DR. PEDRO DENNIS CERENO Vs CA, SPOUSES DIOGENES S. OLAVERE and FE R. SERRANO

Facts:
Raymond S. Olavere a victim of a stabbing incident, was rushed to the emergency room of the Bicol Regional Medical Center (BRMC). He was attended to by Nurse Arlene Balares and Dr. Ruel Levy Realuyo— the emergency room resident physician.

After extending initial medical treatment to Raymond, Dr. Realuyo recommended that the patient undergo “emergency exploratory laparotomy.” Dr. Realuyo then requested the parents of Raymond to procure 500 cc of type “O” blood needed for the operation. Complying with the request, Deogenes and Andrew Olavere went to the Philippine National Red Cross to secure the required blood.

10:30 P.M: Raymond was wheeled inside the operating room. During that time, the hospital surgeons, Drs. Zafe and Cereno, were busy operating on a gunshot victim with Dr. Rosalina Tatad who was the only senior anesthesiologist on duty at BRMC that night.

10:59 P.M: Drs. Zafe and Cereno decided to defer the operation on Raymond because of other emergency procedures needed for other patient. In the meantime, they examine Raymond and they found that the latter’s blood pressure was normal and “nothing in him was significant. That based on the xray result he interpreted, the fluid inside the thoracic cavity of Raymond was minimal.

12:15 A.M.: Petitioners immediately started their operation on Raymond. Upon opening of Raymond’s thoracic cavity, they found that 3,200 cc of blood was stocked therein. The blood was evacuated and petitioners found a puncture at the inferior pole of the left lung.

In his testimony, Dr. Cereno stated that considering the loss of blood suffered by Raymond, he did not immediately transfuse blood because he had to control the bleeders first. Blood was finally transfused on Raymond at 1:40 A.M. At 1:45 A.M., while the operation was on-going, Raymond suffered a cardiac arrest. The operation ended at 1:50 A.M. and Raymond was pronounced dead at 2:30 A.M.

Raymond’s death certificate indicated that the immediate cause of death was “hypovolemic shock” or the cessation of the functions of the organs of the body due to loss of blood.

Parents of Raymond claimed that there was negligence on the part of those who attended to their son and filed a complaint for damages.

The trial court found petitioners negligent in not immediately conducting surgery on Raymond.It noted that petitioners have already finished operating on Charles Maluluy-on as early as 10:30 in the evening, and yet they only started the operation on Raymond at around 12:15 early morning of the following day. The trial court held that had the surgery been performed promptly, Raymond would not have lost so much blood and, therefore, could have been saved.

CA affirmed in toto the judgment rendered by the RTC

Issue:
WON CA ERRED IN RULING THAT PETITIONERS WERE GROSSLY NEGLIGENT IN THE PERFORMANCE OF THEIR DUTIES

Held:
Yes, There were no expert witnesses presented to testify that the course of action taken by petitioners were not in accord with those adopted by other reasonable surgeons in similar situations. Neither was there any testimony given, except that of Dr. Tatad’s, on which it may be inferred that petitioners failed to exercise the standard of care, diligence, learning and skill expected from practitioners of their profession. Dr. Tatad, however, is an expert neither in the field of surgery nor of surgical practices and diagnoses. Her expertise is in the administration of anesthesia and not in the determination of whether surgery ought or not ought to be performed.

The alleged delay in the cross-matching of the blood, if there was any, cannot be attributed as the fault of the petitioners. The petitioners were never shown to be responsible for such delay. It is highly unreasonable and the height of injustice if petitioners were to be sanctioned for lapses in procedure that does not fall within their duties and beyond their control.

Before the operation, Dr. Cereno explained that the reason why no blood transfusion was made on Raymond was because they did not then see the need to administer such transfusion

Given that Dr. Tatad was already engaged in another urgent operation and that Raymond was not showing any symptom of suffering from major blood loss requiring an immediate operation, Court find it reasonable that petitioners decided to wait for Dr. Tatad to finish her surgery and not to call the standby anesthesiologist anymore. There is, after all, no evidence that shows that a prudent surgeon faced with similar circumstances would decide otherwise.

In medical negligence cases, it is settled that the complainant has the burden of establishing breach of duty on the part of the doctors or surgeons. It must be proven that such breach of duty has a causal connection to the resulting death of the patient. A verdict in malpractice action cannot be based on speculation or conjecture. Causation must be proven within a reasonable medical probability based upon competent expert testimony.

The parents of Raymond failed in this respect. Aside from their failure to prove negligence on the part of the petitioners, they also failed to prove that it was petitioners’ fault that caused the injury. Their cause stands on the mere assumption that Raymond’s life would have been saved had petitioner surgeons immediately operated on him; had the blood been cross-matched immediately and had the blood been transfused immediately. There was, however, no proof presented that Raymond’s life would have been saved had those things been done. Those are mere assumptions and cannot guarantee their desired result. Such cannot be made basis of a decision in this case, especially considering that the name, reputation and career of petitioners are at stake.

In the case of Dr. Cruz v. CA, it was held that “[d]octors are protected by a special law. They are not guarantors of care. They do not even warrant a good result. They are not insurers against mishaps or unusual consequences. Furthermore, they are not liable for honest mistake of judgment

Credit:

Edaj Fabi