Case Summary (G.R. No. L-26815)
Key Individuals and Context
• Gerald Albert Gercayo – Three-year-old patient born with imperforate anus who underwent pull-through surgery.
• Dr. Fernando P. Solidum – Consultant anesthesiologist in charge of administering anesthesia.
• Dr. Marichu Abella and Dr. Arnel Razon – Fellow anesthesiologists assisting in the operation.
• Dr. Leandro Resurreccion et al. – Surgical team performing the pull-through procedure.
• Ma. Luz Gercayo – Mother and complainant.
Petitioner
Dr. Fernando P. Solidum
Respondent
People of the Philippines
Key Dates
• June 2, 1992 – Birth of Gerald with imperforate anus.
• May 17, 1995 – Pull-through operation at Ospital ng Maynila.
• July 19, 2004 – RTC conviction for reckless imprudence resulting in serious physical injuries.
• January 20, 2010 – CA affirms conviction under res ipsa loquitur.
• March 10, 2014 – Supreme Court decision (1987 Constitution governs).
Applicable Law
• 1987 Philippine Constitution – Due process and presumption of innocence.
• Revised Penal Code, Articles on reckless imprudence (reckless imprudence defined) and subsidiary liability (Art. 103).
• Rule 111, Section 1, Rules of Court – Civil liability in criminal actions.
Facts of the Case
Gerald underwent colostomy days after birth and was later scheduled for a pull-through operation at age three. During surgery under general anesthesia, he experienced bradycardia and subsequent hypoxic encephalopathy, resulting in permanent loss of sensory and motor functions. His mother filed a complaint for reckless imprudence against attending physicians; only Dr. Solidum was charged. He was accused of failing to monitor anesthesia properly and overdosing at “100% halothane.”
Procedural History
RTC convicted Dr. Solidum (2 months+1 day to 1 year+1 month+10 days; moral and exemplary damages jointly with Ospital ng Maynila). CA modified solidary liability but affirmed conviction, invoking res ipsa loquitur. Petition for certiorari followed.
Issues
- Whether the doctrine of res ipsa loquitur was properly applied.
- Whether the prosecution proved beyond reasonable doubt that Dr. Solidum was criminally negligent.
- Whether Ospital ng Maynila could be held civilly liable under subsidiary liability.
Applicability of the Doctrine of Res Ipsa Loquitur
The doctrine permits an inference of negligence where:
- The accident does not ordinarily occur without negligence;
- The instrumentality was under the defendant’s exclusive control;
- The injured party did not contribute.
Here, only elements 2 and 3 are met. Bradycardia and hypoxia may result from recognized surgical risks (e.g., vago-vagal reflex) despite proper anesthesia care. The first element is lacking because such adverse events, while uncommon, can occur in major operations without negligence. Thus, res ipsa loquitur is inapplicable.
Criminal Negligence Analysis
Reckless imprudence requires an inexcusable lack of precaution causing material damage. Proof demands:
(a) duty of care;
(b) breach of that duty;
(c) causal link to injury;
(d) damages.
In medical malpractice, expert testimony establishes the standard of care and causation. The prosecution failed to present anesthesia experts to define the applicable standard or to explain how Dr. Solidum’s conduct deviated from it. Evidence showed he administered only 1% halothane (not 100%), continuously monitored oxygenation, and responded promptly to bradycardia. The National Bureau of Investigation’s medico-legal officer acknowledged multiple possible causes of hypoxia unrelated to
Case Syllabus (G.R. No. L-26815)
Facts of the Case
- Gerald Albert Gercayo was born on June 2, 1992 with an imperforate anus and underwent colostomy two days later.
- On May 17, 1995, aged three, he was admitted to Ospital ng Maynila for a pull-through operation.
- The surgical team was headed by Dr. Leandro Resurreccion; anesthesiologists were Drs. Marichu Abella, Arnel Razon, and Fernando Solidum.
- During surgery, Gerald suffered bradycardia, lapsed into a coma for two weeks, and on regaining consciousness after a month, was blind, deaf, and immobile.
- His mother filed a complaint for reckless imprudence resulting in serious physical injuries.
- The City Prosecutor charged only Dr. Solidum, alleging he failed to monitor and regulate anesthesia, used 100% halothane, and caused cardiac arrest with hypoxic encephalopathy.
Procedural History
- Information filed in the Metropolitan Trial Court; transferred to the RTC of Manila (Criminal Case No. 01-190889) under R.A. 8369.
- RTC (July 19, 2004) convicted Dr. Solidum of reckless imprudence resulting in serious physical injuries; sentenced to arresto mayor and prision correccional; ordered joint indemnities with the hospital and complainant.
- RTC modified its award, excluding co-physicians from civil liability.
- Court of Appeals (January 20, 2010) affirmed conviction, applying res ipsa loquitur; denied motion for reconsideration on May 7, 2010.
- Petitioner elevated the case to the Supreme Court via petition for review on certiorari.
Charge and Allegations
- Reckless imprudence resulting in serious physical injuries (Article 365, RPC).
- Alleged failure to use due care in administering anesthesia and improper monitoring.
- Alleged administration of 100% halothane leading to patient’s cardiac arrest and hypoxic brain injury.
Issues for Resolution
- Whether the doctrine of res ipsa loquitur pr