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22. Dr. Ninevetch Cruz vs. CA 13.

Lydia was then reoperated because


GR No. 122445 (1997) there was blood oozing from the
abdominal incision.
FACTS: 14. During operation, Dr. Angeles was
1. Rowena Umali De Ocampo summoned.
accompanied her mother, Lydia 15. However, upon arrival of Dr.
Umali, to Perpetual Help Clinic and Angeles, Lydia was already in shock
General Hospital, as she was and her blood pressure was 0/0.
scheduled for a hysterectomy 16. While petitioner was closing the
operation. abdominal wall, the patient died.
2. Rowena noticed that the clinic was 17. The immediate cause of death was
untidy and dirty. Due to this, she “shock” and “disseminated
persuaded her mother to postpone Intravascular Coagulation (DIC)” as
her operation. the antecedent cause.
3. However, the operation still 18. MTCC convicted the Dra. Ninevetch
pushed through. Cruz for evident unpreparedness
4. While the operation was ongoing, and lack of skill during operation.
Dr. Ercillo, the attending 19. RCT and CA affirmed.
anaesthesiologist, told them to buy
Tagamet Ampules. ISSUE:
5. An hour later, there were again Whether or not Dra. Cruz was guilty of the
asked to buy blood for Lydia. crime of reckless imprudence resulting to
6. Petitioner then informed them that homicide.
the operation was finished, and
Lydia was then brought out of the HELD:
operating room. NO.
7. Several minutes later, Rowena and This Court has no recourse but to
company were asked to buy rely on the expert testimonies rendered by
additional blood for Lydia, both prosecution and defense witnesses
however, they were unable to that substantiate rather than contradict
comply with it as it was no longer petitioner's allegation that the cause of
available. Lydia's death was DIC which, as attested to
8. Luckily, a person donated blood by an expert witness, cannot be attributed
which was then transfused to to the petitioner's fault or negligence. The
Lydia. probability that Lydia's death was caused
9. Rowena then noticed that her by DIC was unrebutted during trial and has
mother, who was attached to the engendered in the mind of this Court a
oxygen, was gasping for air. reasonable doubt as to the petitioner's
10. It was then found out that the guilt. Thus, her acquittal of the crime of
oxygen had run out. reckless imprudence resulting in
11. Lydia went into shock and her homicide.
blood pressure dropped.
12. This necessitated the transfer of While we condole with the family
Lydia to San Pablo District Hospital. of Lydia Umali, our hands are bound by the
Done without the consent of dictates of justice and fair dealing which
Rowena and Co.
hold inviolable the right of an accused to case, a doctor in effect represents
be presumed innocent until proven guilty that, having the needed training
beyond reasonable doubt. Nevertheless, and skill possessed by physicians
this Court finds the petitioner civilly liable and surgeons practicing in the
for the death of Lydia Umali, for while a same field, he will employ such
conviction of a crime requires proof training, care and skill in the
beyond reasonable doubt, only a treatment of his patients. He
preponderance of evidence is required to therefore has a duty to use at least
establish civil liability. the same level of care that any other
reasonably competent doctor would
use to treat a condition under the
same circumstances.
DISCUSSIONS:
 It is in this aspect of medical
 Doctors are protected by a special malpractice that expert testimony
rule of law. They are not guarantors is essential to establish not only the
of care. They do not even warrant a standard of care of the profession
good result. They are not insurers but also that the physician's
against mishaps or unusual conduct in the treatment and care
consequences. Furthermore, they falls below such standard. Further,
are not liable for honest mistakes of inasmuch as the causes of the
judgment injuries involved in malpractice
actions are determinable only in
 Nature of Medical Malpractice the light of scientific knowledge, it
 the type of claim which a victim has been recognized that expert
has available to him or her to testimony is usually necessary to
redress a wrong committed by a support the conclusion as to
medical professional which has causation.
caused bodily harm

 Whether or not a physician has  In the recent case of Leonila Garcia-


committed an "inexcusable lack of Rueda v. Wilfred L. Pascasio, et al.,
precaution" in the treatment of his this Court stated that in accepting a
patient is to be determined case, a doctor in effect represents
according to the standard of care that, having the needed training
observed by other members of the and skill possessed by physicians
profession in good standing under and surgeons practicing in the
similar circumstances bearing in same field, he will employ such
mind the advanced state of the training, care and skill in the
profession at the time of treatment treatment of his patients. He
or the present state of medical therefore has a duty to use at least
science. the same level of care that any
other reasonably competent doctor
 In the recent case of Leonila Garcia- would use to treat a condition
Rueda v. Wilfred L. Pascasio, et al., under the same circumstances. It is
this Court stated that in accepting a
in this aspect of medical
malpractice that expert testimony
is essential to establish not only the
standard of care of the profession
but also that the physician's
conduct in the treatment and care
falls below such standard. Further,
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.

 In order that there may be a


recovery for an injury, however, it
must be shown that the "injury for
which recovery is sought must be
the legitimate consequence of the
wrong done; the connection
between the negligence and the
injury must be a direct and natural
sequence of events, unbroken by
intervening efficient causes." In
other words, the negligence must
be the proximate cause of the
injury. For, "negligence, no matter
in what it consists, cannot create a
right of action unless it is the
proximate cause of the injury
complained of." And "the proximate
cause of an injury is that cause,
which, in natural and continuous
sequence, unbroken by any
efficient intervening cause,
produces the injury, and without
which the result would not have
occurred."