Court News Flash February 2007

SC Holds Hospital, Doctor Liable for Medical Negligence

Posted: February 6, 2007 By Jay B. Rempillo The Supreme Court has upheld the solidary liability of the owners of the Medical City General Hospital and Dr. Miguel Ampil, a member of its surgical staff, in the amount of over PhP3 million for medical negligence for leaving behind two pieces of gauze inside a patients body during surgery in 1984. In a 26-page decision penned by Justice Angelina Sandoval-Gutierrez, the Courts First Division affirmed the Court of Appeals September 6, 1996 decision affirming with modification the March 17, 1993 decision of the Quezon City Regional Trial Court, Branch 96 and nullifying the RTCs order dated September 21, 1993. The Court held both the Professional Services, Inc. (PSI), owner of the Medical City Hospital, and Dr. Ampil liable for the injury sustained by Natividad Agana. The Court said Dr. Ampils negligence was the proximate cause of Natividads injury, which could be traced from his act of closing the incision despite the information given by the attending nurses that two pieces of gauze were still missing. It found that Dr. Ampil did not inform Natividad about the two missing pieces of gauze. Worse, he even misled her that the pain she experienced after the procedure was the ordinary consequence of her operation. Natividad died in 1986. To our mind, what was initially an act of negligence by Dr. Ampil has ripened into a deliberate wrongful act of deceiving his patientThis is a clear case of medical malpractice or more appropriately, medical negligence, the Court said. The Court noted that it is not blind to the reality that there are times when danger to a patients life precludes a surgeon from further searching missing sponges or foreign objects left in the body. Such, however, does not leave him free from any obligation, the Court stressed. Citing Ramos v. CA, the Court said that PSI was liable since an employer-employee relationship exists between PSI and Dr. Ampil. Likewise, it added that PSIs liability is anchored upon the agency principle of apparent authority or agency by estoppel and the doctrine of corporate negligence which have gained acceptance in the determination of a hospitals liability for negligent acts of health professionals. The present case serves as a perfect platform to test the applicability of these doctrines, thus, enriching our jurisprudence, the Court said. By accrediting Dr. Ampil and Dr. Juan Fuentes, who performed additional surgery on Natividad, and publicly advertising their qualifications, the hospital created the impression that they were its agents, authorized to perform medical or surgical services for its patients, it added. The Court upheld the trial courts finding holding PSI directly liable for breach of duty based on the doctrine of corporate negligence. It noted that Dr. Ampil and Dr. Fuentes operated on Natividad with the assistance of Medical City Hospitals staff. As such, it is reasonable to conclude that PSI, as the operator of the hospital, has actual or constructive knowledge of the procedures carried out, particularly the report of the attending nurses that the two pieces of gauze were missing. By its failure to investigate and inform Natividad despite the attending nurses report, PSI not only breached its duties to oversee or supervise all persons who

practice medicine within its walls but also failed to take an active step in fixing the negligence committed, the Court stressed. The Court however said that the CA did not err in absolving Dr. Fuentes who assisted Dr. Ampil in the operation. It stressed that Dr. Ampil was the lead surgeon during Natividads operation and that Dr. Ampil had examined Dr. Fuentes work and finding it to be in order allowed him to leave the operating room. In 1984, Natividad underwent surgery for cancer of the sigmoid. The sigmoid colon joins the rectum, which in turn joins the anus, or the opening where waste matter, or stool, passes out of the body. Dr. Ampil, who performed the surgery, found that the cancer had spread to her left ovary, necessitating the removal of certain portions of it through a hysterectomy by Dr. Fuentes. After Dr. Fuentes performed the surgery, Dr. Ampil completed operation and closed the incision. Operation records showed that the attending nurses entered among remarks, sponge count lacking 2, and announced to surgeon searched (sic) done but to no avail continue for closure. After her subsequent discharge from the hospital, Natividad complained of pains but were told by Dr. Ampil and Dr. Fuentes that the pain was the natural consequence of the surgery. She later sought further treatment in the United States and was told she was free of cancer. In August 1984, Natividad went back to Philippines. Later, her daughter found a piece of gauze protruding from her reproductive organ. Dr. Ampil subsequently extracted by hand a piece of gauze and assured Natividad that the pain would vanish. When the pain intensified, Natividad sought treatment at Polymedic General Hospital where a doctor found another foul smelling gauze which badly infected her vaginal vault. She underwent another surgery and subsequently filed a complaint for damages with the RTC. On March 17, 1993, the RTC ruled in Natividads favor finding PSI, Dr. Ampil, and Dr. Fuentes liable for negligence and malpractice. On appeal, the CA dismissed the case against Fuentes and held both PSI and Dr. Ampil liable for medical negligence. Dr. Ampil elevated the case to the High Court when the CA denied his motion for reconsideration. Concurring were Division Chair Chief Justice Reynato S. Puno and members Renato C. Corona and Adolfo S. Azcuna. Justice Cancio C. Garcia did not take part in the deliberations. (Professional Services, Inc v. Agana and Agana, GR No. 126297; Agana, et al. v. Fuentes, GR No. 126467; Ampil v. Agana and Agana; GR No. 127590; January 31, 2007)
Pasted from <http://sc.judiciary.gov.ph/news/courtnews%20flash/2007/02/02060702.php>