1. Reyes vs Sisters of Mercy
Marlyn Rico hastily and
Hospital
Facts:
§ Jorge Reyes has been suffering
from recurring fever with chills for
around days.
§ Home medication afforded him no
relief so he went to Mercy
Community Clinic. He was then
attended by Dr. Marlyn Rico.
§ Since typhoid fever was common
at that time, the Widal test was
performed and he was found
positive for typhoid.
§ Thereafter, Dr. Marlyn Rico indorse
Jorge Reyes to Dr. Marvie Blanes.
§ Suspecting that that Jorge had
typhoid fever, Dr. Marvie Blanes
ordered that Jorge be tested for
compatibility with chloromycetin,
an antibiotic. Such test was
conducted by Nurse Pagente.
§ As there was no adverse reaction,
Dr. Blanes administered 500 mg of
the antibiotic. Another dose was
given 3 hours later.
§ Subsequently, Jorge Reyes
developed high fever and
experienced vomiting and
convulsions. He then turned blue
due to deficiency in oxygen –
cyanosis – and died. The cause of
death was stated to be “ventricular
arrhythmia secondary to
hyperpyrexia and typhoid fever.”
§ The heirs of Reyes filed with the
RTC a complaint for damages
against Sisters of Mercy, Sister
Rose Palacio, Dr. Blanes, Dr. Rico
and Mercy Community Clinic
contending that the death of Jorge
was due to the wrongful
administration of chloromycetin.
(NOTE: Petitioner’s action is for
medical malpractice.)
§ RTC ruled in favor of the
respondents. The CA affirmed in
toto the RTC decision. Hence, this
appeal.
§ Petitioners contend that:
§ Dr.
erroneously relied upon the
Widal test, diagnosed Jorge’s
illness as typhoid fever, and
immediately prescribed the
administration of the antibiotic
chloromycetin
§ Dr. Marvie Blanes erred in
ordering the administration of
the second dose of 500
milligrams of chloromycetin
barely 3 hours after the first
was given.
§ Testimony presented: That of Dr.
Apolinar Vacalares, (Chief
Pathologist of the Northern
Mindanao Training Hospital) who
performed an autopsy on the body
– Dr. Vacalares testified that
Reyes did not die of typhoid fever
but of shock undetermined, which
could be due to allergic reaction or
chloromycetin overdose.
§
Issue: WON there was medical
malpractice. NO
Held:
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Word did not find any entries for your
table of contents.Dr. Apolinar
Vacalares is not a specialist of
typhoid fever and he is thus not
qualified to prove that Dr. Marlyn
Rico erred in her diagnosis.
While petitioners presented Dr. Apolinar
Vacalares as an expert witness, we do
not find him to be so as he is not a
specialist on infectious diseases like
typhoid fever. Furthermore, although he
may have had extensive experience in
performing autopsies, he admitted that
he had yet to do one on the body of a
typhoid victim at the time he conducted
the postmortem on Jorge Reyes. It is
also plain from his testimony that he has
treated only about three cases of
typhoid fever.
The two doctors presented by
respondents clearly were experts on
the subject
They vouched for the correctness of Dr.
Marlyn Rico’s diagnosis. Dr. Peter
Gotiong, a diplomate whose
specialization is infectious diseases and
microbiology and an associate professor
at the Southwestern University College
of Medicine and the Gullas College of
Medicine, testified that he has already
treated over a thousand cases of
typhoid fever.
According to him, when a case of
typhoid fever is suspected, the Widal
test is normally used, and if the 1:320
results of the Widal test on Jorge Reyes
had been presented to him along with
the patient’s history, his impression
would also be that the patient was
suffering from typhoid fever. As to the
treatment of the disease, he stated that
chloromycetin was the drug of choice.
He also explained that despite the
measures taken by respondent doctors
and the intravenous administration of
two doses of chloromycetin,
complications of the disease could not
be discounted.
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Respondents also presented the
testimony of Dr. Ibarra T. Panopio who
is a member of the Philippine and
American Board of Pathology, an
examiner of the Philippine Board of
Pathology, and chief pathologist at the
MetroCebu Community Hospital,
Perpetual Succor Hospital, and the
Andres Soriano Jr. Memorial Medical
Center.
He stated that, as a clinical pathologist,
he recognized that the Widal test is used
for typhoid patients, although he did not
encourage its use because a single test
would only give a presumption
necessitating that the test be repeated,
becoming more conclusive at the
second and third weeks of the disease.
He corroborated Dr. Gotiong’s testimony
that the danger with typhoid fever is
really the possible complications which
could develop like perforation,
hemorrhage, as well as liver and
cerebral complications.
Dr. Rico was not negligent in
administering the 2 doses of 500 g of
chloromycetin
The chloromycetin was likewise a proper
prescription is best established by
medical authority. Even if the deceased
suffered from an anaphylactic shock,
this, of itself, would not yet establish the
negligence of the appellee-physicians
for all that the law requires of them is
that they perform the standard tests and
perform standard procedures. The law
cannot require them to predict every
possible reaction to all drugs
administered.
The practice of medicine requires the
highest degree of diligence
The practice of medicine is a profession
engaged in only by qualified individuals.
It is a right earned through years of
education, training, and by first obtaining
a license from the state through
professional board examinations. Such

license may, at any time and for cause,
be revoked by the government. In
addition to state regulation, the conduct
of doctors is also strictly governed by
the Hippocratic Oath, an ancient code of
discipline and ethical rules which
doctors have imposed upon themselves
in recognition and acceptance of their
great responsibility to society. Given
these safeguards, there is no need to
expressly require of doctors the
observance of “extraordinary” diligence.
As it is now, the practice of medicine is
already conditioned upon the highest
degree of diligence. And, as we have
already noted, the standard
contemplated for doctors is simply the
reasonable average merit among
ordinarily good physicians. That is
reasonable diligence for doctors or, as
the Court of Appeals called it, the
reasonable “skill and competence . . .
that a physician in the same or similar
locality . . . should apply.”
There are thus four elements
involved in medical negligence
cases, namely: duty, breach, injury,
and proximate causation
Petitioner’s action is for medical
malpractice. This is a particular form of
negligence which consists in the failure
of a physician or surgeon to apply to his
practice of medicine that degree of care
and skill which is ordinarily employed by
the profession generally, under similar
conditions, and in like surrounding
circumstances.
In order to successfully pursue such a
claim, a patient must prove that the
physician or surgeon either failed to do
something which a reasonably prudent
physician or surgeon would have done,
or that he or she did something that a
reasonably prudent physician or
surgeon would not have done, and that
the failure or action caused injury to the
patient.
The doctrine of Res Ipsa Loquitor is
not applicable in this case.
Was there a physician-patient
relationship between the respondent
doctors and Jorge Reyes? Yes.
Respondents were thus duty-bound to
use at least the same level of care that
any reasonably competent doctor would
use to treat a condition under the same
circumstances. It is breach of this duty
which constitutes actionable
malpractice.
As to this aspect of medical malpractice,
the determination of the reasonable
level of care and the breach thereof,
expert testimony is essential. Inasmuch
as the causes of the injuries involved in
malpractice actions are determinable
only in the light of scientific knowledge, it
has been recognized that expert
testimony is usually necessary to
support the conclusion as to causation.
The doctrine of res ipsa loquitor is
not applicable in the case at bar
Though expert testimony is usually
needed to prove malpractice, where
common knowledge and experience
teach that the injury would not have
occurred if due care had been
exercised, the doctrine of res ipsa
loquitur can be invoked to establish
negligence.
Hence, in cases where the res ipsa
loquitur is applicable, the court is
permitted to find a physician negligent
upon proper proof of injury to the
patient, without the aid of expert
testimony, where the court from its fund
of common knowledge can determine
the proper standard of care. Where
common knowledge and experience
teach that a resulting injury would not
have occurred to the patient if due care
had been exercised, an inference of
negligence may be drawn giving rise to
an application of the doctrine of res ipsa
loquitur without medical evidence, which
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is ordinarily required to show not only factor that
what occurred but how and why it contributes to
occurred. insanity. A
good history
When the doctrine is appropriate, all that
will reveal the
the patient must do is prove a nexus
between the particular act or omission
ascendants
complained of and the injury sustained afflicted with
while under the custody and insanity.
management of the defendant without • Incestuous
need to produce expert medical Marriage –
testimony to establish the standard of The mental
care. illness is
accentuated
There is nothing unusual about the when they are
death of Jorge Reyes (absence of 1st blood relatives.
requisite that the accident was of a
kind which does not ordinarily occur
• Impaired
unless someone is negligent) Vitality –
In this case, while it is true that the Stress,
patient died just a few hours after tension, worry,
professional medical assistance was grief etc. may
rendered, there is really nothing unusual predispose
or extraordinary about his death. insanity
• Poor Moral
Prior to his admission, the patient training and
already had recurring fevers and chills
breeding –
for five days unrelieved by the
analgesic, antipyretic, and antibiotics
Corrupt moral
given him by his wife. This shows that upbringing in
he had been suffering from a serious the family due
illness and professional medical help to immorality
came too late for him. of the parents
• Psychic
It must be conceded that the doctrine of Factors –
res ipsa loquitur can have no application Factors like
in a suit against a physician or a love, hate,
surgeon which involves the merits of a rage, anger,
diagnosis or of a scientific treatment.
The physician or surgeon is not required
passion,
at his peril to explain why any particular disappointmen
diagnosis was not correct, or why any ts, and
particular scientific treatment did not frustrations
produce the desired result. can hasten a
prone person
to insanity.
2. 5 Factors that contribute to • Physical
Mental Disorders (HI2MP2) factors:
• Heredity –The 1. Non-toxic
most frequent factors –

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4. The
3. Factors that court shall Reliability
consider of Probative Value of the
of DNA testing
• In assessing result
the probative 4. 3 field sobriety test and
value of DNA describe
evidence • Field sobriety tests
presented, shall be done to initially
the court assess and determine
shall consider Alcohol or drug
the following: intoxication. (EWO)
(CTAR) 1. The Eye
1. Chain of Test-
custody refers to
2. The DNA horizontal
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eyes as with both
he or she arms on
gazes the side.
sideways The driver
following is
a moving instructed
object to keep
such as a foot
pen or the raised
tip of a about six
penlight (6) inches
held by off the
the law ground
enforcem for 30
ent seconds.
officer. 5. Describe the 2 main types
2. The of Autopsies (FC)
Walk- • Forensic or
and-turn coroner’s
test- autopsies – seek
requires to find the cause
the driver and manner of
to walk death and to
heel to identify the
toe along decedent
a straight • Clinical or
line for Academic
nine (9) autopsies – are
steps, performed for
turn at the research
end and purposes. They
return to aim to
the point determine,
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any diagnoses that
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3. The One unknown or
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test – the patient’s
requires death.
the driver 6. Give 4 Helpful hints to
to stand safeguard chain of custody
on either (L-CEO)
right or 1. Limit the
left leg number of

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individual levels of stimulation

s and as a
handling consequence, these
evidence. individuals have to
2. Confirm seek out the proper
that all stimulation to
names, increase their
identificati arousal. Under this
on theory, the proper
numbers, stimulation includes
and dates high-risk activities
are listed associated with
on the antisocial behavior,
chain of which consists of
custody sexual promiscuity,
document substance abuse,
s. and crime.
3. Ensure 8. M’naghten test
that all • The M’naghten
evidence Test is a rule for
packagin criminal insanity.
g is Under this rule,
properly the accused is
sealed not guilty of the
and crime charged, if
marked at the time of the
prior to alleged criminal
submissio act, the accused
n was so
4. Obtain deranged that
signed or he did not know
otherwise the nature or
secure quality of her
receipts actions, she was
upon so deranged that
transfer of she did not know
evidence. that what she
7. General arousal theory of was doing was
criminality wrong.
• The General 9. Mistake of Facts
arousal theory of • As a general
Criminality states rule, ignorance
that, individuals or mistake, as to
inherit a nervous particular facts,
system that is honest and real,
unresponsive to low will exempt the

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doer from
felonious
responsibility.
Evil intent must
unite with the
unlawful act for
a crime to exist.
10. Mens Rea
• A concept
rooted in
centuries of
American and
English legal
tradition that is
the commission
of a crime
requires both a
wrongful act and
a culpable
mental state.
The mental
State of Mens
Rea, is the
person’s guilty
state of mind
when committing
the act.

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