Ramos vs. Court of Appeals
Ramos vs. Court of Appeals
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* FIRST DIVISION.
585
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586
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Same; Same; Same; Same; When the doctrine of res ipsa loqui-
tur is availed by the plaintiff, the need for expert medical
testimony is dispensed with because the injury itself provides the
proof of negligence.—Although generally, 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
loquitur is availed by the plaintiff, the need for expert medical
testimony is dispensed with because the injury itself provides the
proof of negligence. The reason is that the general rule on 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. Ordinarily, 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. However, testimony as to the
statements and acts of physicians and surgeons, external
appearances, and manifest conditions which are observable by
any one may be given by non-expert witnesses.
Same; Same; Same; Same; Res ipsa loquitur is not a rigid or
ordinary doctrine to be perfunctorily used but a rule to be
cautiously applied depending upon the circumstances of each case.
—Despite the fact that the scope of res ipsa loquitur has been
measurably enlarged, it does not automatically apply to all cases
of medical negligence as to mechanically shift the burden of proof
to the defendant to show that he is not guilty of the ascribed
negligence. Res ipsa loquitur is not a rigid or ordinary doctrine to
be perfunctorily used but a rule to be cautiously applied,
depending upon the circumstances of each case. It is generally
restricted to situations in malpractice cases where a layman is
able to say, as a matter of common knowledge and observation,
that the consequences of professional care were not as such as
would ordinarily have followed if due care had been exercised.
Same; Same; Same; Same; Res ipsa loquitur is not available
in a malpractice suit if the only showing is that the desired result
of an operation or treatment was not accomplished.—It must be
conceded that the doctrine of res ipsa loquitur can have no
application in a suit against a physician or 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
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587
accountable not only for his own acts but also for those of others
based on the former’s responsibility under a relationship of patria
potestas. Such responsibility ceases when the persons or entity
concerned prove that they have observed the diligence of a good
father of the family to prevent damage. In other words, while the
burden of proving negligence rests
588
KAPUNAN, J.:
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589
Plaintiff Erlinda Ramos was, until the afternoon of June 17, 1985,
a 47-year old (Exh. “A”) robust woman (TSN, October 19, 1989, p.
10). Except for occasional complaints of discomfort due to pains
allegedly caused by the presence of a stone in her gall bladder
(TSN, January 13, 1988, pp. 4-5), she was as normal as any other
woman. Married to Rogelio E. Ramos, an executive of Philippine
Long Distance Telephone Company, she has three children whose
names are
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1 In the United States alone, a great number of people die every year as a result
of medical mishaps. The 13 December 1999 issue of TIME MAGAZINE featured an
article on medical negligence entitled “Doctors’ Deadly Mistakes” which is quoted
in part: “It is hardly news that medical professionals make mistakes—even dumb,
deadly mistakes. What is shocking is how often it happens. Depending on which
statistics you believe, the number of Americans killed by medical screw-ups is
somewhere between 44,000 and 98,000 every year—the eighth leading cause of
death even by the more conservative figure, ahead of car crashes, breast cancer
and AIDS. More astonishing than the huge numbers themselves, though, is the
fact that public health officials had known about the problem for years and hadn’t
made a concerted effort to do something about it.”
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2 Cholecystectomy is the surgical excision of the gall bladder.
3 CA Rollo, pp. 129-140.
4 Records, pp. 270-279.
590
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591
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592
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593
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that the patient was inside the operating room for almost three
(3) hours. For
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5 Id. at 270-275.
6 Docketed as Civil Case No. Q-46885.
594
595
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596
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1996. The petition was filed on 9 May 1996, well within the
extended period given by the Court.
Petitioners assail the decision of the Court Of Appeals
on the following grounds:
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10 Id. at 195.
597
II
III
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11 Rollo, p. 19.
12 Id. at 91-98.
598
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599
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14 Africa, et al. vs. Caltex (Phil.), Inc., et al., 16 SCRA 449, 454 (1966).
15 57B Am Jur 2d, supra note 13 at 499.
16 Ibid.
17 Id. at 502.
18 Ibid.
19 Id.
600
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20 Id. at 503.
21 Voss vs. Bridwell, 364 P2d 955, 970 (1961) citing Worden v. Union
Gas System, 182 Kan. 686, 324 P.2d 501; Lamb v. Hartford Accident and
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Indemnity Co., Primm v. Kansas Power & Light Co., 173 Kan. 443, 249
P.2d 647.
22 St. John’s Hospital and School of Nursing vs. Chapman, 434 P.2d
160, 166 (1967).
23 57B Am Jur 2d, supra note 13, at 513.
24 It is the type of claim which a victim has available to him or her to
redress a wrong committed by a medical professional which has caused
bodily harm. (Garcia-Rueda vs. Pascasio, 278 SCRA 769, 778 [1997]).
25 Voss vs. Bridwell, supra note 21.
601
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602
37
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37
followed if due care had been exercised. A distinction
must
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603
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38 Id. at 968.
39 Rhodes vs. De Haan, 337 P. 2d. 1043, 1047 (1959).
40 Voss vs. Bridwell, supra note 21, at 968.
41 Sanders vs. Smith, 27 So. 2d 889, 893 (1946).
42 Ibid.
43 Voss vs. Bridwell, supra note 21.
604
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44 Id. at 971.
605
606
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607
ATTY. PAJARES:
Q: In particular, what did Dra. Perfecta Gutierrez do, if
any on the patient?
A: In particular, I could see that she was intubating the
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patient.
Q: Do you know what happened to that intubation process
administered by Dra. Gutierrez?
ATTY. ALCERA:
She will be incompetent Your Honor.
COURT:
Witness may answer if she knows.
A: As I have said, I was with the patient, I was beside the
stretcher holding the left hand of the patient and all of
a sudden I heard some remarks coming from Dra.
Perfecta
608
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609
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610
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ATTY. LIGSAY:
Q: In this particular case, Doctora, while you were
intubating at your first attempt (sic), you did not
immediately see the trachea?
DRA. GUTIERREZ:
A: Yes sir.
Q: Did you pull away the tube immediately?
A: You do not pull the . . .
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611
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612
________________
613
ATTY. LIGSAY:
Q: Would you agree, Doctor, that it is good medical
practice to see the patient a day before so you can
introduce yourself to establish good doctor-patient
relationship and gainthe trust and confidence of the
patient?
DRA. GUTIERREZ:
A: As I said in my previous statement, it depends on the
operative procedure of the anesthesiologist and in my
case, with elective cases and normal cardio-pulmonary
clearance like that, I usually don’t do it except on
emergency
58
and on cases that have an abnormalities
(sic).
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614
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615
ATTY. LIGSAY:
Q: In your line of expertise on pulmonology, did you have
any occasion to use pentothal as a method of
management?
DR. JAMORA:
A: We do it in conjunction with the anesthesiologist when
they have to intubate our patient.
Q: But not in particular when you practice pulmonology?
A: No.
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616
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617
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618
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619
________________
620
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621
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622
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623
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624
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626
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83 Id. at 327-328.
627
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84 Id. at 328.
628
Judgment modified.
629
——o0o——
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