing Rogelio, and if indeed Banjo had conspired
with Jun, it is no small wonder why the wounds inflicted were more superficial than mortal, more
mild than grave.

Taken in its entirety, there is a dearth of medical evidence on record to sustain the claim that
petitioners had any intention to kill Rogelio. When such intent is lacking but wounds were
inflicted, the crime is not frustrated homicide but physical injuries only and in this case, less
serious physical injuries considering the attending physicians opinion that the wounds sustained
by Rogelio would take two (2) weeks to heal.

Name: AGUIRRE vs. SECRETARY OF DOJ G.R. No. 170723 March 3, 2008
Facts On June 11,2002 petitioner Gloria Aguirre instituted a criminal complaint for the violation
of Revised Penal Code particularly Articles 172 and 262, both in relation to Republic Act No.7610
against respondents Pedro Aguirre, Olondriz, Dr. Agatep, Dr. Pascual and several John/Jane Doe
alleging that John/Jane Doe upon the apparent instructions of respondents Michelina Aguirre-
Olondriz and Pedro Aguirre actually scouted, prospected, facilitated solicited and/or procured the
medical services of respondents Dr. Pascual and Dr. Agatep on the intended mutilation via bilateral
vasectomy of Laureano Aguirre.
Olondriz denied that the prospected, scouted, facilitated, solicited and/or procured any false
statement mutilated or abused his common law brother, Laureano Aguirre. She further contends that

58
 his common law brother went through a vasectomy procedure but that does not amount to
mutilation.
Dr. Agatep contends that the complainant has no legal personality to file a case since she is
only a common law sister of Larry who has a legal guardian in the person of Pedro Aguirre. He
further contends that Vasectomy does not in any way equate to castration and what is touched in
vasectomy is not considered an organ in the context of law and medicine.
The Assistant City Prosecutor held that the facts alleged did not amount to mutilation, the
vasectomy operation did not deprived Larry of his reproductive organ.
Gloria Aguirre then appealed to the Secretary of the DOJ but Chief State Prosecutor
dismissed the petition stating that the Secretary of Justice may motu propio dismiss outright the
petition if there is no showing of any reversible error in the questioned resolution.
Issue Whether or not the respondents are liable for the crime of mutilation
Held/Ratio: No, the court held that Article 262 of the Revised Penal Code provides that
Art. 262. Mutilation. The penalty of reclusion temporal to reclusion perpetua shall be imposed
upon any person who shall intentionally mutilate another by depriving him, either totally or
partially, of some essential organ for reproduction.Any other intentional mutilation shall be
punished by prision mayor in its medium and maximum periods.A straightforward scrutiny of the
above provision shows that the elements [55] of mutilation under the first paragraph of Art. 262 of
the Revised Penal Code to be 1) that there be a castration, that is, mutilation of organs necessary for
generation; and 2) that the mutilation is caused purposely and deliberately, that is, to deprive the
offended party of some essential organ for reproduction. According to the public prosecutor, the
facts alleged did not amount to the crime of mutilation as defined and penalized above, i.e.,
[t]he vasectomy operation did not in any way deprived (sic) Larry of his reproductive organ,
which is still very much part of his physical self.
Doctrine DETERMINATION OF PROBABLE CAUSE SUBJECT TO JUDICIAL REVIEW

Name: PENTECOSTES, JR. vs PEOPLE OF THE PHILIPPINES G.R. No. 167766 April 7, 2010
Facts 1. On September 2, 1998, Rudy Baclig was drinking with his brother-in-law. After consuming
bottle of gin, he left and went to buy coffee and sugar with his 4 year-old son.
2. On their way there, a gray automobile passed by them. After a while, the vehicle was moving
backward towards them. When the car was about 2 armslength from where they were, it stopped
and he heard the driver call him by his nickname Parrod.
3. Rudy came closer, but after taking one step, the driver, which he identified as the petitioner,
opened the door and while still in the car drew a gun and shot him once, hitting him just below
the left armpit. Rudy immediately ran at the back of the car, while petitioner sped away.
4. After petitioner left, Rudy and his son headed to the seashore. Rudy later went back to the place
where he was shot and shouted for help.
5. The people who assisted him initially brought him to the Municipal Hall of Gonzaga where he
was interrogated by a policeman to identify the assailant. He informed the policeman that
petitioner was the one who shot him. After he was interrogated, he was later brought to
the Don Alfonso Ponce Memorial Hospital at Gonzaga, Cagayan. The following day, he was
discharged from the hospital.
6. An information was filed by the Provincial Prosecutor of Aparri, Cagayan, charging the
petitioner of frustrated murder.
RTC: found petitioner guilty of the crime of attempted murder.
CA: Pentecostes is only found GUILTY OF LESS SERIOUS PHYSICAL INJURIES.
Issue WON the petitioner should be held liable for less serious physical injuries and not attempted murder.
Held/Ratio: YES, The Court concurs with the conclusion of the CA that petitioner is guilty of the crime of less serious
physical injuries, not attempted murder.
RATIO:
The principal and essential element of attempted or frustrated murder is the intent on the part of
the assailant to take the life of the person attacked. Such intent must be proved in a clear and evident
manner to exclude every possible doubt as to the homicidal intent of the aggressor.
In the present case, intent to kill the victim could not be inferred from the surrounding
circumstances. Petitioner only shot the victim once and did not hit any vital part. If he intended to kill
him, petitioner could have shot the victim multiple times or even ran him over with the car of the latters
body. . Favorably to petitioner, the inference that intent to kill existed should not be drawn in the absence
of circumstances sufficient to prove this fact beyond reasonable doubt.
When such intent is lacking but wounds are inflicted upon the victim, the crime is not attempted
murder but physical injuries only. Since the Medico-Legal Certificate issued by the doctor who
attended Rudy stated that the wound would only require ten (10) days of medical attendance, and he was,
in fact, discharged the following day, the crime committed is less serious physical injuries only. The less
serious physical injury suffered by Rudy is defined under Article 265 of the Revised Penal Code, which
provides that "(A)ny person who inflicts upon another physical injuries not described as serious physical
injuries but which shall incapacitate the offended party for labor for ten (10) days or more, or shall require

59
 medical attendance for the same period, shall be guilty of less serious physical injuries and shall suffer
the penalty of arresto mayor."

Name: THE PEOPLE vs. OCAYA G.R. No. L-47448 May 17, 1978
Facts The Office of the Provincial Fiscal filed an information in the court of Hon. Ocaya charging
Esterlina Marapao, Letitia Marapao, and Diosdado Marapao of the crime of serious physical
injuries.
Records show that neither the arraignment nor the trial was made on merit and no warrats of arrest
were issued. Instead, the respondent judge held that the respondents should be charged of either
slight or less serious physical injuries only. This is so, even if the affidavits show that Lolita Ares,
the victim, was incapacitated for more than 30 days and a scar was left on her face, deforming it.
Hon. Ocaya, motu proprio, ordered the dismissal of the case since the crime or slight or less physical
injuries is not within the jurisdiction of the court.
The fiscals motion for reconsideration was denied by Hon. Ocaya. Accordingly, the respondent
judge evaluated the case without hearing the parties nor the witnesses, nor having received their
evidence, as well as ruling against the deformity on the basis of the medical certificate.
The Provincial Fiscal then filed the petition at bar for the nullification of Hon. Ocayas orders.
Issue Whether Hon. Oaya acted with grave abuse of discretion for dismissing the case for lack of
jurisdiction.
Held/Ratio: The orders of the respondent judge was held NULL & VOID.
The jurisdiction of the court in a criminal case is determined by the allegations in the
information or criminal complaint, and not by the result of the evidence presented at the trial, nor
the trial judges personal appraisal of the affidavits and exhibits without hearing the parties and
their witnesses. Moreover, once jurisdiction has attached to the person and subject-matter, the
subsequent happening of events, though it may have prevented jurisdiction from attaching in the
first instance, will not divest the court of jurisdiction already attached.

Name: BONGALON vs. PEOPLE OF THE PHILIPPINES G.R. No. 169533 March 20, 2013
Facts Bongalon was charged for the crime of child abuse under Sec. 10 (a) of RA 7610. Bongalon allegedly
physically abused and/or maltreated Jayson (12 years old) with his palm hitting the latter at his back and
by slapping said minor hitting his left check and uttering derogatory remarks to the latters family. On
his part, Bongalon denied having physically abused or maltreated Jayson but only confronted him when
the latter threw stones at her daughters, calling them as Kimi and for burning one of his daughters
hair. Both the RTC and CA held Bongalon guilty of child abuse.
Issue Whether or not the acts of Bongalon constituted child abuse within the purview RA 7610.
Held/Ratio: NO. Sec 10 (a), Art. VI of RA 7610 under which Bongalon was charged states:
Sec. 10. Other Acts of Neglect, Abuse, Cruelty or Exploitation and other Conditions Prejducial to the
Childs Development (a) Any person who shall commit any other acts of child abuse, cruelty or
exploitation or be responsible for other conditions prejudicial to the childs development including those
covered by Art. 59 of PD 603, as amended, but not covered by the RPC, as amended, shall suffer the
penalty of prision mayor in its minimum period.
Child abuse, on the other hand, is defined by Sec. 3 (b) as maltreatment, whether habitual or not,
of the child which includes:x x x
(2.) Any acts by deeds or words which debases, degrades, or demeans the intrinsic worth and dignity of
a child as a human being;x x x
Not every instance of the laying of hands on a child constitutes child abuse. Only when the
laying of hands is shown beyond reasonable doubt to be intended by the accused to debase,
degrade, or demean the intrinsic worth and dignity of the child as a human being should it be
punished as child abuse. Otherwise, it is punished under RPC. In this case, the records showed that the
laying of hands on Jayson have been done at the spur of the moment and in anger, indicative of his being
overwhelmed by his fatherly concern for the personal safety of his own minor daughters who had just
suffered harm at the hands of Jayson and his companion. With the loss of his self-control, he lacked the
specific intent to debase, degrade, or demean the intrinsic worth and dignity of the child as a human
being that was so essential in the crime of child abuse. However, considering that Jayson suffered
physical injury requiring five to seven days of medical attention, Bongalon is liable for slight physical
injuries under Art. 266 (1) of the RPC.

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SUBJECT OUTLINE BY Atty.Judy Anne Yuki Yulo