Nogales vs. Capitol Medical Center

C. Nogales vs. Capitol Medical Center, GR 142625, December, 2006 RG!"# $. NG%"!&, 'or (imsel' and on be(al' o' t(e minors, RG!R %N)*N+, %N)*N+, %NG!"#C%, N%NC+, and M#C*%!" C*R#&)$*!R, all srnamed NG%"!&, petitioners, NG%"!&, petitioners, vs. C%$#)" M!D#C%" C!N)!R, DR. &C%R !&)R%D%, DR. !"+ -#""%"R, DR. R&% /+, DR. !" !NR#/!, DR. $!R$!)/% "%C&N, DR. N! !&$#N"%, and N/R&! . D/M"%, respondents. D/M"%, respondents.

%C)&3 Dr. Estrada Estrada was the prenatal doctor of the petitioner’s wife, Corazon, for their 4 th child who had a complicated pregnancy. pregnancy. When she complained of mild labor pains, she was admitted to Capitol Medical Center CMC! "pon Estrada’s advised. #o ma$e the long story short, in her admission to the CMC, Corazon then gave b irth to a baby who then died and ca"sed her to s"ffer haemorrhage leading to her death. %etitioner &ogelio, Corazon’s h"sband, h"sband, s"ed Estrada and other CMC doctors and a n"rse who had a hand in the child delivery for damages. Dr. Estrada did not appeal the decision of the C' which affirmed the r"ling of the trial co"rt finding Dr. Estrada solely liable for damages. %etitioners maintain that CMC CMC is vicario"sly liable for Dr. Dr. Estrada(s negligence based on 'rticle )*+ in relation to 'rticle )*- of the Civil Code. #&&/!3 Whether CMC is liable. R/"#NG3 /E0. 'rticle )*+ deals with with the vicario"s liability of an employer. employer. 1n this case, Dr. Dr. Estrada is is classified as a visiting physician of CMC. 1n assessing whether an employer2employee employer2employee relationship in fact e3ists, the control test right to control both the means and the details of the process by which the employeephysician is to accomplish accomplish his tas$! is determining. #he Co"rt finds no single evidence pointing to CMC(s e3ercise of control over Dr. Estrada(s Estrada(s treatment and management of Corazon(s condition. 1t is "ndisp"ted that thro"gho"t Corazon(s pregnancy, she was "nder the e3cl"sive prenatal care of Dr. Estrada. While Dr. Estrada en5oyed staff privileges at CMC, s"ch fact alone did not ma$e him an employee of CMC. CMC merely allowed Dr. Estrada to "se its facilities as it was an emergency. Estrada is not a n employee of CMC, b"t an independent i ndependent contractor. 1n general, a hospital is not liable for the negligence of an independent contractor2physician. #here is, however, an e3ception to this principle. #he hospital may be liable if the physician is the 6ostensible6 agent of the hospital. #his e 3ception is also $nown as the 6doctrine of apparent a"thority.6 1n Gilbert v. Sycamore Municipal Hospital (US case): a hospital can be held vicario"sly liable for the negligent acts of a physician providing care at the hospital, regardless of whether the physician is an independent contractor, "nless the patient $nows, or sho"ld have $nown, that the physician is an independent contractor. #he elements of the action have been set o"t as follows7 68or a hospital to be liable "nder the doctrine of apparent a"thority, a plaintiff m"st show that7 *! the hospital, or its agent, acted in a manner that wo"ld lead a reasonable person to concl"de that the individ"al who was alleged to be negligent was an employee or agent of the hospital9 )! where the acts of the agent create the appearance of a"thority, the plaintiff m"st also prove that the hospital had $nowledge of and ac:"iesced in them9 and ;! the plaintiff acted in reliance "pon the cond"ct of the hospital or its agent, consistent with ordinary care and pr"dence.6 #he element of 6holding o"t6 on the part of the hospital does not re:"ire an e3press representation by the hospital that the person alleged to be negligent is an employee.

&ather, the element is satisfied if the hospital holds itself o"t as a provider of emergency room care witho"t informing the patient that the care is provided by independent contractors. #he element of 5"stifiable reliance on the part of the plaintiff is satisfied if the plaintiff relies "pon the hospital to provide complete emergency room care, rather than "pon a specific physician. #he doctrine of apparent a"thority essentially involves two factors to determine the liability of an independent2contractor physician. #he #R&) %C)R foc"ses on the hospital(s manifestations and is sometimes described as an in:"iry whether the hospital acted in a manner which wo"ld lead a reasonable person to concl"de that the individ"al who was alleged to be negligent was an employee or agent of the hospital. 1n this regard, the hospital need not ma$e e3press representations to the patient that the treating physician is an employee of the hospital9 rather a representation may be general and implied. #he doctrine of apparent a"thority is a species of the doctrine of estoppel. 1n the instant case, CMC impliedly held o"t Dr. Estrada as a member of its medical staff. #hro"gh CMC(s acts, CMC clothed Dr. Estrada with apparent a"thority thereby leading the 0po"ses ead of the =bstetrics and ?ynecology Department of CMC, gave the impression that Dr. Estrada as a member of CMC(s medical staff. #he &!CND %C)R foc"ses on the patient(s reliance. 1t is sometimes characterized as an in:"iry on whether the plaintiff acted in reliance "pon the cond"ct of the hospital or its agent, consistent with ordinary care and pr"dence. #he records show that the 0po"ses