G.R. N . 189218. Ma ch 22, 2017.

OUR LADY OF LOURDES HOSPITAL, e i i ne , vs. SPOUSES

ROMEO and REGINA CAPANZANA, e nden .

Remedial Law; Civil Procedure; Appeals; Petition for Review on

Certiorari; Onl questions of law are entertained in a Rule 45 petition.
We ei e a e he elemen a le ha nl e i n f la a e en e ained in
a R le 45 e i i n. Finding f fac f he l e c a e gene all
c ncl i e and binding n hi C h e f nc i n i n anal e
eigh he e idence all e again. While he e a e e ce i nal ca e in
hich hi C ma e ie nding f fac f he CA, n ne f he e
e ce i n i e en in he ca e a ba . We ee n c m elling ea n
de ia e f m hi gene al le n . We he ef e defe he e inen
fac al nding f he l e c , e eciall beca e he e a e ell-
ed b he ec d . I i in hi ligh ha e af m he nding f b h
he ial and he a ella e c hich f nd negligence n he a f he
n e.

_______________

* FIRST DIVISION.

25
 VOL. 821, MARCH 22, 2017 259
Our Lad of Lourdes Hospital vs. Capan ana

Quasi-delicts; Medical Negligence; In order to successfull pursue a

claim in a medical negligence case, the plaintiff must prove that a health
professional either failed to do something which a reasonabl prudent
health professional would have or have not done; and that the action or
omission caused injur to the patient. In de cce f ll e a
claim in a medical negligence ca e, he lain iff m e ha a heal h
fe i nal ei he failed d me hing hich a ea nabl den heal h
fe i nal ld ha e ha e n d ne; and ha he ac i n mi i n
ca ed inj he a ien . P ceeding f m hi g ideline, he lain iff
m h he f ll ing elemen b a e nde ance f e idence: d f
he heal h fe i nal, b each f ha d , inj f he a ien , and
ima e ca a i n be een he b each and he inj . Mean hile, in ing
a anda d b hich a c ma de e mine he he he h ician el
e f med he e i i e d a d he a ien , e e medical e im nie
f m b h lain iff and defen e a e e ed . In hi ca e, he e e
e im n f i ne f he e nden D . G df e R beni l, a
ne ge n, ided ha he be ime ea h ic ence hal a h i
a he ime f i cc ence; i.e., hen he a ien i e e iencing dif c l
in b ea hing and h ing ign f ca diac a e .
Same; Same; The Supreme Court (SC) has emphasi ed that a higher
degree of caution and an e acting standard of diligence in patient
management and health care are required of a hospital s staff, as the deal
with the lives of patients who seek urgent medical assistance. We ag ee
i h he c bel in hei nding ha hen he a ga ing f b ea h
and ning c an ic, i a he d f he n e in e ene immedia el
b inf ming he e iden d c . Had he d ne , e gena i n
c ld ha e been e ed and he in e en i n e f med i h a ing
al able ime. Tha ch high deg ee f ca e and e n i ene a needed
cann be e em ha i ed c n ide ing ha acc ding e e medical
e idence in he ec d , i ake nl e min e f gen de i a i n f
i e e ible b ain damage e in. Indeed, he C ha em ha i ed ha a
highe deg ee f ca i n and an e ac ing anda d f diligence in a ien
managemen and heal h ca e a e e i ed f a h i al aff, a he deal
i h he li e f a ien h eek gen medical a i ance. I i
inc mben nn e ake eca i n nde ake e afeg a d
a ien

260

260 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana
 nde hei ca e f m an ible inj ha ma a i e in he c e f
he la e ea men and ca e.
Same; Same; There was a dela in the administration of o gen to the
patient, caused b the dela ed response of the nurses of petitioner hospital.
The C f he n e ha he immedia e e n e f he n e a
e eciall im e a i e, ince Regina he elf had a ked f gen. The
h ld ha e been m ed e nd immedia el hen Regina he elf
e e ed he need , e eciall in ha eme genc i a i n hen i a n
ea de e mine i h ce ain he ca e f he b ea hing dif c l .
Indeed, e en if he a ien had n a ked f gen, he me e fac ha he
b ea hing a lab ed an abn mal deg ee h ld ha e im elled he
n e immedia el call he d c and admini e gen. In hi
ega d, b h c f nd ha he e a a dela in he admini a i n f
gen he a ien , ca ed b he dela ed e n e f he n e f
e i i ne h i al. The c mmi ed a b each f hei d e nd
immedia el he need f Regina, c n ide ing he eca i i a i n and
he h ical manife a i n f gen de i a i n.
Same; Same; The records also show another instance of negligence,
such as the dela in the removal of Regina s consumed de trose, a condition
that was alread causing her discomfort. The ec d al h an he
in ance f negligence, ch a he dela in he em al f Regina
c n med de e, a c ndi i n ha a al ead ca ing he di c mf . In
fac , Balad had inf m he n e and he a ien had in c ne f
hem, n ha d .
Same; Same; Pro imate Cause; A failure to act ma be the pro imate
cause if it pla s a substantial part in bringing about an injur . We af m
he nding f he c bel ha he negligen dela n he a f he
n e a he ima e ca e f he b ain damage ffe ed b Regina. In
Ramos v. Court of Appeals, 321 SCRA 584 (1999), he C de ne
ima e ca e a f ll : P ima e ca e ha been de ned a ha hich,
in na al and c n in e ence, nb ken b an ef cien in e ening
ca e, d ce inj , and i h hich he e l ld n ha e
cc ed. An inj damage i ima el ca ed b an ac a fail e
ac , hene e i a ea f m he e idence in he ca e, ha he ac
mi i n la ed a b an ial a in b inging ab

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Our Lad of Lourdes Hospital vs. Capan ana
 ac all ca ing he inj damage; and ha he inj damage
a ei he a di ec e l a ea nabl bable c n e ence f he ac
mi i n. I i he d minan , m ing d cing ca e. (Unde c ing
lied; ci a i n mi ed) Th , a fail e ac ma be he ima e
ca e if i la a b an ial a in b inging ab an inj . N e al ha
he mi i n ef mad ma al c n i e he ima e ca e f
an inj , b nl he e he mi i n ld ha e e en ed he inj . The
C al em ha i e ha he inj need nl be a ea nabl bable
c n e ence f he fail e ac . In he d , he e i n need f
ab l e ce ain ha he inj i a c n e ence f he mi i n. A l ing
he ab e de ni i n he fac in he e en ca e, he mi i n f he
n e hei fail e check n Regina and efe he he e iden
d c and, he eaf e , immedia el ide gen a clea l he
ima e ca e ha led he b ain damage ffe ed b he a ien . A he
ial c and he CA b h held, had he n e m l e nded, gen
ld ha e been immedia el admini e ed he and he i k f b ain
damage le ened, if n a ided.
Same; Same; Vicarious Liabilit ; For the negligence of its nurses,
petitioner is thus liable under Article 2180 in relation to Article 2176 of the
Civil Code. Under Article 2180, an emplo er like petitioner hospital ma be
held liable for the negligence of its emplo ees based on its responsibilit
under a relationship of patria potestas. F he negligence f i n e ,
e i i ne i h liable nde A icle 2180 in ela i n A icle 2176 f he
Ci il C de. Unde A icle 2180, an em l e like e i i ne h i al ma be
held liable f he negligence f i em l ee ba ed n i e n ibili
nde a ela i n hi f patria potestas. The liabili f he em l e nde
hi i i n i di ec and immedia e; i i n c ndi i ned na i
ec e again he negligen em l ee a i h ing f he
in l enc f ha em l ee. The em l e ma nl be elie ed f
e n ibili n a h ing ha i e e ci ed he diligence f a g d fa he
f a famil in he elec i n and e i i n f i em l ee . The le i ha
nce negligence f he em l ee i h n, he b den i n he em l e
e c me he e m i n f negligence n he la e a b ing
b e ance f he e i ed diligence.
Same; Same; Same; While the question of diligent supervision depends
on the circumstances of emplo ment, the Supreme Court

262

262 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana

(SC) nds that b the ver nature of a hospital, the proper supervision
of the attendance of its nurses, who are its frontline health professionals, is
crucial considering that patients conditions can change drasticall in a
matter of minutes. The e i n f f ac al e i i n f he
em l ee k ac al im lemen a i n and m ni ing f c n i en
c m liance i h he le . The e im n f e i i ne A i an N ing
Se ice Di ec , L de H. Nic la i belied b he ac al ec d f
e i i ne . The e h ha N e Da id and Pad lina had been b e ed
be la ec me and ab en ee ; e he e e ne e anc i ned b h e
edl e i ing hem. While he e i n f diligen e ii n
de end n he ci c m ance f em l men , e nd ha b he e
na e f a h i al, he e e i i n f he a endance f i n e ,
h a e i f n line heal h fe i nal , i c cial c n ide ing ha
a ien c ndi i n can change d a icall in a ma e f min e .
Pe i i ne Em l ee Handb k ec gni ed e ac l hi a i dec eed he
e ced e in a ailing f na idable ab ence and he c mmen a e
enal ie f e bal e imand, i en a ning, en i n f m k, and
di mi al in in ance f ne c ed ab ence a dine . Pe i i ne fail e
anc i n he a dine f he defendan n e h an e lack f
ac al im lemen a i n and m ni ing f c m liance i h he le and
l ima el f e ii n e i n e.

PETITION f e ie n ce i a i f he deci i n and e l i n f

he C f A eal .
The fac a e a ed in he ini n f he C .
Zamora, Poblador, Vasque & Breta a f e i i ne .
Padilla, Asuncion, Bote-Veguillas, Matta, Cari o Law Of ces
f e nden .

SERENO, CJ.:

We e l e he in an Pe i i n f Re ie n Certiorari1

_______________

1 Rollo, . 127-205.

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Our Lad of Lourdes Hospital vs. Capan ana

a ailing he Deci i n2 and Re l i n3 ende ed b he C f

A eal (CA), Sec nd Di i i n, in C.A.-G.R. CV N . 89030.

The A ecede Fac

 Regina Ca an ana (Regina), a 40- ea - ld n e and clinical
in c egnan i h he hi d child, a ched led f he hi d
cae a ean ec i n (C- ec i n) n 2 Jan a 1998. H e e , a eek
ea lie , n 26 Decembe 1997, he en in ac i e lab and a
b gh e i i ne h i al f an eme genc C- ec i n. She
nde en a e e a i e h ical e amina i n b D . Mi iam
Ram 4 (D . Ram ) and D . Milag J ce San ,5 (D . San )
he ame a ending h ician in he i childbi h . She a
f nd f ane he ia af e he e nded nega i el e i n
ab be c l i , he ma ic fe e , and ca diac di ea e . On ha
ame da , he ga e bi h a bab b . When he c ndi i n
abili ed, he a di cha ged f m he ec e m and
an fe ed a eg la h i al m.6
A 2:30 a.m. he f ll ing da , 13 h af e he e a i n,
Regina h a hen nde a ch b he niece, Ka he ine L. Balad
(Balad), c m lained f a headache, a chill en a i n, e le ne ,
and h ne f b ea h. She a ked f gen and la e became
c an ic. Af e nde g ing an - a ,

_______________

2 Id., a . 10-40, da ed 24 Oc be 2008; enned b A cia e J ice P ia

Ali -H mach el and c nc ed in b A cia e J ice Hakim S. Abd l ahid
and Te e i a D -Liacc Fl e .
3 Id., a . 42-43, da ed 12 A g 2009; enned b A cia e J ice P ia
Ali -H mach el and c nc ed in b A cia e J ice Hakim S. Abd l ahid
and Fe nanda Lam a -Pe al a.
4 The e a e efe ence he a D . Mi iam Ram b he leading he
bmi ed in hi ca e indica e he name D . Mi iam Ram .
5 The c m lain efe ed he a D . J cel n San b he led he An e
cla if ing ha he h ld be efe ed a D . Milag J ce San .
6 Rollo, . 838.

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264 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana

he a f nd be ffe ing f m lm na edema. She a

e en all an fe ed he In en i e Ca e Uni , he e he a
h ked a mechanical en ila . The im e i n hen a ha he
a h ing ign f amni ic id emb li m.7
On 2 Jan a 1998, hen he c ndi i n ill h ed n
im emen , Regina a an fe ed he Ca dinal San
H i al. The d c he ea f nd ha he a ffe ing f m
 he ma ic hea di ea e mi al en i i h mild lm na
h e en i n, hich c n ib ed he n e f id in he l ng
i e ( lm na edema). Thi de el men e l ed in ca di -
lm na a e and, b e en l , b ain damage. Regina l he
e f he eech, e e igh , hea ing and limb . She a di cha ged,
ill in a ege a i e a e, n 19 Jan a 1998.8
Re nden e Ca an ana led a c m lain f damage 9
again e i i ne h i al, al ng i h c defendan : D . Mi iam
Ram , an b e ician/g nec l gi ; D . Milag J ce San , an
ane he i l gi ; and Jane D e , he n e n d a i ned n he
ec nd f e i i ne h i al n 26-27 Decembe 1997.10
Re nden im ed negligence D . Ram and San f
he la e fail e de ec he hea di ea e f Regina, e l ing in
fail e n nl efe he a ca di l gi f ca diac clea ance,
b al ide he a ia e medical managemen bef e,
d ing, and af e he e a i n. The f he a ed ha he n e
e e negligen f n ha ing m l gi en gen, and ha he
h i al a e all

_______________

7 Id.
8 Id.
9 Rec d (V l. I), . 22-29; da ed 24 Feb a 1998 and d cke ed a Ci il Ca e
N . MC-98-149.
10 Rollo, . 838-839.

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negligen f n making a ailable and acce ible he gen ni n

11
ha ame h i al a he ime.
The a ed f ac al damage am n ing P814,645.80;
c m en a damage , P3,416,278.40; m al damage , P5,000,000;
e em la damage , P2,000,000; a ne fee , P500,000 a ell
a P5,000 e hea ing and he c f i . The like i e a ed f
he j and e i able elief .12
Pe i i ne h i al, defendan D . Ram and D . San led
13
hei e ec i e An e . On he he hand, he e ice f
mm n n he n e a n cce f l, a he e e n l nge
c nnec ed i h he h i al. Th , nl defendan Fl i a Ballan
(Ballan ), h a la e en be a mid ife and n a n e,
14
led he An e .
 Pe i i ne h i al and defendan Ballan claimed ha he e a
n in c i n he h i al he aff lace Regina in a m
i h a andb gen ank. The al claimed ha he n e n
d had m l a ended he need . The a ed ha he
c m lain be di mi ed and e nden de ed a n aid
15
medical bill .
Mean hile, defendan D . Ram claimed ha in all f he
c n l a i n and ena al check f Regina in he la e h ee
egnancie , he ne e c m lained n inf med he d c f an
m m ign f a hea blem. Bef e he la C- ec i n f
Regina, D . Ram e amined he and f nd n abn mal ca diac
nd, m m ign f he ma ic hea ailmen . The d c
f he claimed ha ince he e a i n a an eme genc , he had
n ime chance ha e Regina nde g an ca diac e amina i n
and ec e a ca diac clea ance. M e e , D . Ram claimed ha
he ca di -

_______________

11 Id.
12 Id., a . 293, 839.
13 Rec d (V l. I), . 88-93 (f D . Ram ), . 131-143 (f D . San ), and
. 156-166 (f e i i ne h i al).
14 Rec d (V l. VI), . 1624-1634.
15 Rollo, . 839-840.

266

266 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana

lm na a e k lace 14 h af e he e a i n, l ng af e
he had e f med he e a i n. She a ed ha j dgmen be
ende ed de ing e Ca an ana a he m al damage
am n ing P500,000; e em la damage , P200,000; and
16
a ne fee , P100,000.
On he he hand, defendan D . San claimed ha he a he
ane he i l gi in Regina and ec nd childbi h via C-
ec i n. The d c f he a ed ha i he hi d eme genc
C- ec i n, he c nd c ed a e e a i e e al a i n, and Regina
h ed n ign m m f an hea blem abn mali in
he la e ca di a c la , e i a , cen al ne em .
She hen admini e ed he ane he ia Regina. She al a ed ha
Regina c ndi i n bef e, d ing, and af e he e a i n a able.
D . San a ed ha he c m lain again he be di mi ed.17
 T ial en ed. Plain iff e en ed D . E in Di n, a ca di l gi ;
D . G df e R beni l, a ne l gi ; M . Eli abe h Ta ag; D .
Ele n L e , a ca di l gi ; Ka hleen L ce Balad; R me
Ca an ana; and D . A nci n Rane e , a h ician.18
Af e he lain iff e ed hei ca e, an amended c m lain a
led, hi ime iden if ing and im leading a defendan he n e
n d h incl ded C a ina Ocam , H.R. B la e e, E el n S.
Da id, and Angelica C nce ci n.19 Af e c nd c ing a de i i n f
he e n in cha ge f he n e ched le, e Ca an ana
f he amended hei c m lain im lead n e R chelle
Pad lina and Fl i a Ballan , hile d ing defendan C a ina
Ocam , H.R. B la e e, and Angelica C nce ci n.20

_______________

18 Id., a . 842.
17 Id., a . 840.
16 Id., a . 840-841.
19 Rec d (V l. III), . 811-819.
20 Id. (V l. V), . 1508-1516.

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Our Lad of Lourdes Hospital vs. Capan ana

The ial c n in ed i h he e en a i n f defen e e idence.

The defen e e en ed D . San ; D . Ram ; A . Nic la L e
III, di ec f he B ea f Licen ing and Facili ie f he
De a men f Heal h; L de H. Nic la , he a i an n ing
e ice di ec ; D . G ace de l Angele ; Ma. Sele ina C in, he
acc n ecei able cle k; and Milag de Ve a, he admini a i e
21
e i f he h i al.
On 11 Ma 2005, and ending he e l i n f he ca e bef e
he ial c , Regina died and a b i ed b he hei
22
e e en ed b R me Ca an ana.

The R li g f he RTC

On 29 Decembe 2006, he RTC ende ed j dgmen , nding n

negligence n he a f D . Ram D . San . I f nd ha he
medical c mm ni ec gni ed anda d ac ice in a ending a
a ien in c nnec i n i h a C- ec i n had been d l b e ed b
he d c .23
 The RTC al f nd ha he ima ca e f Regina
ege a i e a e a amni ic id emb li m, an nf na e
c ndi i n ha a n i hin he c n l f an d c an ici a e
e en . Thi c ndi i n a he ca e f he lm na
edema ha led h ic ence hal a h , b ain damage and,
l ima el , Regina ege a i e a e. On he he hand, he ial
c n ed ha h ic ence hal a h a manageable. I c ld
ha e been e en ed, a lea minimi ed, had he e been a imel
admini a i n f gen.24
On he eng h f he e im n f Balad, he RTC f nd ha
negligence n he a f he n e c n ib ed he

_______________

21 Rollo, . 847-851.
22 Id., a . 838.
23 Id., a . 852-856.
24 Id., a . 859.

26

268 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana

inj f Regina. I f nd ha he failed e nd immedia el

hen Regina a e e iencing h ne f b ea h. I k he
n e m e le 10 min e af e being inf med f he c ndi i n
f Regina bef e he checked n he , called f he e iden d c ,
and e e ed gen. While he ial c ackn ledged ha he
immedia e admini a i n f gen a n a g a an ee ha
Regina c ndi i n ld im e, i ga e c edence he e im n
f he e e i ne . The la e ined ha he dela c n ib ed
he n e f h ic ence hal a h diff e b ain damage d e
lack f gen in Regina b ain. The e e i ne al aid ha
had he e been a imel admini a i n f gen he i k f b ain
damage ld ha e been le ened, if n a ided, and he n e f
h ic ence hal a h ed ced. The RTC he ef e f nd he
n e liable f c n ib negligence.25
On he i e f he he e i i ne h i al c ld be held liable
f he negligence f i n e , he RTC led ha he h i al a
able di cha ge he b den f f ha i had e e ci ed he
diligence f a g d fa he f a famil in he elec i n and
e i i n f i em l ee . The ial c a i ed a hi nding
n he ba i f he e im n f he a i an n ing di ec ,
L de Nic la . She a ed ha he elec i n and hi ing f hei
n e a a ig ce , he eb he a lican nde en a
e ie f ced e e amina i n, ien a i n, aining, n- he-j b
b e a i n, and e al a i n bef e he e e hi ed a eg la
em l ee . The n e e e e i ed b hei head n e and he
cha ge n e. The n e e e al in ec ed b hei clinical
e i and n ing di ec . C n e en l , nl he n e e e
held liable a damage . H e e , ince he ial c ac i ed
j i dic i n nl e Ballan am ng h e n d n ha da , he
a he nl ne held liable.26 The di ii e i n f he RTC
deci i n a e :

_______________

25 Id., a . 856-857.
26 Id., a . 857-858.

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Our Lad of Lourdes Hospital vs. Capan ana

WHEREFORE, all f eg ing c n ide ed, j dgmen i ende ed a

f ll :
A. O de ing he defendan FLORITA BALLANO a he lain iff
R me R. Ca an ana and he child en f he e Ca an ana, namel :
R anne, Ri elle, and Reginald (all min ) h a e e e en ed b lain iff
R me R. Ca an ana in e ec he child en igh he in e e f hei
decea ed m he Regina in hi ca e:
1. The am n f Pe : T H nd ed Nine -Nine Th and One H nd ed
T and 04/100 (P299,102.04), a and b a f ac al damage ;
2. The am n f Pe : One H nd ed Th and (P100,000.00), a and b
a f m al damage ;
3. The am n f Pe : One Milli n Nine H nd ed Fif Th and T
H nd ed Si -Nine and 80/100 (P1,950,269.80), a and b a f
c m en a damage ;
4. The am n f Pe : One H nd ed Th and (P100,000.00), a and b
a f a ne fee ;
5. The c f i.
B. O de ing he DISMISSAL f he ca e a again defendan O
Lad f L de H i al, Inc., D . Mi iam Ram and D . Milag J ce
(J cel n) San ; and
C. DISMISSING he c n e claim f he defendan .
SO ORDERED.27

_______________
 27 Id., a . 860-861.

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270 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana

Re nden Ca an ana led hei a eal28 bef e he CA,

a g ing ha he RTC c mmi ed e in h lding ha amni ic id
emb li m, hich c ld n ha e been f e een e en ed b he
e e ci e f an deg ee f diligence and ca e b defendan , ca ed
he ca di - lm na a e , b ain damage, and dea h f he a ien
(in ead f he ma ic hea mi al al e en i hich c ld ha e
been de ec ed and managed). Re nden f he a g ed ha i a
e f he ial c h ld ha defendan D . Ram and D .
San and e i i ne h i al e e ci ed d e diligence and ab l e
hem f m liabili f he n imel dea h f Regina.29
Pe i i ne h i al al led i n ice f a eal.30 I im ed
e he ial c f h lding ha he n e had n e e ci ed
d e diligence in a ending he need f Regina, a ic la l
beca e (1) e nden e failed e an b each f d
n he a f he n e , a ic la l Ballan ; (2) he e a n dela
in he deli e f gen Regina; and (3) Regina a af ic ed
i h amni ic id emb li m, a c ndi i n ha c ld n ha e been
f e een e en ed b an deg ee f ca e b defendan .31 Al ,
e i i ne h i al dec ied he di mi al f i c n e claim and he
e cl i n f he ma e ial e im n f ne f he h i al n e .32

The R li g f he CA

The CA ende ed he a ailed deci i n af ming he RTC ling

i h m di ca i n. The a ella e c held he nd-

_______________

28 CA Rollo, . 44.
29 Rollo, . 945-1017.
30 CA Rollo, . 45-46.
31 Rollo, . 889.
32 Id., a . 757-767. A M i n f Lea e da ed 20 Decembe 2004 a led b
e i i ne h i al ake he de i i n f a i ne , n e- n-d defendan E el n
Da id, b he M i n a denied b he ial c in an O de da ed 12 A il 2005.
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ing f he ial c ha he ima e ca e f Regina c ndi i n

a h ic encel a h , a diff e b ain damage ec nda lack
f gen in he b ain. S eci call , he ca e a h ic
encel a h ec nda lm na ca diac a e n he
backg nd f lm na edema. The CA dec eed ha he fail e f
D . Ram diagn e he he ma ic hea di ea e f Regina a
n he ima e ca e ha b gh ab he la e ege a i e
c ndi i n a a bable na al effec he e f. E en if he
a ella e c ee c ncede ha Regina indeed ffe ed f m
he ma ic hea mi al al e en i , i a n e abli hed ha D .
Ram ign ed anda d medical ced e and e hibi ed an
ab ence f he c m e ence and kill e ec ed f ac i i ne
imila l i a ed.33
The CA e eciall k n e f he fac ha hen Regina a
e a ed n f he hi d ime, albeit in an eme genc i a i n, he
had he bene f he c m le e medical hi . Al , e en he
e e i ne e en ed b he lain iff , D . Di n, e i ed ha
m a ien ffe ing f m mild mi al al e en i a e
a m ma ic, he di ea e cann be de ec ed n h ical
e amina i n. He f he e i ed ha a e e f ca di - lm na
clea ance i di c e i na , and ha a efe al a lm n l gi can
be d ne a a i h if he a ending h ician nd he a ien hea
n mal. Th , he a ella e c held he ling f he ial c
ab l ing D . Ram .34
On he i e f he liabili f D . San , he CA di c edi ed he
he f D . Di n ha he n mal - e a i n d age f 3 li e
f in a en id f 24 h , 1 li e e e 8 h , c ld be
fa al a a ien i h a hea blem. I led ha D . Di n a
e en ed a an e e i ne n ca di l g , and n n
ane he i l g . U h lding he RTC, he a ella e c ga e m e
c edence he e im n

_______________

33 Id., a . 22-25.
34 Id., a . 25.

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272 SUPREME COURT REPORTS ANNOTATED

 Our Lad of Lourdes Hospital vs. Capan ana

f D . San , h a acce ed a an e e i ne in he eld f

ane he i l g and b e ic ane he i l g . She had e i ed ha
e en if he d age a be nd he ec mmended am n , n
ha mf l effec ld ha e en ed if he a ien kidne ee
f nc i ning e l . She e amined Regina bef e he e a i n and
f nd n edema an indica i n ha he la e kidne a
f nc i ning ell. The e im n f D . San emained
nc n e ed. The CA al held he ling ha e nden
imila l failed e ha D . San had ign ed anda d
medical ced e and e hibi ed an ab ence f he c m e ence and
kill e ec ed f ac i i ne imila l i a ed. C n e en l , he
a ella e c al held he ling f he ial c ab l ing D .
35
San .
Mean hile, he CA ab l ed Ballan . Like he RTC, he
a ella e c f nd e idence ha he n e e e negligen . B
c n a he ial c , he CA held ha he e a n h ing
he he Ballan , h a la e iden i ed a a mid ife, a
negligen in a ending he need f Regina. F he , i a n
h n he he Ballan a e en ne f he n e n d h had
a ended Regina. The a ella e c al n ed ha he e ec i n
f heal h ca e ced e and e en ial ima heal h ca e i a
n e (n a mid ife ) d .36
Finall , he CA led ha e i i ne h i al h ld be held liable
ba ed n he d c ine f c a e e n ibili . I a f nd ha
hile he e a e idence e ha e i i ne h i al h ed
diligence in i elec i n and hi ing ce e , he e a n e idence
e ha i e e ci ed he e i ed diligence in he e ii n f
i n e . Al , he a ella e c led ha he n na ailabili f
an gen ni n he h i al , a fac ha a admi ed,
c n i ed g negligence n he a f e i i ne h i al. The
CA e ed ha , a b ne b he ec d , he e a nl

_______________

35 Id., a . 26-27.
36 Id., a . 34-35.

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 ne ank in he a d ec i n f 27 bed . I aid ha e i i ne
h i al h ld ha e de i ed an effec i e a f he aff
e l and imel e nd a need f an gen ank in a
37
i a i n f ac e di e .
Acc dingl , he CA a a ded e nden e ac l he ame
am n dec eed b he RTC. Thi ime, h e e , in ead f
Ballan , e i i ne h i al a deemed di ec l liable a f
38
h e am n .
Onl e i i ne h i al led a M i n f Rec n ide a i n,39
hich he CA denied. The denial came af e a nding ha he e
ai ed in f he m i n e e b an iall a me e ei e a i n
f h e al ead a ed n and c n ide ed in he a ailed
deci i n.40
Hence, hi e i i n.
Pe i i ne h i al i n bef e hi C a ailing he ling .
First, i a g e ha he CA led c n a la and e idence,
beca e he e a n f f an b each f d n he a f he
n e . Pe i i ne a g e ha e en if he e a a fail e ide
gen, i did n ca e he inj ained b Regina. I
em ha i e ha he ffe ed f m amni ic id emb li m, a
c ndi i n ha c ld n be de ec ed e en ed b an deg ee f
ca e n he a f he h i al i n e . Second, i a g e ha i
a an e f he CA h ld he f me liable n he ba i f he
d c ine f c a e e n ibili . Third, i allege ha he
a ella e c e ne l neglec ed nd e nden liable f
he n aid h i al bill. Fourth, i claim ha he CA edl
e ed in h lding he e cl i n f he e im n f defendan
41
Da id. Pe i i ne l ima el a ha he e en e i i n be
g an ed, he a ailed ling f he CA

_______________

37 Id., a . 35-39.
38 Id., a . 39.
39 Id., a . 243-283.
40 Id., a . 241-242.
41 Id., a . 153-154.

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274 SUPREME COURT REPORTS ANNOTATED

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e e ed and e a ide, he ec nd amended c m lain di mi ed,

and e i i ne c n e claim g an ed.42
 Re nden led hei C mmen ,43 a ing ha he CA
c mmi ed n e in nding e i i ne liable f he negligence f
he n e imel admini e gen Regina. Nei he did he
a ella e c , he claim, e in a l ing he d c ine f res ipsa
loquitur in dec eeing ha e i i ne h i al had failed e e ci e
d e diligence in he elec i n and e i i n f he la e n e .
The f he claim ha he CA a c ec in h lding e i i ne
liable nde he d c ine f ica i liabili and c ae
negligence. Re nden al in i ha Regina did n die f
amni ic id emb li m.44 Hence, he a ha he in an e i i n
be denied and ha he a ailed ling f he CA, hich af med ha
f he RTC, be held.45
Pe i i ne led i Re l .46 I ehemen l e he idea ha
Regina died a i hand . I ei e a e ha e nden failed e
ha i ed negligen ac ca ed he inj he ained, and
ha he admini a i n f gen ld ha e e en ed he b ain
damage he la e ffe ed. Pe i i ne al di e he ling ha he
n e e e negligen in a ending he need . I be ail he
e cl i n f he e im n f ne f he defendan n e h c ld
ha e deb nked he e im n f Balad. I e a e i a e ha he
e en e i i n be g an ed and he a ailed ling f he CA
e e ed and e a ide. F he , i a ha he ec nd amended
c m lain be di mi ed and i c n e claim g an ed. Addi i nall ,
albeit bela edl , i a k ha he ca e be emanded he ial c
f he ece i n f he e im n f defendan n e Da id.

_______________

42 Id., a . 203.
43 Id., a . 1461-1526.
44 Id., a . 1463-1525.
45 Id., a . 1525.
46 Id., a . 1544-1575.

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O R li g

We nd he e i i n a iall me i i .
We ei e a e he elemen a le ha nl e i n f la a e
47
en e ained in a R le 45 e i i n. Finding f fac f he l e
c a e gene all c ncl i e and binding n hi C h e
f nc i n i n anal e eigh he e idence all e again.
While he e a e e ce i nal ca e in hich hi C ma e ie
nding f fac f he CA, n ne f he e e ce i n i e en in he
48
ca e a ba . We ee n c m elling ea n de ia e f m hi
gene al le n . We he ef e defe he e inen fac al nding
f he l e c , e eciall beca e he e a e ell- ed b
he ec d . I i in hi ligh ha e af m he nding f b h he
ial and he a ella e c hich f nd negligence n he a f
he n e .
In de cce f ll e a claim in a medical negligence
ca e, he lain iff m e ha a heal h fe i nal ei he failed
d me hing hich a ea nabl den heal h fe i nal
ld ha e ha e n d ne; and ha he ac i n mi i n ca ed
inj he a ien . P ceeding f m hi g ideline, he lain iff
m h he f ll ing elemen b a e nde ance f e idence:
d f he heal h fe i nal, b each f ha d , inj f he
a ien , and ima e ca a i n be een he b each and he
inj .49

_______________

47 RULES OF COURT, R le 45. See Pascual v. Burgos, G.R. N . 171722, Jan a

11, 2016, 778 SCRA 189; L nvil Fishing Enterprises, Inc. v. Ariola, 680 Phil. 696;
664 SCRA 679 (2012); Abad v. Guimba, 503 Phil. 321; 465 SCRA 356 (2005);
Collector of Customs v. Court of Appeals, 242 Phil. 26; 158 SCRA 293 (1988).
48 Rosaldes v. People, G.R. N . 173988, Oc be 8, 2014, 737 SCRA 592;
Castillo v. Court of Appeals, 329 Phil. 150; 260 SCRA 374 (1996).
49 Solidum v. People, G.R. N . 192123, Ma ch 10, 2014, 718 SCRA 263; Flores
v. Pineda, 591 Phil. 699; 571 SCRA 83 (2008); Re es v. Sisters of Merc Hospital,
396 Phil. 87; 341 SCRA 760 (2000).

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276 SUPREME COURT REPORTS ANNOTATED

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Mean hile, in ing a anda d b hich a c ma de e mine

he he he h ician e l e f med he e i i e d ad
he a ien , e e medical e im nie f m b h lain iff and
defen e a e e ed .50
In hi ca e, he e e e im n f i ne f he e nden
D . G df e R beni l, a ne ge n, ided ha he be ime
ea h ic ence hal a h i a he ime f i cc ence; i.e.,
hen he a ien i e e iencing dif c l in b ea hing and h ing
ign f ca diac a e .51
 T ecall, he ec d , incl ding e i i ne N e N e,
indi abl h ha Regina c m lained f dif c l in b ea hing
bef e e en all h ing ign f c an i .52 We ag ee i h he
c bel in hei nding ha hen he a ga ing f b ea h
and ning c an ic, i a he d f he n e in e ene
immedia el b inf ming he e iden d c . Had he d ne ,
e gena i n c ld ha e been e ed and he in e en i n
e f med i h a ing al able ime. Tha ch high deg ee f
ca e and e n i ene a needed cann be e em ha i ed
c n ide ing ha acc ding e e medical e idence in he ec d ,
i ake nl e min e f gen de i a i n f i e e ible
53
b ain damage e in. Indeed, he C ha em ha i ed ha a
highe deg ee f ca i n and an e ac ing anda d f diligence in
a ien managemen and heal h ca e a e e i ed f a h i al aff,
a he deal i h he li e f a ien h eek gen medical
54
a i ance. I i inc mben n n e ake eca i n
nde ake e afeg a d a ien

_______________

50 Casumpang v. Cortejo, 752 Phil. 379; 752 SCRA 379 (2015); Solidum v.
People, id.; Li v. Soliman, 66 Phil. 29; 651 SCRA 32 (2011).
51 Rollo, . 999.
52 Id., a . 159.
53 Id., a . 856-857.
54 Hospital Management Services, Inc.-Medical Center Manila v. Hospital
Management Services, Inc.-Medical Center Manila Emplo ees Association-AFW, 656
Phil. 57; 641 SCRA 59 (2011).

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nde hei ca e f m an ible inj ha ma a i e in he c e

55
f he la e ea men and ca e.
The C f he n e ha he immedia e e n e f he n e
a e eciall im e a i e, ince Regina he elf had a ked f
gen. The h ld ha e been m ed e nd immedia el
hen Regina he elf e e ed he need , e eciall in ha
eme genc i a i n hen i a n ea de e mine i h
ce ain he ca e f he b ea hing dif c l . Indeed, e en if he
a ien had n a ked f gen, he me e fac ha he b ea hing
a lab ed an abn mal deg ee h ld ha e im elled he n e
immedia el call he d c and admini e gen.
 In hi ega d, b h c f nd ha he e a a dela in he
admini a i n f gen he a ien , ca ed b he dela ed
e n e f he n e f e i i ne h i al. The c mmi ed a
b each f hei d e nd immedia el he need f Regina,
c n ide ing he eca i i a i n and he h ical manife a i n
f gen de i a i n. We e bel he c cial nding f he
ial c :

[W]hen Ka hleen [Balad] en he n e a i n inf m he n e

he ea ha he a n a e e iencing h ne f b ea hing and needed
gen n b d hed an e he gen call. I km e le 10
min e f he e n e g in ide he m a end and check he
c ndi i n f hei a ien . When he n e came in he a he a ien a
ha ing chill en a i n i h dif c l in b ea hing [and a ] a he ame
ime a king f gen. The n e lea ned f m Ka hleen ha he a ien
a ha ing an a hma a ack. The n e immedia el called e iden
h ician D . De L Angele

_______________

55 Sec. 27 f A icle V f Re blic Ac N . (R.A.) 7164 an ACT REGULATING

THE PRACTICE OF NURSING IN THE PHILIPPINES effec i e n 21 N embe 1991 al h gh
hi a la e e ealed b R.A. 9173 an ACT PROVIDING FOR A MORE RESPONSIVE
NURSING PROFESSION, REPEALING FOR THE PURPOSE REPUBLIC ACT NO. 7164 effec i e 21
Oc be 2002.

27

278 SUPREME COURT REPORTS ANNOTATED

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ceed m 328 and he h i al aide b ing in he gen ank in

he aid m. The eaf e , e iden d c G n ale and de L Angele
a i ed and f ll ed b he h i al aide i h he gen ank. I a clea
ha he gen ank came la e beca e he e e f i f m he n e
al came la e. Had he n e e e ci ed ce ain deg ee f m ne and
diligence in e nding he a ien [ ] call f hel [,] he cc ence f
h ic ence hal a h c ld ha e been a ided ince lack inade a e
l f gen he b ain f 5 min e ill ca e damage i.
(Unde c ing lied)56

56 Rollo, . 20-21, 836-857.

The CA ag eed i h he ial c fac al nding f dela in
he admini a i n f gen a c m e en l e i ed b Balad.
He e im n , hich i nc n e ed in he ec d , ceeded a
f ll :
Q [A . Di kn ]: D ing hi ime f m ab 1:30 in he m ning
a ima el 2:00 in he m ning, did an n e en e he m ha
e e in?
A [Balad]: N ne, i .
Q: Af e ha c n e a i n be een a n hen he a king
[ n] ff he ai c n and ning n [sic] again and hen ned i ff, d
ha e an cca i n alk i h he ?
A: N ne, i .
Q: H did de c ibe he h ical a ea ance hen he a elling
ha hinihika ata ako?
A: She feel [sic] e c ld e en if e e al blanke e e laced in [sic] he
b d and he i [sic] c ghing a he ame ime.

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Q: Wha ab d ing he ime ha d ed me ill a he back?

A: She a nning he b ea h i , at inaalala ni a ang operas on ni a.
Q: Seeing he c ndi i n like ha ha did d if an hing ge an hel
f he ?
A: I b e ed, i .
Q: Ab h man ime[ ] did b f hel ?
A: Se e al ime , i , beca e I a Tita Regie [Regina] a if he d e n
[sic] ake i an m e, i .
Q: H l ng did i ake bef e an n e c me [sic] he m?
A: Ten (10) f een (15 min e ) beca e he e e n in he n e
a i n, i .

Q: Wha did he n e d hen he en e ed he m?

A: She a ked me if e ha e an [sic] hi f a hma, i , in he famil .
Q: Wha a an e .
A: We ha e, i , hen he h ld [sic] he hand f Tita Regie.
Q: Wha , if an hing, did Tita Regie a ing [sic] a ha ime hen he n e
a in ide he m?
A: She a nning he b ea h and he a men i ning gen, gen,
i.
Q: Wha ha ened af e ha ?
A: The n e en , i , I a h lding Tita Regie a he ame ime I
called Tito R m , i .
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280 SUPREME COURT REPORTS ANNOTATED

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Q: G ing back he ime hen he n e came in and a ked if

famil ha an [sic] hi f a hma. Af e ha and af e ching he
hand f Regina, ha did he n e d ?
A: She en beca e Tita Regie a a king f an gen, i .
Q: Did he n e a an hing gi e an in c i n bef e lea ing he
m?
A: I cann ecall, i , beca e I a al ead af aid f he c l [c an i ] f
Tita Regie, i .
Q: H l ng did i ake bef e an gen a i ed if e e ?
A: Ab 57
20 min e , i . (Em ha e lied)

The a ella e c al c ec l n ed ha e en he i ne f
e i i ne , e iden h ician D . G ace de l Angele , n iced ha
i k me ime bef e he gen a i ed a h n in he
e im n :

Q [A . Tanada]: B d kn h m ch ime ela ed f m he ime

gen a e e ed ince e en e he e?

A [D . Del Angele ]: The ne h de n c n ide ing he n e

de , i a me h de ed f he gen.

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57 TSN, 25 Feb a 1999, . 31-36.

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Q: A n e made an ea lie de al ?
A: Ye , i .

Q: D ecall ha ing hea d a a emen made b an d c he effec

h did he gen ank j a i e[d] a ha m men ?

A: When he n e, aid nagpakuha na ng gen, I c ld n ecall if i i

[sic] me D a. G n ale , e a ked he Bakit wala pa?
Q: S an e i he e a meb d h made ha c mmen ?
58
A: Ye , Y H n . (Unde c ing lied)

The CA al f nd ha he e a negligen dela in efe ing

Regina he h ician .59 In fac , a membe f he medical aff
chided he n e f n immedia el efe ing he a ien
c ndi i n he h ician a he f ll ing e ce h :

Q [A . Di kn ]: Wi h men i ning an m e h m belie ed be

he eake . C ld j ela ha e e he hing ha hea d,
aid a ha ime.

A [Balad]: Wh i i ha he de ei nl n , h did n a kf
a i-

_______________

58 TSN, 26 Se embe 2003, . 29-30.

59 Rollo, . 34.

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282 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana

ance immedia el , i .60 (Unde c ing lied)

The ec d al h an he in ance f negligence, ch a he

dela in he em al f Regina c n med de e, a c ndi i n
ha a al ead ca ing he di c mf . In fac , Balad had inf m
he n e and he a ien had in c ne f hem, n ha d
a can be een in hi a f Balad e im n :

Q [A . Di kn ]: W ld ecall ha e e he d ha ee
ed b a n in elling ab he de e?
A [Balad]: Acc ding he call [ he] n e a he n e a i n f he
em e he de e f m m hand, i .

Q: When a ha [sic] (2) n e he e a he n e a i n, ha

e e he d ing?
A: The he ne i i ing ea ing pansit, i , and he he ne i anding
h lding a b le, i .
Q: Wha did ell hem, if an hing, hen a i ed a he n e
a i n?
A: I ld hem ha he de e a R m 238 a al ead ni hed, i .

Q: H l ng did i ake bef e an n e a i ed in ide R m 238?

A: I en back he n e a i n beca e n ne e nded f m [sic] m
call, i .

_______________

60 TSN, 25 Feb a 1999, . 38-40.

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Q: Ab h man min e had ela ed f m he ime en he

n e a i n f he ime and f m he ime en f he ec nd
ime?
A: Ab h ee (3) e (5) min e , i . Yung pangalawang tawag ko na
sa kan a a nakasunod na si a sa akin, i .
Q: The ec nd ime hen he n e a al ead f ll ing back he
m. Wha ha ened he e hen g [sic] in ide he m?
A: The n e a ached m Tita Regie and acc ding m Tita Regie,
N e, lea e em e i beca e m hand a al ead b lging, i .
Q: Wha i he e n e f he n e ha c mmen f a n ie?
A: She a f ll ing he in c i n f m Tita Regie and hen he ld me
ge a el, i , be laced n he hand, namaga na, i . 61
(Unde c ing lied)

Taken ge he , he ab e in ance f dela c n inced he c

bel , a ell a hi C , ha he e a a b each f d n he
a f he h i al n e . The CA he ef e c ec l af med he
nding f he ial c ha he n e e nded la e, and ha
Regina a al ead c an ic hen he a efe ed he e iden
d c .
Regina ffe ed f m b ain damage, a ic la l h po ic
encephalopath , hich i ca ed b lack f gen in he b ain. The
e im nie f D . Di n and D . R beni l ed hi fac . And he
ima e ca e f he b ain damage a

_______________

61 Id., a . 22-26.
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284 SUPREME COURT REPORTS ANNOTATED

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he dela in e nding Regina call f hel and f gen. The

ial c aid:

Had he n e e e ci ed ce ain deg ee f m ne and diligence in

e nding he a ien [ ] call f hel [,] he cc ence f h ic
ence hal a h c ld ha e been a ided ince lack inade a e l
f gen he b ain f 5 min e ill ca e damage i .62

The CA af med he ab e ling f he RTC, ha ha e e he

ca e f he gen de i a i n a , i imel and ef cien
managemen ld ha e ed he chain f e en ha led
Regina c ndi i n.
We af m he nding f he c bel ha he negligen
dela n he a f he n e a he ima e ca e f he b ain
damage ffe ed b Regina. In Ramos, he C de ne ima e
ca e a f ll :

P ima e ca e ha been de ned a ha hich, in na al and

c n in e ence, nb ken b an ef cien in e ening ca e, d ce
inj , and i h hich he e l ld n ha e cc ed. An inj
damage i ima el ca ed b an ac a fail e ac , hene e i
a ea f m he e idence in he ca e, ha he ac mi i n la ed a
b an ial a in b inging ab ac all ca ing he inj damage;
and ha he inj damage a ei he a di ec e l a ea nabl
bable c n e ence f he ac mi i n. I i he d minan , m ing
d cing ca e. (Unde c ing lied; ci a i n mi ed)63

Th , a fail e ac ma be he ima e ca e if i la a
b an ial a in b inging ab an inj . N e al ha he
mi i n e f mad ma al c n i e he i-

_______________

62 Rollo, . 856-857.
63 Ramos v. Court of Appeals, 378 Phil. 1198; 321 SCRA 584 (1999).

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 VOL. 821, MARCH 22, 2017 285
Our Lad of Lourdes Hospital vs. Capan ana

ma e ca e f an inj , b nl he e he mi i n ld ha e
64
e en ed he inj . The C al em ha i e ha he inj
need nl be a ea nabl bable c n e ence f he fail e ac .
In he d , he e i n need f ab l e ce ain ha he inj
i a c n e ence f he mi i n.65
A l ing he ab e de ni i n he fac in he e en ca e, he
mi i n f he n e hei fail e check n Regina and
efe he he e iden d c and, he eaf e , immedia el
ide gen a clea l he ima e ca e ha led he
b ain damage ffe ed b he a ien . A he ial c and he CA
b h held, had he n e m l e nded, gen ld ha e
been immedia el admini e ed he and he i k f b ain damage
le ened, if n a ided.
F he negligence f i n e , e i i ne i h liable nde
A icle 218066 in ela i n A icle 217667 f he Ci il

64 Sangc , Ce a J., Philippine Law on Torts and Damages, . 263

(1984 e . ed.).
65 Supra n e 63.
66 A . 2180. The bliga i n im ed b A icle 2176 i demandable
n nl f ne n ac mi i n , b al f h e f e n f
h m ne i e n ible.

The ne and manage f an e abli hmen en e i e a e like i e

e n ible f damage ca ed b hei em l ee in he e ice f he
b anche in hich he la e a e em l ed n he cca i n f hei
f nc i n .
Em l e hall be liable f he damage ca ed b hei em l ee and
h eh ld hel e ac ing i hin he c e f hei a igned a k , e en
h gh he f me a e n engaged in an b ine ind .

The e n ibili ea ed f in hi a icle hall cea e hen he e n

he ein men i ned e ha he b e ed all he diligence f a g d fa he
f a famil e en damage.
67 A . 2176. Wh e e b ac mi i n ca e damage an he ,
he e being fa l negligence, i bliged a f he damage d ne. S ch
fa l negligence, if he e i n ee i ing

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286 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana
C de. Unde A icle 2180, an em l e like e i i ne h i al ma
be held liable f he negligence f i em l ee ba ed n i
e n ibili nde a ela i n hi f patria potestas.68 The liabili
f he em l e nde hi i i n i di ec and immedia e; i i
n c ndi i ned n a i ec e again he negligen
em l ee a i h ing f he in l enc f ha em l ee. 69
The em l e ma nl be elie ed f e n ibili n a h ing
ha i e e ci ed he diligence f a g d fa he f a famil in he
elec i n and e i i n f i em l ee . The le i ha nce
negligence f he em l ee i h n, he b den i n he em l e
e c me he e m i n f negligence n he la e a b
70
ing b e ance f he e i ed diligence.
In he in an ca e, he e i n di e ha e i i ne a he
em l e f he n e h ha e been f nd be negligen in he
e f mance f hei d ie . Thi fac ha ne e been in i e.
Hence, e i i ne had he b den f h ing ha i e e ci ed he
diligence f a g d fa he f a famil n nl in he elec i n f he
negligen n e , b al in hei e i i n.
On hi in , he ling f he RTC and he CA di e ge. While
he ial c f nd d e diligence in b h he elec i n and he
e i i n f he n e , he a ella e c f nd ha e i i ne
ed d e diligence nl in he elec i n, b n in he
e i i n, f he n e .
Af e a ca ef l e ie f he ec d , e nd ha he
e nde ance f e idence he nding f he CA ha he
h i al failed di cha ge i b den f ing d e

_______________

c n ac al ela i n be een he a ie , i called a a i-delic and i g e ned b he

ii n f hi Cha e .
68 Supra n e 63.
69 Manliclic v. Calaunan, 541 Phil. 617; 512 SCRA 642 (2007).
70 OMC Carriers v. Nabua, 636 Phil. 634; 622 SCRA 624 (2010); S ki v. Begasa,
460 Phil. 381; 414 SCRA 237 (2003); Metro Manila Transit Corp. v. Court of
Appeals, G.R. N . 104408, J ne 21, 1993, 223 SCRA 521.

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VOL. 821, MARCH 22, 2017 287

Our Lad of Lourdes Hospital vs. Capan ana

diligence in he e i i n f i n e and i he ef e liable f

hei negligence. I m be em ha i ed ha e en h gh i ed
d e diligence in he elec i n f i n e , he h i al a able
di e f nl half he b den i m e c me.71
We he ef e n e i h a al hi nding f he CA:

While L de H i al add ced e idence in he elec i n and hi ing

ce e f i em l ee , i failed add ce e idence h ing he deg ee
f e i i n i e e ci ed e i n e . In neglec ing ffe ch f,
f f imila na e, e nden [he ein e i i ne ] h i al failed
di cha ge i b den nde he la a ag a h f A icle 2180. C n e en l ,
i h ld be held liable f he negligence f i n e hich ca ed damage
Regina.72

Indeed, he he n he diligence f a g d fa he f a famil

ha been e e ci ed b e i i ne i a ma e f f,73 hich nde
he ci c m ance in he ca e a ba ha n been clea l e abli hed.
The C nd ha he e i n en gh e idence n ec d ha
ld e n he e m i n f negligence. In e laining i
ba i f a ing ha e i i ne ed d e diligence in he
e i i n f he n e , he ial c me el aid:

A e i ed b M . L de Nic la , he a i an n ing di ec , he
ce f elec i n and hi ing f hei n e a a ig ce
he eb he a lican nde g e ie f e amina i n, ien a i n, aining,
n- he-j b b e a i n and e al a i n bef e he a e hi ed a eg la
em l ee . The n e a e e i ed b hei head n e and he cha ge
n e and in ec ed b hei clinical e i and n ing di ec . Ba ed
f m hi

_______________

71 Valen uela v. Court of Appeals, 323 Phil. 374; 253 SCRA 303 (1996).
72 Rollo, . 37.
73 Metro Manila Transit Corp. v. Court of Appeals, supra n e 70.

288 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana

e idence he c belie e ha defendan h i al had e e ci ed dence

and diligence e i ed f i . The n e i em l ed e e e i ed i h
f cien kn ledge and in c i n and a e able e f m hei k and
familia i h he d ie and e n ibili ie a igned hem.74
 Indeed, he f m la i n f a e i hie a ch , c m an
le and eg la i n , and di ci lina mea e n em l ee in
ca e f b each, i indi en able. H e e , e d e diligence in
he e i i n f em l ee , i i n en gh f an em l e ch
a e i i ne em il in ke he e i ence f ch a f m la i n.
Wha i m e im an i he ac al im lemen a i n and m ni ing
f c n i en c m liance i h he le . Unde andabl , hi ac al
im lemen a i n and m ni ing h ld be he c n an c nce n f
he em l e , ac ing h gh de endable e i h h ld
eg la l e n hei e i f nc i n . Th , he e m be
f f diligence in he ac al e i i n f he em l ee
75
k.
In he e en ca e, he e i n f f ac al e i i n f he
em l ee k ac al im lemen a i n and m ni ing f
c n i en c m liance i h he le . The e im n f e i i ne
A i an N ing Se ice Di ec , L de H. Nic la i belied b
he ac al ec d 76 f e i i ne . The e h ha N e Da id and
Pad lina had been b e ed be la ec me and ab en ee ; e he
e e ne e anc i ned b h e edl e i ing hem. While
he e i n f

_______________

74 Rollo, . 857.
75 Ple to v. Lombo , 476 Phil. 373; 432 SCRA 329 (2004). See al Metro
Manila Transit Corp. v. Court of Appeals, supra n e 70.
76 The Te mina ing Em l ee A ai al igned b he n ing e i , Si e
Vicencia, and n ed b Si e E ella h ed defendan Da id a an cca i nal
la ec me and ab en ee and a di h ne and in ince e (Rec d [V l. VII], . 2024)
hile he Te mina ing Em l ee A ai al igned b he e i , Si e Hi ene,
h ed defendan Pad lina a a habi al la ec me and ab en ee (Rec d [V l. VII],
. 2045).

VOL. 821, MARCH 22, 2017 289

Our Lad of Lourdes Hospital vs. Capan ana

diligen e i i n de end n he ci c m ance f em l men ,77

e nd ha b he e na e f a h i al, he e e ii n
f he a endance f i n e , h a e i f n line heal h
fe i nal , i c cial c n ide ing ha a ien c ndi i n can
change d a icall in a ma e f min e . Pe i i ne Em l ee
78
Handb k ec gni ed e ac l hi a i dec eed he e
ced e in a ailing f na idable ab ence and he
c mmen a e enal ie f e bal e imand, i en a ning,
en i n f m k, and di mi al in in ance f ne c ed
79
ab ence a dine . Pe i i ne fail e anc i n he a dine
f he defendan n e h an e lack f ac al im lemen a i n
and m ni ing f c m liance i h he le and l ima el f
e ii n e i n e.
M e im an , n ha fa al nigh , i a n h n h ee
he ac al n e n d and h a e i ing he e n e .
Al h gh L de H. Nic la e lained in he e im n ha
n e a e a igned a he n e a i n f each hif and ha he
ae e i ed b he head n e he cha ge n e , he
d c men f e i i ne h c n ic ing acc n f ha ha ened
n he fa ef l da f 26 and 27 f Decembe 1997.
The ched le f n e ini iall bmi ed b he di ec f he
n ing e ice f e i i ne h i al, Si e E ella C i l g ,
indica ed ha Da id a n d f m 2 .m. 11 .m. n 26
Decembe 1997 and ha Pad lina and Ballan e e n d f m 10
.m. f 26 Decembe 1997 6 a.m. f 27 Decembe 1997. Ballan ,
h e e , a em l ed a a mid ife and n a n e.80 Al , he
al de i i n f Si e E ella C i -

_______________

77 Supra n e 71.
78 Rec d (V l. VII), . 2022.
79 Rollo, . 646.
80 In a Manife a i n da ed 15 Ma 2001, e i i ne a ed ha Bailan a a
mid ife and n a n e. (Rec d [V l. VI], . 1521-1522). In he An e ih
C m l C n e claim da ed 11 Se embe

2 0

290 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana

l g indica ed ha a ce ain M lina, a n e, did n e f k

f m 10 .m. f 26 Decembe 1997 6 a.m. f 27 Decembe 1997
lea ing nl Pad lina a he n e n d d ing he aid e i d
hile E el n Da id a n d nl f m 2 .m. 11 .m. n 26
Decembe 1997.81 H e e , in a Manife a i n82 da ed 15 J l
1999, e i i ne bmi ed a e i ed and m e acc a e ched le f
n e e a ed b he n e e i , Cha ina G. Ocam , hich
c i l c n ained e a e n he i n e aining E el n
Da id in ha Da id a n h n be n d f m 10 .m. n
83
26 Decembe 1997 6 a.m. n 27 Decembe 1997.
 An he iece f d c men a e idence, he N e N e , a
al n ih inc n i encie . In a Manife a i n and M i n84
da ed 3 J ne 2003, e i i ne admi ed ha ing inad e en l failed
incl de an en age in he N e N e ini iall bmi ed
he ial c .85 Tha en a he N e Ob e a i n and
Re n Ca an ana f m 8 .m. f 26 Decembe 1997 3:20 a.m.
f 27 Decembe 1997 igned b Da id.86 M e e , in he e im n
f i ne f e i i ne , Milag de Ve a, he admini a i e
e i f he h i al, i a e ealed ha en ie in he N e
N e e e made in diffe en c l f ink de ending n he hif f
he n e: bl e ink f he m ning hif , black f af e n n, and ed
f nigh . In e e ingl , a manife ed b he c n el f
e nden , he en ie made f m 2:45 2:50 a.m. f 27
Decembe 1997 e e in b h bl e and ed.87

_______________

2001, Ballan claimed ha he a em l ed a a mid ife. (Rec d [V l. VI], .

1625)
81 TSN, 11 Decembe 2000, . 15-17.
82 Rec d (V l. II), . 542-543.
83 Id., a . 545-547.
84 Rec d (V l. VI), . 1847-1849.
85 Id. (V l. III), . 821-842.
86 Id. (V l. VI), . 1851.
87 TSN, 12 N embe 2004, . 20-21.

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Our Lad of Lourdes Hospital vs. Capan ana

All he e nega e he d e diligence n he a f he n e , hei

e i , and l ima el , he h i al.
We he ef e af m he a ella e c in nding e i i ne
di ec l liable f he negligence f i n e nde A icle 2180 in
ela i n A icle 2176 f he Ci il C de.
We a e lef i h min i e ha need be add e ed in
de c m le el e l e he e i i n. T ecall, e i i ne
e i ned bef e he CA n nl he ial c denial f
e i i ne M i n f Lea e ake he de i i n f a i ne b
al he denial f i c n e claim . In he a ailed Deci i n and
Re l i n, he a ella e c failed make a n ncemen
e e l add e ing he i e . Pe i i ne n a ha e emand
 he ca e he ial c f he ece i n f he e im n f i
i ne and ha e g an i c n e claim .
In f he i e, e i i ne in ke
n ncemen in H att Manufacturing Corp. v. Le Construction
Development Corp.,88 in hich hi C af med he a ella e
c ling emand he ca e he ial c and de he
de i i n- aking ceed. T b ing hi i e a cl e, e ee
he need e en a n anced a ing f he diffe ence be een he
ci c m ance in H att and in he e en e i i n. First, in he ci ed
ca e, he a ing he de i i n made n a an ed claim f
dela . Thi C f nd ha i a n he e e f de i i n, b
he l min leading led b he ing a , ha ca ed he
dela in he c ceeding . In hi ca e, h e e , he e i ea n
ec ha he e e a indeed mean dela beca e he
in ended de i i n in 2004 a mean be an addi i nal -
eb al e idence Balad e im n hich, e cha ac e i icall
ake n e, a gi en in 1999, a l ng e ea bef e. M e e , he
ial c ea ned ha he ca e had been ied f man ea and
a ab be decided:

_______________

88 519 Phil. 272; 484 SCRA 286 (2006).

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292 SUPREME COURT REPORTS ANNOTATED

Our Lad of Lourdes Hospital vs. Capan ana

The imeline f he m i n f lea e f c ake de i i n h gh

i en in e ga ie ca d b he he n i a in ended f he
dela he ceeding f hi ca e. The in an ca e ha b ained
c n ide able leng h in i adj dica i n and all m an -defendan
ake de i i n f M . Da id [ he i ne -de nen ] ld nl f he
dela i di i i n and ld ce ainl defea he e f a di ii n
hich i e edi e ceeding .89

Second, in H att, he ial c a bi a il cancelled he aking f

de i i n , hich had been ched led e i l . In he d,
e e hing had been e , and he de nen e e a ailable f
de i i n. Dela , if an , ld ha e been minimal. In he e en
ca e, n de i i n a e e ched led, and he a ailabili f he
ed de nen a n e en a ce ained. In fac , he nce ain
in he aking f he de i i n a ne f he ea n ci ed b he
ial c hen i denied he M i n f Lea e.90
 Third, he RTC in hi ca e n ed ha e i i ne had ag eed a
elf-im ed deadline f he bmi i n f i - eb al e idence.
When he ched led hea ing came, e i i ne c n el failed
a end edl beca e he a indi ed. B a c i l
b e ed b he ial c , he ece i n f - eb al e idence n
ha da e c ld n ha e ceeded an a ince e i i ne had n
91
i ne e . The ial c like i e n ed ha e i i ne failed
a e an lid g nd j if he g an f he aking f ha
de i i n, e ce f he la e naked a e i n ha he i ne
be de ed a f he c n .92 The C nd ha he e
c n ide a i n , aken ge he , ided ne f he ea n f he
RTC e l den he M i n f Lea e ake he de i i n f
a i ne . In H att, he

_______________

89 Rollo, . 769.
90 Id., a . 768.
91 Id., a . 768-769.
92 Id., a . 769.

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m an a c m le el fa l le ; in he e en ca e, e i i ne
failed n nl be e en a he ched led hea ing f he
bmi i n f i - eb al e idence, b al h g d fai h
in i e e .
Fourth, he m an in H att a clea l ej diced b he denial
f i e e , hich i had m l made bef e e ial. The ame
cann be aid in he e en ca e beca e e i i ne led he m i n
ake de i i n i ea af e ial had a ed. In fac , e i i ne
a c n den en gh ag ee a deadline f he bmi i n f i
- eb al e idence, a deadline ha had l ng a ed hen i led a
M i n f Lea e. Pe i i ne i , he ef e, e ed f m claiming
ha i a e e ej diced.
All in all, e i i ne a g men ega ding he ial c denial
f e i i ne M i n f Lea e ake he de i i n fail
im e .
Thi n i h anding, e nd me i in an he a g men
cce i el ai ed b e i i ne bef e he C f A eal and
bef e hi C i h e ec he n aid h i al bill f
e nden an i e n add e ed again b he CA in he
a ailed ling. The n aid h i al bill a e i i ne h i al
am n ed P20,141.60 a f 30 Oc be 1998.93 Thi fac a
nc n e ed b e nden . Since he am n f ac al damage
a li ed b e nden in hei c m lain a al ead incl i e f
he h i al bill inc ed a e i i ne h i al and a Ca dinal
San H i al, e deem i e ded c he n aid h i al bill
f m he ac al damage dec eed b he l e c and af med b
he a ella e c . H e e , e addi i nall im e he a men f
in e e n he e l ing am n c nf m i h e ailing
94
j i dence.

_______________

93 Id., a . 922.
94 Nacar v. Galler Frames, G.R. N . 189871, A g 13, 2013, 703 SCRA 439,
456-459.

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294 SUPREME COURT REPORTS ANNOTATED

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WHEREFORE, emi e c n ide ed, e AFFIRM

MODIFICATION he Deci i n and Re l i n ende ed b he
C f A eal in C.A.-G.R. CV N . 89030 in ha e i i ne i
he eb decla ed liable f he a men e nden f he al
am n f P299,102.04 a ac al damage min P20,141.60
e e en ing he n aid h i al bill a f 30 Oc be 1998;
P1,950,269.80 a c m en a damage ; P100,000.00 a m al
damage ; P100,000.00 a and b a f a ne fee ; and he
c f i , a ell a in e e a he a e f i e cen (6%) per
annum n he e l ing am n f m he nali f hi j dgmen
n il f ll a men .
SO ORDERED.

Leonardo-De Castro, Del Castillo, Perlas-Bernabe and

Caguioa, JJ., c nc .

Judgment and resolution af rmed with modi cation.

N e . Medical mal ac ice, m e a ia el , medical

negligence, i ha e f claim hich a ic im ha a ailable him
he ed e a ng c mmi ed b a medical fe i nal
hich ha ca ed b dil ha m. (Li vs. Soliman, 651 SCRA 32
[2011])
 C ha ec gni ed ha medical negligence ca e a e be
ed b ini n f e e i ne e bel nging in he ame
gene al neighb h d and in he ame gene al line f ac ice a
defendan h ician ge n. (Id.)

C gh 2020 Ce a B S , I c. A gh e e ed.