Dr. Ninevetch Cruz v.

CA
G.R. No. 122445
November 18, 1997

FRANCISCO, J.:

STATEMENTS OF THE FACTS:

Rowena Umali de Ocampo (Rowena) accompanied her mother to the Perpetual Help
Clinic and General Hospital in San Pablo City to have her examined. It was found out that her
mother, Lydia de Ocampo (Lydia), had myoma in her uterus and was scheduled for a
hysterectomy operation. Rowena and her mother slept in the clinic to await the operation the
next day. Rowena noticed that the clinic was untidy and the floor and windows very dusty, she
thus tried to convince her mother to transfer hospitals to which the latter refused.
The operation proceeded and during which Rowena was tasked by Dr. Lina Ercillo
(Ercillo) to get additional blood packs and Tagamet ampules to which she immediately procured.
After the operation, additional blood and oxygen tank were required. The procurement of the
oxygen tank was too late and Rowenas mother was put into shock. Lydia had to be transferred
to a better hospital, and was done so without notice and consent to Rowena.
When Lydia was wheeled into the operating room of San Pablo District Hospital, Dr.
Bartolome Angeles (Angeles) arrived upon call and saw that Lydia has blood coming out rom her
abdominal incision and saw that she was in shock and that her blood pressure was already at
0/0. Dr. Angeles informed Dr. Ercillo and Rowena that it was too late and that there was nothing
he could to save the patient. A death certificate was issued which stated that the immediate
cause of death was Disseminated Intravascular Coagulation DIC as the antecedent cause.

STATEMENT OF THE CASE:

A case was filed before the MTCC of San Pablo City against Dr. Ercillo for reckless
imprudence and negligence resulting to homicide. The MTCC ruled Dr. Ercillo not guilty, while
the co-accused Dr. Cruz was held responsible for the death of Lydia Umali and was thus guilty of
Art. 365 of the RPC.
Cruz Appealed before the RTC which affirmed in toto the decision of the MTCC. Cruz
appealed before the CA who upheld the decision of the RTC wit modification to the damages.
Hence the petition before the SC.

ISSUE:
Whether or not there was any reckless imprudence on the part of Dra. Cruz resulting
to the death of Lydia

RULING:
No, In litigations involving medical negligence, the plaintiff has the burden of
establishing appellant's negligence and for a reasonable conclusion of negligence, there must be
proof of breach of duty on the part of the surgeon as well as a casual connection of such breach
and the resulting death of his patient.

All three courts below bewail the inadequacy of the facilities of the clinic and its untidiness; the
lack of provisions such as blood, oxygen, and certain medicines; the failure to subject the patient
to a cardio-pulmonary test prior to the operation; the omission of any form of blood typing
before transfusion; and even the subsequent transfer of Lydia to the San Pablo Hospital and the
reoperation performed on her by the petitioner. But while it may be true that the circumstances
pointed out by the courts below seemed beyond cavil to constitute reckless imprudence on the
part of the surgeon, this conclusion is still best arrived at not through the educated surmises nor
conjectures of laymen, including judges, but by the unquestionable knowledge of expert
witnesses. For whether a physician or surgeon has exercised the requisite degree of skill and care
in the treatment of his patient is, in the generality of cases, a matter of expert opinion. For
whether a physician or surgeon has exercised the requisite degree of skill and care in the
treatment of his patient is, in the generality of cases, a matter of expert opinion. The deference
of courts to the expert opinion of qualified physicians stems from its realization that the latter
possess unusual technical skills which laymen in most instances are incapable of intelligently
evaluating. Expert testimony should have been offered to prove that the circumstances cited by
the courts below are constitutive of conduct falling below the standard of care employed by
other physicians in good standing when performing the same operation.

One cannot merely rely on the statements of a layman, but instead depend on the
opinion of expert witnesses to which all advised that it was highly improbable that it was the
fault of Dra. Cruz since the doctors who examined the autopsy had seen that all the sutures were
closed, and this was the only possible source of fault of the surgeon. Being closed, the surgeon
properly performed his duties to his patient. The other cause was hemorrhage which cannot be
prevented, as stated by multiple expert witnesses.