JURISPRUDENCE IN

NURSING PRACTICE
SOMERA CASE
 FACTS OF THE CASE
Several days prior to May 26, 1929, Pedro Clemente took his daughter,
Anastacia Clemente, to Dr. Gregorio Favis at Manila. The latter decided to
perform a tonsillectomy and instructed the father and daughter to go to
St. Paul’s Hospital where he would perform the operation at 7am on May
26, 1929.
 Assisting Lorenza Somera, a Head Nurse, were student nurses Valentina
Andaya and Consolacion Montinola. The assistant surgeon was Dr.
Bartolome. During the operation, Dr. Favis asked Dr. Bartholome for
Novocain solution. Ms. Montinola handed Dr. Bartolome a syringe of
solution which was handed in turn to Dr. Favis who injected the same to
the patient. After a few minutes, Dr. Bartolome noticed that the patient
was becoming pale and acting as if dying. He called the attention of Dr.
Favis to this but the latter said it was not unusual. A third syringe of
solution was injected and a few minutes later, the patient died in a few
minutes. Dr. Favis asked if the Novocain was fresh. Ms. Somera replied
that the solution was not Novocain but 10% cocaine.
 In court, Ms. Montinola testified she heard Dr. Favis order cocaine with
adrenalin for injection and heard Ms. Somera to have verified the order.
The autopsy report and testimony of the Medico-legal Officer showed
that the patient was suffering from status lymphaticus and that such
patients were known to die even with so slight an injury as a needle-
prick.
 MALPRACTICE IN NURSING.
 MALPRACTICE has been defined as the
improper or unethical conduct by a
professional conduct by a professional,
resulting in harm, injury or death of
another person.
ELEMENTS OF MALPRACTICE
 DUTY
 BREACH
 INJURY
 PROXIMATE CAUSATION
 PROXIMATE CAUSE
 is that which, in natural and continuous
sequence, unbroken by any efficient
intervening cause, produces an injury, and
without which the result wound not have
occurred. It is that adequate and efficient
cause in the natural order of events, and
under the particular circumstances
surrounding the case would naturally
produce the event.
 CONTRACTS AND WILLS
 CONTRACT – it is a meeting of minds
between two persons whereby one binds
himself with respect to the other, to give
something or render some service. It is an
agreement which creates a valid legal
obligation.
 CONTRACTS AND WILLS
 WILL – is an act whereby a person is
permitted, with the formalities prescribed
by law, to control to a certain degree the
disposition of his/her estates or properties,
to take effect after his/her death.
 2 kinds of Will:
 NOTARIAL WILL – requires, among other
things, an attestation clause, and an
acknowledgement before a notary public.
 HOLOGRAPHIC WILL – one which is
entirely written, dated and signed by the
testator. It does not need any attestation
or acknowledgement.
JURISPRUDENTIAL DOCTRINES
IN NURSING PRACTICE
1. BONUS PATER FAMILIAS AND
RESPONDEAT SUPERIOR
 Bonus Pater Familias – Diligence of a
Good Father of a Family
 Respondeat superior – “let the master or
superior answer” or “let the principal
answer for the acts of his agents”
 2. DOCTRINE OF NEGLIGENT
CONDUCT
 Under this doctrine, the nurse is liable for
damages or injuries to the patient as a
result of negligent performance or non-
performance of the nurse’s obligation in
the hospital.
 3. DOCTRINE OF RES IPSA
LOQUITUR and COMMON
KNOWLEDGE
 literally means “the thing speaks for itself”
 To use this principle in a negligence case, the
plaintiff must prove that:
 the harm would not ordinarily have occurred
without someone’s negligence
 the instrumentality of the harm was under the
exclusive control of the defendant at the time of the
likely negligent act; and
 the plaintiff did not contribute to the harm by his
own negligence
 4. DOCTRINE OF DAMNUN
ABSQUE INJURIA
 Means that “although there was physical
damage there was no legal injury” it
simply means that even if a victim
suffered physical injury, the same is not
considered “legal injury” which entitles
him to recover for damages.
 5. DOCTRINE OF FORCE
MAJEURE
 It refers to an event which cannot be
foreseen, or which being foreseen, is
inevitable. The intervention of irresistible
force in any nursing action that causes
damage or injury to a patient may free or
exempt a nurse from any criminal liability
if he/she can show that he/she exercises
due care and diligence in the performance
of his/her function.
 6. DOCTRINE OF STARE
DECISIS
 Stare decisis et non quieta movere literally
means “stand by decisions and do not
move that which is quiet”
 7. PRINCIPLE OF NOLO
CONTENDERE.
 It is a latin legal phrase for “I will not
defend it.” It is a plea of no contest, which
has the effect of plea of guilty in some
jurisdictions because it is considered as an
admission of guilt for a crime charged.
 8. PRINCIPLE OF:
 MALFEASANCE –is the performance of
some act which ought not to be done.
 MISFEASANCE – is the improper
performance of some act which might
lawfully be done.
 NONFEASANCE – is the omission of some
act which ought to be performed.
 9. OF INFORMED CONSENT
 it consist of two parts:
 INFORMATION. There must be full disclosure by
the physician or nurse of the facts surrounding
the disease and the physician’s treatment of the
client so that the client (patient) can have full
comprehension of the same.
 CONSENT. Then requisite is voluntary consent of
the client. This doctrine is based on the principle
of dignity, respect for the rights and autonomy of
every individual patient.
 The basic elements of informed
consent are as follows:
 the consent must be voluntary
 the patient has legal capacity to give
consent
 the patient has sufficient understanding
of the situation
 the patient must make an enlightened
decision.
 Consent may be either EXPRESS or
IMPLIED.
 ADMINISTRATIVE CONSENT – given by
the chief house officer of the day or
physician in charge of the hospital during
trauma and emergency cases.
10. DOCTOR’S ORDER RULE
 the physician’s order or prescription may
be made verbally or in writing.
 Basic standards of clinical nursing practice as
regards to taking orders through the phone:

 have another nurse listen on the phone

as a witness, who then initials the order
for verification of accuracy
 repeat the order aloud to the physician
and ask, “is that correct?”
 document the order when said doctor
arrives at the hospital.
NURSE AS A WITNESS RULE
 Two kinds of witness
 ORDINARY WITNESS – is one who can
testify as to the conditions or circumstances
present in the issue or surrounding the case
 EXPERT WITNESS – can testify on the issue
by giving his opinion or advice from the
facts presented.