G.R. No.

124354 December 29, 1999

RAMOS VS CA
Lessons Applicable: Personal Injury and Death (Torts and Damages)
Laws Applicable:

FACTS:

June 17, 1985 afternoon: Erlinda Ramos, 47-year old robust woman
underwent on an operation to the stone at her gall bladder removed after
being tested that she was fit for "cholecystectomy" operation performed
by Dr. Orlino Hozaka. Dr. Hosaka charged a fee of P16,000.00, which was
to include the anesthesiologist's fee and which was to be paid after the
operation. He assured Rogelio E. Ramos, husband that he will get a
good anesthesiologist who was Dra. Perfecta Gutierrez. Erlinda's hand
was held by Herminda Cruz, her sister -in-law who was the Dean of the
College of Nursing at the Capitol Medical Center together with her
husband went down with her to the operating room.
Instead of 9:30 am, Dr. Hosaka arrived at about 12:15 P.M.
Herminda noticing what Dra. Perfecta Gutierrez was doing, saw the
nailbed of Erlinda becoming bluish and Dr. Hosaka called for
another anesthesiologist Dr. Calderon.
She went out of the operating room to tell Rogelio that something is
wrong.
When she went back she saw Erlinda in a trendelenburg position and
at 3 p.m. she was taken to the Intensive Care Unit (ICU) where she
stayed for a month due to bronchospasm incurring P93,542.25 and she
was since then comatosed.
She suffered brain damage as a result of the absence of oxygen
in her brain for four to five minutes.
She was also diagnosed to be suffering from "diffuse cerebral
parenchymal damage"
Monthly expenses ranged from P8,000 to P10,000
Spouses Ramos and their minors filed against Dr. Hosaka and Dra.
Perfecta Gutierrez

RTC: favored the Ramos' awarding P8,000 as actual monthly expenses

totalling to P632,000 as of April 15, 1992, P100,000 atty. fees, P800,000
moral damages,P200,000 exemplary damages and cost of suit
CA: reversed ordering the Ramos' to pay their
unpaid bills of P93,542.25 plus interest

ISSUE: W/N the Ramos' are entitled to damages

HELD: YES. CA modified in favor of petitioners, and solidarily against private

respondents the following: 1) P1,352,000 actual damages computed as of

the date of promulgation plus a monthly payment of P8,000.00 up to the
time that petitioner Erlinda Ramos expires or miraculously survives; 2)
P2,000,000 moral damages, 3) P1,500,000 temperate damages; 4)
P100,000 exemplary damages and P100,000 attorney's fees; and, 5) the
costs of the suit.

The application of res ipsa loquitur in medical negligence cases

presents a question of law since it is a judicial function to determine
whether a certain set of circumstances does, as a matter of law, permit a
given inference.
doctrine of res ipsa loquitur is availed by the plaintiff, the need for
expert medical testimony is dispensed with because the injury itself
provides the proof of negligence - applicable in this case
doctrine of res ipsa loquitur can have no application in a suit against a
physician or surgeon which involves the merits of a diagnosis or of a
scientific treatment
As borne by the records, respondent Dra. Gutierrez failed to properly
intubate the patient according to witness Herminda
With her clinical background as a nurse, the Court is satisfied
with her testimony
Dra. Gutierrez' act of seeing her patient for the first time only an hour
before the scheduled operative procedure was, therefore, an act of
exceptional negligence and professional irresponsibility
Generally, to qualify as an expert witness, one must have acquired
special knowledge of the subject matter about which he or she is to
testify, either by the study of recognized authorities on the subject or by
practical experience.
Dr. Jamora, not an anesthesiologist, stated that oxygen
deprivation which led to anoxic encephalopathy was due to an

unpredictable drug reaction to the short-acting barbiturate was not

accepted as expert opinion
Dr. Hosaka's negligence can be found in his failure to exercise the
proper authority in not determining if his anesthesiologist observed
proper anesthesia protocols
Dr. Hosaka had scheduled another procedure in a different hospital at
the same time as Erlinda's cholecystectomy, and was in fact over three
hours late for the latter's operation. Because of this, he had little or no
time to confer with hisanesthesiologist regarding the anesthesia delivery.
This indicates that he was remiss in his professional duties towards his
patient
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.
Art. 2199. Except as provided by law or by stipulation, one is entitled
to an adequate compensation only for such pecuniary loss suffered by
him as he has duly proved. Such compensation is referred to as actual or
compensatory damages.
temperate damages can and should be awarded on top of actual or
compensatory damages in instances where the injury is chronic and
continuing. And because of the unique nature of such cases, no
incompatibility arises when both actual and temperate damages are
provided for. The reason is that these damages cover two distinct phases.
They should not be compelled by dire circumstances to provide
substandard care at home without the aid of professionals, for anything
less would be grossly inadequate. Under the circumstances, an award of
P1,500,000.00 in temperate damages would therefore be reasonable.
the damage done to her would not only be permanent and lasting, it
would also be permanently changing and adjusting to the physiologic
changes which her body would normally undergo through the years.
Erlinda Ramos was in her mid-forties when the incident occurred. She
has been in a comatose state for over fourteen years now
Ramos' are charged with the moral responsibility of the care of the
victim. The family's moral injury and suffering in this case is clearly a real
one. Award of P2,000,000 in moral damages would be appropriate.

Finally, by way of example, exemplary damages in the amount of

P100,000.00 are hereby awarded. Considering the length and nature of
the instant suit we are of the opinion that attorney's fees valued at
P100,000 are likewise proper.