Carlos Borromeo v Family Family Care Hospital Inc. (G.R. No. 191018) Date: January 25, 2016 Ponente: Justice Brion Facts: On July 13, 1999, the Borromeo brought his i!e to the "amily #are $os%ital because she ha& been com%laining o! acute %ain at the loer stomach area an& !e'er !or to &ays( )he as a&mitte& at the hos%ital an& %lace& un&er the care o! Dr( *nso( Dr( *nso sus%ecte& that +ilian might be suering !rom acute a%%en&icitis( $oe'er, there as insu-cient &ata to rule out other %ossible causes an& to %rocee& ith an a%%en&ectomy( .hus, he or&ere& or&ere& +ilian/s +ilian/s connement connement !or testing testing an& e'aluation( e'aluation( $oe'er, $oe'er, the tests tests ere not conclusi'e enough to conrm that she ha& a%%en&icitis( +ilian abru%tly &e'elo%e& an acute surgical ab&omen( On July 15, 1999, Dr( *nso &eci&e& to con&uct an e%loratory la%arotomy on +ilian because o! the n&ings on her ab&omen an& his !ear that she might ha'e a ru%ture& a%%en&i( During the o%eration, Dr( *nso conrme& that +ilian as suering !rom acute a%%en&icitis( $e %rocee&e& to remo'e her a%%en&i hich as alrea&y in!ecte& an& congeste& ith %us( .he o%eration as success!ul( )i hours a!ter +ilian as brought bac to her room, Dr( *nso as in!orme& that her bloo& %ressure as lo( !ter assessing her con&ition, he or&ere& the in!usion o! more intra'enous 4* 7ui&s hich someho raise& her bloo& %ressure( )ubse8uently, a nurse in!orme& him that +ilian as becoming restless( Dr( *nso imme&iately ent to +ilian an& sa that she as 8uite %ale( $e imme&iately re8ueste& a bloo& trans!usion( +ilian &i& not res%on& to the bloo& trans!usion e'en a!ter recei'ing recei'ing to 500 ccunits o! bloo&( 'entually, an en&otracheal tube connecte& to an oygen tan as inserte& into +ilian to ensure her airay as clear an& to com%ensate !or the lac o! circulating oygen in her bo&y !rom the loss o! re& bloo& cells( ;e'ertheless, ;e'ertheless, her con&ition continue& to &eteriorate( &eteriorate( t this %oint, Dr( *nso sus%ecte& that +ilian ha& Disseminate& *ntra'ascular #oagulation 4D*#, a bloo& &isor&er characterinit 4*#>( >n!ortunately, "amily #are &i& not ha'e an *#> because it as only a secon&ary hos%ital an& as not re8uire& by the De%artment o! $ealth to ha'e one( Dr( Dr( *nso then %ersonally coor&inate& coor&inate& ith the ?untinlu%a ?e&ical #enter 4??# hich ha& an a'ailable a'ailable be&( >%on reaching the ??#, a me&ical team as on han& to resuscitate( >n!ortunately, +ilian %asse& aay &es%ite eorts to resuscitate her( ccor&ing to the auto%sy re%ort, Dr( =eyes conclu&e& that the cause o! +ilian/s &eath as haemorrhage &ue to blee&ing %etechial bloo& 'essels: internal blee&ing( $e !urther conclu&e& that the internal blee&ing blee&ing as cause& by the 0(5 0(5 cm o%ening in the re%air site( $e o%ine& that the blee&ing coul& ha'e been a'oi&e& i! the site as re%aire& re%aire& ith &ouble suturing instea& o! the single continuous suture re%air re%air that he !oun&( Base& on the auto%sy, the %etitioner le& a com%laint !or &amages against "amily #are an& against Dr( *nso !or me&ical negligence( *ssue: @hether or not res%on&ents are guilty o! me&ical negligence 4;O =uling: =uling: me&ical %ro!essional %ro!essional has the &uty to obser'e the stan&ar& o! care an& eercise eercise the &egree o! sill, nole&ge, an& training or&inarily e%ecte& o! other similarly traine& me&ical %ro!essionals acting un&er the same circumstances( breach o! the acce%te& stan&ar& o! care constitutes negligence or mal%ractice an& ren&ers the &e!en&ant liable !or the resulting inAury to his %atient(
.he stan&ar& is base& on the norm obser'e& by other reasonably com%etent members o! the %ro!ession %racticing the same el& o! me&icine( Because me&ical mal%ractice cases are o!ten highly technical, e%ert testimony is usually essential to establish: 41 the stan&ar& o! care that the &e!en&ant as boun& to obser'e un&er the circumstances 42 that the &e!en&ant/s con&uct !ell belo the acce%table stan&ar& an& 43 that the &e!en&ant/s !ailure to obser'e the in&ustry stan&ar& cause& inAury to his %atient( .he e%ert itness must be a similarly traine& an& e%erience& %hysician( .hus, a %ulmonologist is not 8ualie& to testi!y as to the stan&ar& o! care re8uire& o! an anesthesiologist an& an auto%sy e%ert is not 8ualie& to testi!y as a s%ecialist in in!ectious &iseases( Dr( =eyes is not an e%ert itness ho coul& %ro'e Dr( *nso/s allege& negligence( $is testimony coul& not ha'e establishe& the stan&ar& o! care that Dr( *nso as e%ecte& to obser'e nor assesse& Dr( *nso/s !ailure to obser'e this stan&ar&( $is testimony cannot be relie& u%on to &etermine i! Dr( *nso committe& errors &uring the o%eration, the se'erity o! these errors, their im%act on +ilian/s %robability o! sur'i'al, an& the eistence o! other &iseasesCcon&ition( .he %etitioner cannot in'oe the &octrine o! res i%sa lo8uitur to shi!t the bur&en o! e'i&ence onto the res%on&ent( =es i%sa lo8uitur, literally, the thing s%eas !or itsel!E is a rule o! e'i&ence that %resumes negligence !rom the 'ery nature o! the acci&ent itsel! using common human nole&ge or e%erience( .he a%%lication o! this rule re8uires: 41 that the acci&ent as o! a in& hich &oes not or&inarily occur unless someone is negligent 42 that the instrumentality or agency hich cause& the inAury as un&er the eclusi'e control o! the %erson charge& ith negligence an& 43 that the inAury suere& must not ha'e been &ue to any 'oluntary action or contribution !rom the inAure& %erson( .he concurrence o! these elements creates a %resum%tion o! negligence that, i! unrebutte&, o'ercomes the %lainti/s bur&en o! %roo!( .he rule is not a%%licable in cases such as the %resent one here the &e!en&ant/s allege& !ailure to obser'e &ue care is not imme&iately a%%arent to a layman( .hese instances re8uire e%ert o%inion to establish the cul%ability o! the &e!en&ant &octor( *t is also not a%%licable to cases here the actual cause o! the inAury ha& been i&entie& or establishe&( @hile this #ourt sym%athi
