Case Summary (G.R. No. 192973)
Relevant Dates and Applicable Constitutional Provision
• Patient’s admission: February 2, 1992
• First operation (cesarean section): February 3, 1992
• Second operation (exploratory laparotomy): February 12, 1992
• Patient’s death: February 13, 1992
• RTC decision: January 28, 2003
• CA decision: December 15, 2009
• Supreme Court resolution: September 29, 2014
Applicable Law
1987 Philippine Constitution; Civil Code (medical negligence under Articles 2176 et seq.); relevant jurisprudence (Lucas v. Tuaño).
Factual Background of Medical Treatment
Carmen Castillo Dela Torre was admitted for overdue labor and pre-eclampsia. After failure of spontaneous delivery, Dr. Nestor performed a cesarean section. Postoperatively, Carmen developed abdominal pain, difficulty urinating (diagnosed as UTI), and increasing abdominal distension. Dr. Norma initially attributed this to flatulence; when symptoms persisted, she recommended—and with Carmen’s and Pedrito’s written consent—an exploratory laparotomy. Despite surgery, Carmen’s condition deteriorated, she vomited blood on February 13, and died that evening.
Contrasting Expert Findings on Cause of Death
Hospital’s death certificate cited cardio-respiratory arrest secondary to cerebrovascular accident, hypertension and chronic nephritis. Dr. Richard Patilano’s autopsy—limited by lack of aseptic protocol and failure to examine key organs—attributed death to severe peritonitis with multiple intestinal adhesions. Dr. Bienvenido Torres (PNP Crime Laboratory) testified that Patilano omitted vital organ examination, rendering his conclusion inconclusive.
Trial Court’s Findings and Award
RTC credited Dr. Patilano’s testimony, found the respondents negligent in surgical technique and postoperative care, and awarded:
• Actual damages: ₱28,759.46
• Indemnity for death: ₱50,000.00
• Moral damages: ₱50,000.00
• Exemplary damages: ₱20,000.00
• Attorney’s fees: ₱20,000.00
• Costs of suit
Court of Appeals’ Reversal and Counterclaim Award
The CA held that respondents exercised the degree of care, skill and diligence required of medical practitioners. It reversed the RTC judgment and granted the hospital’s counterclaim for unpaid bills and professional fees in the amount of ₱48,515.58.
Legal Standards for Medical Negligence
Under the Civil Code and jurisprudence, a medical negligence claim requires proof of (1) duty; (2) breach of that duty (failure to meet the standard of care exercised by reasonably prudent practitioners in similar locality and specialty); (3) injury; and (4) proximate causation. Expert testimony must establish both the deviation from standard care and causal link to the patient’s harm within reasonable medical probability.
Supreme Court’s Analysis on Expert Competency and Causation
The Suprem
...continue readingCase Syllabus (G.R. No. 192973)
Parties and Title
- Petitioner: Pedrito dela Torre.
- Respondents: Dr. Arturo Imbuido and Dra. Norma Imbuido, in their capacity as owners/operators of Divine Spirit General Hospital, Olongapo City; and Dr. Nestor Pasamba.
- Supreme Court Third Division, G.R. No. 192973; Decision rendered September 29, 2014.
Factual Background
- Carmen Castillo dela Torre admitted on February 2, 1992 for anticipated delivery.
- On February 3, 1992 at about 3:00 p.m., Dr. Nestor performed an emergency caesarean section; baby delivered by 5:30 p.m.
- Early February 4, 1992: Carmen developed abdominal pain and difficulty urinating; diagnosed with urinary tract infection and treated by Dra. Norma.
- February 10, 1992: Noticed progressive abdominal enlargement; Dra. Norma attributed it to flatulence.
- February 12, 1992 at about 3:00 p.m.: A second exploratory laparotomy was performed for suspected intestinal obstruction; Dra. Norma reported in the evening that “everything was going on fine.”
- February 13, 1992 at 9:30 p.m.: Carmen vomited dark red blood and expired.
Medical Findings
- Hospital death certificate: Immediate cause—cardio-respiratory arrest secondary to cerebrovascular accident, hypertension, and chronic nephritis induced by pregnancy.
- Autopsy by Dr. Richard Patilano: Cause of death—shock due to severe peritonitis with multiple intestinal adhesions; status post caesarean section and exploratory laparotomy.
Procedural History
- Pedrito filed a complaint for damages, alleging respondents were negligent and failed to exercise the required degree of care in Carmen’s treatment.
- Respondents denied negligence, asserted observance of standard medical care, and counterclaimed:
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