RAMOS v. COURT OF APPEALS 8.

The CA reversed and directed petitioners to pay their “unpaid medical bills”
11 April 2002 | Kapunan, J. | Hospital Liability; Vicarious Liability of Hospitals to private respondents.
9. Petitioners filed a petition for review on certiorari with the SC. The SC
FACTS: ruled in favor of petitioners.
1. Petitioner Erlinda RAMOS, after seeking professional medical help, was 10. Hence, this motion for reconsideration filed by private respondents.
advised to undergo an operation for the removal of a stone in her gall blad-
der (cholecystectomy). ISSUE/s:
2. She was referred to Dr. HOSAKA, a surgeon, who agreed to perform the 1. WoN DLSMC is solidarily liable with Dr. HOSAKA and Dr. GUTIERREZ
operation on her. The operation was scheduled for operation for 17 June for the injury suffered by petitioner Erlinda RAMOS – NO
1985 at 9:00 am at private respondent De Los Santos Medical Center
(DLSMC). Since neither petitioner Erlinda RAMOS nor her husband, peti- RULING: SC reversed the finding of liability on the part of DLSMC. WHERE-
tioner Rogelio RAMOS, knew of any anesthesiologist, Dr. HOSAKA rec- FORE, the assailed Decision is hereby modified as follows: (1) Private respondent
ommended to them the services of Dr. GUTIERREZ. De Los Santos Medical Center is hereby absolved from liability arising from the
3. Petitioner Erlinda was admitted to the DLSMC the day before the scheduled injury suffered by petitioner Erlinda Ramos on June 17, 1985; (2) Private respon-
operation. By 7:30 am of the following day, petitioner Erlinda was already dents Dr. Orlino Hosaka and Dr. Perfecta Gutierrez are hereby declared to be solidar-
being prepared for operation. Upon the request of RAMOS, her sister-in- ily liable for the injury suffered by petitioner Erlinda on June 17, 1985 and are or-
law, Herminda CRUZ, who was then Dean of the College of Nursing at the dered to pay petitioners — (a) P1,352,000.00 as actual damages; (b) P2,000,000.00
Capitol Medical Center, was allowed to accompany her inside the operating as moral damages; (c) P100,000.00 as exemplary damages; (d) P100,000.00 as attor-
room. ney's fees; and (e) the costs of the suit. SO ORDERED.
4. At around 9:30 am, Dr. HOSAKA had not yet arrived so Dr. GUTIERREZ
tried to get in touch with him by phone. Thereafter, Dr. GUTIERREZ in- RATIO:
formed CRUZ that the operation might be delayed due to the late arrival of 1. DLSMC maintains that first, a hospital does not hire or engage the ser-
Dr. HOSAKA. By 10 am, when Dr. HOSAKA was still not around, peti- vices of a consultant, but rather, accredits the latter and grants him or
tioner Rogelio already wanted to pull out his wife from the operating room. her the privilege of maintaining a clinic and/or admitting patients in the
Dr. HOSAKA finally arrived at the hospital at around 12:10 pm, or more hospital upon a showing by the consultant that he or she possesses the nec-
than 3 hours after the scheduled operation. essary qualifications, such as accreditation by the appropriate board (diplo-
5. CRUZ, who was then still inside the operating room, heard about Dr. Hosa- mate), evidence of fellowship and references.
ka's arrival. While she held the hand of RAMOS, CRUZ saw Dr. GUTIER- 2. Second, it is not the hospital but the patient who pays the consultant's
REZ trying to intubate the patient. CRUZ heard Dr. GUTIERREZ utter: fee for services rendered by the latter.
"ang hirap ma-intubate nito, mali yata ang pagkakapasok. O lumalaki ang 3. Third, a hospital does not dismiss a consultant; instead, the latter may
tiyan. CRUZ noticed a bluish discoloration of Erlinda's nailbeds on her left lose his or her accreditation or privileges granted by the hospital.
hand. CRUZ then heard Dr. HOSAKA instruct someone to call Dr. 4. Lastly, DLSMC argues that when a doctor refers a patient for admission in a
Calderon, another anesthesiologist. When he arrived, Dr. Calderon attempt- hospital, it is the doctor who prescribes the treatment to be given to said
ed to intubate the patient. The nailbeds of the patient remained bluish, thus, patient. The hospital's obligation is limited to providing the patient with
she was placed in a trendelenburg position — a position where the head of the preferred room accommodation, the nutritional diet and medica-
the patient is placed in a position lower than her feet. At this point, CRUZ tions prescribed by the doctor, the equipment and facilities necessary for
went out of the operating room to express her concern to petitioner Rogelio the treatment of the patient, as well as the services of the hospital staff who
that Erlinda's operation was not going well. perform the ministerial tasks of ensuring that the doctor's orders are carried
6. CRUZ quickly rushed back to the operating room and saw that the patient out strictly.
was still in trendelenburg position. At almost 3:00 pm, she saw Erlinda be- 5. After a careful consideration of the arguments raised by DLSMC, the
ing wheeled to the ICU. The doctors explained to petitioner Rogelio that his Court finds that respondent hospital's position on this issue is meritori-
wife had bronchospasm. Erlinda stayed in the ICU for a month. She was ous. There is no employer-employee relationship between DLSMC and
released from the hospital only 4 months later or on 15 November 1985. Drs. Gutierrez and Hosaka which would hold DLSMC solidarily liable
Since the ill-fated operation, Erlinda remained in comatose condition until for the injury suffered by petitioner Erlinda under Article 2180 of the
she died on 3 August 1999. Civil Code.
7. Petitioners filed with the RTC a civil case for damages against private re- 6. As explained by respondent hospital, that the admission of a physician to
spondents. The RTC ruled in favor of petitioners. It found private respon- membership in DLSMC's medical staff as active or visiting consultant is
dents were negligent in the performance of their duties. first decided upon by the Credentials Committee thereof, which is com-
posed of the heads of the various specialty departments such as the Depart-
 ment of Obstetrics and Gynecology, Pediatrics, Surgery with the department
head of the particular specialty applied for as chairman. The Credentials
Committee then recommends to DLSMC's Medical Director or Hospital
Administrator the acceptance or rejection of the applicant physician, and
said director or administrator validates the committee's recommendation.
7. Similarly, in cases where a disciplinary action is lodged against a consul-
tant, the same is initiated by the department to whom the consultant con-
cerned belongs and filed with the Ethics Committee consisting of the de-
partment specialty heads. The medical director/hospital administrator mere-
ly acts as ex-officio member of said committee.
8. Neither is there any showing that it is DLSMC which pays any of its con-
sultants for medical services rendered by the latter to their respective pa-
tients. Moreover, the contract between the consultant in respondent
hospital and his patient is separate and distinct from the contract be-
tween respondent hospital and said patient. The first has for its object
the rendition of medical services by the consultant to the patient, while
the second concerns the provision by the hospital of facilities and ser-
vices by its staff such as nurses and laboratory personnel necessary for
the proper treatment of the patient.
9. Further, no evidence was adduced to show that the injury suffered by peti-
tioner Erlinda was due to a failure on the part of respondent DLSMC to
provide for hospital facilities and staff necessary for her treatment.
10. For these reasons, we reverse the finding of liability on the part of
DLSMC for the injury suffered by petitioner Erlinda.

Petitioners: 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
Respondents: De Los Santos Medical Center; Dr. Orlino Hosaka; Dr. Perfecta
Gutierrez