PROFESSIONAL SERVICES, INC.

VS
NATIVIDAD and ENRIQUE AGANA

G.R. no. 126297 January 31, 2007

NATIVIDAD and ENRIQUE AGANA

VS
JUAN FUENTES

G.R. no. 127590 January 31, 2007

Facts:

Natividad Agana was rushed to the Medical City Hospital Dr. Miguel Ampil diagnosed
her to be suffering from “cancer of the sigmoid”. Dr. Ampil performed the surgery and found the
malignancy in her sigmoid necessitating the removal. Dr. Juan Fuentes performs hysterectomy
Dr. Ampil took over, completed the operation and closed the incision. The attending nurse
entered the remarks that the sponge count lacking 2. Since nowhere to be found the surgeon
avail to continue closure. After a couple of days, Natividad complained of excruciating pain she
consulted both the doctors about it but they told that it was natural consequence of the surgery.
Dr. Ampil. Natividad, went to the United States after four months of consultation and laboratory
examinations, she was free of cancer. Natividad flew back to the Philippines, still suffering from
pains, her daughter found gauze protruding from her Vagina. Then after the pain intensified,
prompting Natividad to seek treatment. Dr. Ramon Gutierez detected the presence of another
foreign object in her vagina – a foul-smelling gauze which badly infected her vaginal vault.
Natividad underwent another surgery to remedy the damage.

Natividad and her husband filed with the RTC, Quezon City a complaint for damages
against the Professional Services, Inc. (PSI), owner of the Medical City Hospital, Dr. Ampil, and
Dr. Fuentes. Enrique Agana also filed with the Professional Regulation Commission (PRC) an
administrative complaint for gross negligence and malpractice against Dr. Ampil and Dr.
Fuentes. The PRC Board of Medicine heard the case but it failed to acquire jurisdiction over Dr.
Ampil who was then in the United States. The case was pending; Natividad died and was duly
substituted by her above-named children (the Aganas). RTC rendered its Decision in favor of
the Aganas, finding PSI, Dr. Ampil and Dr. Fuentes liable for negligence and malpractice,
ordering the defendants PROFESSIONAL SERVICES, INC., Dr Miguel Ampil and Dr. Juan
Fuentes to pay to the plaintiffs, jointly and severally, except in respect of the award for
exemplary damages and the interest thereon which are the liabilities of defendants Dr. Ampil
and Dr. Fuentes.

Aggrieved, PSI, Dr. Fuentes and Dr. Ampil interposed an appeal to the Court of Appeals,
Aganas filed with the RTC a motion for a partial execution of its Decision. Aganas again filed a
motion for an alias writ of execution against the properties of PSI and Dr. Fuentes. RTC granted
the motion and issued the corresponding writ, prompting Dr. Fuentes to file with the Court of
Appeals a petition for certiorari and prohibition, with prayer for preliminary injunction. During its
pendency, the Court of Appeals issued a Resolution5 granting Dr. Fuentes’ prayer for injunctive
relief.
 PRC Board of Medicine rendered its Decision in Administrative Case dismissing the
case against Dr. Fuentes. The prosecution failed to show that Dr. Fuentes was the one who left
the two pieces of gauze inside Natividad’s body. The Court of Appeals rendered its Decision Dr.
Miguel Ampil is liable to reimburse defendant-appellant Professional Services, Inc., whatever
amount the latter will pay or had paid to the plaintiffs-appellees. Dr. Ampil filed a motion for
reconsideration, but it was denied in a Resolution

Aganas maintain that the Court of Appeals erred in finding that Dr. Fuentes is not guilty
of negligence or medical malpractice, invoking the doctrine of res ipsa loquitur. Dr. Ampil
asserts that the Court of Appeals erred in finding him liable for negligence and malpractice.

Issues:

(1) Whether the Court of Appeals erred in holding Dr. Ampil liable for negligence and
malpractice

(2) Whether the Court of Appeals erred in absolving Dr. Fuentes of any liability

(3) Whether PSI may be held solidarily liable for the negligence of Dr. Ampil.

Held:

(1) Dr. Ampil is liable for Negligence and Malpractice, an attempt to absolve himself, gears the
Court’s attention to other possible causes of Natividad’s detriment. His arguments are purely
conjectural and without basis. He did not present any evidence to prove that the American
doctors were the ones who put or left the gauzes in Natividad’s body. Neither submit evidence
to rebut the correctness of the record of operation, particularly the number of gauzes used. As
to the alleged negligence of Dr. Fuentes, we are mindful that Dr. Ampil examined his (Dr.
Fuentes’) work and found it in order.

(2) The court is not convinced, that the Court of Appeals Erred in Absolving Dr. Fuentes of any
Liability. It was duly established that Dr. Ampil was the lead surgeon during the operation of
Natividad. He requested the assistance of Dr. Fuentes only to perform hysterectomy when he
(Dr. Ampil) found that the malignancy in her sigmoid area had spread to her left ovary. Dr.
Fuentes performed the surgery and thereafter reported and showed his work to Dr. Ampil. The
latter examined it and finding everything to be in order, allowed Dr. Fuentes to leave the
operating room. Dr. Ampil then resumed operating on Natividad. He was about to finish the
procedure when the attending nurses informed him that two pieces of gauze were missing. A
"diligent search" was conducted, but the misplaced gauzes were not found. Dr. Ampil then
directed that the incision be closed. During this entire period, Dr. Fuentes was no longer in the
operating room and had, in fact, left the hospital.

(3) The issue of whether PSI is solidarily liable with Dr. Ampil for damages, that PSI, failed to
adduce evidence showing that it exercised the diligence of a good father of a family in the
accreditation and supervision of the latter. Moreover PSI is also directly liable to the Aganas.
When a doctor practices medicine in a hospital setting, the hospital and its employees are
deemed to sub serve him in his ministrations to the patient and his actions are of his own
responsibility. The nature of the relationship between the hospital and the physicians is an
employer-employee relationship the 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, are required to submit proof of completion of residency, their educational
qualifications, evidence of accreditation by the appropriate board (diplomate), evidence of
fellowship in most cases, and references. These requirements in other words, private hospitals,
hire, fire and exercise real control over their attending and visiting ‘consultant’ staff. 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. PSI publicly displays in the lobby of
the Medical City Hospital the names and specializations of the physicians associated or
accredited by it, including those of Dr. Ampil and Dr. Fuentes. PSI failed to discharge its burden
under the last paragraph of Article 2180 cited must be adjudged solidarily liable with Dr. Ampil.

ROGELIO P. NOGALES, for himself and on behalf of the minors, ROGER ANTHONY,
ANGELICA, NANCY, and MICHAEL CHRISTOPHER, all surnamed NOGALES, petitioners,
vs.
CAPITOL MEDICAL CENTER, DR. OSCAR ESTRADA, DR. ELY VILLAFLOR, DR. ROSA UY,
DR. JOEL ENRIQUEZ, DR. PERPETUA LACSON, DR. NOE ESPINOLA, and NURSE J.
DUMLAO, respondents.

G.R. No. 142625 December 19, 2006

Facts:

Corazon Nogales ("Corazon"), 37 years old pregnant with her fourth child, under the
exclusive prenatal care of Dr. Oscar Estrada ("Dr. Estrada"). The Doctor noted an increase in
her blood pressure and development of leg edema indicating preeclampsia. Corazon started to
experience mild labor pains Dr. Estrada advised her immediate admission to the Capitol Medical
Center ("CMC"). The staff nurse noted the written admission request of Dr. Estrada. Due to the
"Consent on Admission and Agreement" and "Admission Agreement" signed by Corazon’s
husband she was then brought to the labor room of the CMC.

Corazon manifest moderate vaginal bleeding which rapidly became profusely, Dr.
Espinola ordered immediate hysterectomy. Rogelio was made to sign”Consent to Operation."
Due to the inclement weather, Dr. Espinola arrived an hour late. He examined the patient and
ordered some resuscitative measures to be administered. Despite Dr. Espinola's efforts,
Corazon died the cause of death was "hemorrhage, post partum."

Petitioners filed a complaint for damages with the Regional Trial Court of Manila
contending that defendant physicians and CMC personnel were negligent in the treatment and
management of Corazon's condition also in the selection and supervision of defendant
physicians and hospital staff. The defendant fail to file their answer to the complaint the trial
court declared Dr. Estrada, Dr. Enriquez, and Nurse Dumlao in default. CMC, Dr. Villaflor, Dr.
Uy, Dr. Espinola, and Dr. Lacson filed their respective answers denying and opposing the
allegations in the complaint. The trial court rendered judgment finding Dr. Estrada solely liable
for damages.
 Petitioners appealed the trial court's decision, The Court of Appeals affirmed the
decision of the trial court. Petitioners filed a motion for reconsideration which was denied in its
Resolution. Hence, petitioners filed a Manifestation that respondents "need no longer be notified
of the petition because they are not involved in the issue raised before the [Court], regarding the
liability of [CMC]." The Court of Appeals concluded that since Rogelio engaged Dr. Estrada as
the attending physician of his wife, any liability for malpractice must be Dr. Estrada's sole
responsibility. While it found the amount of damages fair and reasonable, the Court of Appeals
held that no interest could be imposed on unliquidated claims or damages. Hence this petition.

Issue: Whether or not CMC is vicariously liable for the negligence?

Held:

On the Liability of CMC

CMC is vicariously liable for Dr. Estrada's negligence based on Article 2180 in relation to Article
2176 of the Civil Code. Art. 2180. The obligation imposed by article 2176 is demandable not
only for one's own acts or omissions, but also for those of persons for whom one is responsible.
Employers shall be liable for the damages caused by their employees. The records show that
Rogelio testified that he and his wife specifically chose Dr. Estrada to handle Corazon's delivery
not only because of their friend's recommendation, but more importantly because of Dr.
Estrada's "connection with a reputable hospital, to provide the best medical care and support
services for Corazon's delivery.

On the Liability of the Other Respondents

There was no evidence showing that the other respondents are liable for negligent act. The
records show that all are acting with good faith.

On the Award of Interest on Damages

The award of interest on damages is proper and allowed under Article 2211 of the Civil Code,
which states that in crimes and quasi-delicts, interest as a part of the damages may, in a proper
case, be adjudicated in the discretion of the court. The Court partly grants the petition finds
respondent Capitol Medical Center vicariously liable for the negligence of Dr. Oscar Estrada.
The actual damages and moral damages should each earn legal interest at the rate of six
percent (6%) per annum computed from the date of the judgment of the trial court.