Transportation Law Cases

Transportation Law Assignment
Date of Submission: June 28,2018
(a) What is Res Ipsa Loquitor? Elaborate.

(b) State brief facts, issue in Ruling of the Supreme Court and following cases: 1
(1) Cariaga et al vs Laguna Tayabas Bus Co. 110 phil. 346;
(2) Leah Alesna Reyes, et al vs Sisters of Mercy Hospital G.R.No. 130547, Oct.
3,2000.
Res ipsa loquitur is a Latin phrase that means "the thing speaks for itself." In personal
injury law, the concept of res ipsa loquitur (or just "res ipsa" for short) operates as an
evidentiary rule that allows plaintiffs to establish a rebuttable presumption of negligence on
the part of the defendant through the use of circumstantial evidence. This means that while
plantiffs typically have to prove that the defendant acted with a negligent state of mind,
through res ipsa loquitur, if the plaintiff puts forth certain circumstantial facts, it becomes
the defendant's burden to prove he or she was not negligent.
Background
Accidents happen all the time, and the mere fact that an accident has occurred doesn't
necessarily mean that someone's negligence caused it. In order to prove negligence in a
personal injury lawsuit, a plaintiff must present evidence to demonstrate that the
defendant's negligence resulted in the plaintiff's injury. Sometimes, direct evidence of the
defendant's negligence doesn't exist, but plaintiffs can still use circumstantial evidence in
order to establish negligence.
Circumstantial evidence consists of facts that point to negligence as a logical conclusion

rather than demonstrating it outright. Rather than directly proving a defendant's negligence,
circumstantial evidence allows judges and juries to infer negligence based on the totality of
the circumstances and the shared knowledge that arises out of human experience.
Res ipsa is one type of circumstantial evidence that allows a reasonable fact finder to
determine that the defendant's negligence caused an unusual event that subsequently
caused injury to the plaintiff. The res ipsa doctrine arose out of a case where the plaintiff
suffered injuries from a falling barrel of flour while walking by a warehouse. At the trial, the
plaintiff's attorney argued that the facts spoke for themselves and demonstrated the
warehouse's negligence since no other explanation could account for the cause of the
plaintiff's injuries.
As it has developed since then, res ipsa allows judges and juries to apply common sense to
a situation in order to determine whether or not the defendant acted negligently.
HazelMapz2018
Elements of Res Ipsa Loquitur
Since the laws of personal injury and evidence are determined at the state level, the law
regarding res ipsa loquitur varies slightly between states. That said, a general consensus
has emerged, and most states follow one basic formulation of res ipsa.
Under this model for res ipsa, there are three requirements that the plaintiff must meet
before a jury can infer that the defendant's negligence caused the harm in question: 2
 The event doesn't normally occur unless someone has acted negligently;
 The evidence rules out the possibility that the actions of the plaintiff or a third party
caused the injury; and
 The type of negligence in question falls with the scope of the defendant's duty to the
plaintiff.
The Presence of Negligence
As mentioned above, not all accidents occur because of someone else's negligence. Some
accidents, on the other hand, almost never occur unless someone has acted negligently.
Going back to the old case of the falling flour-barrel, it's a piece of shared human knowledge
that things don't generally fall out of warehouse windows unless someone hasn't taken care
to block the window or hasn't ensured that items on the warehouse floor are properly
stored. When something does fall out of a warehouse window, the law will assume that it
happened because someone was negligent.
Only the Defendant Is Responsible
The second component of a res ipsa case hinges on whether the defendant carries sole
responsibility for the injury. If the plaintiff can't prove by a preponderance of the evidence
that the defendant's negligence cause the injury, then they will not be able to recover under
res ipsa.
States sometimes examine whether the defendant had exclusive control over the specific
instrumentality that caused the accident in order to determine if the defendant's negligence
caused the injury. For example, if a surgeon leaves a sponge inside the body of a patient, a
jury can infer that the surgeon's negligence caused the injury since he had exclusive control
over the sponges during the operation.
The Defendant Owes the Plaintiff a Duty of Care
In addition to the first two elements, the defendant must also owe a duty of care to protect
the plaintiff from the type of injury at issue in the suit. If the defendant does not have such
a duty, or if the type of injury doesn't fall within the scope of that duty, then there is no
liability.
For example, in many states, landowners don't owe trespassers any duty to protect them
against certain types of dangers on their property. Thus, even if a trespasser suffers an
HazelMapz2018
injury that was caused by the defendant's action or inaction and that wouldn't normally
occur in the absence of negligence, res ipsa loquitur won't establish negligence since the
landowner never had any responsibility to prevent injury to the trespasser in the first place.
Rebutting Res Ipsa
Res ipsa only allows plaintiffs to establish the inference of the defendant's negligence, not to
prove the negligence completely. Defendants can still rebut the presumption of negligence 3
that res ipsa creates by refuting one of the elements listed above.
For example, the defendant could prove by a preponderance of the evidence that the injury
could occur even if reasonable care took place to prevent it. An earthquake could shake an
item loose and it could fall out of the warehouse window, for instance.
A defendant could also demonstrate that the plaintiff's own negligence contributed to the
injury. To go back to the flour-barrel example, if the defendant shows that the plaintiff was
standing in an area marked as dangerous it could rebut the presumption of negligence
created by res ipsa.
Finally, the defendant could establish that he did not owe the plaintiff a duty of care under
the law, or that the injury did not fall within the scope of the duty owed. For example, if the
law only imposes a limited duty on the defendant not to behave recklessly, then res ipsa will
not help the plaintiff by creating an inference of negligence since a negligent action would
not violate the duty owed to the plaintiff.
Get a Free Claim Review by an Experienced Attorney
Minor details can become extremely important when determining whether the elements
exist for a res ipsa loquitur action -- details best left to an exerienced lawyer. By having an
attorney review your claim for free, you can have the peace of mind of knowing the strength
of your claim and any steps you'll need to take moving forward.
HazelMapz2018
G.R. No. L-11037 December 29, 1960
EDGARDO CARIAGA, ET AL., plaintiffs-appellants,

vs.
LAGUNA TAYABAS BUS COMPANY, defendant-appellant.
MANILA RAILROAD COMPANY, defendant-appellee.
Ozaeta, Lichauco and Picazo for defendant and appellant. 4

E.A. Fernandez and L.H. Fernandez for plaintiffs and appellants.
Gov't. Corp. Counsel A. Padilla and Atty. F.A. Umali for appellee.
DIZON, J.:
At about 1:00 p.m. on June 18, 1952, Bus No. 133 of the Laguna Tayabas Bus
Co. — hereinafter referred to as the LTB — driven by Alfredo Moncada, left its station at Azcarraga St.,
Manila, for Lilio, Laguna, with Edgardo Cariaga, a fourth-year medical student of the University of Santo
Tomas, as one of its passengers. At about 3:00 p.m., as the bus reached that part of the poblacion of
Bay, Laguna, where the national highway crossed a railroad track, it bumped against the engine of a train
then passing by with such terrific force that the first six wheels of the latter were derailed, the engine and
the front part of the body of the bus was wrecked, the driver of the bus died instantly, while many of its
passengers, Edgardo among them, were severely injured. Edgardo was first confined at the San Pablo
City Hospital from 5:00 p.m., June 18, 1952, to 8:25 a.m., June 20 of the same year when he was taken
to the De los Santos Clinic, Quezon City. He left that clinic on October 14 to be transferred to the
University of Santo Tomas Hospital where he stayed up to November 15. On this last date he was taken
back to the De los Santos Clinic where he stayed until January 15, 1953. He was unconscious during the
first 35 days after the accident; at the De los Santos Clinic Dr. Gustilo removed the fractured bones which
lacerated the right frontal lobe of his brain and at the University of Santo Tomas Hospital Dr. Gustilo
performed another operation to cover a big hole on the right frontal part of the head with a tantalum plate.
The LTB paid the sum of P16,964.45 for all the hospital, medical and miscellaneous expenses incurred
from June 18, 1952 to April, 1953. From January 15, 1953 up to April of the same year Edgardo stayed in
a private house in Quezon, City, the LTB having agreed to give him a subsistence allowance of P10.00
daily during his convalescence, having spent in this connection the total sum of P775.30 in addition to the
amount already referred to.
On April 24, 1953 the present action was filed to recover for Edgardo Cariaga, from the LTB and the MRR
Co., and total sum of P312,000.00 as actual, compensatory, moral and exemplary damages, and for his
parents, the sum of P18,00.00 in the same concepts. The LTB disclaimed liability claiming that the
accident was due to the negligence of its co-defendant, the Manila Railroad Company, for not providing a
crossing bar at the point where the national highway crossed the railway track, and for this reason filed
the corresponding cross-claim against the latter company to recover the total sum of P18,194.75
representing the expenses paid to Edgardo Cariaga. The Manila Railroad Company, in turn, denied
liability upon the complaint and cross-claim alleging that it was the reckless negligence of the bus driver
that caused the accident.
The lower court held that it was the negligence of the bus driver that caused the accident and, as a result,
rendered judgment sentencing the LTB to pay Edgardo Cariaga the sum of P10,490.00 as compensatory
damages, with interest at the legal rate from the filing of the complaint, and dismissing the cross-claim
against the Manila Railroad Company. From this decision the Cariagas and the LTB appealed.
The Cariagas claim that the trial court erred: in awarding only P10,490.00 as compensatory damages to
Edgardo; in not awarding them actual and moral damages, and in not sentencing appellant LTB to pay
attorney's fees.
HazelMapz2018
On the other hand, the LTB's principal contention in this appeal is that the trial court should have held that
the collision was due to the fault of both the locomotive driver and the bus driver and erred, as a
consequence, in not holding the Manila Railroad Company liable upon the cross-claim filed against it.
We shall first dispose of the appeal of the bus company. Its first contention is that the driver of the train
locomotive, like the bus driver, violated the law, first, in sounding the whistle only when the collision was
about to take place instead of at a distance at least 300 meters from the crossing, and second, in not
ringing the locomotive bell at all. Both contentions are without merits.
5
After considering the evidence presented by both parties the lower court expressly found:
. . . While the train was approximately 300 meters from the crossing, the engineer sounded two
long and two short whistles and upon reaching a point about 100 meters from the highway, he
sounded a long whistle which lasted up to the time the train was about to cross it. The bus
proceeded on its way without slackening its speed and it bumped against the train engine,
causing the first six wheels of the latter to be derailed.
xxx xxx xxx
. . . that the train whistle had been sounded several times before it reached the crossing. All
witnesses for the plaintiffs and the defendants are uniform in stating that they heard the train
whistle sometime before the impact and considering that some of them were in the bus at the
time, the driver thereof must have heard it because he was seated on the left front part of the bus
and it was his duty and concern to observe such fact in connection with the safe operation of the
vehicle. The other L.T.B. bus which arrived ahead at the crossing, heeded the warning by
stopping and allowing the train to pass and so nothing happened to said vehicle. On the other
hand, the driver of the bus No. 133 totally ignored the whistle and noise produced by the
approaching train and instead he tried to make the bus pass the crossing before the train by not
stopping a few meters from the railway track and in proceeding ahead.
The above findings of the lower court are predicated mainly upon the testimony of Gregorio Ilusondo, a
witness for the Manila Railroad Company. Notwithstanding the efforts exerted by the LTB to assail his
credibility, we do not find in the record any fact or circumstance sufficient to discredit his testimony. We
have, therefore, no other alternative but to accept the findings of the trial court to the effect, firstly, that the
whistle of locomotive was sounded four times — two long and two short — "as the train was
approximately 300 meters from the crossing"; secondly, that another LTB bus which arrived at the
crossing ahead of the one where Edgardo Cariaga was a passenger, paid heed to the warning and
stopped before the "crossing", while — as the LTB itself now admits (Brief p. 5) — the driver of the bus in
question totally disregarded the warning.
But to charge the MRR Co. with contributory negligence, the LTB claims that the engineer of the
locomotive failed to ring the bell altogether, in violation of the section 91 of Article 1459, incorporated in
the charter of the said MRR Co. This contention — as is obvious — is the very foundation of the cross-
claim interposed by the LTB against its
co-defendant. The former, therefore, had the burden of proving it affirmatively because a violation of law
is never presumed. The record discloses that this burden has not been satisfactorily discharged.
The Cariagas, as appellants, claim that the award of P10,000.00 compensatory damages to Eduardo is
inadequate considering the nature and the after effects of the physical injuries suffered by him. After a
careful consideration of the evidence on this point we find their contentions to be well-founded.
From the deposition of Dr. Romeo Gustilo, a neurosurgeon, it appears that, as a result of the injuries
suffered by Edgardo, his right forehead was fractured necessitating the removal of practically all of the
right frontal lobe of his brain. From the testimony of Dr. Jose A. Fernandez, a psychiatrist, it may be
HazelMapz2018
gathered that, because of the physical injuries suffered by Edgardo, his mentality has been so reduced
that he can no longer finish his studies as a medical student; that he has become completely misfit for
any kind of work; that he can hardly walk around without someone helping him, and has to use a brace on
his left leg and feet.
Upon the whole evidence on the matter, the lower court found that the removal of the right frontal lobe of
the brain of Edgardo reduced his intelligence by about 50%; that due to the replacement of the right
frontal bone of his head with a tantalum plate Edgardo has to lead a quite and retired life because "if the
6
tantalum plate is pressed in or dented it would cause his death."
The impression one gathers from this evidence is that, as a result of the physical injuries suffered by
Edgardo Cariaga, he is now in a helpless condition, virtually an invalid, both physically and mentally.
Appellant LTB admits that under Art. 2201 of the Civil Code the damages for which the obligor, guilty of a
breach of contract but who acted in good faith, is liable shall be those that are the natural and probable
consequences of the breach and which the parties had forseen or could have reasonably forseen at the
time the obligation was constituted, provided such damages, according to Art. 2199 of the same Code,
have been duly proved. Upon this premise it claims that only the actual damages suffered by Edgardo
Cariaga consisting of medical, hospital and other expenses in the total sum of P17,719.75 are within this
category. We are of the opinion, however, that the income which Edgardo Cariaga could earn if he should
finish the medical course and pass the corresponding board examinations must be deemed to be within
the same category because they could have reasonably been foreseen by the parties at the time he
boarded the bus No. 133 owned and operated by the LTB. At that time he was already a fourth-year
student in medicine in a reputable university. While his scholastic may not be first rate (Exhibits 4, 4-A to
4-C), it is, nevertheless, sufficient to justify the assumption that he could have passed the board test in
due time. As regards the income that he could possibly earn as a medical practitioner, it appears that,
according to Dr. Amado Doria, a witness for the LTB, the amount of P300.00 could easily be expected as
the minimum monthly income of Edgardo had he finished his studies.
Upon consideration of all the facts mentioned heretofore this Court is of the opinion, and so holds, that
the compensatory damages awarded to Edgardo Cariaga should be increased to P25,000.00.
Edgardo Cariaga's claim for moral damages and attorney's fees was denied by the trial court, the
pertinent portion of its decision reading as follows:
Plaintiffs' claim for moral damages cannot also be granted. Article 2219 of the Civil Code
enumerates the instances when moral damages may be covered and the case under
consideration does not fall under any one of them. The present action cannot come under
paragraph 2 of said article because it is not one of the quasi-delict and cannot be considered as
such because of the pre-existing contractual relation between the Laguna Tayabas Bus Company
and Edgardo Cariaga. Neither could defendant Laguna Tayabas Bus Company be held liable to
pay moral damages to Edgardo Cariaga under Article 2220 of the Civil Code on account of
breach of its contract of carriage because said defendant did not act fraudulently or in bad faith in
connection therewith. Defendant Laguna Tayabas Bus Company had exercised due diligence in
the selection and supervision of its employees like the drivers of its buses in connection with the
discharge of their duties and so it must be considered an obligor in good faith.
The plaintiff Edgardo Cariaga is also not entitled to recover for attorney's fees, because this case
does not fall under any of the instances enumerated in Article 2208 of the Civil Code.
We agree with the trial court and, to the reason given above, we add those given by this Court in Cachero
vs. Manila Yellow Taxicab Co., Inc.(101 Phil., 523, 530, 533):
HazelMapz2018
A mere perusal of plaintiff's complaint will show that this action against the defendant is
predicated on an alleged breach of contract of carriage, i.e., the failure of the defendants to bring
him "safely and without mishaps" to his destination, and it is to be noted that the chauffeur of
defendant's taxicab that plaintiff used when he received the injuries involved herein, Gregorio
Mira, has not even made a party defendant to this case.
Considering, therefore, the nature of plaintiff's action in this case, is he entitled to compensation
for moral damages? Article 2219 of the Civil Code says the following:
7
Art. 2219. Moral damages may be recovered in the following and analogous cases:
(1) A criminal offense resulting in physical injuries;
(2) Quasi-delicts causing physical injuries;
(3) Seduction, abduction, rape, or other lascivious acts;
(4) Adultery or concubinage;
(5) Illegal or arbitrary detention or arrest;
(6) Illegal search;
(7) Libel, slander or any other form of defamation;
(8) Malicious prosecution;
(9) Acts mentioned in Article 309;
(10) Acts and actions referred to in Articles 21, 26, 27, 28, 29, 30, 32, 34, and 35.
xxx xxx xxx
Of course enumerated in the just quoted Article 2219 only the first two may have any bearing on
the case at bar. We find, however, with regard to the first that the defendant herein has not
committed in connection with this case any "criminal offense resulting in physical injuries". The
one that committed the offense against the plaintiff is Gregorio Mira, and that is why he has been
already prosecuted and punished therefor. Altho (a) owners and managers of an establishment
and enterprise are responsible for damages caused by their employees in the service of the
branches in which the latter are employed or on the occasion of their functions; (b) employers are
likewise liable for damages caused by their employees and household helpers acting within the
scope of their assigned task (Article 218 of the Civil Code); and (c) employers and corporations
engaged in any kind of industry are subsidiary civilly liable for felonies committed by their
employees in the discharge of their duties (Art. 103, Revised Penal Code), plaintiff herein does
not maintain this action under the provisions of any of the articles of the codes just mentioned and
against all the persons who might be liable for the damages caused, but as a result of an
admitted breach of contract of carriage and against the defendant employer alone. We, therefore,
hold that the case at bar does not come within the exception of paragraph 1, Article 2219 of the
Civil Code.
The present complaint is not based either on a "quasi-delict causing physical injuries" (Art. 2219,
par. 2 of the Civil Code). From the report of the Code Commission on the new Civil Code. We
copy the following:
HazelMapz2018
A question of nomenclature confronted the Commission. After a careful deliberation, it was
agreed to use the term "quasi-delict" for those obligations which do not arise from law, contracts,
quasi-contracts, or criminal offenses. They are known in Spanish legal treaties as "culpa
aquiliana", "culpa-extra-contractual" or "cuasi-delitos". The phrase "culpa-extra-contractual" or its
translation "extra-contractual-fault" was eliminated because it did not exclude quasi-contractual or
penal obligations. "Aquilian fault" might have been selected, but it was thought inadvisable to
refer to so ancient a law as the "Lex Aquilia". So "quasi-delict" was chosen, which more nearly
corresponds to the Roman Law classification of the obligations and is in harmony with the nature
of this kind of liability. 8
The Commission also thought of the possibility of adopting the word "tort" from Anglo-American
law. But "tort" under that system is much broader than the Spanish-Philippine concept of
obligations arising from non-contractual negligence. "Tort" in Anglo-American jurisprudence
includes not only negligence, but also intentional criminal act, such as assault and battery, false
imprisonment and deceit. In the general plan of the Philippine legal system, intentional and
malicious acts are governed by the Penal Code, although certain exceptions are made in the
Project. (Report of the Code Commission, pp. 161-162).
In the case of Cangco, vs. Manila Railroad, 38 Phil. 768, We established the distinction between
obligation derived from negligence and obligation as a result of a breach of contract. Thus, we
said:
It is important to note that the foundation of the legal liability of the defendant is the contract of
carriage, and that the obligation to respond for the damage which plaintiff has suffered arises, if at
all, from the breach of that contract by reason of the failure of defendant to exercise due care in
its performance. That is to say, its liability is direct and immediate, differing essentially in the legal
viewpoint from the presumptive responsibility for the negligence of its servants, imposed by
Article 1903 of the Civil Code (Art. 2180 of the new), which can be rebutted by proof of the
exercise of due care in their selection of supervision. Article 1903 is not applicable to obligations
arising EX CONTRACTU, but only to extra-contractual obligations — or to use the technical form
of expression, that article relates only to CULPA AQUILIANA' and not to CULPA
CONTRACTUAL.lawphil.net
The decisions in the cases of Castro vs. Acro Taxicab Co., (82 Phil., 359; 46 Off. Gaz., No. 5, p.
2023); Lilius, et al. vs. Manila Railroad, 59 Phil., 758) and others, wherein moral damages were
awarded to the plaintiffs, are not applicable to the case at bar because said decision were
rendered before the effectivity of the new Civil Code (August 30, 1950) and for the further reason
that the complaints filed therein were based on different causes of action.
In view of the foregoing the sum of P2,000 was awarded as moral damages by the trial court has
to be eliminated, for under the law it is not a compensation awardable in a case like the one at
bar.
What has been said heretofore relative to the moral damages claimed by Edgardo Cariaga obviously
applies with greater force to a similar claim (4th assignment of error) made by his parents.
The claim made by said spouses for actual and compensatory damages is likewise without merits. As
held by the trial court, in so far as the LTB is concerned, the present action is based upon a breach of
contract of carriage to which said spouses were not a party, and neither can they premise their claim
upon the negligence or quasi-delict of the LTB for the simple reason that they were not themselves
injured as a result of the collision between the LTB bus and train owned by the Manila Railroad Company.
Wherefore, modified as above indicated, the appealed judgement is hereby affirmed in all other respects,
with costs against appellant LTB.
HazelMapz2018
Cariaga vs. LAGUNA TAYABAS BUS COMPANY and MANILA RAILROAD COMPANY
Dizon, J. December 29, 1960 G.R. No. L-11037
Doctrine Damages recoverable from common carriers; Actual or compensatory –
An obligor guilty of a breach of contract in good faith is liable under Art. 2201, NCC for
such damages which are the “natural and probable consequences of the breach and which
the parties had foreseen at the time the obligation was constituted,” provided such
damages, according to Art. 2199 of the same Code, have been duly proved. This would be
the premise for the award of actual damages. 9
However, in increasing the award for compensatory damages, the Court also took in
consideration the income Cariaga would have earned had he been able to finish his studies
and pass the Board because they could have reasonably been foreseen by the parties at the
time he boarded the bus No. 133 owned and operated by the LTB.
Summary Cariaga, a medical student, was on board the LTB bus bound for Laguna when, upon
reaching the train crossing, it bumped the engine of the moving train of the MRR. He was
hospitalized for his serious injuries which reduced his intelligence and made him incapable
of finishing his studies. He sued the LTB and MRR for actual, compensatory, exemplary,
and moral damages and attorney’s fees. The trial court held LTB liable for compensatory
damages. The Supreme Court held that the MRR was not guilty of contributory negligence
and that its driver made many warnings upon the crossing. The SC increased the award of
compensatory damages, taking into account the income he should have earned had he been
able to finish his studies and pass the boards (which is now impossible because of his
injuries). Moral damages, compensatory damages, and attorney’s fees weren’t granted,
however, since the cause of action did not arise out of a quasi-delict resulting to physical
injuries.
Facts  The Accident. Cariaga was a passenger of the LTB bus bound for Lilio, Laguna
which left Manila at 1:00 pm. At about 3:00 p.m., as the bus reached that part of
the poblacion of Bay, Laguna, where the national highway crossed a railroad track,
it bumped against the engine of a train then passing by with such terrific force that
the first six wheels of the latter were derailed, the engine and the front part of the
body of the bus was wrecked, the driver of the bus died instantly, while many of its
passengers were injured.
 Cariaga was severely injured – he was hospitalized from June 18, 1952 to January
15, 1953 in four different hospitals; unconscious for the first 35 days after the
incident; that he underwent two operations to remove the fractured bones which
lacerated the right frontal lobe of his brain and to cover the big hole on his head
with titanium plate.
 LTB paid the sum of P16,964.45 for all the hospital, medical and miscellaneous
expenses incurred from June 18, 1952 to April, 1953. From January to April 1953,
he stayed at a private residence in Quezon City wherein LTB provided him with a
subsistence allowance of P10.00 daily during his convalescence, having spent in
this connection the total sum of P775.
 Damages Suit. Filed against the LTB and MRR for P312,000.00 as actual,
compensatory, moral and exemplary damages, and for his parents, the sum of
P18,00.00 in the same concepts. LTB disclaimed liability by arguing that it was the
train driver who’s negligent by not giving any warning at the crossing. It filed a
cross-claim against MRR to recover the total sum of P18,194.75 representing the
expenses paid to Cariaga.
 Trial Court. Held LTB liable; ordered it to pay P10,490.00 as compensatory
HazelMapz2018
damages, with interest at the legal rate from the filing of the complaint, and
dismissing the cross-claim against the Manila Railroad Company
 Both Cariaga and LTB appealed from the decision. Cariaga said the TC erred in
only awarding said sum as compensatory damages and for not awarding actual and
moral d.
1. Whether LTB’s cross-claim should be granted by the trial court (or whether
Ratio/Issues
MRR was guilty of contributory negligence) NO
LTB: The train driver, like the bus driver, violated the law, first, in sounding the whistle 10
only when the collision was about to take place instead of at a distance at least 300 meters
from the crossing, and second, in not ringing the locomotive bell at all.
COURT: A. The trial court relied upon the testimony of the witness for MRR who
testified that the whistle of locomotive was sounded four times — two long and two short
— "as the train was approximately 300 meters from the crossing"; and that another LTB
bus which arrived at the crossing ahead of the one where Edgardo Cariaga was a passenger,
paid heed to the warning and stopped before the "crossing", while — as the LTB itself now
admits — the driver of the bus in question totally disregarded the warning.
B. LTB claimed that MRR violated section 91 of Article 1459 of its charter by not making
any warning sounds, but, the Court held that LTB failed to discharge the burden of proving
that MRR violated the law.
2. Whether the award of P10,000 as compensatory damages was adequate (NO –

as a result of his injuries, he became virtually an invalid, physically and
mentally)
COURT: A. From the deposition of Dr. Romeo Gustilo, a neurosurgeon , as a result of the
injuries suffered by Edgardo, his right forehead was fractured necessitating the removal of
practically all of the right frontal lobe of his brain. According to the testimony of Dr. Jose
Fernandez, a psychiatrist, due to his physical injuries,
his mentality has been so reduced that he can no longer finish his studies as a medical
student; that he has become completely misfit for any kind of work; that he can hardly
walk around without someone helping him, and has to use a brace on his left leg and feet.
B. His injuries reduced his intelligence by 50% and that due to the replacement of the right
frontal bone of his head with a tantalum plate Edgardo has to lead a quite and retired life
because if the tantalum plate is pressed in or dented it would cause his death.
C. (See doctrine) While his scholastic may not be first rate, it is sufficient to justify the
assumption that he could have passed the board test in due time. As regards the income that
he could possibly earn as a medical practitioner, it appears that, according to Dr. Amado
Doria, a witness for the LTB, the amount of P300.00 could easily be expected.
3. Whether the award of moral damages and attorney’s fees is proper (NO)
COURT: A. As for the moral damages – Article 2219 of the Civil Code enumerates the
instances when moral damages may be covered and the case under consideration does not
fall under any one of them. The present action cannot come under paragraph 2 of said
article because it is not one of the quasi-delict and cannot be considered as such because of
the pre-existing contractual relation between the Laguna Tayabas Bus Company and
Edgardo Cariaga.
B. As for the attorney’s fees – this case does not fall under any of the instances enumerated
in Article 2208.
The Court also cited Cachero vs. Manila Yellow Taxicab Co., Inc. which discussed how an
action for damages arising from a breach of contract of carriage, like in this case, cannot
give rise to moral damages.
HazelMapz2018
C. The claim made by said spouses for actual and compensatory damages is likewise
without merits. As held by the trial court, in so far as the LTB is concerned, the present
action is based upon a breach of contract of carriage to which said spouses were not a
party, and neither can they premise their claim upon the negligence or quasi-delict of the
LTB for the simple reason that they were not themselves injured.
Held Modified as above indicated, the appealed judgement is hereby affirmed in all other
respects, 11
Cariaga vs Laguna Tayabas Bus Company; Dec. 29, 1960
Facts:
At about 1:00 pm, June 18, 1952, Bus No. 133 of the Laguna Tayabas Bus
-
Company (LTB) bound for Lilio Laguna (departing from Azcarriaga St., Manila)
collided with the engine of a train then passing by the national railroad tracks of
the poblacion of Bay, Laguna.
- One of the injured: Edgardo Cariaga
o 4th year medical student (UST).
o Sustained grave injuries; He was unconscious for 35 days, and his right
forehead was fractured in such a way that it necessitated the removal of
practically all of the right frontal lobe of his brain. Under the testimony of
Dr. Fernandez (psychiatrist), Cariaga’s mental capacity has been reduced
to that he can no longer finish his studies. Right frontal bone of his head
was replaced by a tantalum plate that when pressed in or dented in (the
brain), could cause Cariaga’s death. The gist of it is that he became an
invalid after the accident.
o LTB paid for the expenses in the hospitalization of Cariaga.
- Cariaga (plus parents) filed a case against LTB and the Manila Railroad Company
(MRR Co.) for the recovery of P312,000.00 worth of actual, compensatory, moral
and exemplary damages.
o Lower Court: Negligence of the bus driver that caused the accident;
sentenced LTB to pay Cariaga P10,490.00.
- Both the Cariaga and the LTB appealed.
o Cariaga: for awarding only P10K+ in compensatory damages and not
awarding them actual and moral damages
o LTB: the fault should not have been bore by them alone; MRR Co. should
be included (collision: both because of MRR Co. and bus driver).
Issues/Held:
- Regarding LTB’s appeal:
o Untenable; all the witnesses on both side (LTB and MRR Co.) swore that
they heard the train whistle sometime before the collision, but that it was
the Bus that refused to slow down.
o LTB was unable to discredit MRR Co.’s witness that effect!
- Regarding the Cariagas’ appeal:
o Compensatory damages of P10K+ is too low considering the effects (and
the evidence thereof) of said accident.
o LTB: Under A. 2201 of the CC, the damages for which the obligor, guilty of
a breach of contract but who acted in good faith, is liable shall be for
those that are the natural and probable consequences of the breach and
which the parties had forseen or could have reasonably forseen at the
HazelMapz2018
time the obligation was constituted, provided such damages, according to
A. 2199 of the same code, have been duly proved.
 Only the hospital expenses of P17,719.75 has been duly proved
o SC: The income of Cariaga had he finished his medical studies should be
considered too; could have been reasonably forseen by the parties at the
time Cariaga boarded the bus.
o Upon consideration of all facts, compensatory damages should be
increased to P25K. 12
o Moral damage and atty’s fees cannot be awarded:
 Current case not one of those contemplated in Art. 2219 that
enumerated the instances such damage can be awarded; cannot
come under par. 2 thereon because the present action is not one
quasi-delict (due to the pre-existing contractual relation between
Cariaga and LTB).
 Neither can LTB be held accountable for moral damages under A.
2220 of the CC because LTB did not act fraudulently or in bad faith
and that LTB exercised due diligence in the selection and
supervision of its buses in connection with the discharge of their
duties.
 Cachero vs Manila Yellow Taxi Cab:
 Not a liability arising from crime, because the one who
committed the offense is the driver.
 Liability = as a result of a breach of contract.
 Quasi-delict = for those obligations which do not arise from
law, contracts, quasi-contracts or criminal offenses.
HazelMapz2018
SECOND DIVISION
[G.R. No. 130547. October 3, 2000]
LEAH ALESNA REYES, ROSE NAHDJA, JOHNNY, and minors LLOYD and KRISTINE,
all surnamed REYES, represented by their mother, LEAH ALESNA
REYES, petitioners, vs. SISTERS OF MERCY HOSPITAL, SISTER ROSE PALACIO, DR.
MARVIE BLANES, and DR. MARLYN RICO,respondents. 13
DECISION
MENDOZA, J.:
This is a petition for review of the decision [1] of the Court of Appeals in CA-G.R. CV No.
36551 affirming the decision of the Regional Trial Court, Branch IX, Cebu City which
dismissed a complaint for damages filed by petitioners against respondents.
The facts are as follows:
Petitioner Leah Alesna Reyes is the wife of the late Jorge Reyes. The other petitioners,
namely, Rose Nahdja, Johnny, Lloyd, and Kristine, all surnamed Reyes, were their
children. Five days before his death on January 8, 1987, Jorge had been suffering from a
recurring fever with chills. After he failed to get relief from some home medication he was
taking, which consisted of analgesic, antipyretic, and antibiotics, he decided to see the
doctor.
On January 8, 1987, he was taken to the Mercy Community Clinic by his wife. He was
attended to by respondent Dr. Marlyn Rico, resident physician and admitting physician on
duty, who gave Jorge a physical examination and took his medical history. She noted that
at the time of his admission, Jorge was conscious, ambulatory, oriented, coherent, and with
respiratory distress.[2] Typhoid fever was then prevalent in the locality, as the clinic had
been getting from 15 to 20 cases of typhoid per month. [3] Suspecting that Jorge could be
suffering from this disease, Dr. Rico ordered a Widal Test, a standard test for typhoid fever,
to be performed on Jorge. Blood count, routine urinalysis, stool examination, and malarial
smear were also made.[4]After about an hour, the medical technician submitted the results
of the test from which Dr. Rico concluded that Jorge was positive for typhoid fever. As her
shift was only up to 5:00 p.m., Dr. Rico indorsed Jorge to respondent Dr. Marvie Blanes.
Dr. Marvie Blanes attended to Jorge at around six in the evening. She also took Jorges
history and gave him a physical examination. Like Dr. Rico, her impression was that Jorge
had typhoid fever. Antibiotics being the accepted treatment for typhoid fever, she ordered
that a compatibility test with the antibiotic chloromycetin be done on Jorge. Said test was
administered by nurse Josephine Pagente who also gave the patient a dose of triglobe. As
she did not observe any adverse reaction by the patient to chloromycetin, Dr. Blanes
ordered the first five hundred milligrams of said antibiotic to be administered on Jorge at
around 9:00 p.m. A second dose was administered on Jorge about three hours later just
before midnight.
HazelMapz2018
At around 1:00 a.m. of January 9, 1987, Dr. Blanes was called as Jorges temperature rose
to 41C. The patient also experienced chills and exhibited respiratory distress, nausea,
vomiting, and convulsions. Dr. Blanes put him under oxygen, used a suction machine, and
administered hydrocortisone, temporarily easing the patients convulsions. When he
regained consciousness, the patient was asked by Dr. Blanes whether he had a previous
heart ailment or had suffered from chest pains in the past. Jorge replied he did not.[5] After
about 15 minutes, however, Jorge again started to vomit, showed restlessness, and his
14
convulsions returned. Dr. Blanes re-applied the emergency measures taken before and, in
addition, valium was administered. Jorge, however, did not respond to the treatment and
slipped into cyanosis, a bluish or purplish discoloration of the skin or mucous membrane due
to deficient oxygenation of the blood. At around 2:00 a.m., Jorge died. He was forty years
old. The cause of his death was Ventricular Arrythemia Secondary to Hyperpyrexia and
typhoid fever.
On June 3, 1987, petitioners filed before the Regional Trial Court of Cebu City a
complaint[6]for damages against respondents Sisters of Mercy, Sister Rose Palacio, Dr.
Marvie Blanes, Dr. Marlyn Rico, and nurse Josephine Pagente. On September 24, 1987,
petitioners amended their complaint to implead respondent Mercy Community Clinic as
additional defendant and to drop the name of Josephine Pagente as defendant since she was
no longer connected with respondent hospital. Their principal contention was that Jorge did
not die of typhoid fever.[7]Instead, his death was due to the wrongful administration of
chloromycetin. They contended that had respondent doctors exercised due care and
diligence, they would not have recommended and rushed the performance of the Widal
Test, hastily concluded that Jorge was suffering from typhoid fever, and administered
chloromycetin without first conducting sufficient tests on the patients compatibility with said
drug. They charged respondent clinic and its directress, Sister Rose Palacio, with negligence
in failing to provide adequate facilities and in hiring negligent doctors and nurses. [8]
Respondents denied the charges. During the pre-trial conference, the parties agreed to limit
the issues on the following: (1) whether the death of Jorge Reyes was due to or caused by
the negligence, carelessness, imprudence, and lack of skill or foresight on the part of
defendants; (2) whether respondent Mercy Community Clinic was negligent in the hiring of
its employees; and (3) whether either party was entitled to damages. The case was then
heard by the trial court during which, in addition to the testimonies of the parties, the
testimonies of doctors as expert witnesses were presented.
Petitioners offered the testimony of Dr. Apolinar Vacalares, Chief Pathologist at the Northern
Mindanao Training Hospital, Cagayan de Oro City. On January 9, 1987, Dr. Vacalares
performed an autopsy on Jorge Reyes to determine the cause of his death. However, he did
not open the skull to examine the brain. His findings[9] showed that the gastro-intestinal
tract was normal and without any ulceration or enlargement of the nodules. Dr. Vacalares
testified that Jorge did not die of typhoid fever. He also stated that he had not seen a
patient die of typhoid fever within five days from the onset of the disease.
For their part, respondents offered the testimonies of Dr. Peter Gotiong and Dr. Ibarra
Panopio. Dr. Gotiong is a diplomate in internal medicine whose expertise is microbiology and
infectious diseases. He is also a consultant at the Cebu City Medical Center and an associate
HazelMapz2018
professor of medicine at the South Western University College of Medicine in Cebu City. He
had treated over a thousand cases of typhoid patients. According to Dr. Gotiong, the
patients history and positive Widal Test results ratio of 1:320 would make him suspect that
the patient had typhoid fever. As to Dr. Vacalares observation regarding the absence of
ulceration in Jorges gastro-intestinal tract, Dr. Gotiong said that such hyperplasia in the
intestines of a typhoid victim may be microscopic. He noted that since the toxic effect of
typhoid fever may lead to meningitis, Dr. Vacalares autopsy should have included an
15
examination of the brain.[10]
The other doctor presented was Dr. Ibarra Panopio, a member of the American Board of
Pathology, examiner of the Philippine Board of Pathology from 1978 to 1991, fellow of the
Philippine Society of Pathologist, associate professor of the Cebu Institute of Medicine, and
chief pathologist of the Andres Soriano Jr. Memorial Hospital in Toledo City. Dr. Panopio
stated that although he was partial to the use of the culture test for its greater reliability in
the diagnosis of typhoid fever, the Widal Test may also be used. Like Dr. Gotiong, he agreed
that the 1:320 ratio in Jorges case was already the maximum by which a conclusion of
typhoid fever may be made. No additional information may be deduced from a higher
dilution.[11] He said that Dr. Vacalares autopsy on Jorge was incomplete and thus
inconclusive.
On September 12, 1991, the trial court rendered its decision absolving respondents from
the charges of negligence and dismissing petitioners action for damages. The trial court
likewise dismissed respondents counterclaim, holding that, in seeking damages from
respondents, petitioners were impelled by the honest belief that Jorges death was due to
the latters negligence.
Petitioners brought the matter to the Court of Appeals. On July 31, 1997, the Court of
Appeals affirmed the decision of the trial court.
Hence this petition.
Petitioners raise the following assignment of errors:
I. THE HONORABLE COURT OF APPEALS COMMITTED A REVERSIBLE ERROR WHEN IT

RULED THAT THE DOCTRINE OF RES IPSA LOQUITUR IS NOT APPLICABLE IN THE INSTANT
CASE.
II. THE HONORABLE COURT OF APPEALS COMMITTED REVERSIBLE ERROR WHEN IT MADE
AN UNFOUNDED ASSUMPTION THAT THE LEVEL OF MEDICAL PRACTICE IS LOWER IN
ILIGAN CITY.
III. THE HONORABLE COURT OF APPEALS GRAVELY ERRED WHEN IT RULED FOR A LESSER
STANDARD OF CARE AND DEGREE OF DILIGENCE FOR MEDICAL PRACTICE IN ILIGAN CITY
WHEN IT APPRECIATE[D] NO DOCTORS NEGLIGENCE IN THE TREATMENT OF JORGE REYES.
Petitioners action is for medical malpractice. This 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.[12] In order to successfully pursue
HazelMapz2018
such a claim, a patient must prove that the physician or surgeon either failed to do
something which a reasonably prudent physician or surgeon would have done, or that he or
she did something that a reasonably prudent physician or surgeon would not have done,
and that the failure or action caused injury to the patient. [13] There are thus four elements
involved in medical negligence cases, namely: duty, breach, injury, and proximate
causation.
16
In the present case, there is no doubt that a physician-patient relationship existed between
respondent doctors and Jorge Reyes. Respondents were thus duty-bound to use at least the
same level of care that any reasonably competent doctor would use to treat a condition
under the same circumstances. It is breach of this duty which constitutes actionable
malpractice.[14]As to this aspect of medical malpractice, the determination of the reasonable
level of care and the breach thereof, expert testimony is essential. Inasmuch as the causes
of the injuries involved in malpractice actions are determinable only in the light of scientific
knowledge, it has been recognized that expert testimony is usually necessary to support the
conclusion as to causation.[15]
Res Ipsa Loquitur
There is a case when expert testimony may be dispensed with, and that is under the
doctrine of res ipsa loquitur. As held in Ramos v. Court of Appeals:[16]
Although generally, expert medical testimony is relied upon in malpractice suits to prove
that a physician has done a negligent act or that he has deviated from the standard medical
procedure, when the doctrine of res ipsa loquitor is availed by the plaintiff, the need for
expert medical testimony is dispensed with because the injury itself provides the proof of
negligence. The reason is that the general rule on the necessity of expert testimony applies
only to such matters clearly within the domain of medical science, and not to matters that
are within the common knowledge of mankind which may be testified to by anyone familiar
with the facts. Ordinarily, only physicians and surgeons of skill and experience are
competent to testify as to whether a patient has been treated or operated upon with a
reasonable degree of skill and care. However, testimony as to the statements and acts of
physicians and surgeons, external appearances, and manifest conditions which are
observable by any one may be given by non-expert witnesses. Hence, in cases where
the res ipsa loquitur is applicable, the court is permitted to find a physician negligent upon
proper proof of injury to the patient, without the aid of expert testimony, where the court
from its fund of common knowledge can determine the proper standard of care. Where
common knowledge and experience teach that a resulting injury would not have occurred to
the patient if due care had been exercised, an inference of negligence may be drawn giving
rise to an application of the doctrine of res ipsa loquitur without medical evidence, which is
ordinarily required to show not only what occurred but how and why it occurred. When the
doctrine is appropriate, all that the patient must do is prove a nexus between the particular
act or omission complained of and the injury sustained while under the custody and
management of the defendant without need to produce expert medical testimony to
establish the standard of care. Resort to res ipsa loquitor is allowed because there is no
other way, under usual and ordinary conditions, by which the patient can obtain redress for
injury suffered by him.
HazelMapz2018
Thus, courts of other jurisdictions have applied the doctrine in the following
situations: leaving of a foreign object in the body of the patient after an operation, injuries
sustained on a healthy part of the body which was not under, or in the area, of treatment,
removal of the wrong part of the body when another part was intended, knocking out a
tooth while a patients jaw was under anesthetic for the removal of his tonsils, and loss of an
eye while the patient was under the influence of anesthetic, during or following an operation
for appendicitis, among others.[17]
17
Petitioners asserted in the Court of Appeals that the doctrine of res ipsa loquitur applies to
the present case because Jorge Reyes was merely experiencing fever and chills for five days
and was fully conscious, coherent, and ambulant when he went to the hospital. Yet, he died
after only ten hours from the time of his admission.
This contention was rejected by the appellate court.
Petitioners now contend that all requisites for the application of res ipsa loquitur were
present, namely: (1) the accident was of a kind which does not ordinarily occur unless
someone is negligent; (2) the instrumentality or agency which caused the injury was under
the exclusive control of the person in charge; and (3) the injury suffered must not have
been due to any voluntary action or contribution of the person injured.[18]
The contention is without merit. We agree with the ruling of the Court of Appeals. In
the Ramos case, the question was whether a surgeon, an anesthesiologist, and a hospital
should be made liable for the comatose condition of a patient scheduled for
cholecystectomy.[19] In that case, the patient was given anesthesia prior to her operation.
Noting that the patient was neurologically sound at the time of her operation, the Court
applied the doctrine of res ipsa loquitur as mental brain damage does not normally occur in
a gallblader operation in the absence of negligence of the anesthesiologist. Taking judicial
notice that anesthesia procedures had become so common that even an ordinary person
could tell if it was administered properly, we allowed the testimony of a witness who was
not an expert. In this case, while it is true that the patient died just a few hours after
professional medical assistance was rendered, there is really nothing unusual or
extraordinary about his death. Prior to his admission, the patient already had recurring
fevers and chills for five days unrelieved by the analgesic, antipyretic, and antibiotics given
him by his wife. This shows that he had been suffering from a serious illness and
professional medical help came too late for him.
Respondents alleged failure to observe due care was not immediately apparent to a layman
so as to justify application of res ipsa loquitur. The question required expert opinion on the
alleged breach by respondents of the standard of care required by the
circumstances. Furthermore, on the issue of the correctness of her diagnosis, no
presumption of negligence can be applied to Dr. Marlyn Rico. As held in Ramos:
. . . . Res ipsa loquitur is not a rigid or ordinary doctrine to be perfunctorily used but a rule
to be cautiously applied, depending upon the circumstances of each case. It is generally
restricted to situations in malpractice cases where a layman is able to say, as a matter of
common knowledge and observation, that the consequences of professional care were not
as such as would ordinarily have followed if due care had been exercised. A distinction must
HazelMapz2018
be made between the failure to secure results, and the occurrence of something more
unusual and not ordinarily found if the service or treatment rendered followed the usual
procedure of those skilled in that particular practice. It must be conceded that the doctrine
of res ipsa loquitur can have no application in a suit against a physician or a surgeon which
involves the merits of a diagnosis or of a scientific treatment. The physician or surgeon is
not required at his peril to explain why any particular diagnosis was not correct, or why any
particular scientific treatment did not produce the desired result.[20]
18
Specific Acts of Negligence
We turn to the question whether petitioners have established specific acts of negligence
allegedly committed by respondent doctors.
Petitioners contend that: (1) Dr. Marlyn Rico hastily and erroneously relied upon the Widal
test, diagnosed Jorges illness as typhoid fever, and immediately prescribed the
administration of the antibiotic chloromycetin;[21] and (2) Dr. Marvie Blanes erred in
ordering the administration of the second dose of 500 milligrams of chloromycetin barely
three hours after the first was given.[22] Petitioners presented the testimony of Dr. Apolinar
Vacalares, Chief Pathologist of the Northern Mindanao Training Hospital, Cagayan de Oro
City, who performed an autopsy on the body of Jorge Reyes. Dr. Vacalares testified that,
based on his findings during the autopsy, Jorge Reyes did not die of typhoid fever but of
shock undetermined, which could be due to allergic reaction or chloromycetin overdose. We
are not persuaded.
First. While petitioners presented Dr. Apolinar Vacalares as an expert witness, we do not
find him to be so as he is not a specialist on infectious diseases like typhoid
fever.Furthermore, although he may have had extensive experience in performing
autopsies, he admitted that he had yet to do one on the body of a typhoid victim at the time
he conducted the postmortem on Jorge Reyes. It is also plain from his testimony that he
has treated only about three cases of typhoid fever. Thus, he testified that: [23]
ATTY. PASCUAL:
Q Why? Have you not testified earlier that you have never seen a patient who died of
typhoid fever?
A In autopsy. But, that was when I was a resident physician yet.
Q But you have not performed an autopsy of a patient who died of typhoid fever?
A I have not seen one.
Q And you testified that you have never seen a patient who died of typhoid fever within five
days?
A I have not seen one.
Q How many typhoid fever cases had you seen while you were in the general practice of
medicine?
HazelMapz2018
A In our case we had no widal test that time so we cannot consider that the typhoid fever is
like this and like that. And the widal test does not specify the time of the typhoid fever.
Q The question is: how many typhoid fever cases had you seen in your general practice
regardless of the cases now you practice?
A I had only seen three cases.

19
Q And that was way back in 1964?
A Way back after my training in UP.
Q Clinically?
A Way back before my training.
He is thus not qualified to prove that Dr. Marlyn Rico erred in her diagnosis. Both lower
courts were therefore correct in discarding his testimony, which is really inadmissible.
In Ramos, the defendants presented the testimony of a pulmonologist to prove that brain
injury was due to oxygen deprivation after the patient had bronchospasms[24] triggered by
her allergic response to a drug,[25] and not due to faulty intubation by the
anesthesiologist. As the issue was whether the intubation was properly performed by an
anesthesiologist, we rejected the opinion of the pulmonologist on the ground that he was
not: (1) an anesthesiologist who could enlighten the court about anesthesia practice,
procedure, and their complications; nor (2) an allergologist who could properly advance
expert opinion on allergic mediated processes; nor (3) a pharmacologist who could explain
the pharmacologic and toxic effects of the drug allegedly responsible for the
bronchospasms.
Second. On the other hand, the two doctors presented by respondents clearly were experts
on the subject. They vouched for the correctness of Dr. Marlyn Ricos diagnosis. Dr. Peter
Gotiong, a diplomate whose specialization is infectious diseases and microbiology and an
associate professor at the Southwestern University College of Medicine and the Gullas
College of Medicine, testified that he has already treated over a thousand cases of typhoid
fever.[26] According to him, when a case of typhoid fever is suspected, the Widal test is
normally used,[27]and if the 1:320 results of the Widal test on Jorge Reyes had been
presented to him along with the patients history, his impression would also be that the
patient was suffering from typhoid fever.[28] As to the treatment of the disease, he stated
that chloromycetin was the drug of choice.[29] He also explained that despite the measures
taken by respondent doctors and the intravenous administration of two doses of
chloromycetin, complications of the disease could not be discounted. His testimony is as
follows:[30]
ATTY. PASCUAL:
Q If with that count with the test of positive for 1 is to 320, what treatment if any would be
given?
HazelMapz2018
A If those are the findings that would be presented to me, the first thing I would consider
would be typhoid fever.
Q And presently what are the treatments commonly used?
A Drug of choice of chloramphenical.
Q Doctor, if given the same patient and after you have administered chloramphenical about 20
3 1/2 hours later, the patient associated with chills, temperature - 41oC, what could possibly
come to your mind?
A Well, when it is change in the clinical finding, you have to think of complication.
Q And what will you consider on the complication of typhoid?
A One must first understand that typhoid fever is toximia. The problem is complications are
caused by toxins produced by the bacteria . . . whether you have suffered complications to
think of -- heart toxic myocardities; then you can consider a toxic meningitis and other
complications and perforations and bleeding in the ilium.
Q Even that 40-year old married patient who received medication of chloromycetin of 500
milligrams intravenous, after the skin test, and received a second dose of chloromycetin of
500 miligrams, 3 hours later, the patient developed chills . . . rise in temperature to 41 oC,
and then about 40 minutes later the temperature rose to 100 oF, cardiac rate of 150 per
minute who appeared to be coherent, restless, nauseating, with seizures: what significance
could you attach to these clinical changes?
A I would then think of toxemia, which was toxic meningitis and probably a toxic meningitis
because of the high cardiac rate.
Q Even if the same patient who, after having given intramuscular valium, became conscious
and coherent about 20 minutes later, have seizure and cyanosis and rolling of eyeballs and
vomitting . . . and death: what significance would you attach to this development?
A We are probably dealing with typhoid to meningitis.
Q In such case, Doctor, what finding if any could you expect on the post-mortem
examination?
A No, the finding would be more on the meninges or covering of the brain.
Q And in order to see those changes would it require opening the skull?
A Yes.
As regards Dr. Vacalares finding during the autopsy that the deceaseds gastro-intestinal
tract was normal, Dr. Rico explained that, while hyperplasia [31] in the payers patches or
layers of the small intestines is present in typhoid fever, the same may not always be
grossly visible and a microscope was needed to see the texture of the cells. [32]
HazelMapz2018
Respondents also presented the testimony of Dr. Ibarra T. Panopio who is a member of the
Philippine and American Board of Pathology, an examiner of the Philippine Board of
Pathology, and chief pathologist at the MetroCebu Community Hospital, Perpetual Succor
Hospital, and the Andres Soriano Jr. Memorial Medical Center. He stated that, as a clinical
pathologist, he recognized that the Widal test is used for typhoid patients, although he did
not encourage its use because a single test would only give a presumption necessitating
that the test be repeated, becoming more conclusive at the second and third weeks of the
21
disease.[33] He corroborated Dr. Gotiongs testimony that the danger with typhoid fever is
really the possible complications which could develop like perforation, hemorrhage, as well
as liver and cerebral complications.[34] As regards the 1:320 results of the Widal test on
Jorge Reyes, Dr. Panopio stated that no additional information could be obtained from a
higher ratio.[35] He also agreed with Dr. Gotiong that hyperplasia in the payers patches may
be microscopic.[36]
Indeed, the standard contemplated is not what is actually the average merit among all
known practitioners from the best to the worst and from the most to the least experienced,
but the reasonable average merit among the ordinarily good physicians.[37] Here, Dr. Marlyn
Rico did not depart from the reasonable standard recommended by the experts as she in
fact observed the due care required under the circumstances. Though the Widal test is not
conclusive, it remains a standard diagnostic test for typhoid fever and, in the present case,
greater accuracy through repeated testing was rendered unobtainable by the early death of
the patient. The results of the Widal test and the patients history of fever with chills for five
days, taken with the fact that typhoid fever was then prevalent as indicated by the fact that
the clinic had been getting about 15 to 20 typhoid cases a month, were sufficient to give
upon any doctor of reasonable skill the impression that Jorge Reyes had typhoid fever.
Dr. Rico was also justified in recommending the administration of the drug chloromycetin,
the drug of choice for typhoid fever. The burden of proving that Jorge Reyes was suffering
from any other illness rested with the petitioners. As they failed to present expert opinion
on this, preponderant evidence to support their contention is clearly absent.
Third. Petitioners contend that respondent Dr. Marvie Blanes, who took over from Dr. Rico,
was negligent in ordering the intravenous administration of two doses of 500 milligrams of
chloromycetin at an interval of less than three hours. Petitioners claim that Jorge Reyes died
of anaphylactic shock[38] or possibly from overdose as the second dose should have been
administered five to six hours after the first, per instruction of Dr. Marlyn Rico. As held by
the Court of Appeals, however:
That chloromycetin was likewise a proper prescription is best established by medical

authority. Wilson, et. al., in Harrisons Principle of Internal Medicine, 12th ed. write that
chlorampenicol (which is the generic of chloromycetin) is the drug of choice for typhoid
fever and that no drug has yet proven better in promoting a favorable clinical response.
Chlorampenicol (Chloromycetin) is specifically indicated for bacterial meningitis, typhoid
fever, rickettsial infections, bacteriodes infections, etc. (PIMS Annual, 1994, p. 211) The
dosage likewise including the first administration of five hundred milligrams (500 mg.) at
around nine oclock in the evening and the second dose at around 11:30 the same night was
still within medically acceptable limits, since the recommended dose of chloromycetin is one
HazelMapz2018
(1) gram every six (6) hours. (cf. Pediatric Drug Handbook, 1st Ed., Philippine Pediatric
Society, Committee on Therapeutics and Toxicology, 1996). The intravenous route is
likewise correct. (Mansser, ONick, Pharmacology and Therapeutics) Even if the test was not
administered by the physician-on-duty, the evidence introduced that it was Dra. Blanes who
interpreted the results remain uncontroverted. (Decision, pp. 16-17) Once more, this Court
rejects any claim of professional negligence in this regard.
22
....
As regards anaphylactic shock, the usual way of guarding against it prior to the
administration of a drug, is the skin test of which, however, it has been observed: Skin
testing with haptenic drugs is generally not reliable. Certain drugs cause nonspecific
histamine release, producing a weal-and-flare reaction in normal individuals. Immunologic
activation of mast cells requires a polyvalent allergen, so a negative skin test to a univalent
haptenic drug does not rule out anaphylactic sensitivity to that drug. (Terr, Anaphylaxis and
Urticaria in Basic and Clinical Immunology, p. 349) What all this means legally is that even
if the deceased suffered from an anaphylactic shock, this, of itself, would not yet establish
the negligence of the appellee-physicians for all that the law requires of them is that they
perform the standard tests and perform standard procedures. The law cannot require them
to predict every possible reaction to all drugs administered. The onus probandi was on the
appellants to establish, before the trial court, that the appellee-physicians ignored standard
medical procedure, prescribed and administered medication with recklessness and exhibited
an absence of the competence and skills expected of general practitioners similarly
situated.[39]
Fourth. Petitioners correctly observe that the medical profession is one which, like the
business of a common carrier, is affected with public interest. Moreover, they assert that
since the law imposes upon common carriers the duty of observing extraordinary diligence
in the vigilance over the goods and for the safety of the passengers, [40] physicians and
surgeons should have the same duty toward their patients.[41] They also contend that the
Court of Appeals erred when it allegedly assumed that the level of medical practice is lower
in Iligan City, thereby reducing the standard of care and degree of diligence required from
physicians and surgeons in Iligan City.
The standard of extraordinary diligence is peculiar to common carriers. The Civil Code
provides:
Art. 1733. Common carriers, from the nature of their business and for reasons of public
policy, are bound to observe extraordinary diligence in the vigilance over the goods and for
the safety of the passengers transported by them, according to the circumstances of each
case. . . .
The practice of medicine is a profession engaged in only by qualified individuals. It is a right

earned through years of education, training, and by first obtaining a license from the state
through professional board examinations. Such license may, at any time and for cause, be
revoked by the government. In addition to state regulation, the conduct of doctors is also
strictly governed by the Hippocratic Oath, an ancient code of discipline and ethical rules
which doctors have imposed upon themselves in recognition and acceptance of their great
HazelMapz2018
responsibility to society. Given these safeguards, there is no need to expressly require of
doctors the observance of extraordinary diligence. As it is now, the practice of medicine is
already conditioned upon the highest degree of diligence. And, as we have already noted,
the standard contemplated for doctors is simply the reasonable average merit among
ordinarily good physicians. That is reasonable diligence for doctors or, as the Court of
Appeals called it, the reasonable skill and competence . . . that a physician in the same or
similar locality . . . should apply.
23
WHEREFORE, the instant petition is DENIED and the decision of the Court of Appeals is
AFFIRMED.
SO ORDERED.
Bellosillo, (Chairman), Quisumbing, Buena, and De Leon, Jr., JJ., concur.
Reyes vs. Sisters of Mercy Hospital, G.R. No. 130547, Oct. 3, 2000
FACTS: Petitioner, Leah Alesna Reyes, is the wife of the deceased patient, Jorge Reyes.
Five days before the latter’s death, Jorge has been suffering from recurring fever with chills.
The doctors confirmed through the Widal test that Jorge has typhoid fever. However, he did
not respond to the treatment and died. The cause of his death was “Ventricular Arrythemia
Secondary to Hyperpyrexia and typhoid fever.” Consequently, petitioner filed the instant
case for damages before the Regional Trial Court of Cebu City, which dismissed the case
and was affirmed by the Court of Appeals.
The contention was that Jorge did not die of typhoid fever. Instead, his death was
due to the wrongful administration of chloromycetin. They contended that had respondent
doctors exercised due care and diligence, they would not have recommended and rushed
the performance of the Widal Test, hastily concluded that Jorge was suffering from typhoid
fever, and administered chloromycetin without first conducting sufficient tests on the
patient’s compatibility with said drug.
ISSUE: Whether or not Sisters of Mercy Hospital is liable for the death of Jorge Reyes.
RULING: Sisters of Mercy Hospital is not liable for the death of Jorge Reyes.
There is no showing that the attending physician in this case deviated from the usual
course of treatment with respect to typhoid fever. Jorge was given antibiotic choloromycetin
and some dose of triglobe after compatibility test was made by the doctor and found that no
adverse reactions manifested which would necessitate replacement of the medicines.
but the reasonable average merit among the ordinarily good physicians. Here, the doctors
did not depart from the reasonable standard recommended by the experts as they in fact
observed the due care required under the circumstances.
POLICY : In Medical Negligence cases, it is incumbent upon the plaintiff to establish that
the usual procedure in treating the illness is not followed by the doctor. Failure to prove
this, the doctor is not liable. Physicians are not insurers of the success of every procedure
HazelMapz2018
undertaken and if the procedure was shown to be properly done but did not work, they
cannot be faulted for such result.
CONCEPT:
Petitioner’s action is for medical malpractice. This is a particular form of negligence which
degree of care and skill which is ordinarily employed by the profession generally, under 24
similar conditions, and in like surrounding circumstances. In order to successfully pursue
such a claim, a patient must prove that the physician or surgeon either failed to do
something which a reasonably prudent physician or surgeon would have done, or that he or
she did something that a reasonably prudent physician or surgeon would not have done,
and that the failure or action caused injury to the patient. There are thus four elements
involved in medical negligence cases, namely: duty, breach, injury, and proximate
causation.
Elements of Medical Malpractice

duty – the existence of a physician-patient relationship
breach of duty
injury caused
causal connection between the breach of duty and the injury caused
Evidentiary Rule
TWO-PRONGED EVIDENCE:
evidence of the recognized standards

the physician negligently departed from these standards
EXPERT TESTIMONY ESSENTIAL:
In the present case, there is no doubt that a physician-patient relationship existed between
respondent doctors and Jorge Reyes. Respondents were thus duty-bound to use at least the
same level of care that any reasonably competent doctor would use to treat a condition
under the same circumstances. It is breach of this duty which constitutes actionable
malpractice. As to this aspect of medical malpractice, the determination of the reasonable
level of care and the breach thereof, expert testimony is essential. Inasmuch as the causes
of the injuries involved in malpractice actions are determinable only in the light of scientific
conclusion as to causation. (Reyes vs. Sisters of Mercy Hospital, supra)
EXCEPTION:
There is a case when expert testimony may be dispensed with, and that is under the
doctrine of res ipsa loquitur. As held in Ramos v. Court of Appeals:
Although generally, expert medical testimony is relied upon in malpractice suits to prove
that a physician has done a negligent act or that he has deviated from the standard medical
procedure, when the doctrine of res ipsa loquitor is availed by the plaintiff, the need for
expert medical testimony is dispensed with because the injury itself provides the proof of
negligence. The reason is that the general rule on the necessity of expert testimony applies
only to such matters clearly within the domain of medical science, and not to matters that
HazelMapz2018
are within the common knowledge of mankind which may be testified to by anyone familiar
with the facts. Ordinarily, only physicians and surgeons of skill and experience are
competent to testify as to whether a patient has been treated or operated upon with a
reasonable degree of skill and care. However, testimony as to the statements and acts of
physicians and surgeons, external appearances, and manifest conditions which are
observable by any one may be given by non-expert witnesses. Hence, in cases where the
res ipsa loquitur is applicable, the court is permitted to find a physician negligent upon
proper proof of injury to the patient, without the aid of expert testimony, where the court 25
from its fund of common knowledge can determine the proper standard of care. Where
common knowledge and experience teach that a resulting injury would not have occurred to
the patient if due care had been exercised, an inference of negligence may be drawn giving
rise to an application of the doctrine of res ipsa loquitur without medical evidence, which is
ordinarily required to show not only what occurred but how and why it occurred. When the
doctrine is appropriate, all that the patient must do is prove a nexus between the particular
act or omission complained of and the injury sustained while under the custody and
management of the defendant without need to produce expert medical testimony to
establish the standard of care. Resort to res ipsa loquitor is allowed because there is no
other way, under usual and ordinary conditions, by which the patient can obtain redress for
injury suffered by him. (Reyes vs. Sisters of Mercy Hospital, supra)
Standard of Diligence Required - the standard of care in the locality (“Locality” Rule)
- a physician is not liable for error in judgment (“Error in Judgment” Rule), provided he
applied reasonable skill and care
STANDARD OF DILIGENCE REQUIRED:
but the reasonable average merit among the ordinarily good physicians.
STANDARD IS NOT EXTRAORDINARY DILIGENCE:
The standard of extraordinary diligence is peculiar to common carriers. The Civil Code
provides: "Art. 1733. Common carriers, from the nature of their business and for reasons of
public policy, are bound to observe extraordinary diligence in the vigilance over the goods
and for the safety of the passengers transported by them, according to the circumstances of
each case. . . ."

doctors the observance of “extraordinary” diligence. As it is now, the practice of medicine is
already conditioned upon the highest degree of diligence. And, as we have already noted,
the standard contemplated for doctors is simply the reasonable average merit among
ordinarily good physicians. That is reasonable diligence for doctors or, as the Court of
Appeals called it, the reasonable “skill and competence . . . that a physician in the same or
HazelMapz2018
similar locality . . . should apply.” (Reyes vs. Sisters of Mercy Hospital, supra)
Responsibility of the Hospital
Ramos vs. CA, G.R. No. 124354, Dec. 29, 1999
RESPONSIBILITY OF THE HOSPITAL:

26
The unique practice (among private hospitals) of filling up specialist staff with attending and
visiting "consultants," who are allegedly not hospital employees, presents problems in
apportioning responsibility for negligence in medical malpractice cases. However, the
difficulty is only more apparent than real.
In the first place, hospitals exercise significant control in the hiring and firing of consultants
and in the conduct of their work within the hospital premises. Doctors who apply for
"consultant" slots, visiting or attending, are required to submit proof of completion of
residency, their educational qualifications; generally, evidence of accreditation by the
appropriate board (diplomate), evidence of fellowship in most cases, and references. These
requirements are carefully scrutinized by members of the hospital administration or by a
review committee set up by the hospital who either accept or reject the application. This is
particularly true with respondent hospital.
After a physician is accepted, either as a visiting or attending consultant, he is normally

required to attend clinico-pathological conferences, conduct bedside rounds for clerks,
interns and residents, moderate grand rounds and patient audits and perform other tasks
and responsibilities, for the privilege of being able to maintain a clinic in the hospital, and/or
for the privilege of admitting patients into the hospital. In addition to these, the physician's
performance as a specialist is generally evaluated by a peer review committee on the basis
of mortality and morbidity statistics, and feedback from patients, nurses, interns and
residents. A consultant remiss in his duties, or a consultant who regularly falls short of the
minimum standards acceptable to the hospital or its peer review committee, is normally
politely terminated.
In other words, private hospitals, hire, fire and exercise real control over their attending and
visiting "consultant" staff. While "consultants" are not, technically employees, a point which
respondent hospital asserts in denying all responsibility for the patient's condition, the
control exercised, the hiring, and the right to terminate consultants all fulfill the important
hallmarks of an employer-employee relationship, with the exception of the payment of
wages. In assessing whether such a relationship in fact exists, the control test is
determining. Accordingly, on the basis of the foregoing, we rule that for the purpose of
allocating responsibility in medical negligence cases, an employer-employee relationship in
effect exists between hospitals and their attending and visiting physicians. This being the
case, the question now arises as to whether or not respondent hospital is solidarily liable
with respondent doctors for petitioner's condition.
HazelMapz2018
Reyes Vs. Sisters Of Mercy
Facts:
 Jorge Reyes has been suffering from recurring fever with chills for around days.
 Home medication afforded him no relief so he went to Mercy Community Clinic. He
was then attended by Dr. Marlyn Rico.
 Since typhoid fever was common at that time, the Widal test was performed and he 27
was found positive for typhoid.
 Thereafter, Dr. Marlyn Rico indorse Jorge Reyes to Dr. Marvie Blanes.
 Suspecting that that Jorge had typhoid fever, Dr. Marvie Blanes ordered that Jorge
be tested for compatibility with chloromycetin, an antibiotic. Such test was
conducted by Nurse Pagente.
 As there was no adverse reaction, Dr. Blanes administered 500 mg of the antibiotic.
Another dose was given 3 hours later.
 Subsequently, Jorge Reyes developed high fever and experienced vomiting and
convulsions. He then turned blue due to deficiency in oxygen – cyanosis – and died.
The cause of death was stated to be “ventricular arrhythmia secondary to
hyperpyrexia and typhoid fever.”
 The heirs of Reyes filed with the RTC a complaint for damages against Sisters of
Mercy, Sister Rose Palacio, Dr. Blanes, Dr. Rico and Mercy Community Clinic
contending that the death of Jorge was due to the wrongful administration of
chloromycetin. (NOTE: Petitioner’s action is for medical malpractice.)
 RTC ruled in favor of the respondents. The CA affirmed in toto the RTC decision.
Hence, this appeal.
 Petitioners contend that:
 Dr. Marlyn Rico hastily and erroneously relied upon the Widal test, diagnosed
Jorge’s illness as typhoid fever, and immediately prescribed the
administration of the antibiotic chloromycetin
 Dr. Marvie Blanes erred in ordering the administration of the second dose of
500 milligrams of chloromycetin barely 3 hours after the first was given.
 Testimony presented: That of Dr. Apolinar Vacalares, (Chief Pathologist of the
Northern Mindanao Training Hospital) who performed an autopsy on the body – Dr.
Vacalares testified that Reyes did not die of typhoid fever but of shock undetermined,
which could be due to allergic reaction or chloromycetin overdose.
Issue: WON there was medical malpractice. NO
Held:
Dr. Apolinar Vacalares is not a specialist of typhoid fever and he is thus not
qualified to prove that Dr. Marlyn Rico erred in her diagnosis.
While petitioners presented Dr. Apolinar Vacalares as an expert witness, we do not find him
to be so as he is not a specialist on infectious diseases like typhoid fever. Furthermore,
although he may have had extensive experience in performing autopsies, he admitted that
he had yet to do one on the body of a typhoid victim at the time he conducted the
postmortem on Jorge Reyes. It is also plain from his testimony that he has treated only
about three cases of typhoid fever.
The two doctors presented by respondents clearly were experts on the subject
They vouched for the correctness of Dr. Marlyn Rico’s diagnosis. Dr. Peter Gotiong, a
HazelMapz2018
diplomate whose specialization is infectious diseases and microbiology and an associate
professor at the Southwestern University College of Medicine and the Gullas College of
Medicine, testified that he has already treated over a thousand cases of typhoid fever.
According to him, when a case of typhoid fever is suspected, the Widal test is normally
used, and if the 1:320 results of the Widal test on Jorge Reyes had been presented to him
along with the patient’s history, his impression would also be that the patient was suffering
from typhoid fever. As to the treatment of the disease, he stated that chloromycetin was 28
the drug of choice. He also explained that despite the measures taken by respondent
doctors and the intravenous administration of two doses of chloromycetin, complications of
the disease could not be discounted.
Respondents also presented the testimony of Dr. Ibarra T. Panopio who is a member of the
Philippine and American Board of Pathology, an examiner of the Philippine Board of
Pathology, and chief pathologist at the MetroCebu Community Hospital, Perpetual Succor
Hospital, and the Andres Soriano Jr. Memorial Medical Center.
He stated that, as a clinical pathologist, he recognized that the Widal test is used for typhoid
patients, although he did not encourage its use because a single test would only give a
presumption necessitating that the test be repeated, becoming more conclusive at the
second and third weeks of the disease.
He corroborated Dr. Gotiong’s testimony that the danger with typhoid fever is really the
possible complications which could develop like perforation, hemorrhage, as well as liver
and cerebral complications.
Dr. Rico was not negligent in administering the 2 doses of 500 g of chloromycetin
The chloromycetin was likewise a proper prescription is best established by medical
authority. Even if the deceased suffered from an anaphylactic shock, this, of itself, would
not yet establish the negligence of the appellee-physicians for all that the law requires of
them is that they perform the standard tests and perform standard procedures. The law
cannot require them to predict every possible reaction to all drugs administered.
The practice of medicine requires the highest degree of diligence

doctors the observance of “extraordinary” diligence.
As it is now, the practice of medicine is already conditioned upon the highest degree of
diligence. And, as we have already noted, the standard contemplated for doctors is simply
the reasonable average merit among ordinarily good physicians. That is reasonable diligence
for doctors or, as the Court of Appeals called it, the reasonable “skill and competence . . .
that a physician in the same or similar locality . . . should apply.”
There are thus four elements involved in medical negligence cases, namely: duty,
breach, injury, and proximate causation
Petitioner’s action is for medical malpractice. This is a particular form of negligence which
HazelMapz2018
degree of care and skill which is ordinarily employed by the profession generally, under
similar conditions, and in like surrounding circumstances.
In order to successfully pursue such a claim, a patient must prove that the physician or
surgeon either failed to do something which a reasonably prudent physician or surgeon
would have done, or that he or she did something that a reasonably prudent physician or
surgeon would not have done, and that the failure or action caused injury to the patient.
29
The doctrine of Res Ipsa Loquitor is not applicable in this case.
Was there a physician-patient relationship between the respondent doctors and

Jorge Reyes? Yes.
Respondents were thus duty-bound to use at least the same level of care that any
reasonably competent doctor would use to treat a condition under the same circumstances.
It is breach of this duty which constitutes actionable malpractice.
As to this aspect of medical malpractice, the determination of the reasonable level of care
and the breach thereof, expert testimony is essential. Inasmuch as the causes of the
injuries involved in malpractice actions are determinable only in the light of scientific
conclusion as to causation.
The doctrine of res ipsa loquitor is not applicable in the case at bar
Though expert testimony is usually needed to prove malpractice, where common knowledge
and experience teach that the injury would not have occurred if due care had been
exercised, the doctrine of res ipsa loquitur can be invoked to establish negligence.
Hence, in cases where the res ipsa loquitur is applicable, the court is permitted to find a
physician negligent upon proper proof of injury to the patient, without the aid of expert
testimony, where the court from its fund of common knowledge can determine the proper
standard of care. Where common knowledge and experience teach that a resulting injury
would not have occurred to the patient if due care had been exercised, an inference of
negligence may be drawn giving rise to an application of the doctrine of res ipsa loquitur
without medical evidence, which is ordinarily required to show not only what occurred but
how and why it occurred.
When the doctrine is appropriate, all that the patient must do is prove a nexus between the
particular act or omission complained of and the injury sustained while under the custody
and management of the defendant without need to produce expert medical testimony to
establish the standard of care.
There is nothing unusual about the death of Jorge Reyes (absence of 1st requisite
that the accident was of a kind which does not ordinarily occur unless someone is
negligent)
In this case, while it is true that the patient died just a few hours after professional medical
assistance was rendered, there is really nothing unusual or extraordinary about his death.
Prior to his admission, the patient already had recurring fevers and chills for five days
unrelieved by the analgesic, antipyretic, and antibiotics given him by his wife. This shows
that he had been suffering from a serious illness and professional medical help came too
late for him.
It must be conceded that the doctrine of res ipsa loquitur can have no application in a suit
HazelMapz2018
against a physician or a surgeon which involves the merits of a diagnosis or of a scientific
treatment. The physician or surgeon is not required at his peril to explain why any particular
diagnosis was not correct, or why any particular scientific treatment did not produce the
desired result.
30
HazelMapz2018

Transportation Law Cases

Caricato da

Informazioni sul documento

Descrizione originale:

Titolo originale

Copyright

Formati disponibili

Condividi questo documento

Condividi o incorpora il documento

Opzioni di condivisione

Hai trovato utile questo documento?

Questo contenuto è inappropriato?

Copyright:

Formati disponibili

Transportation Law Cases

Caricato da

Copyright:

Formati disponibili

Transportation Law Assignment

Date of Submission: June 28,2018

(a) What is Res Ipsa Loquitor? Elaborate.

Circumstantial evidence consists of facts that point to negligence as a logical conclusion

The Presence of Negligence

Only the Defendant Is Responsible

The Defendant Owes the Plaintiff a Duty of Care

Rebutting Res Ipsa

Get a Free Claim Review by an Experienced Attorney

EDGARDO CARIAGA, ET AL., plaintiffs-appellants,

Ozaeta, Lichauco and Picazo for defendant and appellant. 4

xxx xxx xxx

(1) A criminal offense resulting in physical injuries;

(2) Quasi-delicts causing physical injuries;

(3) Seduction, abduction, rape, or other lascivious acts;

(4) Adultery or concubinage;

(5) Illegal or arbitrary detention or arrest;

(6) Illegal search;

(7) Libel, slander or any other form of defamation;

(8) Malicious prosecution;

(9) Acts mentioned in Article 309;

xxx xxx xxx

2. Whether the award of P10,000 as compensatory damages was adequate (NO –

Cariaga vs Laguna Tayabas Bus Company; Dec. 29, 1960

[G.R. No. 130547. October 3, 2000]

The facts are as follows:

Hence this petition.

Petitioners raise the following assignment of errors:

I. THE HONORABLE COURT OF APPEALS COMMITTED A REVERSIBLE ERROR WHEN IT

Res Ipsa Loquitur

This contention was rejected by the appellate court.

A In autopsy. But, that was when I was a resident physician yet.

A I have not seen one.

A I have not seen one.

A I had only seen three cases.

A Way back after my training in UP.

A Way back before my training.

Q And presently what are the treatments commonly used?

A Drug of choice of chloramphenical.

Q And what will you consider on the complication of typhoid?

A We are probably dealing with typhoid to meningitis.

That chloromycetin was likewise a proper prescription is best established by medical

The practice of medicine is a profession engaged in only by qualified individuals. It is a right

Bellosillo, (Chairman), Quisumbing, Buena, and De Leon, Jr., JJ., concur.

Elements of Medical Malpractice

evidence of the recognized standards

EXPERT TESTIMONY ESSENTIAL:

STANDARD OF DILIGENCE REQUIRED:

STANDARD IS NOT EXTRAORDINARY DILIGENCE:

The practice of medicine is a profession engaged in only by qualified individuals. It is a right

Responsibility of the Hospital

Ramos vs. CA, G.R. No. 124354, Dec. 29, 1999

RESPONSIBILITY OF THE HOSPITAL:

After a physician is accepted, either as a visiting or attending consultant, he is normally

Issue: WON there was medical malpractice. NO

The practice of medicine requires the highest degree of diligence

Was there a physician-patient relationship between the respondent doctors and

Potrebbero piacerti anche