Title
Cabugao vs. People
Case
G.R. No. 163879
Decision Date
Jul 30, 2014
A 10-year-old boy died from untreated appendicitis; surgeon found guilty of gross negligence, civil liability persists post-death; general practitioner acquitted.

Case Summary (G.R. No. 163879)

Procedural History

• RTC (Feb. 28, 2003): Found both doctors grossly negligent for failing to diagnose and operate on acute appendicitis; convicted both for reckless imprudence resulting in homicide
• CA (June 4, 2004): Affirmed that both doctors neglected to monitor and to perform appendectomy; treated them as acting in conspiracy
• SC (July 30, 2014): Reviewed factual findings; applied the 1987 Constitution; distinguished liability between surgeon (Ynzon) and referring physician (Cabugao)

Issues for Resolution

  1. Whether the Information properly charged failure to perform immediate operation for acute appendicitis
  2. Whether the doctors acted in conspiracy
  3. Whether Dr. Cabugao, as a non-surgeon, had a duty to operate
  4. Sufficiency of proof on causation and duty by prosecution’s expert witnesses
  5. Whether failure to perform appendectomy constituted criminal negligence

Standard for Reckless Imprudence

Elements under Article 365(1) RPC:

  1. Voluntary act or omission
  2. Without malice
  3. Material damage resulted
  4. Inexcusable lack of precaution, measured against professional standards (degree of skill and care expected of practitioners in the same field)

Liability of Dr. Ynzon

• Expert testimony (Dr. Mateo) established that given JR’s presentation and test results, immediate surgery was indicated to prevent rupture, peritonitis, septicemia, and death.
• Dr. Ynzon’s actions—brief rounds, reliance on residents, telephone orders, failure to act after 24-hour observation despite worsening symptoms—demonstrated gross negligence and indifference to known risks.
• He failed to perform appendectomy or pursue alternative diagnoses, despite being in the best position as attending surgeon to detect changes.
• His voluntary omission, inexcusable lack of precaution, and resulting death satisfied all elements of reckless imprudence resulting in homicide.

Liability of Dr. Cabugao

• Dr. Cabugao, a general practitioner, lacked surgical training and properly referred JR to Dr. Ynzon upon suspecting appendicitis.
• He ordered antibiotics and pain relief, monitored the patient before transfer, and notified staff of his leave.
• There was no proof he could or should have performed surgery; the prosecution failed to establish his personal duty or proximate causation.
• His supervision and referral evidenced appropriate exercise of care within his professional scope; thus, he is acquitted.

Civil Liability

• Dr. Ynzon died on December 23, 2011, extinguishing criminal liability but not civil liability based on quasi-delict.
• Heirs may enforce a separate civil action against his estate or representative under Rule 111(4) of the R


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