Professional Services Inc.

vs Natividad Agana

GR No. 12629

Facts:

 On April 4, 1984, Natividad Agana was rushed to Makati City Hospital

because of bowel movement and bloody anal discharge.
 After a series of examination, Dr. Miguel Ampil diagnosed her to be
suffering from Cancer of the Sigmoid.
 On April 11, 1984, Dr. Ampil assisted by the Medical Staff of Makati City
Hospital performed an anterior resection surgery on Natividad Agana and
found out that the malignancy of her Sigmoid had spread to her left ovary.
 Dr. Ampil obtained the consent of Mr. Enrique Agana, Natividad’s husband
to permit Dr. Juan Fuentes to perform hysterectomy on her.
 After hysterectomy operation had completed by Dr. Fuentes, Dr. Ampil took
over, completed the operation and close the incision after searching for the
missing 2 gauzes, despite the information given by the Nurse that the 2
pieces of Gauze is still missing.
 On April 24, 1984, Natividad Agana was released from the hospital.
 After a couple of days, Natividad Agana complained of excruciating pain on
her anal region. She consulted both Dr. Ampil and Dr. Fuentes about it.
They told her that it is a natural consequences of the surgery.
 Dr. Ampil recommended her to consult an Oncologist to examine the
cancerous nodes that were not removed during the surgery.
 On May 9, 1984, Natividad Agana accompanied by her husband, Mr.
Enrique Agana went to the United States of America for further evaluation
and treatment.
 After 4 months of consultation and laboratory examination, she was told
to be cancer free. And was advised to go home to the Philippines.
 On August 31, 1984, flew back to the Philippines still suffering from pains.
 Two weeks after, her daughter found a piece of gauze protruding from her
vagina .
  Dr. Ampil removed it by hand. The gauze measured 1.5 inches in width
and assured her that the pain will soon vanished.
 Dr. Apil assurance did not come true, prompting Natividad Agana to seek
treatment at Polymedic General Hospital.
 While confined , Dr. Ramon Gutierrez detected another foreign object in her
vagina. A foul smelling gauze measuring 1.5 inches in width which badly
infected the vaginal vault.
 A recto-vaginal fistula was formed in her reproductive organ forcing the
stool to excrete through her vagina.
 On October 1984, underwent another surgery to remedy the damage.
 On November 12, 1984, Natividad Agana and her husband Enrique Agana
filed a complaint with the RTC. Branch 16, Quezon City for damages
against PSI owner of Makati City Hospital, for Dr. Ampil and Dr. Fuentes for
Malpractice for concealing their act of Negligence, liable for leaving
2 pieces of gauze inside Natividad Agana’s body.
 Mr. Enrique Agana also filed with Professional Regulation Commission
(PRC) an Administrative complaint for gross negligence and malpractice
against Dr. Ampil and Dr. Fuentes.
 On February 16, 1986, pending the outcome of the above case, Natividad
Agana died and was substituted by her children. (The Aganas)

Issues:

 Whether or not Dr. Miguel Ampil and Dr. Juan Fuentes are liable for
medical malpractice.
 Professional Services Inc. (PSI) liable for damages due to the negligence of
the said doctors. (Dr. Ampil and Dr. Fuentes.)

Court Decision/ Rulling:

 Regional Trial Court (RTC)

 Dr. Miguel Ampil and Dr. Juan Fuentes are liable of MEDICAL
MALPRACTICE AND NEGLIGENCE.

 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 and other foreign substances in the wound
after the incision had been closed is at least prima facie negligence by
the operating surgeon. The removal of all sponges is part of surgical
operation and when physician or surgeon fails to remove a sponge he
has placed in the patient’s body that should be removed as part of the
operation, he hereby leaves his operation uncompleted. Such act is
negligence per se. After Dr. Fuentes performed and completed the
Hysterectomy, Dr. Ampil took over completed the operation and
closed the incision after searching for the missing gauze but failed to
locate it despite the information given by the nurse that 2 gauzes are
missing. Dr. Ampil should have informed the patient of the 2 gauzes,
worsed he even told her that the pain she experiencing is the
consequences of the surgery. This is a clear case of medical
malpractice or more appropriately medical negligence.

 Court of Appeal (CA)

The case against defendant-appellant Dr. Juan Fuentes is hereby
DISMISSED and with the pronouncement of defendant- appellant Dr.
Ampil liable to reimburse Professional Services, Inc. whatever
amount to the latter, the decision appealed is hereby AFFIRMED and
the instant appeal DISMISSED.
 Dr. Juan Fuentes is not guilty of negligence and medical malpractice,
invoking the doctrine of Res Ipsa Liquitor – “the thing that speaks for
itself. “. They contained that the pieces of gauze are prima facie proofs
that the operating surgeons have been negligent.
 Dr. Miguel Ampil, liable for negligence and malpractice since
evidence the 2 pieces of guaze in Natividad’s vagina.
  Professional Services Inc. (PSI ) Alleged in its petition that:
o 1. It is estopped from raising the defense that Dr. Ampil is not
its employee but a mere consultant or independent contractor,
thus he alone will answer for his negligence.
o 2. It is solidarily liable with Dr. Ampil
o 3. It is not entitled to its counterclaim against the Aganas.

 SUPREME COURT (SC );

All the petitions were DENIED and AFFIRM the challenged decision
of the Court of Appeal CA-G.R. CV NO. 426062 and CA-G.R. SP No.
32198.

Doctrine Used:

 Res Ipsa Liquitor - the thing that speaks for itself.

The requisites for the doctrine of res ipsa liquitor:

 1. Occurrence of an injury.
 2. The thing which caused the injury was under the control
and management of the defendant.
 3. The occurrence was such that in the ordinary course of
things would not have happened if those who had control or
mmanagement used proper care , and;
 4. The absence of explanation by the defendant.
 Captain of the Ship:
 The Surgeon is the person in complete charge of the
operating room and the personnel connected with the
operation.
 Doctrine of Corporate Responsibility-
 It has the duty to see that it meets the standards of
responsibilities for the care of the patient. Such duty includes
the proper supervision of the members of the medical staff.
 The hospital accordingly has the duty to make a reasonable
effort to monitor and over see the treatment prescribed and
administered by the physician practicing in its premises.

Conclusion:
o Therefore if Dr. Ampil had only observed all the diligence of
a good father of the family to prevent damage…this might
not have had happened. Once a physician undertakes the
treatment and care of a patient. The law imposes on him
certain obligation. In order to escape responsibility. He must
processes reasonable degree of learning.
o

Submitted by :

Joni Jane C, Villanueva

Student
MMHo A, Roxas City, Capiz