Nogales vs Capitol Medical Center
GR No. 142625 December 19, 2006
Facts: Pregnant with her fourth child, Corazon Nogales, who was then 37 y/o was under the exclusive prenatal care of Dr. Oscar Estrada beginning on her fourth month of pregnancy or as early as December 1975. While Corazon was on her last trimester of pregnancy, Dr. Estrada noted an increase in her blood pressure and development of leg edemas indicating preeclampsia which is a dangerous complication of pregnancy. Around midnight of May 26, 1976, Corazon started to experience mild labor pains prompting Corazon and Rogelio Nogales to see Dr. Estrada at his home. After examining Corazon, Dr. Estrada advised her immediate admission to Capitol Medical Center (CMC). Upon her admission, an internal examination was conducted upon her by a resident-physician. Based on the doctor’s sheet, around 3am, Dr. Estrada advised for 10mg valium to be administered immediately by intramuscular injection, he later ordered the start of intravenous administration of syntociron admixed with dextrose, 5% in lactated ringer’s solution, at the rate of 8-10 micro-drops per minute. When asked if he needed the services of anesthesiologist, he refused. Corazon’s bag of water ruptured spontaneously and her cervix was fully dilated and she experienced convulsions. Dr. Estrada ordered the injection of 10g of magnesium sulfate but his assisting Doctor, Dr. Villaflor, only administered 2.5g. She also applied low forceps to extract Corazon’s baby. In the process, a 10 x 2.5cm piece of cervical tissue was allegedly torn. The baby came out in an apric, cyanatic weak and injured condition. Consequently the baby had to be intubated and resuscitated. Corazon had professed vaginal bleeding where a blood typing was ordered and she was supposed to undergo hysterectomy, however, upon the arrival of the doctor, she was already pronounced dead due to hemorrhage.
Issue: Whether or not in the conduct of child delivery, the doctors and the respondent hospital is liable for negligence.
Held: Yes. 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 exception is also known as the doctrine of apparent authority.
Under 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.
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 acquired in them; and 3.) the plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent with ordinary care and prudence.
Borrowed servant doctrine provides that once a surgeon enters the operating room and takes charge of the acts or omissions of operating room personnel and any negligence associated with each 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.