Case Name: Reyes v.

Sisters of Mercy Hospital By: John Paumig

GR No. 130547 Topic: Medical Malpractice
Date: October 3, 2000

FACTS
Leah Alesna Reyes was the wife of the deceased Jorge Reyes who was diagnosed with Typhoid by Dr. Maryln Rico at
the Mercy Community Clinic
Before seeking professional help, Jorge had been doing home medication since he was suffering from a recurring
fever. When his condition did not do any better, he was taken to the Mercy Community Clinic by his wife, herein
petitioner. (Leah Reyes)
Dr. Marlyn Rico conducted a Widal Test since she surmised that the area had been getting from 15 to 20 cases of
typhoid fever. Jorge was found positive for typhoid. Dr. Rico then indorsed him to Dr. Marvie Blanes when her shift
ended. Dr. Blanes also had the same diagnosis as Dr. Rico, that Jorge is suffering from typhoid fever.
Dr. Blanes ordered the administration of chloromycetin (drug used for typhoid cases); this was administered by nurse
Josephine Pagente.
Jorges condition did not improve and continued to worsen. Eventually, he died. Cause of death was Ventricular
Arrythemia Secondary to Hyperpyrexia and typhoid fever.
Petitioner Reyes was prompted to file a case against Sisters of Mercy, Sister Rose Palacio, Dr. Blanes, Dr. Rico and
Nurse Pagente. The complaint was amended to implead Mercy Community Clinic and to remove Nurse Pagente.
Petitioners Argument:
Jorge did not simply die of typhoid fever but his death was due to wrongful administration of chloromycetin.
Had respondent doctors exercised due care and diligence, they would not have recommended and rushed the
performance of the Widal Test; hastily concluded that Jorge had been suffering from typhoid without checking the
compatibility of the drug to the patient.
The Clinic and its directress, Sister Rose Palacio, was negligent in failing to provide adequate facilities and in
hiring negligent doctors and nurses.
These were all denied by the respondents.
ISSUE
W/N Jorges death was due to negligence, carelessness, imprudence, and lack of skill or foresight

HELD
SUPREME COURT held that there was no liability on the part of the doctors (Dr. Rico, and Dr. Blanes), nurse Pagente, and
Mercy Community Clinic in the performance of their duties in taking care of the patient (Jorge Reyes).

ARGUMENTS
Petitioner presented the testimony of Dr. Apolinar Valcares, as expert testimony, which states that Jorge did not die of
typhoid fever. Even stated that, he had not seen a patient die of typhoid fever within five days from onset of the disease.
(Dr. Valcares did not examine the brain of the patient)
Respondent presented the testimonies of Dr. Peter Gotiong and Dr. Ibarra Ponopio, as expert testimonies. Dr. Gotiong
stated that according to the patients history and positive Widal Test results, Jorge indeed had typhoid fever. The
gastrointestinal tract of the patient is irrelevant as the toxic effect of typhoid fever may be microscopic and that instead
Dr. Valcares should have examined the brain of the patient in his autopsy as typhoid fever may lead to meningitis. As
such, the autopsy of the patient was incomplete and inconclusive. Dr. Ponopio stated that Widal Test had been used in
the industry for its greater reliability that other tests, and he agreed with Dr. Gotiong.

RULING
RTC: Absolved RESPONDENTS from charges of negligence and dismissing the complaint
CA: Affirmed the ruling of RTC
SUPREME COURT:
Jorges death was not due to negligence, carelessness, imprudence, and lack of skill or foresight
While it is true that Jorge died a couple of hours after professional medical assistance was administered, there
was nothing extraordinary with his death.
It was established that prior to his admission, he had been suffering from recurring fevers and chills for FIVE
days. As such, this shows that he had been suffering from a serious illness and professional medical help came
too late for him.
Respondent doctors and clinics alleged failure to observe due care was not immediately apparent to a layman as
to justify the application of res ipsa loquitur.
Dr. Ricos diagnosis had no presumption of negligence. Dr. Rico is not bound to explain why any particular
diagnosis is not correct.
Dr. Valcares testimony as an expert witness is not reliable as the court found that he is not a specialist on
infectious diseases like typhoid fever. He even admitted that he had yet to conduct an autopsy of typhoid victims
 at the time he conducted the autopsy on Jorges body.
Dr. Rico is correct in recommending the administration of the drug choloromycetin nor was Dr. Blanes was
incorrect in ordering the drugs administration.
As regards to the claim of anaphylactic shock, the law cannot require the respondents to predict every possible
reaction to all drugs administered to a patient. As such, it would not yet establish the negligence of the physicians
in question.
As for the degree of diligence, 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. The standard contemplated for doctors is simply the reasonable average merit among
ordinarily good physicians. That is reasonable diligence for doctors or, the reasonable skill and competence that a
physician in the same or similar locality should apply.
Doctrine Notes
Action for 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 have done, or that he or she did something
that a reasonably prudent physician or surgeon would not have done, and
that the failure or action caused injury to the patient.

Elements of Medical Negligence Cases:

1. Duty duty of the physician or surgeon in taking care of the
patient (patient-physician relationship)
2. Breach failure to do something which a reasonably prudent
physician or surgeon would have done
3. Injury damage sustained by the patient due to physician or
surgeons failure
4. Proximate Causation cause of injury is due to the failure of the
physician or surgeon

Res Ipsa Loquitor; when may be dispensed with

General Rule: (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) 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. This is because 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.
Courts Duty: 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.
The patient must: 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.
Res ipsa loquitur is generally restricted to situations in malpractice cases
where a layman is able to say that the consequences of professional care
were not as such as would ordinarily have followed if due care had been
exercised. It has no application in a suit against a physician or a surgeon
which involves the merits of a diagnosis or of a scientific treatment. The
physician or surgeon is not required at his peril to explain why any
particular diagnosis was not correct, or why any particular scientific
treatment did not produce the desired result.