Professional Services Inc. v.

Agana
Facts:
Natividad Agana (R) was rushed to the Medical City General Hospital (Medical City
Hospital) because of difficulty of bowel movement and bloody anal discharge. After a
series of medical exams, Dr. Miguel Ampil (P) diagnosed her with cancer of the sigmoid.
Dr. Ampil did an anterior resection surgery and permitted Dr. Fuentes performed
hysterectomy. She was released from the hospital but she had anal pains. R had more
pains even after going to the US to get treated so she went back to P where a gauze
was pulled out of her private parts to which he said she was to be cured after this.
However, the Polymedic General Hospital detected another gauze in her private parts
wherein it found a recto-vaginal fistula had formed in her reproductive organs which
forced stool to excrete through the vagina. Another surgical operation was needed to
remedy the damage.
R filed for damages against PSI, owner of Medical City and P.
The RTC found for R. The CA modified this wherein Dr. Fuentes wasnt held liable.
Issues:
1. Whether P is liable for negligence.
2. Whether Fuentes is liable for negligence.
3. Whether PSI is liable for negligence.
Ruling:
1. Yes. An operation requiring the placing of sponges in the incision is not complete
until the sponges are properly removed, and it is settled that the leaving of
sponges or other foreign substances in the wound after the incision has been
closed is at least prima facie negligence by the operating surgeon. P did not
inform Natividad about the missing two pieces of gauze. Worse, he even misled
her that the pain she was experiencing was the ordinary consequence of her
operation. Had he been more candid, R could have taken the immediate and
appropriate medical remedy to remove the gauzes from her body. To our mind,
what was initially an act of negligence by P has ripened into a deliberate wrongful
act of deceiving his patient.

2. No. The element of "control and management of the thing which caused the
injury" to be wanting. Hence, the doctrine of res ipsa loquitur will not lie. P was

the lead surgeon during the operation of Natividad. Under the "Captain of the
Ship" rule, the operating surgeon is the person in complete charge of the surgery
room and all personnel connected with the operation. Their duty is to obey his
orders.

3. Yes. In the present case, it was duly established that PSI operates the Medical
City Hospital for the purpose and under the concept of providing comprehensive
medical services to the public. Accordingly, it has the duty to exercise reasonable
care to protect from harm all patients admitted into its facility for medical
treatment. Unfortunately, PSI failed to perform such duty. PSIs liability is
traceable to its failure to conduct an investigation of the matter reported in the
nota bene of the count nurse. PSI, apart from a general denial of its
responsibility, failed to adduce evidence showing that it exercised the diligence of
a good father of a family in the accreditation and supervision of the latter. It
followed the doctrine of corporate negligence.