ROGELIO P. NOGALES, vs. CAPITOL MEDICAL CENTER, G.R. No. 142625, December 19, 2006

FACTS:
Corazon Nogales (Corazon) was pregnant of her 4th child and was under the exclusive prenatal care of Dr. Oscar Estrada (Dr. Estrada). On her last trimester of pregnancy, Dr. Estrada noted an increase in Corazon’s blood pressure and development of leg edema which may lead to a dangerous complication of pregnancy. When Corazon started experiencing mild labor pains, she and his husband Rogelio opted to see Dr. Estrada for examination, and the latter advised them to admit Corazon to the Capitol Medical Center (CMC). Short after Corazon’s bag of water ruptured, she started to experience convulsions. Dr. Estrada and another physician in the name of Dr. Villaflor began extracting the baby, which allegedly torn a piece of cervical tissue of the patient. After the baby was taken out of the womb, Corazon began to manifest moderate vaginal bleeding which rapidly became profuse. Despite efforts to revive the patient, Corazon died. The cause of which was “hemorrhage, post-partum.”

Rogelio Nogales, et al. (petitioners) filed a complaint for damages against CMC, Dr. Estrada, and the other involved medical personnel of the hospital (Dr. Villaflor, Dr. Uy, Dr. Enriquez, Dr. Lacson, Dr. Espinola, and a certain Nurse J. Dumlao) for the death of Corazon, charging CMC with negligence in the selection and supervision of defendant physicians and hospital staff.

The RTC (Manila) rendered judgment finding Dr. Estrada solely liable for damages. In ruling the same, the Court finds no legal justification to find the other impleaded physicians and hospital personnel civilly liable.

Upon appeal, petitioners claimed that aside from Dr. Estrada, the remaining respondents should be held equally liable for negligence, pointing out the extent of each respondent’s alleged liability.

The CA affirmed the decision of the trial court and on ruling the same, the Court of Appeals applied the “borrowed servant” doctrine considering that Dr. Estrada was an independent contractor who was merely exercising hospital privileges. This doctrine provides that once the surgeon enters the operating room and takes charge of the proceedings, the acts or omissions of operating room personnel, and any negligence associated with such acts or omissions, are imputable to the surgeon. While the assisting physicians and nurses may be employed by the hospital, or engaged by the patient, they normally become the temporary servants or agents of the surgeon in charge while the operation is in progress, and liability may be imposed upon the surgeon for their negligent acts under the doctrine of respondeat superior. Hence, the petition.

ISSUE:
Whether CMC is vicariously liable for the negligence of Dr. Estrada.

HELD:
YES. Art. 2180. The obligation imposed by article 2176 is demandable not only for one’s own acts or omissions, but also for those of persons for whom one is responsible.
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Employers shall be liable for the damages caused by their employees and household helpers acting within the scope of their assigned tasks, even though the former are not engaged in any business or industry.
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The responsibility treated of in this article shall cease when the persons herein mentioned prove that they observed all the diligence of a good father of a family to prevent damage.
Art. 2176. Whoever by act or omission causes damage to another, there being fault or negligence, is obliged to pay for the damage done. Such fault or negligence, if there is no pre-existing contractual relation between the parties, is called a quasi-delict and is governed by the provisions of this Chapter.

In general, a hospital is not liable for the negligence of an independent contractor-physician. There is, however, an exception to this principle. The hospital may be liable if the physician is the “ostensible” agent of the hospital. This is known as the “doctrine of apparent authority.” In Gilbert v. Sycamore Municipal Hospital, the Illinois Supreme Court explained the doctrine of apparent authority in this wise:

[U]nder the doctrine of apparent authority a hospital can be held vicariously liable for the negligent acts of a physician providing care at the hospital, regardless of whether the physician is an independent contractor, unless the patient knows, or should have known, that the physician is an independent contractor. The elements of the action have been set out as follows:
“For a hospital to be liable under the doctrine of apparent authority, a plaintiff must show that: (1) the hospital, or its agent, acted in a manner that would lead a reasonable person to conclude that the individual who was alleged to be negligent was an employee or agent of the hospital; (2) where the acts of the agent create the appearance of authority, the plaintiff must also prove that the hospital had knowledge of and acquiesced in them; and (3) the plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent with ordinary care and prudence.”
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The doctrine of apparent authority essentially involves two factors to determine the liability of an independent-contractor physician: The first factor focuses on the hospital’s manifestations and is sometimes described as an inquiry whether the hospital acted in a manner which would lead a reasonable person to conclude that the individual who was alleged to be negligent was an employee or agent of the hospital. In this regard, the hospital need not make express representations to the patient that the treating physician is an employee of the hospital; rather a representation may be general and implied. The second factor focuses on the patient’s reliance. It is sometimes characterized as an inquiry on whether the plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent with ordinary care and prudence.

credit:

Hanna Liia Genilo