Case 048. Reyes vs, SISTERS OF MERCY HOSPITAL, SISTER ROSE PALACIO, DR.

MARVIE
BLANES, and DR. MARLYN RICO
Ref./Date/ Pn. G.R. No. !"#$%. O&to'e( !, )"""*MENDO+A, J. -EN
La/ S'0e&t Med1&a2 Ma23(a&t1&e / To(ts
Case A1d Pat1ent d1ed of t435o1d fe6e(

FACTS:
Pet1t1one( Lea5 A2esna Re4es 1s t5e 1fe of t5e 2ate -o(7e Re4es. T5e ot5e( 3et1t1one(s, e(e t5e1( &512d(en. F16e
da4s 'efo(e 51s deat5 on -ana(4 8, 98%, -o(7e 5ad 'een sffe(1n7 f(o: a (e&((1n7 fe6e( 1t5 &5122s. Afte( 5e
fa12ed to 7et (e21ef f(o: so:e 5o:e :ed1&at1on 5e as ta;1n7, 51&5 &ons1sted of ana27es1&, ant134(et1&, and
ant1'1ot1&s, 5e de&1ded to see t5e do&to(.

On -ana(4 8, 98%, 5e as ta;en to t5e Me(&4 Co::n1t4 C21n1& '4 51s 1fe. He as attended to '4 (es3ondent
D(. Ma(24n R1&o, (es1dent 354s1&1an and ad:1tt1n7 354s1&1an on dt4, 5o 7a6e -o(7e a 354s1&a2 e<a:1nat1on and
too; 51s :ed1&a2 51sto(4. Ss3e&t1n7 t5at -o(7e &o2d 'e sffe(1n7 f(o: t51s d1sease, D(. R1&o o(de(ed a =1da2
Test, a standa(d test fo( t435o1d fe6e(, to 'e 3e(fo(:ed on -o(7e >$* Afte( a'ot an 5o(, t5e :ed1&a2 te&5n1&1an
s':1tted t5e (es2ts of t5e test f(o: 51&5 D(. R1&o &on&2ded t5at -o(7e as 3os1t16e fo( t435o1d fe6e(. As 5e(
s51ft as on24 3 to #"" 3.:., D(. R1&o 1ndo(sed -o(7e to (es3ondent D(. Ma(61e B2anes.

D(. Ma(61e B2anes attended to -o(7e at a(ond s1< 1n t5e e6en1n7. L1;e D(. R1&o, 5e( 1:3(ess1on as t5at -o(7e
5ad t435o1d fe6e(. Ant1'1ot1&s 'e1n7 t5e a&&e3ted t(eat:ent fo( t435o1d fe6e(, s5e o(de(ed t5at a &o:3at1'121t4 test
1t5 t5e ant1'1ot1& &52o(o:4&et1n 'e done on -o(7e. As s5e d1d not o'se(6e an4 ad6e(se (ea&t1on '4 t5e 3at1ent to
&52o(o:4&et1n, D(. B2anes o(de(ed t5e f1(st f16e 5nd(ed :12217(a:s of sa1d ant1'1ot1& to 'e ad:1n1ste(ed on -o(7e
at a(ond 9"" 3.:. A se&ond dose as ad:1n1ste(ed on -o(7e a'ot t5(ee 5o(s 2ate( 0st 'efo(e :1dn175t.

At a(ond "" a.:. of -ana(4 9, 98%, D(. B2anes as &a22ed as -o(7es te:3e(at(e (ose to $C. T5e 3at1ent
a2so e<3e(1en&ed &5122s and e<51'1ted (es31(ato(4 d1st(ess, nasea, 6o:1t1n7, and &on62s1ons. D(. B2anes 3t 51:
nde( o<47en, sed a s&t1on :a&51ne, and ad:1n1ste(ed 54d(o&o(t1sone, te:3o(a(124 eas1n7 t5e 3at1ents
&on62s1ons. Afte( a'ot # :1ntes, 5oe6e(, -o(7e a7a1n sta(ted to 6o:1t, s5oed (est2essness, and 51s
&on62s1ons (et(ned. D(. B2anes (ea3321ed t5e e:e(7en&4 :eas(es ta;en 'efo(e and, 1n add1t1on, 6a21: as
ad:1n1ste(ed. -o(7e, 5oe6e(, d1d not (es3ond to t5e t(eat:ent and s2133ed 1nto &4anos1s, a '21s5 o( 3(321s5
d1s&o2o(at1on of t5e s;1n o( :&os :e:'(ane de to def1&1ent o<47enat1on of t5e '2ood. At a(ond )"" a.:.,
-o(7e d1ed. He as fo(t4 4ea(s o2d. T5e &ase of 51s deat5 as Vent(1&2a( A((4t5e:1a Se&onda(4 to H43e(34(e<1a
and t435o1d fe6e(.

On -ne !, 98%, 3et1t1one(s f12ed 'efo(e t5e Re71ona2 T(1a2 Co(t of Ce' C1t4 a &o:32a1nt
>?*fo( da:a7es a7a1nst

T5e1( 3(1n&13a2 &ontent1on as t5at -o(7e d1d not d1e of t435o1d fe6e(.
>%* Instead, 51s deat5 as de to t5e (on7f2
ad:1n1st(at1on of &52o(o:4&et1n. T5e4 &ontended t5at 5ad (es3ondent do&to(s e<e(&1sed de &a(e and d1217en&e,
t5e4 o2d not 5a6e (e&o::ended and (s5ed t5e 3e(fo(:an&e of t5e =1da2 Test, 5ast124 &on&2ded t5at -o(7e
as sffe(1n7 f(o: t435o1d fe6e(, and ad:1n1ste(ed &52o(o:4&et1n 1t5ot f1(st &ond&t1n7 sff1&1ent tests on t5e
3at1ents &o:3at1'121t4 1t5 sa1d d(7.

Expert Testimonies:
. Pet1t1one(s offe(ed t5e D(. A3o21na( Va&a2a(es, C51ef Pat5o2o71st at t5e No(t5e(n M1ndanao T(a1n1n7
Hos31ta2, Ca7a4an de O(o C1t4. On -ana(4 9, 98%, D(. Va&a2a(es 3e(fo(:ed an ato3s4 on -o(7e Re4es
to dete(:1ne t5e &ase of 51s deat5. Hoe6e(, 5e d1d not o3en t5e s;22 to e<a:1ne t5e '(a1n. H1s
f1nd1n7s>9* s5oed t5at t5e 7ast(o1ntest1na2 t(a&t as no(:a2 and 1t5ot an4 2&e(at1on o( en2a(7e:ent of
t5e nod2es. D(. Va&a2a(es test1f1ed t5at -o(7e d1d not d1e of t435o1d fe6e(. He a2so stated t5at 5e 5ad not
seen a 3at1ent d1e of t435o1d fe6e( 1t51n f16e da4s f(o: t5e onset of t5e d1sease.

). Fo( t5e1( 3a(t, (es3o ndents offe(ed t5e test1:on1es of D(. Pete( Got1 on7 and D(. I'a((a Pano 31o. D(.
Got1on7 1s a d132o:ate 1n 1nte(na2 :ed1&1ne 5ose e<3e(t1se 1s :1&(o'1o2o74 and 1nfe&t1os d1seases. He 1s
a2so a &ons2tant at t5e Ce' C1t4 Med1&a2 Cente( and an asso&1ate 3(ofesso( of :ed1&1ne at t5e Sot5
=este(n @n16e(s1t4 Co22e7e of Med1&1ne 1n Ce' C1t4. A&&o(d1n7 to D(. Got1on7, t5e 3at1ents 51sto(4 and
3os1t16e =1da2 Test (es2ts (at1o of !)" o2d :a;e 51: ss3e&t t5at t5e 3at1ent 5ad t435o1d fe6e(. As to
D(. Va&a2a(es o'se(6at1on (e7a(d1n7 t5e a'sen&e of 2&e(at1on 1n -o(7es 7ast(o1ntest1na2 t(a&t, D(. Got1on7
 sa1d t5at s&5 543e(32as1a 1n t5e 1ntest1nes of a t435o1d 61&t1: :a4 'e :1&(os&o31&. He noted t5at s1n&e t5e
to<1& effe&t of t435o1d fe6e( :a4 2ead to :en1n71t1s, D(. Va&a2a(es ato3s4 s5o2d 5a6e 1n&2ded an
e<a:1nat1on of t5e '(a1n.

!. T5e ot5e( do&to( 3(esented as D(. I'a((a Pano31o, a :e:'e( of t5e A:e(1&an Boa(d of
Pat5o2o74, e<a:1ne( of t5e P5121331ne Boa(d of Pat5o2o74 f(o: 9%8 to 99. D(. Pano31o stated t5at
a2t5o75 5e as 3a(t1a2 to t5e se of t5e &2t(e test fo( 1ts 7(eate( (e21a'121t4 1n t5e d1a7nos1s of t435o1d
fe6e(, t5e =1da2 Test :a4 a2so 'e sed. L1;e D(. Got1on7, 5e a7(eed t5at t5e !)" (at1o 1n -o(7es &ase
as a2(ead4 t5e :a<1:: '4 51&5 a &on&2s1on of t435o1d fe6e( :a4 'e :ade. No add1t1ona2 1nfo(:at1on
:a4 'e ded&ed f(o: a 5175e( d12t1on. >* He sa1d t5at D(. Va&a2a(es ato3s4 on -o(7e as 1n&o:32ete
and t5s 1n&on&2s16e.

ISSUES: 5et5e( t5e deat5 of -o(7e Re4es as de to o( &ased '4 t5e ne7217en&e, &a(e2essness, 1:3(den&e,
and 2a&; of s;122 o( fo(es175t on t5e 3a(t of defendants. NO

HELD: =HEREFORE, t5e 1nstant 3et1t1on 1s DENIED and t5e de&1s1on of t5e Co(t of A33ea2s 1s
AFFIRMED.

RATIONALE:

Pet1t1one(s a&t1on 1s fo( :ed1&a2 :a23(a&t1&e. T51s 1s a 3a(t1&2a( fo(: of ne7217en&e 51&5 &ons1sts 1n t5e fa12(e of
a 354s1&1an o( s(7eon to a3324 to 51s 3(a&t1&e of :ed1&1ne t5at de7(ee of &a(e and s;122 51&5 1s o(d1na(124
e:32o4ed '4 t5e 3(ofess1on 7ene(a224, nde( s1:12a( &ond1t1ons, and 1n 21;e s((ond1n7 &1(&:stan&es. >)* In
o(de( to s&&essf224 3(se s&5 a &2a1:, a 3at1ent :st 3(o6e t5at t5e 354s1&1an o( s(7eon e1t5e( fa12ed to do
so:et51n7 51&5 a (easona'24 3(dent 354s1&1an o( s(7eon o2d 5a6e done, o( t5at 5e o( s5e d1d so:et51n7
t5at a (easona'24 3(dent 354s1&1an o( s(7eon o2d not 5a6e done, and t5at t5e fa12(e o( a&t1on &ased 1n0(4
to t5e 3at1ent. >!* T5e(e a(e t5s fo( e2e:ents 1n6o26ed 1n :ed1&a2 ne7217en&e &ases, na:e24 dt4, '(ea&5,
1n0(4, and 3(o<1:ate &asat1on.

In t5e 3(esent &ase, t5e(e 1s no do't t5at a 354s1&1an3at1ent (e2at1ons513 e<1sted 'eteen (es3ondent do&to(s
and -o(7e Re4es. Res3ondents e(e t5s dt4'ond to se at 2east t5e
sa:e 2e6e2 of &a(e t5at an4 (easona'24 &o:3etent do&to( o2d se to t(eat a &ond1t1on nde( t5e sa:e
&1(&:stan&es. It 1s '(ea&5 of t51s dt4 51&5 &onst1ttes a&t1ona'2e :a23(a&t1&e.
>$*
As to t51s as3e&t of :ed1&a2 :a23(a&t1&e, t5e dete(:1nat1on of t5e (easona'2e 2e6e2 of &a(e and t5e '(ea&5 t5e(eof,
e<3e(t test1:on4 1s essent1a2. Inas:&5 as t5e &ases of t5e 1n0(1es 1n6o26 ed 1n :a23(a&t1&e a&t1ons a(e
dete(:1na'2e on24 1n t5e 2175t of s&1ent1f1& ;no2ed7e, 1t 5as 'een (e&o7n1ed t5at e<3e(t test1:on4 1s sa224
ne&essa(4 to s33o(t t5e &on&2s1on as to &asat1on.

First. =512e 3et1t1one(s 3(esented D(. A3o21na( Va&a2a(es as an e<3e(t 1tness, e do not f1nd 51: to 'e so as 5e
1s not a s3e&1a21st on 1nfe&t1os d1seases 21;e t435o1d fe6e(. F(t5e(:o(e, a2t5o75 5e :a4 5a6e 5ad e<tens16e
e<3e(1en&e 1n 3e(fo(:1n7 ato3s1es, 5e ad:1tted t5at 5e 5ad 4et to do one on t5e 'od4 of a t435o1d 61&t1: at t5e
t1:e 5e &ond&ted t5e 3ost:o(te: on -o(7e Re4es. It 1s a2so 32a1n f(o: 51s test1:on4 t5at 5e 5as t(eated on24
a'ot t5(ee &ases of t435o1d fe6e(.

Second. On t5e ot5e( 5and, t5e to do&to(s 3(esented '4 (es3ondents &2ea(24 e(e e<3e(ts on t5e s'0e&t. T5e4
6o&5ed fo( t5e &o((e&tness of D(. Ma(24n R1&os d1a7nos1s. D(. Pete( Got1on7, test1f1ed t5at 5e 5as a2(ead4 t(eated
o6e( a t5osand &ases of t435o1d fe6e(.>)?*
A&&o(d1n7 to 51:, 5en a &ase of t435o1d fe6e( 1s ss3e&ted, t5e =1da2 test 1s no(:a224 sed, and 1f t5e !)"
(es2ts of t5e =1da2 test on -o(7e Re4es 5ad 'een 3(esented to 51: a2on7 1t5 t5e 3at1ents 51sto(4, 51s 1:3(ess1on
o2d a2so 'e t5at t5e 3at1ent as sffe(1n7 f(o: t435o1d fe6e(.>)8* As to t5e t(eat:ent of t5e d1sease, 5e stated
t5at &52o(o:4&et1n as t5e d(7 of &5o1&e.>)9* He a2so e<32a1ned t5at des31te t5e :eas(es ta;en '4 (es3ondent
do&to(s and t5e 1nt(a6enos ad:1n1st(at1on of to doses of &52o(o:4&et1n, &o:321&at1ons of t5e d1sease &o2d not
'e d1s&onted.

Third. Pet1t1one(s &ontend t5at (es3ondent D(. Ma(61e B2anes, 5o too; o6e( f(o: D(. R1&o,
as ne7217ent 1n o(de(1n7 t5e 1nt(a6enos ad:1n1st(at1on of to doses of #"" :12217(a:s of
&52o(o:4&et1n at an 1nte(6a2 of 2ess t5an t5(ee 5o(s. Pet1t1one(s &2a1: t5at -o(7e Re4es d1ed of
ana3542a&t1& s5o&;.

As 5e2d '4 t5e Co(t of A33ea2s, 5oe6e( That chloromycetin was likewise a proper prescription is best established by
medical authority. The dosage was still within medically acceptable limits, since the recommended dose of chloromycetin is
one (1) gram every six (6)hours . Even if the test was not administered by the physicianonduty, the evidence introduced that it
was Dra. Blanes who interpreted the results remain uncontroverted. Once more, this Court rejects any claim of professional
nelience in this reard.

!hat all this means leally is that even if the deceased suffered from an anaphylactic shock, this, of itself, would not yet
establish the nelience of the appelleephysicians for all that the law re"uires of them is that they perform the standard tests
and perform standard procedures. The law cannot re"uire them to predict every possible reaction to all drus administered.
The onus probandi was on the appellants to establish, before the trial court, that the appelleephysicians inored standard
medical procedure, prescribed and administered medication with recklessness and e#hibited an absence of the competence
and skills e#pected of eneral practitioners similarly situated.

Fourth. Pet1t1one(s &o((e&t24 o'se(6e t5at t5e :ed1&a2 3(ofess1on 1s one 51&5, 21;e t5e 's1ness of a &o::on
&a((1e(, 1s affe&ted 1t5 3'21& 1nte(est. Mo(eo6e(, t5e4 asse(t t5at s1n&e t5e 2a 1:3oses 3on &o::on &a((1e(s
t5e dt4 of o'se(61n7 e<t(ao(d1na(4 d1217en&e 1n t5e 61712an&e o6e( t5e 7oods and fo( t5e safet4 of t5e 3assen7e(s,
>$"* 354s1&1ans and s(7eons s5o2d 5a6e t5e sa:e dt4 toa(d t5e1( 3at1ents.

T5e 3(a&t1&e of :ed1&1ne 1s a 3(ofess1on en7a7ed 1n on24 '4 a21f1ed 1nd161da2s. It 1s a (175t ea(ned t5(o75 4ea(s
of ed&at1on, t(a1n1n7, and '4 f1(st o'ta1n1n7 a 21&ense f(o: t5e state t5(o75 3(ofess1ona2 'oa(d e<a:1nat1ons.
S&5 21&ense :a4, at an4 t1:e and fo( &ase, 'e (e6o;ed '4 t5e 7o6e(n:ent. In add1t1on to state (e72at1on, t5e
&ond&t of do&to(s 1s a2so st(1&t24 7o6e(ned '4 t5e H133o&(at1& Oat5, an an&1ent &ode of d1s&1321ne and et51&a2 (2es
51&5 do&to(s 5a6e 1:3osed 3on t5e:se26es 1n (e&o7n1t1on and a&&e3tan&e of t5e1( 7(eat (es3ons1'121t4 to
so&1et4. G16en t5ese safe7a(ds, t5e(e 1s no need to e<3(ess24 (e1(e of do&to(s t5e o'se(6an&e of e<t(ao(d1na(4
d1217en&e. As 1t 1s no, t5e 3(a&t1&e of :ed1&1ne 1s a2(ead4 &ond1t1oned 3on t5e 5175est de7(ee of d1217en&e. And,
as e 5a6e a2(ead4 noted, t5e standa(d &onte:32ated fo( do&to(s 1s s1:324 t5e (easona'2e a6e(a7e :e(1t a:on7
o(d1na(124 7ood 354s1&1ans. T5at 1s (easona'2e d1217en&e fo( do&to(s o(, as t5e Co(t of A33ea2s &a22ed 1t, t5e
(easona'2e s;122 and &o:3eten&e . . . t5at a 354s1&1an 1n t5e sa:e o( s1:12a( 2o&a21t4 . . . s5o2d a3324.