Ramos vs CA,Dlsmc
ROGELIO E. RAMOS and ERLINDA RAMOS, in their own behalf and as natural guardians of the minors, ROMMEL RAMOS, ROY RODERICK RAMOS, and RON RAYMOND RAMOS, petitioners, vs. COURT OF APPEALS, DE LOS SANTOS MEDICAL CENTER, DR. ORLINO HOSAKA and DR. PERFECTA GUTIERREZ, respondents. G.R. No. 124354 April 11, 2002
The case is about an action for damages filed by petitioners against Dr. Orlino Hosaka (surgeon) and Dr. Perfecta Gutierrez (anaesthesiologist) for negligence in the performance of their duties during the operation conducted to Erlinda Ramos for the removal of a stone in her gall bladder, which resulted to her comatose condition. Delos Santos Medical Center (DLSMC) was impleaded being solidarily liable as their employer. Based on the evidence presented, it was shown that Dr. Gutierrez had wrongfully inserted the endotracheal tube into the esophagus instead of the trachea. Consequently, oxygen was delivered not to the lungs but to the gastrointestinal tract. This resulted to a decrease of blood supply to the patient’s brain. The brain was thus temporarily deprived of oxygen supply causing Erlinda to go into coma. Another factor that lead her into coma is the three (3) long waiting hours lying in the operating bed while waiting for Dr. Hosaka to arrive, which lead to increase her anxiety that adversely affected the administration of anesthesia. Hence, there is negligence on the part of Dr. Hosaka in not arriving promptly on the scheduled time. The trial court rendered a decision in favor of petitioner holding private respondents negligent in the performance of their duties. On appeal, the CA reversed the trial court’s decision and directed petitioners to pay their unpaid medical bills. Petitioners filed a petition for review on certiorari to the SC. The SC reversed the CA’s decision finding private respondents solidarily liable to Erlinda. Aggrieved, private respondents filed a motion for reconsideration. The SC rendered a resolution affirming partly its decision, holding solidarily liable Dr. Hosaka and Dr. Gutierrez only, while absolving DLSMC from any liability. The reason for this is that there is no employeremployee relationship exists between the surgeons and the hospital. The amount of damages awarded to petitioners was modified due to the death of Erlinda at the time of hearing of this motion for reconsideration. Hence, temperate damages was eliminated.
REACTION ON THE DECISION I was amazed how come the decision reached in this case is different from those rendered in the cases of PSI vs. Agana (2007), and Nogales vs. CMC (2006). I think it’ s because this decision was rendered in 2002, which is much earlier than the two (2) above mentioned cases. In this case, the Supreme Court did not yet adopt the doctrine of Apparent Authority. It just relied on the control test to determine whether these specialists are employees of the hospital or not. The fact that these specialists were not under the control of the DLSMC with regards to means on how the end of their tasks will be achieved made them not employees of the hospital. Unlike in the doctrine of apparent authority, once the plaintiff had relied on the fact that they are employed in the hospital through means which would make an ordinary person believed that they are such, the hospital is estopped from claiming that they are not its employees. With the current set up of private hospitals nowadays, on how they operate their businesses, it is clear that most of their consultants and specialists are not employees of the hospital, but rather considered as an independent contractor. I believe that this decision is not in consonance with the rule on fair play and equity, because the hospital escaped from liability despite the fact that in case the operation succeed, it will profit substantially. The doctrine laid down in this decision was abandoned in subsequent medical negligence cases, in which the SC ruled liberally in favor of patient with regard to the interpretation of employer-employee relationship. It adopted the modern views enunciated by US Courts to compel hospital owners to exercise due diligence in the supervision and selection of their employees. However, the SC with regard to Dr. Hosaka’s liability, it did apply the Captain of the Ship theory considering that he is the one overall in-charge of the operation. He became solidarily liable with Dr. Gutierrez because it is his duty to ensure that the latter is working her task diligently. Furthermore, Dr. Hosaka is the one who referred Dr. Gutierrez to the Ramos to be Erlinda’s anaesthesiologist because they have been altogether for a long time every time he performed an operation. The SC belie the claim of Dr. Hosaka that the trend in US jurisprudence should be followed as it do away with the Captain of the Ship doctrine because each doctor has different specialization. Thus, he has no right of control over his anaesthesiologist Dr. Gutierrez. Yet, the SC affirmed its decision to made him liable because he exercise a certain degree of supervision on how the operation to Erlinda should be performed. Finally, with regard to Dr. Gutierrez, I think his negligence is the proximate cause which made Erlinda to comatose, considering the fact that
he erroneously inserted the endotracheal tube into the esophagus instead of the trachea. Hence, the oxygen instead of going to her lungs, was diverted into his gastrointestinal tract, which lead to the loss of supply of oxygen in her brain. If she just performed diligently the pre-operation evaluation, this tragic incident will not happen.
RECOMMENDATION As a hospital administrator, my goal is to make sure that the hospital not only profits but to provide quality medical and health care services /treatment to patients. It is my duty to ensure that each staff is following the standard operating procedure in order not to prejudice the services given to patients, as well as to prevent loss of lives because of making short cuts in the procedure. I should maintain a periodic evaluation of my specialists and other staff to determine their consistency, precision, effectiveness and efficiency in their respective field. Our profession as physician is very noble compare to other profession, considering it is in our hands the life of the patient will depend. The risk is very high in every operation we perform, it is a matter of life and death situation. In order to prevent loss of lives, we should exercise due diligence in the performance of our duty, coupled with the application of skill, knowledge and experience.