9. Cayao-Lasam vs. Sps. Ramolete

FACTS: On July 28, 1994, respondent, three months pregnant Editha Ramolete (Editha) was brought to the Lorma Medical Center (LMC) in San Fernando, La Union due to vaginal bleeding. Upon advice of petitioner relayed via telephone, Editha was admitted to the LMC on the same day. A pelvic sonogram was then conducted on Editha revealing the fetus’ weak cardiac pulsation. The following day, Editha’s repeat pelvic sonogram showed that aside from the fetus’ weak cardiac pulsation, no fetal movement was also appreciated. Due to persistent and profuse vaginal bleeding, petitioner advised Editha to undergo a Dilatation and Curettage Procedure (D&C) or "raspa." The procedure was performed by the petitioner and Editha was discharged the next day. On September 16, 1994, Editha was once again brought at the LMC, as she was suffering from vomiting and severe abdominal pains. She was found to have a massive intra-abdominal hemorrhage and a ruptured uterus. Thus, Editha had to undergo a procedure for hysterectomy and as a result, she has no more chance to bear a child. Respondents: first, petitioner’s failure to check up, visit or administer medication on Editha during her first day of confinement at the LMC; second, petitioner recommended that a D&C procedure be performed on Editha without conducting any internal examination prior to the procedure; third, petitioner immediately suggested a D&C procedure instead of closely monitoring the state of pregnancy of Editha. Petitioner: it was Editha’s gross negligence and/or omission in insisting to be discharged against doctor’s advice and her unjustified failure to return for check-up as directed by petitioner that contributed to her life-threatening condition on; that Editha’s hysterectomy was brought about by her very abnormal pregnancy known as placenta increta, which was an extremely rare and very unusual case of abdominal placental implantation; that whether or not a D&C procedure was done by her or any other doctor, there would be no difference at all because at any stage of gestation before term, the uterus would rupture just the same.

RULING: Medical malpractice is a particular form of negligence which consists in the failure of a physician or surgeon to apply to his practice of medicine that degree of care and skill which is ordinarily employed by the profession generally, under similar conditions, and in like surrounding circumstances. There are four elements involved in medical negligence cases: duty, breach, injury and proximate causation. In the present case, respondents did not present any expert testimony to support their claim that petitioner failed to do something which a reasonably prudent physician or surgeon would have done. Petitioner, on the other hand, presented the testimony of Dr. Augusto M. Manalo, who was clearly an expert on the subject. He testified that the rupture occurred minutes prior to the hysterectomy or right upon admission on September 15, 1994 which is about 1 ½ months after the patient was discharged, after the D&C was conducted. It is evident that the D&C procedure was not the proximate cause of the rupture of Editha’s uterus. The defenses in an action for damages, provided for under Article 2179 of the Civil Code are:

Art. 2179. When the plaintiff’s own negligence was the immediate and proximate cause of his injury he cannot recover damages. But if his negligence was only contributory, the immediate and proximate cause of the injury being the defendant’s lack of due care, the plaintiff may recover damages, but the courts shall mitigate the damages to be awarded. Proximate cause has been defined as that which, in natural and continuous sequence, unbroken by any efficient intervening cause, produces injury, and without which the result would not have occurred. An injury or damage is proximately caused by an act or a failure to act, whenever it appears from the evidence in the case that the act or omission played a substantial part in bringing about or actually causing the injury or damage; and that the injury or damage was either a direct result or a reasonably probable consequence of the act or omission. The Court notes the findings of the Board of Medicine: When complainant was discharged on July 31,1994, herein respondent advised her to return on August 4, 1994 or four (4) days after the D&C. This advise was clear in complainant’s Discharge Sheet. However, complainant failed to do so. This being the case, the chain of continuity as required in order that the doctrine of proximate cause can be validly invoked was interrupted. Had she returned, the respondent could have examined her thoroughly. Contributory negligence is the act or omission amounting to want of ordinary care on the part of the person injured, which, concurring with the defendant’s negligence, is the proximate cause of the injury. Difficulty seems to be apprehended in deciding which acts of the injured party shall be considered immediate causes of the accident. Where the immediate cause of an accident resulting in an injury is the plaintiff’s own act, which contributed to the principal occurrence as one of its determining factors, he cannot recover damages for the injury.

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19. M.H. Rakes vs. The Atlantic Gulf

7 Phil. 359 – Civil Law – Torts and Damages – Kinds of Fault

M.H. Rakes was a black man working as a laborer for Atlantic Gulf in the early 1900s. One day, they were working in the company’s yard and they were transporting heavy rails using two cars (karitons?); each car carrying the opposite ends of the rails. The cars were pulled by rope from the front and other workers are pushing the cars from behind. There were no side guards installed on the sides of the cars but the rails were secured by ropes. The track where the cars move were also weakened by a previous typhoon. It was alleged that Atlantic’s foreman was notified of said damage in the tracks but the same were left unrepaired. While the cars were being moved and when it reached the depressed portion of the track, and while Rakes was beside one of the cars, the ropes gave in and the rails slipped thereby crushing his leg and causing it to be amputated. Rakes sued Atlantic Gulf and he won; he was awarded 5,000 pesos for damages ($2,500).

Atlantic assailed the decision of the lower court alleging that they specifically ordered their workers to be walking only before or after the cars and not on the side of the cars because the cars have no side guards to protect them in case the rails would slip. Atlantic also alleged that Rakes should be suing the foreman as it was him who neglected to have the tracks repaired; that Rakes himself was negligent for having known of the depression on the track yet he continued to work.

ISSUE: Whether or not Atlantic is civilly liable.

HELD: Yes. Rakes as per the evidence could not have  known of the damage in the track as it was another employee who swore he notified the foreman about said damage. Further, his lack of caution in continuing to work is not of a gross nature as to constitute negligence on his part. On the other hand though, Rakes contributory negligence can be inferred from the fact that he was on the side of the cars when in fact there were orders from the company barring workers from standing near the side of the cars. His disobedient to this order does not bar his recovery of damages though; the Supreme Court instead reduced the award of damages from 5,000 pesos to 2,500 pesos.

In this case, the SC also elucidated the two kinds of culpa which are:

1. Culpa as substantive and independent, which on account of its origin arises in an obligation between two persons not formerly bound by any other obligation; may be also considered as a real source of an independent obligation (extra-contractual or culpa aquiliana).

2. Culpa as an incident in the performance of an obligation which cannot be presumed to exist without the other, and which increases the liability arising from the already existing obligation (contractual or culpa contractual).

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29. Nikko Hotel vs. Reyes

FACTS:

Petitioners Nikko Hotel Manila and Ruby Lim assailed the decision of the Court of Appeals in reversing the decision of RTC of Quezon City.  CA held petitioner liable for damages to Roberto Reyes aka “Amang Bisaya”, an entertainment artist.

There are two versions of the story:Mr. Reyes: On the eve of October 13, 1994, Mr. Reyes while having coffee at the lobby of Nikko Hotel was approached by Dr. Violet Filart, a friend several years back.  According to Mr. Reyes, Dr. Filart invited him to join a birthday party at the penthouse for the hotel’s former General Manager, Mr. Tsuruoka.  Plaintiff agreed as Dr. Filart agreed to vouch for him and carried a basket of fruits, the latter’s gift.   He He lined up at the buffet table as soon as it was ready but to his great shock, shame and embarrassment, Ruby Lim, Hotel’s Executive Secretary, asked him to leave in a loud voice enough to be heard by the people around them.  He was asked to leave the party and a Makati policeman accompanied him to step-out the hotel.  All these time, Dr Filart ignored him adding to his shame and humiliation.

Ms. Ruby Lim: She admitted asking Mr. Reyes to leave the party but not in the manner claimed by the plaintiff.  Ms. Lim approached several people including Dr. Filart’s sister, Ms. Zenaida Fruto, if Dr. Filart did invite him as the captain waiter told Ms. Lim that Mr. Reyes was with Dr. Filart’s group.   She wasn’t able to ask it personally with Dr. Filart since the latter was talking over the phone and doesn’t want to interrupt her.  She asked Mr. Reyes to leave because the celebrant specifically ordered that the party should be

intimate consisting only of those who part of the list.  She even asked politely with the plaintiff to finish his food then leave the party.

During the plaintiff’s cross-examination, he was asked how close was Ms. Lim when she approached him at the buffet table.  Mr. Reyes answered “very close because we nearly kissed each other”.  Considering the close proximity, it was Ms. Lim’s intention to relay the request only be heard by him.  It was Mr. Reyes who made a scene causing everybody to know what happened.

ISSUE: Whether or not petitioners acted abusively in asking Mr. Reyes to leave the party.

HELD:

Supreme Court held that petitioners did not act abusively in asking Mr. Reyes to leave the party.  Plaintiff failed to establish any proof of ill-motive on the part of Ms. Lim who did all the necessary precautions to ensure that Mr. Reyes will not be humiliated in requesting him to leave the party.  Considering almost 20 years of experience in the hotel industry, Ms. Lim is experienced enough to know how to handle such matters.   Hence, petitioners will not be held liable for damages brought under Article 19 and 20 of the Civil Code.