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, Edithas 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 intraabdominal 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, petitioners 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 Edithas gross negligence and/or omission in
insisting to be discharged against doctors advice and her unjustified failure to return for check-up as
directed by petitioner that contributed to her life-threatening condition on; that Edithas 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 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 Edithas
uterus. The defenses in an action for damages, provided for under Article 2179 of the Civil Code are:
Art. 2179. When the plaintiffs 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 defendants 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 complainants 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 defendants
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 plaintiffs own act, which contributed to the principal occurrence as
one of its determining factors, he cannot recover damages for the injury.
_____________________________________________________________________________________
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 companys 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 Atlantics 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).
_____________________________________________________________________________________
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 hotels former General Manager, Mr. Tsuruoka. Plaintiff
agreed as Dr. Filart agreed to vouch for him and carried a basket of fruits, the latters 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,
Hotels 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. Filarts sister, Ms. Zenaida Fruto, if Dr. Filart did
invite him as the captain waiter told Ms. Lim that Mr. Reyes was with Dr. Filarts group. She wasnt able to
ask it personally with Dr. Filart since the latter was talking over the phone and doesnt 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 plaintiffs 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. Lims 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.