12.) Dr. Rubi Li V.

Spouses Reynaldo and Lina Soliman

G.R. No. 165279
June 7, 2011

PETITIONERS: Dr. Rubi Li

RESPONDENTS: Spouses Reynaldo and Lina Soliman as parents/heirs of
deceased Angelica Soliman
TOPIC: Informed consent–Essential Medicolegal Issues
PONENTE: Villarama, Jr., J

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. Luke's
Medical Center (SLMC). Results showed that Angelica was suffering
from osteosarcoma, osteoblastic type, a high-grade cancer of the bone which
usually afflicts teenage children. Following this diagnosis and as primary
intervention, Angelica's right leg was amputated by Dr. Jaime Tamayo in
order to remove the tumor. As adjuvant treatment to eliminate any remaining
cancer cells, and hence minimize the chances of recurrence and prevent the
disease from spreading to other parts of the patient's body (metastasis),
chemotherapy was suggested by Dr. Tamayo. Dr. Tamayo referred Angelica
to another doctor at SLMC, herein petitioner Dr. Rubi Li, a medical
oncologist.

On August 18, 1993, Angelica was admitted to SLMC. However, she died
on September 1, 1993, just eleven (11) days after the administration of the
first cycle of the chemotherapy regimen.

On February 21, 1994, respondents filed a damage suit against petitioner,

Dr. Leo Marbella, Mr. Jose Ledesma, a certain Dr. Arriete and SLMC.
Respondents charged them with negligence and disregard of Angelica's
safety, health and welfare by their careless administration of the
chemotherapy drugs, their failure to observe the essential precautions in
detecting early the symptoms of fatal blood platelet decrease and stopping
early on the chemotherapy, which bleeding led to hypovolemic shock that
caused Angelica's untimely demise. Further, it was specifically averred that
petitioner assured the respondents that Angelica would recover in view of
95% chance of healing with and when asked regarding the side effects,
petitioner mentioned only slight vomiting, hair loss and
weakness. Respondents thus claimed that they would not have given their
consent to chemotherapy had petitioner not falsely assured them of its side
effects. In dismissing the complaint, the trial court held that petitioner
was not liable for damages as she observed the best known procedures and
employed her highest skill and knowledge in the administration of
chemotherapy drugs on Angelica but despite all efforts said patient died.

The heirs of Reyes filed with the RTC a complaint for damages against Sisters
of Mercy, Sister Rose Palacio, Dr. Blanes, Dr. Rico and Mercy Community
Clinic contending that the death of Jorge was due to the wrongful

1
administration of chloromycetin. RTC ruled in favor of the respondents. The
CA affirmed in toto the RTC decision. Hence, this appeal.

ISSUE: Whether Dr. Rubi Li is negligent and is liable for damages.

RULING:

NO. There are four essential elements a plaintiff must prove 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 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 case requires the plaintiff to "point to
significant undisclosed information relating to the treatment which would
have altered her decision to undergo it.

Examining the evidence on record, the Court held that there was
adequate disclosure of material risks inherent in the chemotherapy procedure
performed with the consent of Angelica's parents. Respondents could not
have been unaware in the course of initial treatment and amputation of
Angelica's lower extremity, that her immune system was already weak on
account of the malignant tumor in her knee.On the other hand, it is difficult
to give credence to respondents' claim that petitioner told them of 95%
chance of recovery for their daughter, as it was unlikely for doctors like
petitioner who were dealing with grave conditions such as cancer to have
falsely assured patients of chemotherapy's success rate. Besides, informed
consent laws in other countries generally require only a reasonable
explanation of potential harms, so specific disclosures such as statistical
data, may not be legally necessary.

DISPOSITION:
WHEREFORE, the petition for review on certiorari is GRANTED. The Decision dated June
15, 2004 and the Resolution dated September 1, 2004 of the Court of Appeals in CA-G.R. CV No.
58013 are SET ASIDE.