Bontilao vs Gerona (GR No. 176675 September 15, 2010)

Bontilao vs Gerona
GR No. 176675 September 15, 2010

Facts: On December 28, 1991, respondent Dr. Carlos Gerona, an orthopedic surgeon at the Vicente Gullas Memorial Hospital, treated petitioner’s son, 8 y/o Allen Roy Bontilao, for a fractured right wrist. Respondent administered a “U-spint” and immobilized Allen’s wrist with a cast, then sent Allen home. On June 4, 1992, Alen re-fractured the same wrist and was brought back to the hospital. The x-ray examination showed a complete fractured and displacement bone, with the fragments overlapping each other. Respondent performed a closed reduction procedure, with Dr. Vicente Jabagat as the anesthesiologist. Then he placed Allen’s arm in a plaster cast to immobilize it. He allowed Allen to go home after the post reduction x-ray showed that the bones were properly aligned, but advised Allen’s mother, petitioner Sherlina Bontilao, to bring Allen back for re-tightening of the cast not later than June 15, 1992. Allen was however, only brought back after the said date. By then, because the cast had not be re-tightened, a rotational deformity had developed in Allen’s arm. The x-ray examination showed that the deformity was caused by a re-displacement of the bone fragments, so it was agreed that an open reduction surgery will be conducted on June 24, 1992 by the respondent, again with Dr. Jabagat as the anesthesiologist. On the said date, Sherlina was allowed to observe the operation behind a glass panel. Dr. Jabagat failed to intubate the patient after 5 attempts so anesthesia was administered through a gas mask. Respondent asked Dr. Jabagat if the operation should be postponed given the failure to intubate, but Dr. Jabagat said that it was alright to proceed. Respondent verified that Allen was breathing properly before proceeding with the surgery. As respondent was about to finish the suturing, Sherlina decided to go out of the operating room to make a telephone call and wait for her son. Later, she was informed that her son died on the operating table. The cause of death was asphyxia due to the congestion and edema of the epiglottis. Hence, a criminal, administrative and civil case was filed by the parents of Allen against the doctors for the negligence that caused Allen’s death.

Issue: Whether or not respondent is liable for medical negligence due to the death of Allen.

Held: No. The trial court erred in applying the doctrine of res ipsa liquitor to pin liability on respondent for Allen’s death. Res ipsa liquitor is a rebuttable presumption or influence that the defendant was negligent. The presumption only arises upon proof that the instrumentality causing injury was in the defendant’s exclusive control, and that the accident was one which ordinarily does not happen in the absence of negligence. It is a rule of evidence whereby negligence of the alleged wrong does may be inferred from the mere fact that the accident happened, provided that the character of the accident and circumstances attending it lead reasonably to the belief that in the absence of negligence it would not have occurred and that the thing which caused injury is shown to have been under the management and control of the alleged wrong doer.

Res ipsa liquitor is not a rigid or ordinary doctrine to be perfunctorily used but a rule to be cautiously applied defending upon the circumstances of each case. In malpractice case, the doctrine is generally restricted to situations where a layman is able to say, as a matter of common knowledge and observation, that the consequence of professional care were not as such as would ordinarily have followed if due care had been exercised.

Moreover, we note that in the instant case, the instrument which caused the injury or damage was not even within respondent’s exclusive control and management as Dr. Jabagat was exclusively in control and management of the anesthesia and endotracheal tube. The doctrine of res ipsa liquitor allows the mere existence of an injury to justify a presumption of negligence or the part of the person who controls the instrument causing the injury, provided that the following requisites concur:

  1. The accident is of a kind which ordinarily does not occur in the absence of someone’s negligence;
  2. It is caused by an instrumentality within the exclusive control of the defendant or co-defendants;
  3. The possibility of contributing conduct which would make the plaintiff responsible is eliminated.

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