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The doctors in the above case got out scot-free, even if the RTC found
out that they failed to assess the patient’s heart disease—a rheumatic heart
disease with mitral stenosis—which led to the patients pulmonary
hypertension, then pulmonary edema, and eventual respiratory arrest; all
because the nurse didn’t assess the respiratory function of the patient; an
assessment which, in my humble asseveration, could, and should, have been
done with greater accuracy and thoroughness by the admitting physician.
The lesson to be learned from this case, for me, is that nurses must do
everything in their power not to be the “fall guy”, the “stodge”, or the
“scapegoat.” They must assess each patient like their jobs, liberty, and
dignity depend on it; and must never rely solely on the good doctor’s
proclamation that the “coast is clear.”
4
Kozier, Fundamentals of Nursing, 2012.
5
Aquino, Civil Law Review 2018.
6
See Par. 6, Article 11, RA 3815.
7
GR 189218, March 22, 2017.
8
ibid
Laws, and jurisprudence, ultimately are the ones that ensure doctors
and nurses do their jobs properly. The practice of medicine in our time is
highly evolved. The science is in such an advanced state, that the maladies
of yore do not court death as they often do. The science is there. It’s just up
to doctors and nurses to stick to their job descriptions and comply with the
standards. And this is as true in the area of respiratory assessment.
Because it’s when the children of medicine or nursing let their egos
govern and break rules that patients die. In the case of Rogelio Nogales v
Capitol Medical Center, Dr. Oscar Estrada et al 9, a pregnant mother was
admitted with preeclampsia, a condition characterized by severe
hypertension with risk for convulsion accompanying the pregnancy. In
jurisprudence, the mother with pre-eclampsia is usually made to give birth
by Caesarian Section for her safety, not through NSVD (normal spontaneous
vaginal delivery); she may even legally undergo abortion—terminate and
expel the fetus—to save her life.10 That is probably why, in this case, the
anesthesiologist of Capitol Medical Center offered his services to Dr Oscar
Estrada. But Estrada refused the services of the anesthesiologist and
proceeded with the NSVD, as documented by the nurse in the nurses notes
(good job of the nurse). Nevertheless, the good anesthesiologist remained in
the hospital to monitor the situation. Indeed, the worst happened: the blood
pressure of the mother spiked and she experienced convulsions. Magnesium
sulfate was injected to her, to no avail. Doctor Estrada pulled the baby out
by forceps delivery, tearing a chunk of the mother’s cervix and injuring the
baby’s head in the process (the baby came out pale and apneic). A series of
medical treatments was done with many specialists involved, but the mother
ultimately died to postpartum haemorrhage. The Supreme Court upheld the
decision reached by the RTC (Regional Trial Court) after eleven (11) years
of trial: that it was the malpractice of Dr. Oscar Estrada and the negligence
of Capitol Medical Center that caused the patient’s death. As a result,
Capitol Medical Center is made vicariously liable with Dr. Estrada for Php
105,000 for actual damages, and Php 700,000 for moral damages.
9
GR 142625, Dec 19, 2006.
10
Reyes, Criminal Law, 2016. See Par 4, Art. 11 of RA 3815.