Petitioner Vs Vs Respondents: Second Division
Petitioner Vs Vs Respondents: Second Division
Petitioner Vs Vs Respondents: Second Division
DECISION
QUISUMBING , J : p
For review on certiorari are the Decision 1 dated October 3, 2002 and Resolution 2
dated November 19, 2003 of the Court of Appeals in CA-G.R. CV No. 58184, which
a rmed with modi cation the Decision 3 dated March 3, 1997 of the Regional Trial Court
of Quezon City, Branch 98, in Civil Case No. Q-93-16562.
The facts, culled from the records, are as follows:
Petitioner Dr. Milagros L. Cantre is a specialist in Obstetrics and Gynecology at the
Dr. Jesus Delgado Memorial Hospital. She was the attending physician of respondent Nora
S. Go, who was admitted at the said hospital on April 19, 1992.
At 1:30 a.m. of April 20, 1992, Nora gave birth to her fourth child, a baby boy.
However, at around 3:30 a.m., Nora suffered profuse bleeding inside her womb due to
some parts of the placenta which were not completely expelled from her womb after
delivery. Consequently, Nora suffered hypovolemic shock, resulting in a drop in her blood
pressure to "40" over "0." Petitioner and the assisting resident physician performed various
medical procedures to stop the bleeding and to restore Nora's blood pressure. Her blood
pressure was frequently monitored with the use of a sphygmomanometer. While petitioner
was massaging Nora's uterus for it to contract and stop bleeding, she ordered a droplight
to warm Nora and her baby. 4 Nora remained unconscious until she recovered. caCEDA
While in the recovery room, her husband, respondent John David Z. Go noticed a
fresh gaping wound two and a half (2 1/2) by three and a half (3 1/2) inches in the inner
portion of her left arm, close to the armpit. 5 He asked the nurses what caused the injury.
He was informed it was a burn. Forthwith, on April 22, 1992, John David led a request for
investigation. 6 In response, Dr. Rainerio S. Abad, the medical director of the hospital, called
petitioner and the assisting resident physician to explain what happened. Petitioner said
the blood pressure cuff caused the injury.
On May 7, 1992, John David brought Nora to the National Bureau of Investigation for
a physical examination, which was conducted by medico-legal o cer Dr. Floresto Arizala,
Jr. 7 The medico-legal o cer later testi ed that Nora's injury appeared to be a burn and
that a droplight when placed near the skin for about 10 minutes could cause such burn. 8
He dismissed the likelihood that the wound was caused by a blood pressure cuff as the
scar was not around the arm, but just on one side of the arm. 9
On May 22, 1992, Nora's injury was referred to a plastic surgeon at the Dr. Jesus
Delgado Memorial Hospital for skin grafting. 1 0 Her wound was covered with skin sourced
from her abdomen, which consequently bore a scar as well. About a year after, on April 30,
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1993, scar revision had to be performed at the same hospital. 1 1 The surgical operation
left a healed linear scar in Nora's left arm about three inches in length, the thickest portion
rising about one-fourth (1/4) of an inch from the surface of the skin. The costs of the skin
grafting and the scar revision were shouldered by the hospital. 1 2
Unfortunately, Nora's arm would never be the same. Aside from the unsightly mark,
the pain in her left arm remains. When sleeping, she has to cradle her wounded arm. Her
movements now are also restricted. Her children cannot play with the left side of her body
as they might accidentally bump the injured arm, which aches at the slightest touch. IDaEHS
Thus, on June 21, 1993, respondent spouses led a complaint 1 3 for damages
against petitioner, Dr. Abad, and the hospital. Finding in favor of respondent spouses, the
trial court decreed:
In view of the foregoing consideration, judgment is hereby rendered in
favor of the plaintiffs and against the defendants, directing the latters, (sic) jointly
and severally —
(a) to pay the sum of Five Hundred Thousand Pesos (P500,000.00) in
moral damages;
SO ORDERED. 1 4
Petitioner, Dr. Abad, and the hospital all appealed to the Court of Appeals, which
affirmed with modification the trial court decision, thus:
WHEREFORE, in view of all the foregoing, and nding no reversible error in
the appealed Decision dated March 3, 1997 of Branch 98 of the Regional Trial
Court of Quezon City in Civil Case No. Q-93-16562, the same is hereby AFFIRMED,
with the following MODIFICATIONS: HcSETI
Petitioner's motion for reconsideration was denied by the Court of Appeals. Hence,
the instant petition assigning the following as errors and issues:
I.
WHETHER OR NOT, THE LOWER COURT, AND THE COURT OF APPEALS
COMMITTED GRAVE ABUSE OF THEIR DISCRETION WHEN, NOTWITHSTANDING
THAT BOTH PARTIES HAVE RESTED THEIR RESPECTIVE CASES, THE LOWER
COURT ADMITTED THE ADDITIONAL EXHIBITS FURTHER OFFERED BY
RESPONDENTS NOT TESTIFIED TO BY ANY WITNESS AND THIS DECISION OF
THE LOWER COURT WAS UPHELD BY THE COURT OF APPEALS LIKEWISE
COMMITTING GRAVE ABUSE OF DISCRETION; DCAEcS
II.
WHETHER OR NOT THE LOWER COURT COMMITTED GRAVE ABUSE OF ITS
DISCRETION WHEN, CONTRARY TO PREPONDERANCE OF EVIDENCE
PRESENTED BY THE PETITIONER, IT RULED THAT THE PETITIONER HAS NOT
AMPLY SHOWED THAT THE DROPLIGHT DID NOT TOUCH THE BODY OF MRS.
NORA GO, AND THIS DECISION OF THE LOWER COURT WAS UPHELD BY THE
COURT OF APPEALS LIKEWISE COMMITTING GRAVE ABUSE OF DISCRETION;
III.
IV.
VI.
WHETHER OR NOT THE LOWER COURT AND THE COURT [OF] APPEALS
COMMITTED GRAVE ABUSE OF DISCRETION WHEN, CONTRARY TO THE
DETAILED PROCEDURES DONE BY PETITIONER, BOTH RULED THAT THE
RESPONDENT WAS LEFT TO THE CARE OF THE NURSING STAFF;
VII.
Respondents, however, counter that the genuineness and due execution of the
additional documentary exhibits were duly admitted by petitioner's counsel. Respondents
point out that petitioner's blood pressure cuff theory is highly improbable, being
unprecedented in medical history and that the injury was de nitely caused by the droplight.
At any rate, they argue, even if the injury was brought about by the blood pressure cuff,
petitioner was still negligent in her duties as Nora's attending physician.
Simply put, the threshold issues for resolution are: (1) Are the questioned additional
exhibits admissible in evidence? (2) Is petitioner liable for the injury suffered by
respondent Nora Go? Thereafter, the inquiry is whether the appellate court committed
grave abuse of discretion in its assailed issuances. DaIACS
As to the rst issue, we agree with the Court of Appeals that said exhibits are
admissible in evidence. We note that the questioned exhibits consist mostly of Nora's
medical records, which were produced by the hospital during trial pursuant to a subpoena
duces tecum. Petitioner's counsel admitted the existence of the same when they were
formally offered for admission by the trial court. In any case, given the particular
circumstances of this case, a ruling on the negligence of petitioner may be made based on
the res ipsa loquitur doctrine even in the absence of such additional exhibits.
Petitioner's contention that the medico-legal o cer who conducted Nora's physical
examination never saw her original injury before plastic surgery was performed is without
basis and contradicted by the records. Records show that the medico-legal o cer
conducted the physical examination on May 7, 1992, while the skin grafting and the scar
revision were performed on Nora on May 22, 1992 and April 30, 1993, respectively.
Coming now to the substantive matter, is petitioner liable for the injury suffered by
respondent Nora Go?
The Hippocratic Oath mandates physicians to give primordial consideration to the
well-being of their patients. If a doctor fails to live up to this precept, he is accountable for
his acts. This notwithstanding, courts face a unique restraint in adjudicating medical
negligence cases because physicians are not guarantors of care and, they never set out to
intentionally cause injury to their patients. However, intent is immaterial in negligence
cases because where negligence exists and is proven, it automatically gives the injured a
right to reparation for the damage caused. 1 7 ASHaTc
Petitioner's defense that Nora's wound was caused not by the droplight but by the
constant taking of her blood pressure, even if the latter was necessary given her condition,
does not absolve her from liability. As testi ed to by the medico-legal o cer, Dr. Arizala,
Jr., the medical practice is to de ate the blood pressure cuff immediately after each use.
Otherwise, the in ated band can cause injury to the patient similar to what could have
happened in this case. Thus, if Nora's wound was caused by the blood pressure cuff, then
the taking of Nora's blood pressure must have been done so negligently as to have
in icted a gaping wound on her arm, 2 0 for which petitioner cannot escape liability under
the "captain of the ship" doctrine.
Further, petitioner's argument that the failed plastic surgery was not intended as a
cosmetic procedure, but rather as a measure to prevent complication does not help her
case. It does not negate negligence on her part.
Based on the foregoing, the presumption that petitioner was negligent in the
exercise of her profession stands unrebutted. In this connection, the Civil Code provides:
ART. 2176. Whoever by act or omission causes damage to another,
there being fault or negligence, is obliged to pay for the damage done. . . .
Clearly, under the law, petitioner is obliged to pay Nora for moral damages suffered
by the latter as a proximate result of petitioner's negligence.
We note, however, that petitioner has served well as Nora's obstetrician for her past
three successful deliveries. This is the rst time petitioner is being held liable for damages
due to negligence in the practice of her profession. The fact that petitioner promptly took
care of Nora's wound before infection and other complications set in is also indicative of
petitioner's good intentions. We also take note of the fact that Nora was suffering from a
critical condition when the injury happened, such that saving her life became petitioner's
elemental concern. Nonetheless, it should be stressed that all these could not justify
negligence on the part of petitioner. IHcTDA
Footnotes
1. Rollo, pp. 43-68.
2. Id. at 40-41.
3. Records, pp. 218-227.
4. TSN, December 5, 1995, pp. 54-55.
9. Id. at 23.
10. Exhibit "L," folder of exhibits, p. 42.
11. TSN, January 31, 1994, pp. 35-36.
12. TSN, April 29, 1994, p. 16; TSN, June 25, 1996, p. 23.
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13. Records, pp. 1-6.