Nogales v.

Capitol Medical Center

G.R. No. 142625 December 19, 2006
Facts: Corazon Nogales, 37, was under
exclusive prenatal care of Dr. Oscar Estrada with
her fourth child. An increase in her blood
pressure and development of leg edema
indicating preeclampsia was noted during her
last trimester of pregnancy; a dangerous
complication of her pregnancy. On 26 May 1976,
Corazon was admitted to CMC after the staff
nurse noted the written admission request for
Dr. Estrada. Rogelio executed and signed the
Consent Admission and Agreement and
Admission Agreement. During the operation,
Dr. Estrada was assisted by doctors of CMC. The
baby came out in an apnic, cyanotic, weak and
injured condition and had to be incubated and
resuscitated by Drs. Enriquez and Payumo.
Corazons blood pressure dropped, she had
continuous vaginal bleeding, was administered
hemacel
and
undergone
immediate
hysterectomy. Eventually, she died at 9:15 a.m.
with hemorrhage, post partum.
Hence, a complaint for damages was
filed. For failure to answer, trial ensued. CA
upheld the trial courts ruling.
Issue: Whether or not CMC is vicariously liable
for the negligence of Dr. Estrada under Art. 2180
in relation to Art. 2176 of the Civil Code.
Ruling: Under the control test, an employeremployee relationship between hospitals and
their attending and visiting physicians must exist
in allocating responsibility in medical negligence
cases. The Court finds no single evidence
pointing to CMC's exercise of control over Dr.
Estrada's treatment and management of
Corazon's condition. It is undisputed that
throughout Corazon's pregnancy, she was under
the exclusive prenatal care of Dr. Estrada. At the
time of Corazon's admission at CMC and during
her delivery, it was Dr. Estrada, assisted by Dr.
Villaflor, who attended to Corazon. There was no
showing that CMC had a part in diagnosing
Corazon's condition. While Dr. Estrada enjoyed
staff privileges at CMC, such fact alone did not
make him an employee of CMC. CMC merely
allowed Dr. Estrada to use its facilities when
Corazon was about to give birth, which CMC
considered an emergency. Considering these
circumstances, Dr. Estrada is not an employee of
CMC, but an independent contractor.
In general, a hospital is not liable for the
negligence of an independent contractorphysician except under the doctrine of apparent
authority. In the instant case, CMC impliedly
held out Dr. Estrada as a member of its medical
staff. Through CMCs acts, CMC clothed Dr.
Estrada with apparent authority thereby leading
the Spouses Nogales to believe that Dr. Estrada
was an employee or agent of CMC. CMC cannot
now repudiate such authority.

CMC is liable for damages. Dr. Estrada did not

appeal the findings of CA, rendering him solely
liable for damages.
[Note: * 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."
The element of "holding out" on the part of the
hospital
does
not
require
an
express
representation by the hospital that the person
alleged to be negligent is an employee. Rather,
the element is satisfied if the hospital holds itself
out as a provider of emergency room care
without informing the patient that the care is
provided by independent contractors.
The element of justifiable reliance on the part of
the plaintiff is satisfied if the plaintiff relies upon
the hospital to provide complete emergency
room care, rather than upon a specific
physician.]
People v. Yatar
G.R. No. 150224 May 19, 2004
Facts: On or about June 30, 1998, Joel Yatar
wilfully, unlawfully, and feloniously stabbed
seventeen year old Kathylyn Uba with a bladed
weapon that resulted in the latters death. On
the occasion or by reason thereof, Yatar, wilfully,
unlawfully and feloniously, and by means of
force and violence had carnal knowledge of said
Kathlyn D. Uba against her will. Yatar was
charged and convicted with the crime of Rape
with Homicide. He was sentenced with Death. An
automatic appeal was brought to Court.
Issue: (1) Whether or not the Court erred in
giving much weight to the evidence presented
by the prosecution.
(2) Whether or not the DNA tests were
conducted in violation of the Yatars right to
remain silent as well as his right against selfincrimination.

Ruling: Absent any showing that the trial judge

overlooked, misunderstood, or misapplied some
facts or circumstances of weight which would
affect the result of the case, the trial judges
assessment of credibility deserves the appellate
courts highest respect. Where there is nothing
to show that the witnesses for the prosecution
were actuated by improper motive, their
testimonies are entitled to full faith and credit.
The weight of the prosecutions evidence must
be appreciated in light of the well-settled rule
which provides that an accused can be convicted
even if no eyewitness is available, as long as
sufficient circumstantial evidence is presented
by the prosecution to prove beyond doubt that
the accused committed the crime. In the given
case, there is sufficient circumstantial evidence
to prove beyond reasonable doubt that the
accused committed the crime. The estimated
time of death of the victim coincides with the
timeframe within which the lone presence of the
accused was seen lurking in the house of Isabel
Dawang where the victim was staying. In
addition, subsequent testing showed that the
Deoxyribonucleic acid (DNA) of the sperm
specimen from the vagina of the victim was
identical the semen to be that of appellants
gene type.
In an attempt to exclude the DNA
evidence, Yatar contends that the blood sample
taken from him as well as the DNA tests were
conducted in violation of his right to remain
silent as well as his right against selfincrimination. The Supreme Court held that the
kernel of the right is not against all compulsion,
but against testimonial compulsion. The right
against self- incrimination is simply against the
legal process of extracting from the lips of the
accused an admission of guilt. It does not apply
where the evidence sought to be excluded is not
an incrimination but as part of object evidence.
Thus, the Supreme Court affirmed the
penalty of Yatar to Death for a special complex
crime of rape with homicide.
[Note: * Circumstantial evidence, to be
sufficient to warrant a conviction, must form an
unbroken chain which leads to a fair and
reasonable conclusion that the accused, to the
exclusion of others, is the perpetrator of the
crime. To determine whether there is sufficient
circumstantial evidence, three requisites must
concur:
(1)
there
is
more
than
one
circumstance; (2) facts on which the inferences
are derived are proven; and (3) the combination
of all the circumstances is such as to produce a
conviction beyond reasonable doubt.
* Deoxyribonucleic acid (DNA) is a
molecule that encodes the genetic information in
all living organisms. A persons DNA is the same
in each cell and it does not change throughout a
persons lifetime; the DNA in a persons blood is
the same as the DNA found in his saliva, sweat,
bone, the root and shaft of hair, earwax, mucus,

urine, skin tissue, and vaginal and rectal cells.

Most importantly, because of polymorphisms in
human genetic structure, no two individuals
have the same DNA, with the notable exception
of identical twins.
DNA print or identification technology
has been advanced as a uniquely effective
means to link a suspect to a crime, or to
exonerate a wrongly accused suspect, where
biological evidence has been left. For purposes
of criminal investigation, DNA identification is a
fertile
source
of
both
inculpatory
and
exculpatory evidence. It can assist immensely in
effecting a more accurate account of the crime
committed, efficiently facilitating the conviction
of the guilty, securing the acquittal of the
innocent, and ensuring the proper administration
of justice in every case.
DNA evidence collected from a crime
scene can link a suspect to a crime or eliminate
one from suspicion in the same principle as
fingerprints are used. Incidents involving sexual
assault would leave biological evidence such as
hair, skin tissue, semen, blood, or saliva which
can be left on the victims body or at the crime
scene. Hair and fiber from clothing, carpets,
bedding, or furniture could also be transferred to
the victims body during the assault. Forensic
DNA evidence is helpful in proving that there
was physical contact between an assailant and a
victim. If properly collected from the victim,
crime scene or assailant, DNA can be compared
with known samples to place the suspect at the
scene of the crime.
*The following are the elements
constitutive of rape with homicide: (1) the
appellant had carnal knowledge of a woman; (2)
carnal knowledge of a woman was achieved by
means of force, threat or intimidation; and (3)
by reason or on the occasion of such carnal
knowledge by means of force, threat or
intimidation, appellant killed the woman. 52
However, in rape committed by close kin, such
as the victims father, step-father, uncle, or the
common-law spouse of her mother, it is not
necessary that actual force or intimidation be
employed. Moral influence or ascendancy takes
the place of violence and intimidation. The fact
that the victims hymen is intact does not negate
a finding that rape was committed as mere entry
by the penis into the lips of the female genital
organ, even without rupture or laceration of the
hymen, suffices for conviction of rape. The
strength and dilatability of the hymen are
invariable; it may be so elastic as to stretch
without laceration during intercourse. Absence
of hymenal lacerations does not disprove sexual
abuse especially when the victim is of tender
age.]

People of the Philippines v. Erinia

G.R. No. L-26298 January 20, 1927
Facts: Julian Erinia endeavored to have carnal
intercourse with a child of 3 years and 11
months. The physician who examined the genital
organ of the child a few hours after the
commission of the crime found a slight
inflammation of the exterior parts of the organ,
indicating that an effort had been made to enter
the vagina, but in testifying before the court, he
expressed doubts as to whether the entry had
been effected. The mother of the child testified
that she found its genital organ covered with a
sticky substance, but that cannot be conclusive
evidence of penetration.
Issue:
Whether
or
not
there
consummation of the crime of rape.

was

Ruling: It is probably true that a complete

penetration was impossible due to the fact that
the child was of such tender age, but such
penetration is not essential to the commission of
the crime; it is sufficient if there is a penetration
of the labia. In the case of Kenny v. State where
the offended party was a child of the age of 3
years and 8 months the testimony of several
physicians was to the effect that her labia of the
privates of a child of that age can be entered by
a mans male organ to the hymen and the
defendant was found guilty of the consummated
crime rape. However, there being no conclusive
evidence of penetration of the genital organ of
the offended party, the Supreme Court held that
the defendant is entitled to the benefit of the
doubt and can only be found guilty of frustrated
rape. In view of the fact that the defendant was
living in the house of the parents of the child as
their guest, the aggravating circumstance of
abuse of confidence existed and the penalty
must therefore be imposed in its maximum
degree.
People of the Philippines v. Campuhan
G.R. No. 129433 March 30, 2000
Facts: On April 25, 1996, Ma. Corazon
Pamintuan found Primo Campuhan, a helper of
Corazons brother, forcing his penis into her
daughters vagina. Horrified, Corazon cursed
Primo and boxed him several times. He evaded
her blows, pulled up his pants and then pushed
Corazon aside when she tried to block his path.
Corazon ran out and shouted for help. Seconds
later, Primo was apprehended by those who
answered Corazons call for help.
Issue: Whether or not there was rape.
Ruling: In concluding that carnal knowledge
took place, full penetration of the vaginal orifice
is not an essential ingredient, nor is the rupture
of the hymen necessary; the mere touching of
the external genitalia by the penis capable of
consummating the sexual act is sufficient to

constitute carnal knowledge. But the act of

touching should be understood here as
inherently part of the entry of the penis into the
labias of the female organ and not mere
touching alone of the mons pubis or the
pudendum. Jurisprudence dictates that the labia
majora must be entered for rape to be
consummated, and not merely for the penis to
stroke the surface of the female organ. Thus, a
grazing of the surface of the female organ or
touching the mons pubis of the pudendum is not
sufficient to constitute consummated rape.
Absent any showing of the slightest penetration
of the female organ, i.e., touching of either labia
of the pudendum by the penis, there can be no
consummated rape; at most, it can only be
attempted rape, if not acts of lasciviousness. In
the given case, the possibility of Primo's penis
having breached the child's vagina is belied by
the child's own assertion that she resisted
Primo's advances by putting her legs close
together; consequently, she did not feel any
intense pain but just felt "not happy" about what
Primo did to her. Thus, she only shouted
"Ayo'ko, ayo'ko!" not "Aray ko, aray ko!" In
cases
where
penetration
was
not
fully
established, the Court had anchored its
conclusion
that
rape
nevertheless
was
consummated on the victim's testimony that she
felt pain, or the medico-legal finding of
discoloration in the inner lips of the vagina, or
the labia minora was already gaping with
redness, or the hymenal tags were no longer
visible. None was shown in this case. Although a
child's testimony must be received with due
consideration on account of her tender age, the
Court endeavors at the same time to harness
only what in her story appears to be true,
acutely aware of the equally guaranteed rights
of the accused. Thus, the Supreme Court ruled
that even on the basis of the testimony of the
child alone the accused cannot be held liable for
consummated rape; worse, be sentenced to
death.
[Note: * In cases of rape where there is a
positive testimony and a medical certificate,
both should in all respects complement each
other; otherwise, to rely on the testimonial
evidence alone, in utter disregard of the
manifest variance in the medical certificate,
would be productive of unwarranted or even
mischievous results. It is necessary to carefully
ascertain whether the penis of the accused in
reality entered the labial threshold of the female
organ to accurately conclude that rape was
consummated. Failing in this, the thin line that
separates attempted rape from consummated
rape will significantly disappear. Under Art. 6, in
relation to Art. 335, of the Revised Penal Code,
rape
is
attempted
when
the
offender
commences the commission of rape directly by
overt acts, and does not perform all the acts of
execution which should produce the crime of
rape by reason of some cause or accident other
than his own spontaneous desistance.]

People of the Philippines v. Llanita

G.R. No. 134101 September 5, 2001
Facts: On automatic review is the decision of
the Regional Trial Court finding Felino Llanita
(accused) guilty beyond reasonable doubt of the
crime of qualified rape. The victim, Catherine,
testified that she was raped by the accused
inside the latters house in the presence of her
playmates, the children of the accused, at noon
of March 25, 1996. The accused denied the
allegations.
Issue: Whether or not the accused is guilty of
the crime of qualified rape.
Ruling: The accused-appellant's claim that
CATHERINE's testimony is contradicted by the
findings of the medical report as testified to by
Dr. Armie Soreta-Umil, who stated that she did
not find any fresh lacerations when she
examined CATHERINE the day following the
commission of the alleged rape is unconvincing.
Absence of hymenal lacerations does not
disprove sexual abuse especially when the victim
is of tender age. To prove rape, it is sufficient to
establish that the penis touched the labia of the
pudendum of the victim. In the present case,
CATHERINE's testimony, where she stated that
the accused-appellant inserted his penis into her
vagina, is uncontroverted. Dr. Armie Soreta-Umil
herself confirmed that there was possibility of
penetration of the tip of the male organ into the
vagina despite CATHERINE's tender age.
Moreover, the medical report in fact corroborates
CATHERINE's testimony to the effect that she
was previously raped on two occasions by
accused-appellant since the medical report
reveals that there were "old healed complete
hymenal lacerations present" on CATHERINE.
Thus, the Supreme Court affirmed the decision
of the Regional Trial Court.
People of the Philippines v. Genosa
G.R. No. 135981 January 15, 2004
Facts: On or about the 15th day of November
1995, at Barangay Bilwang, Municipality of
Isabel, province of Leyte, accused Marivic
Genosa, with intent to kill, with treachery and
evident premeditation, did then and there
willfully, unlawfully and feloniously attack,
assault, hit and wound BEN GENOSA, her
legitimate husband, with the use of a hard
deadly weapon, which the accused had provided
herself for the purpose, inflicting several wounds
which caused his death.
The lower court found the accused,
Marivic Genosa y Isidro, GUILTY beyond
reasonable doubt of the crime of parricide and
sentenced the accused with the penalty of
DEATH.
On appeal, the appellant alleged that
despite the evidence on record of repeated and
severe beatings she had suffered at the hands of

her
her
the
her

husband, the lower court failed to appreciate

self-defense theory. She claimed that under
surrounding circumstances, her act of killing
husband was equivalent to self-defense.

Issue: Whether or not the battered woman

syndrome as a viable plea within the concept of
self-defense is applicable in this case.
Ruling: No. The court, however, is not
discounting the possibility of self-defense arising
from the battered woman syndrome. The Court
sums up the main points. First, each of the
phases of the cycle of violence must be proven
to have characterized at least two battering
episodes between the appellant and her intimate
partner. Second, the final acute battering
episode preceding the killing of the batterer
must have produced in the battered persons
mind an actual fear of an imminent harm, from
her batterer and an honest belief that she
needed to use force in order to save her life.
Third, at the time of the killing, the batterer
must have posed probablenot necessarily
immediate and actualgrave harm to the
accused, based on the history of violence
perpetrated by the former against the latter.
Taken altogether, these circumstances could
satisfy the requisites of self-defense. Under the
existing facts of the present case, however, not
all of these elements were duly established.
Appellant is not completely exonerated because
there was no unlawful aggression --- no
immediate and unexpected attack on her by her
batterer-husband at the time she shot him.
However, the severe beatings repeatedly
inflicted on appellant constituted a form of
cumulative provocation that broke down her
psychological resistance and self-control. This
"psychological paralysis" she suffered diminished
her will power, thereby entitling her to the
mitigating factor under paragraphs 9 and 10 of
Article 13 of the Revised Penal Code. In addition,
appellant should also be credited with the
extenuating circumstance of having acted upon
an impulse so powerful as to have naturally
produced passion and obfuscation. The acute
battering she suffered that fatal night in the
hands of her batterer-spouse, in spite of the fact
that she was eight months pregnant with their
child, overwhelmed her and put her in the
aforesaid emotional and mental state, which
overcame her reason and impelled her to
vindicate her life and her unborn child's.
Considering the presence of these two
mitigating circumstances arising from BWS, as
well as the benefits of the Indeterminate
Sentence Law, she may now apply for and be
released from custody on parole, because she
has already served the minimum period of her
penalty while under detention during the
pendency of this case.
[Note: *A battered woman has been defined
as a woman "who is repeatedly subjected to any

forceful physical or psychological behavior by a

man in order to coerce her to do something he
wants her to do without concern for her rights.
Battered women include wives or women in any
form of intimate relationship with men.
Furthermore, in order to be classified as a
battered woman, the couple must go through
the battering cycle at least twice. Any woman
may find herself in an abusive relationship with
a man once. If it occurs a second time, and she
remains in the situation, she is defined as a
battered woman."
Battered
women
exhibit
common
personality traits, such as low self-esteem,
traditional beliefs about the home, the family
and the female sex role; emotional dependence
upon the dominant male; the tendency to accept
responsibility for the batterer's actions; and
false hopes that the relationship will improve.
More graphically, the battered woman syndrome
is characterized by the so-called "cycle of
violence," which has three phases: (1) the
tension-building phase; (2) the acute battering
incident; and (3) the tranquil, loving (or, at
least, nonviolent) phase.
During the tension-building phase,
minor battering occurs -- it could be verbal or
slight physical abuse or another form of hostile
behavior. The woman usually tries to pacify the
batterer through a show of kind, nurturing
behavior; or by simply staying out of his way.
What actually happens is that she allows herself
to be abused in ways that, to her, are
comparatively minor. All she wants is to prevent
the escalation of the violence exhibited by the
batterer. This wish, however, proves to be
double-edged, because her "placatory" and
passive behavior legitimizes his belief that he
has the right to abuse her in the first place.
However, the techniques adopted by the woman
in her effort to placate him are not usually
successful, and the verbal and/or physical abuse
worsens. Each partner senses the imminent loss
of control and the growing tension and despair.
Exhausted from the persistent stress, the
battered woman soon withdraws emotionally.
But the more she becomes emotionally
unavailable, the more the batterer becomes
angry, oppressive and abusive. Often, at some
unpredictable point, the violence "spirals out of
control" and leads to an acute battering incident.
The acute battering incident is said
to be characterized by brutality, destructiveness
and, sometimes, death. The battered woman
deems this incident as unpredictable, yet also
inevitable. During this phase, she has no
control; only the batterer may put an end to the
violence. Its nature can be as unpredictable as
the time of its explosion, and so are his reasons
for ending it. The battered woman usually
realizes that she cannot reason with him, and
that resistance would only exacerbate her
condition.
At this stage, she has a sense of
detachment from the attack and the terrible
pain, although she may later clearly remember

every detail. Her apparent passivity in the face

of acute violence may be rationalized thus: the
batterer is almost always much stronger
physically, and she knows from her past painful
experience that it is futile to fight back. Acute
battering incidents are often very savage and
out of control, such that innocent bystanders or
intervenors are likely to get hurt.
The final phase of the cycle of violence
begins when the acute battering incident ends.
During this tranquil period, the couple
experience profound relief. On the one hand, the
batterer may show a tender and nurturing
behavior towards his partner. He knows that he
has been viciously cruel and tries to make up for
it, begging for her forgiveness and promising
never to beat her again. On the other hand, the
battered woman also tries to convince herself
that the battery will never happen again; that
her partner will change for the better; and that
this "good, gentle and caring man" is the real
person whom she loves.
A battered woman usually believes that
she is the sole anchor of the emotional stability
of the batterer. Sensing his isolation and despair,
she feels responsible for his well-being. The
truth, though, is that the chances of his
reforming, or seeking or receiving professional
help, are very slim, especially if she remains
with him. Generally, only after she leaves him
does he seek professional help as a way of
getting her back. Yet, it is in this phase of
remorseful reconciliation that she is most
thoroughly tormented psychologically.
The
illusion
of
absolute
interdependency is well-entrenched in a battered
woman's psyche. In this phase, she and her
batterer are indeed emotionally dependent on
each other -- she for his nurturant behavior, he
for her forgiveness. Underneath this miserable
cycle of "tension, violence and forgiveness,"
each partner may believe that it is better to die
than to be separated. Neither one may really
feel independent, capable of functioning without
the other.]