L IABILITIES  OF   H OSPITALS  

 
 
 
 
 

 
 
 
 
10/03/12  
JURIS  
 
 
 
 
Atty.  John  Dy     09 :   PSYCH   10:30-­‐12:30  
 
 
 

OUTLINE    Classifications:  
I.  Liabilities  of  Hospitals   III.  Review  Questions    Private  Charitable  Hospital  or  Eleemosynary  
II.  Hospital  for  Ancillary  Services   IV.  Answers  to  Questions  
Hospital:  established  for  the  benefit  of  the  public  
  by  private  individuals  or  corporations  and  not  
  conducted  for  pecuniary  gain  (mainly  no  profits)  
 Private  Pay  Hospital:  established  by  private  
I.  LIABILITIES  OF  HOSPITALS  
individuals  or  corporations  for  profit  (main  purpose  
  is  to  gain  profit)  
HOSPITAL    Other  classifications:  
 An  institution  maintained  for  the  reception,  care  and  treatment    Classified  based  on  Size  or  Bed  capacity:  established  by  law  
of  those  in  need  of  medical  and  surgical  attention   to  determine  the  minimum  standard  requirements  for  a  
  hospital  of  25,  50,  100,  or  450  bed  capacity  
CLASSIFICATIONS    Class  of  Hospital  whether  training  or  not  –  utilized  for  
 As  to  Infirmity  Admitted:   medical  or  paramedical  education  
>>  Hospitals  cannot  practice  medicine  for  the  following  reasons:  
 General  Hospital:  admits  all  types  of  patients  with  different  
• The  practice  of  medicine  by  a  hospital  for  profit  through  employment  of  
diseases  and  injury   licensed  physicians  is  not  in  the  interest  of  public  safety,  health  and  
 e.g.,  Philippine  General  Hospital   welfare,  ergo,  contrary  to  public  policy.  
 Government  hospitals  accept  all  people.  They  can’t   • Hospitals  cannot  be  subjected  to  licensure  examinations.  
refuse  people  because  they  are  run  by  government.   • Physicians  are  the  ones  who  decide  on  patient  care,  not  hospitals.  
 Specialized  Hospital:  one  that  admits  specific  illnesses,   Otherwise,  hospitals  will  be  the  ones  giving  orders  to  physicians  on  how  
treatments,  diseases,  organ  affected  or  class  of  people   to  treat  patients  
 e.g.,  Philippine  Heart  Center    
REGULATION  OF  HOSPITALS  
 

Clarification:  There  are  three  kinds  of  specialized  hospitals.  

• One  devoted  to  treatments  of  a  particular  type  of  illness  or  for  a  particular    Regulation  of  Hospitals:    
condition  requiring  range  of  treatment.  (Ex:  Cancer,  orthopaedics)    The  Bureau  of  Health  and  Facilities  Services  (new  name),  
• Patients  suffering  diseases  of  a  particular  organ  or  group  of  organs  (Ex:   which  is  under  the  Department  of  Health  
eye,  chest)    2  Types  of  Hospital  Regulation:  
• Patients  of  a  particular  class  (Ex:  Children,  women,  seamen)  
 
 State  Regulation  
 As  to  Function:    Applicable  to  all  hospitals  and  embodied  in  the  licensure  
 Diagnostic  Hospital   laws;  includes  implementing  rules  and  regulations  
 Devoted  solely  to  the  diagnosis  of  disease,  defomity,    Laws  passed  by  legislatures  to  regulate  and  monitor  
physical  and  mental  condition   hospitals  
 Maternity  Hospital    Self  Regulation  
 Established  for  the  reception  of  child  birth    Applicable  only  within  a  hospital  for  purposes  of  
 Rehabilitation  Hospital   discipline,  order,  convenience,  among  others  
 Make  disabled  people  return  to  their  usual  activities    Passed  by  the  governing  boards  of  the  hospital  
 Surgical  Hospital    Should  not  be  contrary  to  State  Regulation!  
 Hospital  where  operative  procedures  are  employed  as  a    The  mother  of  regulations  is  still  State  Regulation  
mode  of  treatment    
 Cosmetic  Hospital   PRIMARY  DUTIES  OF  HOSPITALS  
 Enhance  beauty    To  furnish  safe  and  well  maintained  buildings  and  grounds  –  
  must  be  spacious,  well-­‐drained  and  free  from  hazards  that  may  
 As  to  Control  and  Financial  Support:   cause  injury  
 Public  or  Government  Hospital    Query:  What  about  UE,  UST  flooding?  
 A  hospital  operated  wholly  or  partially  by  the    To  furnish  adequate  and  safe  equipment  
government    To  exercise  reasonable  care  in  the  selection  of  the  members  of  
 Either  Local  or  National  Government   the  Hospital  staff  
 Private  Hospital    Exercise  care  and  diligence  in  the  selection  of  employees,  
 Privately  owned;  funds  to  establish  the  hospital  were   otherwise  vicariously  liable  
from  donation,  or  private  capital,  or  other  means  by    Liability  of  hospital:  vicarious  or  corporate  
private  individuals,  association,  religious  organizations  or    Vicarious:  primary  liable  for  an  act  that  they  didn’t  
stock  corporations   commit  –  hospital  will  pay  for  what  an  employee  does  
 Privately  funded    Thus,  when  they  choose  employees,  they  have  to  
>>  But  even  a  private  hospital  receives  aid  from  government   exercise  care  and  diligence,  meaning  they  have  to  
or  if  it  is  exempted  from  tax,  it  is  not  suddenly  changed  into   review  the  qualifications  and  make  sure  that  these  
a  public  hospital.   people  are  truly  qualified.  Because,  at  the  end  of  
 Either  Charitable,  Pay  or  Private  Pay  hospital  

Group  #  9   BATAN.  LAWAS.  MANALO.  NAVARRO.  NGO.  PASTRANA.  REMULLA.  TARUC.  VIVO.  
 
Page  1  of  6  
  
 
 

Liabilities  
L ECTURE   ToITLE
f  Hospitals  
  JURIS  

the  day,  whatever  these  people  do,  the  hospital  will    Government  hospitals  are  adjuncts  of  the  State  (clinics  of  
be  liable  (liable  for  acts  they  did  not  commit).   the  State)    State  runs  these  hospitals    Hence,  their  
  primary  purpose  is  to  perform  government  functions  
3  TYPES  OF  PERSONS    Government  Hospitals  established  to  perform  Proprietary  
COMING  WITHIN  THE  PREMISES  OF  A  HOSPITAL   Functions:  
 A  public  hospital  established  for  profit  
 Invitee  
 They  have  already  gone  down  to  the  level  of  a  private  
 Person  who  is  essential  to  the  operation  of  the  Hospital  or  
for  whom  the  hospital  has  a  purpose   corporation,  which  is  why  they  can  be  sued;  otherwise,  
 Hospital  must  be  in  a  safe  condition  for  the  invitee  and  must   if  they  perform  government  functions,  they  cannot  be  
sued.  
warn  the  invitees  of  the  danger  
 Public  hospital  having  a  pay  ward  does  not  mean  it  is  for  
 e.g.,  Patient,  Attending  Physician,  Private  nurse,  Blood  
profit,  when  profits  for  pay  ward  used  to  maintain  charity  
donors,  Voluntee  workers  
 Hospital  is  duty-­‐bound  to  tell  a  patient  about  any   beds  
potential  dangers  (e.g.,  infectious  disease  outbreak)  in    Ask,  “Is  it  operated  for  profit?”  No,  because  the  profits  
they  receive  from  pay  wards  is  used  for  the  
the  hospital;  otherwise,  they  will  be  held  liable.  
maintenance  of  the  charity  ward  –hence,  it  is  not  
 Trespasser  
 Person  who  enters  the  hospital  or  property  of  another   profitable.  
without  being  granted  the  privilege  to  do  so    
 Private  Charitable,  Voluntary  or  Eleemosynary  Hospitals  
>>  Has  no  legal  right  to  enter  hospital  
 Established  through  donations,  not  for  profit,  pays  no  
 Hospital  is  not  obliged  to  give  ample  protection  to  a  
dividends  
trespasser  
 Hospital  is  not  obliged  to  warn  these  people  of  any    Main  purpose  is  not  to  make  profit  but  to  help  others  
danger    Test  to  determine  if  hospital  is  a  charitable  hospital  or  not:  Is  
it  operated  for  profit?  
 Hospital  is  only  required  to  refrain  form  taking  positive  steps  
 A  Hospital  established  for  profit,  even  though  has  charity  
to  harm  the  trespasser  
 In  fact,  hospital  can  get  that  person  out  when  he/she   wards,  is  not  a  charitable  hospital  
becomes  violent  and  causes  harm  in  a  hospital    On  the  other  hand,  if  they  have  a  pay  ward  and  what  they  
get  from  this  is  used  to  maintain  the  charity  ward,  it  is  
 e.g.,  Robber  
considered  a  charitable  hospital  
 Licensee  
 Liabilities  of  Charitable  Hosptials  
 One  who  is  neither  a  customer  nor  a  servant  nor  a  
trespasser    Before:  Absolute  immunity  from  suit  
 He  has  no  contractual  relation  with  the  hospital    Now:  Some  Courts  allow  damages  to  be  collected  for  
 Injuries  suffered  by  strangers  
 His  presence  is  merely  tolerated  
 Corporate  negligence  
 He  is  permitted,  expressly,  or  impliedly,  to  be  within  the  
hospital  for  his  own  interest  and  convenience    When  there  is  insurance  coverage  
 Hospital  has  no  duty  of  active  vigilance    Injury  sustained  by  pay  ward  patient  
Doctrines  applied  to  private  charitable  hospitals  
 e.g.,  Visitor  
 Trust  Fund  Doctrine  
   Diverting  of  trust  funds  to  pay  for  damages  is  against  the  intentions  
LIABILITIES  OF  HOSPITALS   of  the  donor  
FOR  THE  WRONGFUL  ACTS      Implied  Waiver  Theory  
 Patients  waive  their  right  to  claim  damages,  knowing  that  the  
OF  THEIR  AGENTS  OR  EMPLOYEES  
hospital  is  supported  merely  by  humanitarian  and  benevolent  
 Government  or  Public  Hospitals   contributions  
 General  Rule:  State  is  immune  from  suit.  (Government    Public  Policy  theory  
hospital  established  to  perform  government  functions  is    Such  hospitals  have  a  quasi-­‐public  function  (since  it  is  a  charity  
immune  from  suit  for  damages  because  of  the  negligence  of   hospital)  ergo  it  must  be  immune  just  like  a  public  hospital  
its  staff  and  employees)    Independent  Contractor  Theory  
 Exceptions:    Contract  of  patient  is  with  the  doctor,  not  the  hospital  
 State  consents  to  be  sued    
 Government  Hospital  is  established  for  a  proprietary    Private  Hospital  Operating  for  Profit  (Private  Pay  Hospital)  
function  (can  be  sued  for  damages)    Vicariously  liable  for  the  negligent  act  of  its  employees  
 Government  Hospitals  established  to  perform  Government    They  are  liabile  for  their  employees  and  the  non-­‐
Functions:   maintenance  of  their  facilities,  which  may  cause  harm  to  
 Preserve  life  and  maintain  the  health  of  people   their  invitees  and  licensees  
 Public  health,  treatment  of  the  indigent,  etc    What  is  used  to  determine  whether  or  not  the  hospital  is  
 If  public  hospital  is  established  for  such  duties  by  the   vicariously  liable?  
government,  then  it  is  immune  from  suit  except  when  it    Control  over  the  Employee  (Employer-­‐Employee  
consents  to  be  sued   Relationship)  
 Vicarious  liability  of  Hospital    Hospital  Employer-­‐
Employee  relationship    Defense  of  Hospital  is  usually  

 
Group  #  9   BATAN.  LAWAS.  MANALO.  NAVARRO.  NGO.  PASTRANA.  REMULLA.  TARUC.  VIVO.   Page  2  of  6  
  
 
 

Liabilities  
L ECTURE   ToITLE
f  Hospitals  
  JURIS  

that  the  person  who  caused  the  negligence  is  an    Vicarious  Liability  for  the  Acts  of  Hospital  Employees  
“Independent  Contractor”    See  if  this  person  is  an    Nursing  Staff  
employee  of  the  hospital    Student  Nurse  
 If  hospital  has  control,  then  it  is  liable.      Not  an  employee  
 IF  the  physician  has  control  of  the  hospital  employee,    Professional  Nurse  
then  following  the  “Borrowed  servant”  doctrine,  the    Employee  –  someone  who  mans  the  nursing  station  
physician  is  liable    Special  nurse  
 e.g.,  A  surgeon  uses  an  employee  of  the  hospital—  Independent  contractor  –  contracts  with  the  patient  
that  surgeon  can  be  made  liable  for  the  negligence   to  perform  her  service  
of  that  employee  based  on  the  Borrowed  servant    Medical  Staff  
doctrine    Interns  
 If  both  physician  and  hospital  have  concurrent  control,    Not  an  employee  
then  jointly  liable    Resident  Physician  
   Employee  
CONTRACT  OF  SERVICES      Hospital  is  vicariously  liable  
VS.      “Borrowed  Servant”  applies  when  under  the  
CONTRACT  FOR  SERVICE   control  of  another  physician  
 Consultants  
 Contract  of  Service:  
 Independent  contractor  
 Physician  signs  a  contract  with  the  hospital  to  render  
 Liable  for  his  own  acts  
professional  services  (Employer-­‐Employee  relationship)  
 Attending  physician  may  be  held  jointly  liable  with  
 Hospital  is  vicariously  liable  for  physician’s  negligent  act,  
the  consultant,  if  he  participated  with  the  
provided  that  the  negligent  act  is  within  the  scope  of  his  
consultant  in  making  the  diagnosis  and  treatment  
employment  
of  the  patient  
 e.g.,  If  a  physician  (like  an  opthalmologist)  is  employed  to    

perform  a  specific  surgery  (such  as  an  eye  surgery,  that   ADMISSIONS  IN  HOSPITALS  
being  his  specialty),  he  should  only  perform  that;  if  he    Admission  in  Hospitals  
performs  an  abdominal  surgery  and  is  negligent,  he  will    Every  hospital  must  have  an  admission  section  
be  held  liable  because  the  scope  of  the  employment    Place  in  the  hospital  that  determines  who  are  eligible,  
contract  is  only  an  eye  surgery.   number  of  patients  to  be  admitted  
 Defense  (of  the  Hospital):  Exercise  the  Care  and  Diligence  in    Policies  on  Admission  are  determined  by  the  governing  
the  selection  of  their  Employee   board  of  the  hospital  
 Or  if  it’s  a  physician,  the  “Independent  Contractor”    E.g.,  Bed  capacity,  Availability  of  medical  equipment,  
defense   Availability  of  specialists  
    Private  Hospitals  
 Contract  for  Services:    More  power  to  choose  whom  to  admit  but  admission  poicy  
 Refers  to  Contract  for  Services  entered  by  the  physician  or   must  not  be  oppressive,  discriminatory,  illegal  and  against  
nurse  with  the  patient   public  policy  
 The  hospital  is  not  involved  –  it’s  actually  the  invitee  and    More  leeway  in  their  admission  policies  but  these  should  
rd
a  3  party  going  into  the  contract   not  go  against  public  policy  
 Physician  and  Nurse  considered  independent  contractors    Government  or  Public  Hospitals  
 They  are  liable  for  their  own  negligent  acts    No  privilege  or  choice  of  patients  
 Hospital  not  vicariously  liable    Established  and  maintained  from  public  funds  
 These  people  are  liable  for  their  own  acts  and  the  hospital    Hospitals  affiliated  with  Medical  schools  
is  not  vicariously  liable    May  have  special  beds  for  indigents  and  may  vary  the  cases  
  to  be  admitted  for  purposes  of  instruction  
LIABILITIES    Patients  who  seek  admission  in  these  special  beds  
 Corporate  Liabilities   impliedly  waive  their  rights  to  privacy  of  confidential  
information  
 Liabilities  arising  from  the  failure  of  the  hospital  to  furnish  
 They  can  implement  special  policies  based  on  special  beds  
accomodations  and  facilities  necessary  to  carry  out  its  
for  study  purposes  –  data  gathered  from  patients  who  
purpose  
 Arise  from:     take  these  special  beds  may  be  used  by  students  in  these  
 Failure  to  furnish  safe  and  well  maintained  buildings  and   training  hospitals;  however,  these  hospitals  may  still  ask  
for  a  waiver  from  patients  just  so  they  are  protected  
grounds  
Justifiable  Grounds  for  refusal  of  admission:  
 Failure  to  furnish  safe  and  reliable  equipment  
• Accommodations  are  filled  
 Failure  to  make  a  careful  selection,  review  and   • Patient  is  chronically  ill  
supervision  of  independent  physicians  who  are  permitted   • Patient  only  needs  convalescent  care  
to  practice  in  the  hospital   • No  available  accommodation  for  the  clinical  service  that  patient  is  
suffering  
• Patient’s  disease  is  contagious:  dangerous  to  others  

 
Group  #  9   BATAN.  LAWAS.  MANALO.  NAVARRO.  NGO.  PASTRANA.  REMULLA.  TARUC.  VIVO.   Page  3  of  6  
  
 
 

Liabilities  
L ECTURE   ToITLE
f  Hospitals  
  JURIS  

   

ATTENDANCE  TO  EMERGENCY  CASES   REFUSAL  

 Attendance  to  Emergency  Cases  in  Hospitals  (RA  6615)    Refusal  of  Patient  to  be  Hospitalized  
 Law  requiring  government  and  the  private  hospitals  or    A  patient,  of  legal  age  and  of  sound  mind,  may  not  be  
clinics  duly  licensed  to  render  immediate  emergency   detained  by  the  hospital  if  he  refuses  to  remian  
medical  assistance  and  medicines  within  its  capabilities  to    Attending  physician  must  appraise  him  of  the  untoward  
patients  in  emergency  cases  who  are  in  danger  of  dying   consequences  of  refusing  to  be  hospitalized  
and/or  may  have  suffered  serious  physical  injuries    Explain  to  patient  the  consequences  of  refusal  
 Basically,  hospitals  should  not  refuse  an  emergency    If  the  patient  still  refuses,  there  is  nothing  that  can  be  done  
patient  –  the  emergency  patient  should  be  given  the    
health  services  and  treatment  he  needs    Refusal  to  Remain  in  the  hospital  
 Once  the  emergency  patient  goes  in  the  ER  and  one  of  the    Notation  in  the  clinical  record  “went  home  against  advice”  
attending  physicians  of  the  hospital  attends  to  him,    Note  that  the  patient  went  against  your  will  as  his/her  
immediately,  theres  a  physician-­‐patient  relationship   physician  
 Transfer  of  patient  in  Emergency  cases    Attending  Physician  should  make  him  sign  a  Release  Form  to  
 Transfer  of  patient  from  1  hospital  to  another  can  be  done   protect  the  hospital  from  liability  in  case  of  injury  or  death  
only  if  the  condition  of  the  emergency  ceases  to  be  a  threat    Once  the  patient  signs  the  Release  Form,  any  liability  the  
to  the  life  of  the  patient   patient  has  is  extinguished  
 Transfer  can  only  be  done  if  patient’s  condition  is    If  the  patient  refuses  to  sign  the  Release  Form,  the  Release  
stabilized   Form  should  be  presented  to  the  patient  in  the  presence  of  
 Transfer  itself  should  not  impair  the  life  and  health  of  the   at  least  2  competent  witnesses  
patient    The  law  allows  you  to  have  2  witnesses  to  accompany  you  
 Transfer  must  be  premised  on  the  desire  and  consent  of  the   present  the  Release  Form  to  the  patient  
patient    Witnesses  should  note  that  the  patient  “Refused  to  Sign”  on  
 Once  consent  is  obtained,  patient  can  be  transferred;  if   the  Release  Form.    
patient’s  condition  is  stable  and  he  doesn’t  give  his    The  2  witnesses  should  sign  the  Release  Form  together  
consent,  he  cannot  be  transferred   with  the  physician  or  nurse  who  presented  the  form  to  
 At  time  the  patient  is  admitted  to  the  hospital,  there  is  a   the  patient  
contractual  obligation  that  arises.  The  hospital  has  to  let  the    
patient  avail  of  its  services  until  such  time  when  the  service    Refusal  of  Patient  to  Leave  Hospital  
is  no  longer  necessary    Patient  may  do  so  in  a  private  hospital  but  he  has  to  pay  the  
 In  a  transfer,  2  hospitals  are  involved  –  once  the  patient  is   bills  
cleared  and  leaves  the  original  hospital,  the  patient    He  can  stay  but  have  to  pay  the  bills  
becomes  the  responsibility  of  the  other  hospital    This  might  create  a  problem  with  hospital  space  
   What  to  Do?  
DISCHARGE  OF  PATIENTS    Patients  with  known  address  may  be  sent  home  through  
 The  attending  physician,  after  evaluation,  determines  that   the  Social  Services  Department  of  the  Hospital  
further  hospitalization  is  no  longer  needed,  may  discharge  the    If  the  patient  is  a  newborn  child,  hospital  has  to  contact  
patient  with  or  without  condition   DSWD  for  placement  
 The  Order  of  Discharge  must  always  be  written  into  the  Clinical    Send  to  DSWD  or  for  DSWD  to  take  the  child  and  set  
Records   him/her  up  for  adoption  
 The  Order  of  Discharge  may  simply  state  that  the  patient  “may    
go  home”  or  “advised  to  report  for  check  up  for  1  month”   OTHER  LIABILITIES  
 Has  to  be  documented;  otherwise,  liability  is  possible    Premature  Discharge  
   The  attending  physician  and  the  hospital  may  be  held  liable  
PATIENT’S  CLINICAL  RECORDS   to  the  patient  if  the  patient  is  discharged  from  the  hospital  
 What  is  a  Patient’s  Clinical  Record?   in  spite  of  the  fact  that  further  hospital  in  spite  of  the  fact  
 It  is  the  source  of  all  information  regarding  confinement  and   that  further  hospitalization  is  necessary  
treatment  in  a  hospital  or  management  in  a  clinic    
 Includes  Patient’s  name,  history,  treatment,  billing  history    Detention  of  Patient  for  Non-­‐Payment  of  Bill  
–  anything  that  relates  to  patient  as  he  was  being  treated    A  patient  can  not  be  detained  upon  non-­‐payment  of  hospital  
 Patient’s  records  is  admissible  in  court  as  evidence.  This  is   bills  
true  even  if  the  person  who  made  the  entry  is  dead  or  not    There  is  a  new  law  that  states  that  patients  cannot  be  
available.   detained  for  non-­‐payment  and  instead,  issue  a  
 Why?  The  records  are  the  ordinary  entries  in  the  course   promissory  note    for  the  hospital  
of  business    Remedy:  
  The  hospital  should  sue  for  the  collection  of  the  amount  
owed  to  them  

 
Group  #  9   BATAN.  LAWAS.  MANALO.  NAVARRO.  NGO.  PASTRANA.  REMULLA.  TARUC.  VIVO.   Page  4  of  6  
  
 
 

Liabilities  
L ECTURE   ToITLE
f  Hospitals  
  JURIS  

 The  hospital  should  ask  for  the  issuance  of  promissory    Note:  
note    Emergency  Room  must  keep  a  record  of  patients  
 Nevertheless,  the  hospital  will  have  to  take  legal    Prior  approval  of  the  attending  physician  must  be  sought  
action  against  the  patient  and  ask  him  to  pay  for  his   before  the  police  can  interrogate  the  patient  
debt    e.g.,  If  the  patient  who  enters  the  ER  has  a  gunshot  
 If  hospital  detains  a  patient  for  non-­‐payment  of  bills,  then   wound,  you  immediately  think  it’s  a  medico-­‐legal  case.  
petition  for  habeas  corpus  (a  writ  asking  that  the  person  be   You’ll  have  to  inform  the  administration  and  the  
presented  to  the  presence  of  the  court)  may  be  filed   administration  will  alert  the  police;  It  is  the  duty  of  the  
 If  a  hospital  detains  a  patient,  the  hospital  can  be  liable   hospital  to  inform  the  police  –  however,  when  the  police  
 Is  there  any  instance  when  the  hospital  detain  a  patient?     arrives,  the  control  shifts  to  the  Attending  physician.  
Yes.   Whether  or  not  the  patient  will  be  interviewed  by  the  
 Patient  is  detained  or  convicted  prisoner   police  depends  on  the  physician,  who  will  decide  if  the  
 Patient  is  suffering  from  a  contagious  disease  and  his   patient’s  condition  is  stable  enough  to  make  an  
release  will  prejudice  public  health   interrogation  possible  
 Patient  is  mentally  ill  and  his  release  will  endanger  public    Press  reporters  should  be  directed  ot  the  press  officer  of  the  
safety   hospital  
   The  primary  concern  is  the  welfare  and  safety  of  the  
 Liability  for  Hospital  Infection   patient  
 May  a  hospital  be  liable  to  a  patient  for  infection  while    As  a  general  rule,  physicians  should  not  give  any  press  
confined  at  the  hospital?   statements  because  later  on,  it  can  be  used  against  him  
 Yes.    In  cases  where  a  suspected  crime  has  been  committed,  the  
 Infection  caused  by  equipment  and  faulty  technique   attending  physician  must  inform  the  authorities  
 Contact  with  infected  person  
 

2.  AMBULANCE  SERVICE  
 Negligence  of  staff  and  personnel  
 Hospital  personnel  as  source  of  infection    Ambulance  Service:  either  operated  by  the  Hospital  or  
  operated  by  an  independent  Contractor  
 Operated  by  the  Hospital  –  Liable  for  acts  of  driver  and  
II.  HOSPITAL  FOR  ANCILLARY  SERVICES   ambulance  personnel  
All  5  ancillary  services  (Emergency  room,  Ambulance  service,    Operated  by  Independent  contractor  –  Liability  falls  under  
Hospital  Pharmacy,  Medical  Records  and  Hospital  Peace  &  Order)   the  independent  contractor  
can  be  contracted  out,  meaning  they  can  get  independent  
 

3.  HOSPITAL  PHARMACY  
contractors  to  run  these  ancillary  services  –  which  is  a  current  
trend.    Hospital  is  liable  for  the  acts  of  the  hospital  pharmacist  
 Hospital  must  exercise  due  care  in  the  selection  of  the  
1.  EMERGENCY  ROOM  
Hospital  Pharmacist  
 The  law  mandates  hospitals  (both  public  and  private)  to  render    Pharmacist  must  be  duly  licensed  by  the  PRC  
immediate  assistance  to  emergency  cases    At  the  very  least  be  licensed  by  PRC  
 Therefore,  hospitals  must  have  an  emergency  room    Hospital  Pharmacy  may  be  contracted  out  
 It  is  their  duty  to  render  assistance  for  emergency  cases    

 Hospital  is  liable  if  it  doesn’t  give  emergency  care   4.  MEDICAL  RECORDS  
 Contracting  out  Emergency  Room  Services  via  Contract    Medical  Record:  
 Liability  is  on  the  independent  contractor  unless  hospital  still    A  compilation  of  pertient  facts  of  the  patient’s  history,  
has  control  over  the  emergency  room  facilities   illness  and  treatment  
 Hence,  hospital  should  let  go  of  any  control  in  the  ER  –  all    A  compilation  of  scientific  data  compiled  into  a  document  
control  should  be  on  the  independent  contractor  –   for  various  uses  to  serve  the  patient,  the  physician  and  the  
otherwise,  hospital  will  be  held  liable   hospital  
 2  aspects  of  Emergency  Care:    Uses:  
 Examination  of  the  patient  to  determine  his  condition  and    Patient’s  history  
need  for  emergency  medical  procedures    Patient’s  continuing  care  
 Performance  of  specific  medical  or  surgical  procedure  which    Record  of  billing  
are  required  without  delay  to  protect  patient’s  health    Proof  of  Careful  or  Negligent  Treatment  in  Court  
   If  there  is  a  case  filed  against  a  physician,  he  can  used  the  
 Malpractice  liability  in  Emergency  Room:   medical  record  as  proof  that  he  exercised  due  care  
 Failure  to  Admit    Destruction  or  Alteration  of  Medical  Records  may  be  used  as  
 Failure  to  Examine  and/or  Treat   proof  of  negligence  
 Negligence  in  the  Application  of  Management  Procedure    It  is  suggested  that  if  you  make  a  correction,  you  draw  a  
In  this  case,  if  the  ER  is  being  run  by  the  hospital,  it  suffers  from   line  and  not  write  over  it  –  so  that,  if  used  in  court,  it  
Corporate  Liability  and  the  Attending  Physician’s  negligence  will   takes  away  suspicion  
make  the  hospital  vicariously  liable.  Hence,  2  are  liable:  the    Hospital  Staff  for  Medical  or  Scientific  Study  and  Research  
Hospital  and  the  Attending  Physician    Note:  Hospital  is  liable  for  inaccurate  or  incomplete  
medical  records  
 
Group  #  9   BATAN.  LAWAS.  MANALO.  NAVARRO.  NGO.  PASTRANA.  REMULLA.  TARUC.  VIVO.   Page  5  of  6  
  
 
 

Liabilities  
L ECTURE   ToITLE
f  Hospitals  
  JURIS  

 Who  owns  Medical  Records?    If  facilities  are  limited  and  retention  of  the  records  is  not  
 The  guardian/custodian  and  owner  of  the  medical  records  of   posssible  after  the  statutory  period,  patient  must  be  
a  patient  is  the  hospital   informed.  Patient  will  decide  on  a  designee  
 However,  ownership  is  limited  –  it  is  primarily  custodial    Microfilm  allowed  in  court  but  advisable  to  keep  medical  
 Custodial:  guardian/keeper    hospital  is  basically   records  for  the  statutory  period  required  
keeping  these  records  since  the  patients  still  have  access    To  avoid  liability  
to  their  own  records    
 This  means  that  others  who  have  interest  on  such  medical    Effect  of  Closure  of  Hospital  or  Physician’s  Death  
records  may  be  given  right  to  access  such  records    Confidentiality  is  maintained  
 Access  should  be  given,  provided  certain  requirements  are    Estate  of  physician  is  liable  for  the  safekeeping  or  transfer  of  
followed   the  records  
 Same  rules  apply  to  medical  records  in  a  physician’s  private    Hospital  needs  the  consent  of  patient  if  medical  records  will  
clinic   be  transferred  to  another  entity  
 Medical  Records  should  always  be  kept  confidential      
(Privilege  Communication)    Violation  can  result  to  Liability   5.  HOSPITAL  SECURITY,  PEACE  AND  ORDER  
 When  may  the  contents  of  the  Record  disclosed?    Hospital  required  to  maintain  a  peaceful  environment  for  the  
 When  requested  by  the  patient  or  by  someone  who  could   patient’s  comfort,  peace  of  mind  and  recovery  
act  in  his  behalf,  which  must  be  made  in  writing  (Medical    Can  be  contracted  out  and  thus,  primary  liability  is  on  
records  can  be  compelled  by  the  Writ  of  Mandamus)   independent  contractor  
 When  the  law  requires  such  disclosure,  upon  issuance  of:    Reasonable  restraint  is  allowed  to  be  applied  to  violent  patients  
 Birth  certificate   or  trespassers  
 Death  certificate    Coercive  restraint  or  actions  may  be  employed  if  reasonable  
 Certificate  of  immunization   and  peaceful  restraint  is  not  effective  
 Info  regarding  communicable  disease   >>  A  peace  officer  or  a  private  person  may  arrest  offenders  without  
 Upon  order  of  the  court   a  warrant  if  the  person  is  about  to  commit,  is  committing  or  has  
 Approval  of  the  attending  physician  is  NOT  necessary   committed  an  offense,  or  if  the  person  to  be  arrested  is  an  escaped  
 What  information  is  not  Privileged  (No  authorization  needed)?   prisoner.  
 Information  can  be  accessed  by  anyone    
 Name  of  Physician  and  those  associated  with  the  treatment  
VI.  REVIEW  QUESTIONS  
 Those  not  ordinarily  related  to  the  treatment  
1. Which  individual  is  tolerated  by  the  hospital?  
 Complete  name  of  the  patient   a. Invitee  
 Address  of  the  patient  at  the  time  of  admission   b. Trespasser  
 Date  of  discharge,  names  of  relatives  and  friends   c. Licensee  
 Number  of  times  and  dates  of  visit  of  physician   d. B  and  C  
rd 2. Which  of  the  following  hospitals  can  definitely  be  sued  for  damages?  
 3  persons  who  can  access  medical  records   a. Private  for  profit  
 Lawyer   b. Private  charitable  
 Hosptial  Staff   c. Public  
d. A  and  B  
 Insurance  companies  –  upon  written  authorization  of  the  
e. All  of  the  above  
patient   3. The  negligent  acts  of  which  hospital  worker  will  make  the  hospital  liable?  
  a. Medical  Intern  
 May  medical  Records  be  Duplicated?  Yes.   b. Student  Nurse  
c. Professional  Nurse  
 Upon  written  authorization  of  patient   d. Consultant  
 Duplicate  must  be  used  only  for  the  purpose  requested   4. When  is  it  allowed  to  refuse  admission  in  a  hospital?  
 As  evidentiary  evidence,  the  court  may  issue  an  order  to   a. Patient  is  acutely  ill  
b. Patient  suffers  from  an  infectious  disease  
produce  medical  records  for  comparison  with  the  duplicate   c. Patient  only  needs  convalescent  care  
 e.g.,  Subpoena  duces  tecum   d. Patient  has  no  money  
  5. What  is  a  writ  of  habeas  corpus?  
 How  long  should  Medical  Records  be  kept?   a. It  is  used  in  cases  of  patients  who  are  detained  for  non-­‐payment  of  bills  
b. It  is  used  when  courts  ask  for  presentation  of  clinical  records  of  a  patient  
 As  long  as  possible  in  the  interest  of  science  and  research   c. It  is  the  justification  for  arresting  offenders  in  hospitals  without  warrants  
 Patient  is  an  Adult  –  6  years  (Statutory  period:  prescriptive   d. None  of  the  above  
limitation)   6. What  is  true  of  medical  records?  
a. They  are  owned  by  hospitals  so  they  can  do  whatever  they  want  with  it  
 Patient  is  an  Incompetent  Adult  or  became  incompetent  
b. They  may  not  be  duplicated  
before  6  year  –  until  patient  recovers  plus  the  remaining   c. Confidentiality  may  be  breached  after  death  of  either  the  physician  or  the  
statutory  time   patient  
 Patient  is  a  minor  –  until  patient  reaches  age  of  majority  (18)   d. Name  of  physician  and  other  health  workers  involved  in  patient’s  case  are  not  
privileged  information.  
plus  the  remaining  statutory  time   e.  
 Note:  
VII.  ANSWERS  TO  REVIEW  QUESTIONS  
1  C     2  A     3  C     4  C     5  A     6  D  
 
 
Group  #  9   BATAN.  LAWAS.  MANALO.  NAVARRO.  NGO.  PASTRANA.  REMULLA.  TARUC.  VIVO.   Page  6  of  6