Lozano, Erik Roy V.

Block 3A

DR. RUBI LI vs. SPOUSES REYNALDO AND LINA SOLIMAN, as parents/heirs of

deceased ANGELICA SOLIMAN,
G.R. No. 165279
June 7, 2011

Facts:
Angelica Soliman, daughter of respondents, underwent a biopsy of the mass located in
her lower extremity at the St. Lukes Medical Center (SLMC) and results showed that
Angelica was suffering from a cancer of the bone because of that a necessity of
amputation was conducted by Dr, Tamayo on Angelicas right leg in order to remove the
tumor and to prevent the metastasis that chemotherapy was suggested by Dr. Tamayo,
which he referred to petitioner Dr. Rubi Li, a medical oncologist. The respondent was
admitted to SLMC, however, she died eleven (11) days after the administration of
chemotherapy first cycle. Respondents brought their daughters body to the Philippine
National Police (PNP) Crime Laboratory at Camp Crame for post-mortem examination
after the refusal of the hospital to release the death certificate without full payment of
bills. The Medico-Legal Report showed that the cause of death as "Hypovolemic shock
secondary to multiple organ hemorrhages and Disseminated Intravascular Coagulation.
The respondents filed charges against the SLMC and physicians involve for negligence
and failure to observe the essential precautions in to prevent Angelicas untimely death.
Petitioner denied the allegation for damages as she observed best known procedures,
highest skill and knowledge in the administration of chemotherapy drugs despite all
efforts the patient died. The trial court favored petitioner and ordered to pay their unpaid
hospital bill, but the Court of Appeals reversed the decision favoring the claims of the
respondent.

Issue:

Whether or not the petitioner is liable for failure to fully disclose serious side effects to
the parents of the child patient who died while undergoing treatments suggested by the
petitioner.

Ruling:

No. There are four essential elements a plaintiff must prove in a malpractice action
based upon the doctrine of informed consent: "(1) the physician had a duty to disclose
material risks; (2) he failed to disclose or inadequately disclosed those risks; (3) as a
direct and proximate result of the failure to disclose, the patient consented to treatment
she otherwise would not have consented to; and (4) plaintiff was injured by the proposed
treatment." The gravamen in an informed consent case requires the plaintiff to "point to
significant undisclosed information relating to the treatment which would have altered
her decision to undergo it.

In this instant case there was adequate disclosure of material risks inherent in the
chemotherapy procedure performed with the consent of Angelicas parents. Respondents
could not have been unaware in the course of initial treatment and amputation of
Angelicas lower extremity, that her immune system was already weak on account of the
malignant tumor in her knee. When petitioner informed the respondents beforehand of
Lozano, Erik Roy V. Block 3A
the side effects of chemotherapy which includes lowered counts of white and red blood
cells, decrease in blood platelets, possible kidney or heart damage and skin darkening,
there is reasonable expectation on the part of the doctor that the respondents
understood very well that the severity of these side effects will not be the same for all
patients undergoing the procedure. In other

words, by the nature of the disease itself, each patients reaction to the chemical agents
even with pre-treatment laboratory tests cannot be precisely determined by the
physician. That death can possibly result from complications of the treatment or the
underlying cancer itself, immediately or sometime after the administration of
chemotherapy drugs, is a risk that cannot be ruled out, as with most other major medical
procedures, but such conclusion can be reasonably drawn from the general side effects
of chemotherapy already disclosed.