Ramos v.

CA, DSMC
G.R. No. 124354
December 29, 1999

KAPUNAN, J.:

STATEMENT OF THE FACTS:

Erlinda Ramos (Erlinda) was a robust woman, except for the discomfort caused by a stone in the
bladder. She is married to Rogelio Ramos (Rogelio). Through the intercession of a mutual friend,
Dr. Buenviaje (Buenviaje) referred them to Dr. Orlino Hosaka (Hosaka) and they agreed to
undergo a cholecystectomy in De Los Santos Medical Center (DSMC). Dr. Hosaka promised that
he would choose a good anesthesiologist.
On the day of the operation, Hermind Cruz, Erlindas sister-in-law, was there for moral support
and saw 2-3 nurses and Dr. Perfecta Gutierrez (Gutierrez) as the anesthesiologist. Dr. Hosaka
arrived 3hrs late from the agreed time of the operation, and proceeded regardless of being late.
There was a complication in the intubation of Erlinda whereby Dr. Gutierrez even commented
ang hirap ma-intubate nito, mali yata ang pagkakapasok. O lumalaki ang tiyan. Dr. Hosaka then
called for Dr. Calderon (Calderon) who then immediately reported in. Calderon informed Rogelio
what was happening and then proceeded to intubate Erlinda.
2 day after the operation, Dr. Hosaka informed Rogelio on what happened. Rogelio reminded
the doctor that this incident would not have happened had Dr. Hosaka found a good
anesthesiologist.
4 months after the operation Erlinda was released from the hospital, and during such time she
was merely living in mechanical means as she had suffered brain damage. Two ideas were
presented as to the cause of the brain damage, one being due to the lack of oxygen due to
improper intubation, and the other was due to the allergic reation of Erlinda to the anesthetic
aganet, Thiopental Sodium (Pentothal).

STATEMENT OF THE CASE:

Petitioners filed a case before the RTC of Quezon City against private respondents alleging
negligence in the management and care of Erlinda Ramos. RTC then rule in favor or petitioners.
The case was appealed to the CA who then reversed the decision of the RTC.

ISSUE:
1.) Whether Dr. Hosaka and Dr. Gutierrez were negligent and are solidarily liable for
the damages.

RULING:
YES, under the principle of Res Ipsa Loquitur.

Res ipsa loquitur is a Latin phrase which literally means the thing or the transaction
speaks for itself. The phrase res ipsa loquitur is a maxim for the rule that the fact of the
occurrence of an injury, taken with the surrounding circumstances, may permit an inference or
raise a presumption of negligence, or make out a plaintiffs prima facie case, and present a
question of fact for defendant to meet with an explanation.
Before resort to the doctrine may be allowed, the following requisites must be satisfactorily
shown:
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; and
3. The possibility of contributing conduct which would make the plaintiff responsible is
eliminated.[

In the above requisites, the fundamental element is the control of the instrumentality
which caused the damage. Such element of control must be shown to be within the dominion of
the defendant. In order to have the benefit of the rule, a plaintiff, in addition to proving injury or
damage, must show a situation where it is applicable, and must establish that the essential
elements of the doctrine were present in a particular incident. Considering that a sound and
unaffected member of the body (the brain) is injured or destroyed while the patient is
unconscious and under the immediate and exclusive control of the physicians, we hold that a
practical administration of justice dictates the application of res ipsa loquitur.

Furthermore under the principle captain of the ship it is the surgeons responsibility to
see to it that those under him perform their task in the proper manner. Respondent Dr. Hosakas
negligence can be found in his failure to exercise the proper authority (as the captain of the
operative team) in not determining if his anesthesiologist observed proper anesthesia
protocols. In fact, no evidence on record exists to show that respondent Dr. Hosaka verified if
respondent Dra. Gutierrez properly intubated the patient.Furthermore, it does not escape us
that respondent Dr. Hosaka had scheduled another procedure in a different hospital at the same
time as Erlindas cholecystectomy, and was in fact over three hours late for the latters
operation. Because of this, he had little or no time to confer with his anesthesiologist regarding
the anesthesia delivery. This indicates that he was remiss in his professional duties towards his
patient.Thus, he shares equal responsibility for the events which resulted in Erlindas condition.