1. DELA TORRE VS IMBUIDO (GR NO. 192973 by a medical professional which has caused bodily harm.
SEPTEMBER 29, 2014) In order to successfully pursue such a claim, a patient, or
Dela Torre vs Imbuido
GR No. 192973 September 29, 2014
Facts: At around 3:00pm of February 3, 1992, Carmen
was brought to Divine Spirit General Hospital’s 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 wife’s 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
Carmen’s stomach was getting bigger, but Dr. Norma
dismissed the patient’s condition as mere fratulence.
When Carmen’s 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 Carmen’s 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 Carmen’s 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 Carmen’s death.
Held: 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
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. Partilano’s report,
it was necessary to show first Dr. Partilano’s
specialization and competence to testify on the degree
of care, skill and diligence needed for the treatment of
Carmen’s case. Considering that it was not duly
established that Dr. Partilano practiced and was an
expert on the fields that involved Carmen’s condition, he
could not have accurately identified the said degree of
care, skill and diligence and the medical procedure, that
should have been applied.
ALANO VS LOGMAO (GR NO. 175540 APRIL 7, 2014)
Alano vs Magud-Logmao
GR No. 1755540 April 7, 2014
Facts:
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 Farmer’s Market in Cubao, Quezon City. The patient’s
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 patient’s 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. Lugmoso’s 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 Lugmoso’s 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 nor
second to show that respondent’s emotional suffering at
the sight of the pitful state in which she found her son’s
lifeless body be categorically attributed to petitioner’s
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
son’s death because the notices did not properly state
the name or identity of the deceased, fault cannot be laid
at petitioner’s door. The trial and appellate courts found
that it was the EAMC, who recorded the wrong
information regarding the deceased’s 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.
BONDOC VS MANTALA (GR NO. 203080 NOVEMBER 12,
2014)
Bondoc vs Mantala
GR No. 203080 November 12, 2014
Facts:
Respondent was admitted at the Oriental Mindoro
Provincial Hospital (OMPH) on April 3, 2009, at around
11:00am, with referral from the Bansud Municipal Health
Office. She was due to deliver her 5th child and was
advised for a caesarian section because her baby was big
and there was excessive amniotic fluid in her womb. She
started to labor at 7:00am and was initially brought to
the Bongabon Health Center. However, said health
center also told her to proceed directly to the hospital. In
her complaint-affidavit, respondent alleged that inside
the delivery room of OMPH, she was attended to by
petitioner who instructed the midwife and two younger
assistants to press down on respondent’s abdomen and
even demonstrated to them how to insert their fingers
into her vagina. Thereafter, petitioner went out of the
delivery room and later, his assistants also left. After
hours of being in labor, respondent pleaded for a
caesarian section. The midwife and the younger
assistants pressed down on her abdomen causing
excruciating pains on her ribs and made her very weak.
They repeatedly did this pressing until the bay and
placenta came out. When she regained consciousness,
she was already at the recovery room, she learned that
an operation was performed on her by petitioner to
removed her ruptured uterus but what depressed her
most was her stillborn baby and the loss of her
reproductive capacity. The respondent noticed that her
vulva swollen and there is an open wound which
widened later on and was re-stitched by petitioner.
Petitioner was heard uttering words unbecoming of his
profession pertaining to the respondent’s states while in
labor. Respondent filed then a complaint for grave
misconduct against the petitioner before the
ombudsman. The petitioner resigned as medical officer
of OMPH, alleging that the complaint against him is now
moot and academic.
Issue:
Whether or not petitioner’s conduct during the delivery
of respondent’s baby constitute grave misconduct.
Held:
Yes. Misconduct is defined as a transgression of some
established and definite rule of action, more particularly
unlawful behavior or gross negligence by a public officer,
a forbidden act, a dereliction of duty, willful in character,
and implies wrongful intent and not mere error in
judgement. It generally means wrongful, improper or
unlawful conduct motivated by a premeditated,
obstinate or intentional purpose. The term, however
does not necessarily imply corruption or criminal intent.
To constitute an administrative offense, misconduct
should relate to or be connected with the performance
of the official functions and duties of a public officer. On
the other hand, when the elements of corruption, clear
intent to violate the law or flagrant disregard of
established rule are manifest, the public officer shall be
liable for grave misconduct.
In deliberately leaving the respondent to a midwife and
two inexperienced assistants despite knowing that she
was under prolonged painful labor and about to give
birth to a macrosomic baby by vaginal delivery,
petitioner clearly committed a dereliction of duty and a
breach of his professional obligations. The gravity of
respondent’s conditions is highlighted by the expected
complications she suffered – her stillborn baby, a
ruptured uterus that necessitated the immediate surgery
and blood transfusion and vulvar hematomas.
Article II section 1 of the code of medical ethics of the
medical profession in the Philippines states: A physician,
should attend to his patients faithfully and
conscientiously. He should secure fore them all possible
benefits that may depend upon his professional skill and
care. As the sole tribunal to adjudge the physician’s
failure to fulfill his obligation to his patient is, in most
cases, his own conscience, violation of this rule on his
part is discreditable and inexcusable.
A doctor’s duty to his patient is not required to be
extraordinary. The standard contemplated for doctors is
simply the reasonable coverage merit among ordinarily
good physicians i.e. reasonable skill and competence.
Even by this standard, petitioner fill short when he
routinely delegated an important task that requires his
professional skill and competence to his subordinates
who have no requisite training and capability to make
crucial decisions in difficult child births.
A physician should be dedicated to provide competent
medical care with full professional skill and accordance
with the current standards of care, compassion,
independence, and respect for human dignity.
BONTILAO VS GERONA (GR NO. 176675 SEPTEMBER 15,
2010)
Bontilao vs Gerona
GR No. 176675 September 15, 2010
Facts:
On December 28, 1991, respondent Dr. Carlos Gerona,
an orthopedic surgeon at the Vicente Gullas Memorial
Hospital, treated petitioner’s son, 8 y/o Allen Roy
Bontilao, for a fractured right wrist. Respondent
administered a “U-spint” and immobilized Allen’s wrist
with a cast, then sent Allen home. On June 4, 1992, Alen
re-fractured the same wrist and was brought back to the
hospital. The x-ray examination showed a complete
fractured and displacement bone, with the fragments
overlapping each other. Respondent performed a closed
reduction procedure, with Dr. Vicente Jabagat as the
anesthesiologist. Then he placed Allen’s arm in a plaster
cast to immobilize it. He allowed Allen to go home after
the post reduction x-ray showed that the bones were
properly aligned, but advised Allen’s mother, petitioner
Sherlina Bontilao, to bring Allen back for re-tightening of
the cast not later than June 15, 1992. Allen was however,
only brought back after the said date. By then, because
the cast had not be re-tightened, a rotational deformity
had developed in Allen’s arm. The x-ray examination
showed that the deformity was caused by a re-
displacement of the bone fragments, so it was agreed
that an open reduction surgery will be conducted on June
24, 1992 by the respondent, again with Dr. Jabagat as the
anesthesiologist. On the said date, Sherlina was allowed
to observe the operation behind a glass panel. Dr.
Jabagat failed to intubate the patient after 5 attempts so
anesthesia was administered through a gas mask.
Respondent asked Dr. Jabagat if the operation should be
postponed given the failure to intubate, but Dr. Jabagat
said that it was alright to proceed. Respondent verified
that Allen was breathing properly before proceeding
with the surgery. As respondent was about to finish the
suturing, Sherlina decided to go out of the operating
room to make a telephone call and wait for her son.
Later, she was informed that her son died on the
operating table. The cause of death was asphyxia due to
the congestion and edema of the epiglottis. Hence, a
criminal, administrative and civil case was filed by the
parents of Allen against the doctors for the negligence
that caused Allen’s death.
Issue:
Whether or not respondent is liable for medical
negligence due to the death of Allen.
Held:
No. The trial court erred in applying the doctrine of res
ipsa liquitor to pin liability on respondent for Allen’s
death. Res ipsa liquitor is a rebuttable presumption or
influence that the defendant was negligent. The
presumption only arises upon proof that the
instrumentality causing injury was in the defendant’s
exclusive control, and that the accident was one which
ordinarily does not happen in the absence of negligence.
It is a rule of evidence whereby negligence of the alleged
wrong does may be inferred from the mere fact that the
accident happened, provided that the character of the
accident and circumstances attending it lead reasonably
to the belief that in the absence of negligence it would
not have occurred and that the thing which caused injury
is shown to have been under the management and
control of the alleged wrong doer.
Res ipsa liquitor is not a rigid or ordinary doctrine to be
perfunctorily used but a rule to be cautiously applied
defending upon the circumstances of each case. In
malpractice case, the doctrine is generally restricted to
situations where a layman is able to say, as a matter of
common knowledge and observation, that the
consequence of professional care were not as such as
would ordinarily have followed if due care had been
exercised.
Moreover, we note that in the instant case, the
instrument which caused the injury or damage was not
even within respondent’s exclusive control and
management as Dr. Jabagat was exclusively in control
and management of the anesthesia and endotracheal
tube. The doctrine of res ipsa liquitor allows the mere
existence of an injury to justify a presumption of
negligence or 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 someone’s
negligence;
2. It is caused by an instrumentality within the
exclusive control of the defendant or co-
defendants;
3. The possibility of contributing conduct which
would make the plaintiff responsible is
eliminated.
GR No. 191225 October 13, 2014
Zarsona Medical Clinic (ZMC) v Philippine Health
Insurance Corporation
FACTS:
Philhealth filed a claim against ZMC for violation of
Section 149 of the Revised Implementing Rules and
Regulations of Republic Act No. 7875 the National Health
Insurance Act of 1995 particularly Section 149 thereof
which penalizes any health care provider that increases
the period of actual confinement of any patient with
revocation of accreditation. The case is based on the fact
that ZMC made a claim to Philhealth for the confinement
of Lorna M. Alestre (Alestre) from 6-12 August 2003.
However, in the latter’s salaysay it was stated that her
actual confinement was only from 10-11 August 2003.
The defense of ZMC was that Midwife/Clerk Jennifer R.
Acuram commited an honest mistake in writing 6-12
August 2003 when it should onle be 10-12 August 2003.
Furthermore, ZMC provided an affidavit of explanation
by Alestre wherein she admitted that despite being
confined in the hospital, she was able to log in in the
school (where she was working) on August 12, 2003.
ISSUE: WON ZMC extended the period of confinement
punishable under Section 149 of the Revised
Implementing Rules and Regulations of RA 7875.
LAW: Section 149. Extending Period of Confinement. —
This is committed by any health care provider who, for
the purpose of claiming payment from the NHIP, files a
claim with extended period of confinement
a. Increasing the actual confinement of any patient;
b. Continuously charting entries in the Doctor's
Order, Nurse's Notes and Observation despite
actual discharge or absence of the patients;
c. Using such other machinations that would result
in the unnecessary extension of confinement.
The foregoing offenses shall be penalized by revocation
of accreditation. In addition, a recommendation shall be
submitted to the DOH for cancellation of its license, or
accreditation, or clearance to operate, as appropriate.
CASE HISTORY:
Philhealth Arbiter On 12 December 2007, ZMC was found
liable for the charge of “Extending Period of
Confinement” in violation of Section 149 of the Revised
Rules and Regulations of Republic Act No. 7875 and was
meted the penalty of suspension from participating in
the NHIP for a period of three (3) months and a fine of
P10,000.00.
While Health Insurance Arbiter Michael Troy Polintan
considered the admission date of 6 August 2003
reflected in Alestre’s clinical record as a mere clerical
error, he refused to believe Alestre’s claim that she was
discharged only on 12 August 2003 but on that day, she
was travelling back and forth from hospital to the school
where she teaches. The Philhealth Arbiter gave more
evidentiary weight to the signature of Alestre in the
school’s attendance logbook which established the fact
that she reported for work on 12 August 2003.
Philhealth Board of Directors ZMC appealed but on 24
July 2008, the Philhealth Board of Directors (the Board)
issued Philhealth Board Resolution No. 1151, Series of
2008 dismissing the appeal and affirming the 12
December 2007 Decision of the Philhealth Arbiter.
The Board ruled that the contents of the Affidavit of
Explanation dated 3 May 2005 executed by Alestre is
“too good to be true” because “in the first place, she has
stated in detail all her acts from 7:17 a.m. to 8:15 [a.m.],
9:30 [a.m.], 9:50 [a.m.], 12:00 [noon]; 12:55 p.m., 1:30
p.m., 1:50 p.m., 2:15 p.m. and 2:30 p.m. The recollection
of all these times after 22 months is not only fantastic but
likewise incredible.” Moreover, the Board also noted
that Alestre could not possibly be in ZMC and in the
school at the same time on 12 August 2003 while her son
was still confined at the hospital.
Court of Appeals:
On 28 January 2009, the Court of Appeals dismissed the
petition for failure on the part of ZMC to attach a valid
SPA. The appellate court found the SPA defective on the
ground that it does not explicitly authorize Dr. Bragat to
sign and execute the required verification and
certification of non-forum shopping in this case. The
appellate court noted that the powers granted to Dr.
Bragat pertain only to her administrative functions as
Medical Director of ZMC.
ZMC moved for reconsideration but it was denied for lack
of merit on 7 December 2009. In his Dissent, Court of
Appeals Associate Justice Ruben Ayson believed that
ZMC should be given the opportunity to rectify any
defect or infirmity in the petition pursuant to the
preference on liberal construction of the Rules of Court
over strict construction.cralawlawlibrary
RULING OF THE SUPREME COURT: The Philhealth Arbiter
and the Board did not give weight to the Affidavit of
Explanation submitted by the patient herself recanting
her previous statement and categorically stating that she
was discharged only on 12 August 2003.
It is an oft-repeated rule that findings of administrative
agencies are generally accorded not only respect but also
finality when the decision and order are not tainted with
unfairness or arbitrariness that would amount to abuse
of discretion or lack of jurisdiction. The findings of facts
must be respected, so long as they are supported by
substantial evidence even if not overwhelming or
preponderant.20cralawlawlibrary
After an exhaustive review of the records, we find that
this case warrants a departure from said rule.
We are inclined to give more credence to Alestre’s
Affidavit, which is essentially a recantation of her
previous Salaysay, for the following reasons: First,
Alestre has fully explained to our satisfaction why she
initially misdeclared her dates of confinement in ZMC. In
her desire to report and be compensated for one day of
work, Alestre hied back and forth between school and
the hospital. It is difficult to believe that she would risk
her reputation as a public school teacher, as well as
prosecution for violation of civil service rules, to be an
abettor of ZMC. Second, Alestre truly cannot be in two
places at the same time. But her narration clearly
accounts for her whereabouts on 12 August 2003. She
travelled at least 3 times to and from the hospital and
school. She admitted that the school was a mere ten-
minute drive away from the hospital so she can easily
traverse between the two locations. Third, ZMC had in
fact admitted to its error in indicating the dates of
Alestre’s confinement so there is no reason for ZMC to
further conceal the actual days of Alestre’s confinement.
Fourth, the Salaysay is not notarized. While recantation
is frowned upon and hardly given much weight in the
determination of a case, the affidavit is still a notarized
document which carries in its favor the presumption of
regularity with respect to its due execution, and that
there must be clear, convincing and more than merely
preponderant evidence to contradict the same.
Based on the foregoing, the ZMC is not guilty of
extending the period of confinement.
COMMISSIONER OF INTERNAL REVENUE vs. ST. LUKE’S
MEDICAL CENTER, INC.
G.R. No. 195909, September 26, 2012
MANILA DOCTORS HOSPITAL, petitioner, vs. SO UN
CHUA and VICKY TY, respondents.
G.R. No. 150355 | July 31, 2006 (1D)
Facts:
 Respondent Chua, mother of Ty, was admitted to
petitioner hospital for hypertension and diabetes.
 While Chua was confined, another daughter Judith
Chua was admitted for treatment of injuries
sustained after a vehicular accident. Ty shouldered
the hospital bills for the two.
 After Judith was discharged, respondent Chua
remained confined. Ty was able to pay P435,800.00.
The hospital bills eventually totaled P1,075,592.95.
When Ty was unable to pay the bills, the hospital
allegedly pressured her, by cutting off the telephone
line in her room and removing the air-conditioning
unit, television set, and refrigerator, refusing to
render medical attendance and to change the
hospital gown and bed sheets, and barring the
private nurses or midwives from assisting the
patient, to settle the same through the signing of a
promissory note.
 Ty issued postdated checks to pay the note. The
checks bounced. The petitioner alleged that that as
early as one week after respondent Chua had been
admitted to its hospital, Dr. Rody Sy, her attending
physician, had already given instructions for her to
be discharged, but respondents insisted that Chua
remain in confinement.
 It also alleged that Ty voluntarily signed the
agreement that she will pay the bills and that no
undue pressure was exerted by them; and that the
cutting-off of the telephone line and removal of the
air-conditioning unit, television set, and refrigerator
cannot constitute unwarranted actuations, for the
same were resorted to as cost-cutting measures and
to minimize respondents' charges that were already
piling up, especially after respondent Ty refused to
settle the balance notwithstanding frequent
demands. Finally it alleged that this case was
instituted by Ty to provide leverage against the
hospital for filing criminal charges against the latter
for violation of BP 22.
Issue:
Whether or not the hospital is liable for damages
Held: No
 Conclusions are bereft of sound evidentiary basis,
self-serving and uncorroborated as they are
 Indeed the operation of private pay hospitals and
medical clinics is impressed with public interest and
imbued with a heavy social responsibility. But the
hospital is also a business, and, as a business, it has
a right to institute all measures of efficiency
commensurate to the ends for which it is designed,
especially to ensure its economic viability and
survival. And in the legitimate pursuit of economic
considerations, the extent to which the public may
be served and cured is expanded, the pulse and life
of the medical sector quickens, and the
regeneration of the people as a whole becomes
more visibly attainable.
 In the institution of cost-cutting measures, the
hospital has a right to reduce the facilities and
services that are deemed to be non-essential, such
that their reduction or removal would not be
detrimental to the medical condition of the patient.
For the moment, the question to be considered is
whether the subject facilities are indeed non-essential –
the air-conditioner, telephone, television, and
refrigerator – the removal of which would cause the
adverse health effects and emotional trauma the
respondents so claimed.
Corollary to this question is whether the petitioner
observed the diligence of a good father of the family in
the course of ascertaining the possible repercussions of
the removal of the facilities prior to the removal itself
and for a reasonable time thereafter, with a view to
prevent damage.
The evidence in the record firmly establishes that the
staff of the petitioner took proactive steps to inform the
relatives of respondent Chua of the removal of facilities
prior thereto, and to carry out the necessary
precautionary measures to ensure that her health and
well-being would not be adversely affected: as early as
around two weeks after her admission
Authorities, including those of common law origin,
explicitly declare that a patient cannot be detained in a
hospital for non-payment of the hospital bill.
If the patient cannot pay the hospital or physician's bill,
the law provides a remedy for them to pursue, that is, by
filing the necessary suit in court for the recovery of such
fee or bill.
If the patient is prevented from leaving the hospital for
his inability to pay the bill, any person who can act on his
behalf can apply in court for the issuance of the writ of
habeas corpus.
The form of restraint must be total; movement must be
restrained in all directions. If restraint is partial, e.g., in a
particular direction with freedom to proceed in another,
the restraint on the person's liberty is not total.
However, the hospital may legally detain a patient
against his will:
a. when he is a detained or convicted prisoner, or
b. when the patient is suffering from a very
contagious disease where his release will be
prejudicial to public health, or when the patient
is mentally ill such that his release will endanger
public safety,
c. or in other exigent cases as may be provided by
law.
Moreover, under the common law doctrines on tort, it
does not constitute a trespass to the person to
momentarily prevent him from leaving the premises or
any part thereof because he refuses to comply with some
reasonable condition subject to which he entered them.
In all cases, the condition of this kind of restraint must be
reasonable in the light of the circumstances.
At any rate, as stated above, the patient is free to leave
the premises, even in the ostensible violation of these
conditions, after being momentarily interrupted by the
hospital staff for purposes of informing him of those
reasonable conditions, such as the assessment of
whether the patient is fit to leave, insane, or suffering
from a contagious disease, etc., or simply for purposes of
making a demand to settle the bill.
If the patient chooses to abscond or leave without the
consent of the hospital in violation of any of the
conditions deemed to be reasonable under the
circumstances, the hospital may nonetheless register its
protest and may choose to pursue the legal remedies
available under law, provided that the hospital may not
physically detain the patient, unless the case falls under
the exceptions abovestated.
Authorities are of the view that, ordinarily, a hospital,
especially if it is a private pay hospital, is entitled to be
compensated for its services, by either an express or an
implied contract, and if no express contract exists, there
is generally an implied agreement that the patient will
pay the reasonable value of the services rendered; when
a hospital treats a patient's injuries, it has an enforceable
claim for full payment for its services, regardless of the
patient's financial status.
571 SCRA 585 – Labor Law – Labr Relations – Labor
Standards – Strike – Managerial Employees – Control –
Illegal Dismissal
Facts:
Ronaldo Lanzanas and Merceditha Lanzanas are doctors
employed by Calamba Medical Center, Inc. They are
given a retainer’s fee by the hospital as well as shares
from fees obtained from patients.
One time, Ronaldo was overheard by Dr. Trinidad talking
to another doctor about how low the admission rate to
the hospital is. That conversation was reported to Dr.
Desipeda who was then the Medical Director of the
hospital.
Eventually Ronaldo was suspended. Ronaldo filed a case
for Illegal Suspension in March 1998. In the same month,
the rank and file employees organized a strike against the
hospital for unfair labor practices. Desipeda eventually
fired Ronaldo for his alleged participation in the strike,
which is not allowed under the Labor Code for he is a
managerial employee. Desipeda also fired Merceditha on
the ground that she is the wife of Ronaldo who naturally
sympathizes with him.
The Labor Arbiter ruled that there was no Illegal
Suspension for there was no employer-employee
relationship because the hospital has no control over
Ronaldo as he is a doctor who even gets shares from the
hospitals earnings.
The National Labor Relations Commission as well as the
Court of Appeals reversed the LA.
ISSUE:
Whether or not there is an employer-employee
relationship?
HELD:
Yes. Under the control test, an employment relationship
exists between a physician and a hospital if the hospital
controls both the means and the details of the process
by which the physician is to accomplish his task. There is
control in this case because of the fact that Desipeda
schedules the hours of work for Ronaldo and his wife.

The doctors are also registered by the hospital under the

SSS which is premised on an employer-employee
relationship.

There is Illegal Dismissal committed against Rolando for

there was no notice and hearing held. It was never shown
that Rolando joined the strike. But even if he did, he has
the right to do so for he is not a part of the managerial or
supervisory employees. As a doctor, their decisions are
still subject to revocation or revision by Desipeda.

There is Illegal Dismissal committed against Merceditha

for the ground therefor was not mentioned in Article 282
of the Labor Code.

When is Control (One of the Four Tests of Employer-

Employee Relationship) Absent?

Where a person who works for another does so more or

less at his own pleasure and is not subject to definite
hours or conditions of work, and is compensated
according to the result of his efforts and not the amount
thereof, the element of control is absent.