Case Summary (G.R. No. 126297)
Procedural Background
• Regional Trial Court (Quezon City, Branch 96) – March 17, 1993 decision: held PSI solidarily liable with Drs. Ampil and Fuentes for damages stemming from retained gauzes.
• Court of Appeals – September 6, 1996 decision: absolved Dr. Fuentes; affirmed liability of Dr. Ampil and PSI, subject to PSI’s right of reimbursement from Dr. Ampil.
• Supreme Court First Division – January 31, 2007 decision and February 11, 2008 resolution: affirmed CA ruling, imposed direct liability on PSI under respondeat superior.
• Supreme Court En Banc – referral upon PSI’s second motion for reconsideration and intervenors’ motions: addressed whether a hospital may be held liable for negligence of permitted physician-consultants.
Facts
On April 11, 1984, Drs. Ampil and Fuentes operated on Natividad Agana at PSI’s hospital. Two surgical gauzes were inadvertently left in her body. The Aganas filed a damages complaint alleging negligence in removal and in PSI’s oversight.
Issue
Whether PSI may be held liable for the negligence of independent consultant physicians practicing on its premises.
Applicable Law under the 1987 Constitution and Civil Code
• Article III (Due Process and Equal Protection guarantees contextualize liability principles)
• Civil Code, Article 2176 (fault or negligence) and Article 2180 (liability for acts of persons one is responsible for)
• Civil Code, Article 1431 (estoppel) and Article 1869 (implied agency)
• Jurisprudential tests: “control test” for employer-employee relationship (Calamba Medical Center v. NLRC) and ostensible agency (Nogales v. Capitol Medical Center)
Analysis – Respondeat Superior (Employer-Employee)
• Both RTC and CA found Dr. Ampil to be an independent contractor, not an employee of PSI.
• PSI lacked the requisite control over the means and details of Dr. Ampil’s professional work.
• Concurrent findings on absence of employment relationship became final and conclusive.
• PSI cannot be vicariously liable under respondeat superior.
Analysis – Ostensible Agency
• PSI’s accreditation and public representation of Dr. Ampil as a staff physician created the appearance of agency.
• Enrique Agana relied on Dr. Ampil’s hospital affiliation when selecting him for his wife’s treatment.
• PSI’s “consent for hospital care” form reinforced the impression that all medical staff, including Dr. Ampil, acted as its agents.
• Under the doctrine of apparent authority, PSI is vicariously liable for Dr. Ampil’s negligence.
Analysis – Corporate Negligence
• PSI admitted a corporate duty to review procedural irregularities, notably the reported missing gauzes.
• PSI’s se
Case Syllabus (G.R. No. 126297)
Facts
- On April 11, 1984, Natividad Agana underwent surgery at Medical City General Hospital, owned and operated by Professional Services, Inc. (PSI).
- Surgeons Dr. Miguel Ampil and Dr. Juan Fuentes performed the operation; two gauzes (sponges) were inadvertently left inside the patient’s body.
- Natividad suffered injuries from the retained gauzes, and her husband Enrique Agana conferred with and relied upon Dr. Ampil’s accreditation with PSI.
- Enrique’s decision to have his wife treated by Dr. Ampil at Medical City was influenced by the doctor’s perceived staff-member status and hospital prominence.
- During surgery, a gauze count discrepancy was noted in the operation record but no immediate hospital investigation was conducted.
- Post-operation, Natividad experienced pain but did not notify hospital staff; she only complained to Drs. Ampil and Fuentes.
Procedural History
- April 1985: Complaint for damages filed in RTC Quezon City, Branch 96, docketed Civil Case No. Q-43322, impleading PSI, Dr. Ampil, and Dr. Fuentes.
- March 17, 1993: RTC held PSI, Ampil, and Fuentes solidarily liable for damages; doctors found independent contractors.
- September 6, 1996: Court of Appeals absolved Dr. Fuentes; affirmed liability of PSI and Dr. Ampil, allowing PSI reimbursement rights.
- January 31, 2007: Supreme Court First Division affirmed CA decision, holding PSI vicariously and directly liable.
- February 11, 2008: Supreme Court denied PSI’s first motion for reconsideration.
- PSI filed a second motion for reconsideration and sought an en banc referral; Manila Medical Services, Asian Hospital, and PHAP intervened.
- June 2008 to March 2009: Motions for intervention granted; en banc accepted the referral; oral arguments focused on hospital liability for consultant negligence.
Issues
- Whether a hospital may be held liable for negligence of physicians-consultants practicing on its premises.
- Existence of an employer-employee relationship between PSI and Dr. Ampil.
- Applicability of ostensible agency doctrine where no employer-employee re