TRANSPORTATION LAW

A.Y. 2018-2019

CASE TITLE: Rogelio Ramos et al. vs. CA

G.R. NO/DATE: G.R. No. 124354. December 29, 1999.
Res ipsa loquitur; Negligence; Damages --- Private respondents were not able to disprove
DOCTRINE: the presumption of negligence on their part in the care of Erlinda and their negligence was
the proximate cause of her condition.

FACTS:

Erlinda Ramos underwent a surgical procedure to remove stone from her gall bladder
(cholecystectomy). They hired Dr. Hosaka, a surgeon, to conduct the surgery at the De Los Santos
Medical Center (DLSMC). Hosaka assured them that he would find a good anesthesiologist. But the
operation did not go as planned, Dr. Osaka arrived at the hospital late, Dr. Guttierez, the
anesthesiologist, started to intubate Erlina when Herminda (Erlinda’s sister-in-law) heard her say that
intubating Erlinda is quite difficult and there were complications. This prompt Dr. Osaka to order a call to
another anesthesiologist, Dr. Caldron who successfully intubated Erlina. The patient’s nails became
bluish and the patient was placed in a trendelenburg position. After the operation, Erlina was diagnosed
to be suffering from diffuse cerebral parenchymal damage and that the petitioner alleged that this was
due to lack of oxygen supply to Erlinda’s brain which resulted from the intubation.

The family of Ramos (petitioners) sued the hospital, the surgeon and the anesthesiologist for
damages. The petitioners showed expert testimony showing that Erlinda's condition was caused by the
anesthesiologist in not exercising reasonable care in “intubating” Erlinda. Eyewitnesses heard the
anesthesiologist saying “Ang hirap ma-intubate nito, mali yata ang pagkakapasok. O lumalaki ang tiyan.”

Diagnostic tests prior to surgery showed that Erlinda was robust and fit to undergo surgery.

The RTC held that the anesthesiologist ommitted to exercise due care in intubating the patient,
the surgeon was remiss in his obligation to provide a “good anesthesiologist” and for arriving 3 hours late
and the hospital is liable for the negligence of the doctors and for not cancelling the operation after the
surgeon failed to arrive on time. The surgeon, anesthesiologist and the DLSMC were all held jointly and
severally liable for damages to petitioners. The CA reversed the decision of the Trial Court.

ISSUE:

Whether or not the private respondents were negligent and thereby caused the comatose
condition of Ramos.

HELD:

Yes, private respondents were all negligent and are solidarily liable for the damages.

Res ipsa loquitur – a procedural or evidentiary rule which means “the thing or the transaction
speaks for itself.” It is a maxim for the rule that the fact of the occurrence of an injury, taken with the
surrounding circumstances, may permit an inference or raise a presumption of negligence, or make out a
plaintiff’s prima facie case, and present a question of fact for defendant to meet with an explanation,
where ordinarily in a medical malpractice case, the complaining party must present expert testimony to
prove that the attending physician was negligent.

This doctrine finds application in this case. On the day of the operation, Erlinda Ramos already
surrendered her person to the private respondents who had complete and exclusive control over her.
Apart from the gallstone problem, she was neurologically sound and fit. Then, after the procedure, she
was comatose and brain damaged—res ipsa loquitur.

Negligence – Private respondents were not able to disprove the presumption of negligence on
their part in the care of Erlinda and their negligence was the proximate cause of her condition. One need
not be an anesthesiologist in order to tell whether or not the intubation was a success. [res ipsa loquitur
applies here]. The Supreme Court also found that the anesthesiologist only saw Erlinda for the first time
on the day of the operation which indicates unfamiliarity with the patient and which is an act of negligence
and irresponsibility.

The head surgeon, Dr. Hosaka was also negligent. He failed to exercise the proper authority as
the “captain of the ship” in determining if the anesthesiologist observed the proper protocols. Also,
because he was late, he did not have time to confer with the anesthesiologist regarding the anesthesia
delivery.

The hospital failed to adduce evidence showing that it exercised the diligence of a good father of
the family in hiring and supervision of its doctors (Art. 2180). The hospital was negligent since they are
the one in control of the hiring and firing of their “consultants”. While these consultants are not
employees, hospitals still exert significant controls on the selection and termination of doctors who work
there which is one of the hallmarks of an employer-employee relationship. Thus, the hospital was
allocated a share in the liability.

Damages – temperate damages can and should be awarded on top of actual or compensatory
damages in instances where the injury is chronic and continuing.