Case Summary (G.R. No. 250919)
Standard of Care and Need for Expert Testimony
Medical negligence requires proof of duty, breach, injury, and proximate causation. Complex obstetrical cases demand expert testimony to establish the applicable standard of care. Plaintiffs’ failure to present a surviving expert witness did not bar review because the respondent’s own expert testimony was examined for signs of breach.
Failure to Diagnose and Manage Placenta Accreta
Although ultrasound and MRI are recognized modalities to suspect placenta accreta, Dr. Dela Cruz relied on a more than one-month-old ultrasound (July 18, 2006) and did not order repeat imaging upon admission for bleeding and contractions. Expert testimony confirmed that timely imaging could have prompted earlier surgical intervention to control bleeding, but no such steps were taken during the critical 16-hour interval between admission and massive hemorrhage.
Duty to Source Blood and Prepare for Emergency
Given Marissa’s high-risk profile—multiparity, prior cesarean, active bleeding, rare blood type AB—respondents should have ensured immediate availability of blood units. Instead, petitioners sourced blood externally, and the hospital delayed transfusion, exacerbating hypovolemic shock.
Vicarious Liability of MEMCI
Under Civil Code Article 2180 and the doctrine of apparent authority, MEMCI is vicariously liable despite Dr. Dela Cruz’s status as a consultant. By providing facilities, coordinating the surgical team, and overseeing in-hospital care, the hospital held her out as a member of its staff; it cannot now disclaim responsibility for her negligence.
Damages Awarded
• Actual d
Case Syllabus (G.R. No. 250919)
Facts of the Case
- Petitioners are the heirs and dependents of the late Marissa Baco Allarey: her common-law partner Jude Carlo M. Allarey (father and natural guardian), their common children Hero B. Allarey and Jude Carlo B. Allarey, Jr., Marissa’s daughter from a previous relationship Karen Valerie B. Salazar (via guardian ad litem), and Marissa’s parents Rufo C. Baco, Jr. and Rosalie C. Baco.
- Marissa, age 35, died on August 29, 2006 after preterm labor at 30–31 weeks gestation; her newborn daughter Julia Carla Allarey died the next day.
- Dr. Ma. Ditas F. Dela Cruz performed a prior cesarean for Marissa in August 2005 and managed her prenatal care in 2006, including consultations on March 18, April 22, June 10, July 18, and August 3.
- On August 28, 2006, Marissa experienced vaginal bleeding and was admitted to Manila East Medical Center, Inc. (MEMCI) for close observation and tocolysis, with initial bleeding controlled overnight.
- On August 29, 2006, Marissa’s bleeding recurred. Delays in securing a P10,000 deposit and sourcing rare type AB blood were alleged. Julia Carla was delivered by emergency cesarean at 3:34 p.m.; Marissa underwent hysterectomy by 4:20 p.m. but died at 5:45 p.m.
- On August 30, 2006, petitioners paid for a ventilator for Julia Carla, which arrived past noon; the infant died at 2:30 p.m.
Procedural History
- RTC Decision dated July 8, 2017: Complaint for damages based on quasi-delict dismissed against Dr. Dela Cruz and MEMCI for failure of petitioners to present competent expert testimony and for finding that standard care was observed.
- RTC denied petitioners’ Motion for Reconsideration on October 10, 2017.
- Court of Appeals (CA) Decision dated May 30, 2019 and Resolution dated November 13, 2019: Petition for damages denied; CA held petitioners failed to prove negligence or causation, and that