Facts: September 21, 1988 petitioner performed a simple cesarean section on Mrs. Villegas, the private respondent. After leaving the hospital, respondent began to suffer abdominal pains and complained of being feverish. She also gradually lost her appetite, so she consulted the petitioner who prescribed for her certain medicines which she took up for 3 months. When the pain became unbearable she consulted Dr. Ma. Salud Kho at the Holy Child’s Hospital in Dumaguete City on January 20, 1989.

Dr. Ma. Salud Kho examined the respondentand found the latter to be feverish, pale and was breathing fast. Upon examination she felt an abdominal mass one finger below the umbilicus which she suspected to be either a tumor of the uterus or an ovarian cyst, either of which could be cancerous.A blood count showed that respondent had an infection inside her abdominal cavity. The result of all those examinations impelled Dr. Kho to suggest that Mrs. Villegas submit to another surgery to which the latter agreed.

When Dr. Kho opened the abdomen of the respondent she found whitish-yellow discharge inside, an ovarian cyst on each of the left and right ovaries which gave out pus, dirt and pus behind the uterus, and a piece of rubber materials on the right side of the uterus embedded on the ovarian cyst, 2 inches by 3/4 inch in size. This piece of rubber material which Dr. Kho described as a “foreign body” looked like a piece of a “rubber glove” . . . and which is also “rubber-drain like . . . . It could have been a torn section of a surgeon’s gloves or could have come from other sources. And this foreign body was the cause of the infection of the ovaries and consequently of all the discomfort suffered by Mrs. Villegas after her delivery on September 21, 1988.

A case was filed against the petitioner but the piece of rubber allegedly found near private respondent’s uterus was not presented in court. Dr. Ma. Salud Kho testified that she sent it to a pathologist in Cebu City for examination, but it was not mentioned in the pathologist’s Surgical Pathology Report.Aside from Dr. Kho’s testimony, the evidence which mentioned the piece of rubber are a Medical Certificate, a Progress Record, an Anesthesia Record, a Nurse’s Record, and a Physician’s Discharge Summary

RTC, however, regarded these documentary evidence as mere hearsay, “there being no showing that the person or persons who prepared them are deceased or unable to testify on the facts therein stated . . . . Except for the Medical Certificate (Exhibit “F”), all the above documents were allegedly prepared by persons other than Dr. Kho, and she merely affixed her signature on some of them to express her agreement thereto . . . .” RTC also refused to give weight to Dr. Kho’s testimony regarding the subject piece of rubber as Dr. Kho “may not have had first-hand knowledge” thereof. Thus, RTC held in favor of the petitioners but was subsequently reversed by CA.

Issue: WON
(1) CA committed grave abuse of discretion by resorting to findings of fact not supported by the evidence on record, and
(2) CA exceeded its discretion, amounting to lack or excess of jurisdiction, when it gave credence to testimonies punctured with contradictions and falsities.

Held: NO. The CA was correct in giving credence to the testimony.
The petitioners emphasize that the private respondents never reconciled Dr. Kho’s testimony with Dr. Batiquin’s claim on the witness stand that when Dr. Batiquin confronted Dr. Kho about the foreign body, the latter said that there was a piece of rubber but that she threw it away. Although hearsay, Dr. Batiquin’s claim was not objected to, and hence, the same is admissible but it carries no probative value. Nevertheless, assuming otherwise, Dr. Batiquin’s statement cannot belie the fact that Dr. Kho found a piece of rubber near private respondent Villegas’ uterus. And even if we were to doubt Dr. Kho as to what she did to the piece of rubber, i.e., whether she threw it away or sent it to Cebu City, we are not justified in distrusting her as to her recovery of a piece of rubber from private respondent Villegas’ abdomen. On this score, it is perfectly reasonable to believe the testimony of a witness with respect to some facts and disbelieve his testimony with respect to other facts. And it has been aptly said that even when a witness is found to have deliberately falsified in some material particulars, it is not required that the whole of his uncorroborated testimony be rejected, but such portions thereof deemed worthy of belief may be credited.

While the petitioners claim that contradictions and falsities punctured Dr. Kho’s testimony, a reading of the said testimony reveals no such infirmity and establishes Dr. Kho as a credible witness. Dr. Kho was frank throughout her turn on the witness stand. Furthermore, no motive to state any untruth was ever imputed against Dr. Kho, leaving her trustworthiness unimpaired.The trial court’s following declaration shows that while it was critical of the lack of care with which Dr. Kho handled the piece of rubber, it was not prepared to doubt Dr. Kho’s credibility, thus only supporting out appraisal of Dr. Kho’s trustworthiness.

Considering that we have assessed Dr. Kho to be a credible witness, her positive testimony that a piece of rubber was indeed found in private respondent Villegas’ abdomenprevails over the negative testimony in favor of the petitioners.

As such, the rule of res ipsa loquitur comes to fore. This Court has had occasion to delve into the nature and operation of this doctrine:
This doctrine [res ipsa loquitur] is stated thus: “Where the thing which causes injury is shown to be under the management of the defendant, and the accident is such as in the ordinary course of things does not happen if those who have the management use proper care, it affords reasonable evidence, in the absence of an explanation by the defendant, that the accident arose from want of care.” Or as Black’s Law Dictionary puts it:

Res ipsa loquitur. The thing speaks for itself. Rebuttable presumption or inference that defendant was negligent, which arises upon proof that [the] instrumentality causing injury was in defendant’s exclusive control, and that the accident was one which ordinary does not happen in absence of negligence. Res ipsa loquitur is [a] rule of evidence whereby negligence of [the] alleged wrongdoer may be inferred from [the] mere fact that [the] accident happened provided [the] character of [the] accident and circumstances attending it lead reasonably to belief that in [the] absence of negligence it would not have occurred and that thing which caused injury is shown to have been under [the] management and control of [the] alleged wrongdoer . . . . Under [this] doctrine . . . the happening of an injury permits an inference of negligence where plaintiff produces substantial evidence that [the] injury was caused by an agency or instrumentality under [the] exclusive control and management of defendant, and that the occurrence [sic] was such that in the ordinary course of things would not happen if reasonable care had been used.
xxx xxx xxx

The doctrine of [r]esipsa loquitur as a rule of evidence is peculiar to the law of negligence which recognizes that prima facie negligence may be established without direct proof and furnishes a substitute for specific proof of negligence. The doctrine is not a rule of substantive law, but merely a mode of proof or a mere procedural convenience. The rule, when applicable to the facts and circumstances of a particular case, is not intended to and does not dispense with the requirement of proof of culpable negligence on the party charged. It merely determines and regulates what shall be prima facie evidence thereof and facilitates the burden of plaintiff of proving a breach of the duty of due care. The doctrine can be invoked when and only when, under the circumstances involved, direct evidence is absent and not readily available.[36]
In the instant case, all the requisites for recourse to the doctrine are present. First, the entire proceedings of the cesarean section were under the exclusive control of Dr. Batiquin. In this light, the private respondents were bereft of direct evidence as to the actual culprit or the exact cause of the foreign object finding its way into private respondent Villegas’ body, which, needless to say, does not occur unless through the intervention of negligence. Second, since aside from the cesarean section, private respondent Villegas underwent no other operation which could have caused the offending piece of rubber to appear in her uterus, it stands to reason that such could only have been a by-product of the cesarean section performed by Dr. Batiquin. The petitioners, in this regard, failed to overcome the presumption of negligence arising from resort to the doctrine of res ipsa loquitur. Dr. Batiquin is therefore liable for negligently leaving behind a piece of rubber in private respondent Villegas’ abdomen and for all the adverse effects thereof.


Vi Ran 

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