PSI v.

Agana (Resolution)
(Hi Blockmates, I focused more on the doctrines applicable under this topic
since we all know what happened in this case.)
Doctrines:
On the three ways a Hospital can be held liable in Medical Malpractice suits
Where an employment relationship exists, the hospital may be held
vicariously liable under Article 2176 in relation to Article 2180 of the Civil
Code or the principle of respondeat superior. Even when no employment
relationship exists but it is shown that the hospital holds out to the patient
that the doctor is its agent, the hospital may still be vicariously liable under
Article 2176 in relation to Article 1431 and Article 1869 of the Civil Code or
the principle of apparent authority. Moreover, regardless of its
relationship with the doctor, the hospital may be held directly liable to the
patient for its own negligence or failure to follow established
standard of conduct to which it should conform as a corporation.
On vicarious liability under the Employer-Employee Relationship
Control as a determinative factor in testing the employer-employee
relationship between doctor and hospital under which the hospital could be
held vicariously liable to a patient in medical negligence cases is a requisite
fact to be established by preponderance of evidence. Here, there was
insufficient evidence that PSI exercised the power of control or wielded such
power over the means and the details of the specific process by which Dr.
Ampil applied his skills in the treatment of Natividad. Consequently, PSI
cannot be held vicariously liable for the negligence of Dr. Ampil under the
principle of respondeat superior. (Also, the lower courts found no EE-ER
relationship, and the Aganas did not appeal this finding).
On vicarious liability through the principle of apparent authority
The hospital (PSI) held out to the patient (Natividad) that the doctor (Dr.
Ampil) was its agent. Present are the two factors that determine apparent
authority: first, the hospital's implied manifestation to the patient which led
the latter to conclude that the doctor was the hospital's agent; and second,
the patients reliance upon the conduct of the hospital and the doctor,
consistent with ordinary care and prudence.
Facts:
1. Natividad Agana went in for surgery at The Medical City with Dr. Ampil

as the surgeon.

2. During the surgery, he negligently left a piece of gauze inside Agana,

and did closed the incision without further action despite nurses
reports stating a missing gauze piece.
3. Natividad soon developed complications, and upon visiting another
doctor, she found the gauze piece lodged inside her uterus, causing
infections to develop in the form of puss and dirt.
Issues:
1. Whether Dr. Ampil was negligent.
2. Whether the Hospital could be held vicariously liable for Dr. Ampils
negligence.
Held/Ratio
1. Yes, we all know that.
2. Yes. While MedCity (owned and operated by PSI) cannot be held liable
as Dr. Ampils employer, it can be held liable as his agent.
a. Not an Employer
i. PSI had no power of control on the means and method by
which Dr. Ampil conducted his operation on Agana.
ii. The defendant-doctors were only consultants, and their
relationship with the Hospital was one of an independent
contractorship.
iii. There was a lack of evidence showing any control
exercised by the hospital over Dr. Ampil.
iv. Lower courts findings on the absence of an EE-ER
relationship are binding on the SC as the Aganas did not
appeal that aspect of the case.
b. Ostensible Agency
i. Enrique, Natividads husband, chose Dr. Ampil because he
knew him to be part of the staff of Med City, which was a
prominent and known hospital.
ii. PSIs acts tended to affirm Enriques view when they
referred to Dr. Ampil as a physician of this hospital in the
consent forms which needed to be signed before surgery
could be performed.
Side issue: Remember that PSI was also held liable under Corporate
Negligence.