Medical Act of 1959

RA 2382 as amended by RA 4224 and RA 5946

*Board of Medical Education- CHED na ngayon

*Board of Medical Examiners

PRC Law
PRC- was created in year 1974

Practice of Medicine
Three Acts that characterized practice of medicine
a. Physical examine, diagnose, treat, operate, prescribe (Physicians)
Violation: Illegal Practice of Medicine (1k to 2k)

b. Offer or undertake to do service to an individual

c. Falsely use MD (graduate only of college of medicine)
Violation: Illegal Act

Exception: emergency assistance if no doctor available

Requirements
1. Age- 21 years old

2. Board Exam- twice a year, 75% passing, no grade less than 50%
-Failed 3 times, refresher for one year
-Qualifying Term to pass the board exam- SATISFACTORILY (cheaters never win)

3. Certificate of Registration- PRC License, piece of paper

-best proof to check if he is a physician

Foreign Practice- foreigners are allowed to practice in PH

-reciprocity rule
-substantially the same requirements in the PH
-endorsement policy
-take board exam in PH

Limited Practice
-specific case only (ex. consultation only)
-international agencies
-exchange professors (demonstrate latest technique)
-US Armed forces
-students, graduates, RN (if there is an emergency and no enough doctors ex.
pandemic)
 FEB 18 DISCUSSION (Kuya Erwin Notes)
REGULATION OF PRACTICE OF MEDICINE
BOARD OF MEDICINE
 Exam
 Oath
 Certificate of Registration
 Administrative Investigation – Investigation in relation ot the practice of medical
profession (administratively liable.- reprimand, suspended or revoke license) – it is
exclusive original jurisdiction of the Board of Medicine, no other body can revoke,
pursuant to its authority under Med Act of 1959
1. Admin Liability – doctor’s license revoked
2. Criminal Liability – dr gets imprisoned
3. Civil Liability – dr pays damage
 Reinstatement – even if license gets revoked, (appeal to PRC), the BOM can
reinstate the license

If you want to revoke license – go to Board of Medicine- appeal PRC- CA- SC

If you want to get damages (civil) – file damages in court

Board of Medicine - They are quasi legislative and quasi judicial

Process of Filing Complaint

 Complaint filed with Board of Medicine by injured patient

 BOM sends copy to the doctor to file an answer summons
 Doctor needs to file answer within 15days – failure doc declared in default – then
he cannot participate anymore
 Decisions of BOM can dismiss complaint, or reprimand, or suspend or revoke
license of doctor to practice
 Decision of BOM is appealable to PRC
 PRC modernization act authorizes PRC to supervise different regulatory boards
including BOM, either affirm, reverse or modify
 PRC decision appealable to CA under Rule 43 ONLY (no other rule) appeal
of decisions of quasijudicial agencies only, enumeration in rule 43 is not
exclusive
 CA decision appealable under Rule 45 to SC

▪ CSC, OP – hindi na aakyat if magpaparevoke ng license ng doc

▪ Decision of BOM is appealable in PRC and CA then SC

IF:

BOM – revokes license

PRC affirms decisions
CA – affirms decision
 SC – affirms

 After 2 years ng finality of decision to revoke license, then that’s the time you can
only apply for Petition for Reinstatement of License sa BOM

Next remedy under Med Act -

▪ Doctor can apply for petition for REINSTATAMENT WITH BOM
▪ BOM
▪ Physician must prove that he has no more disqualification
▪ After granting reinstatement, he can right away practice
▪
The law does not qualify whether government or private – use Medical Act

MARCH 4 DISCUSSION

Regulation of Practice of Medicine

RA 10912- Continuous professional development (CPD)

-to renew license, need training units. Para sa lawyers, MCLE

Medical Societies- PMA, Ph College of Surgeon (regulate the profession), Ph Pediatrian

Society
-gives practice guidelines
-organization of surgeons in the PH
-case- this is the way

Hospital Policies- contractual provisions, need to abide

Medical/Negligence Physician Liabilities (3 recourse of patients) can be any or all

(3 Fold Liability)
1. Administrative Liabilities-revoke license
-substantial evidence
2. Civil Liabilities- money (filed in courts, depend on amount) RTC-CA-SC
-preponderance evidence
-Breach of Contract/ Quasi-Delict (render medical service)
*Doctor-patient relationship
-claim for damages

3. Criminal Liabilities- violation (imprisonment)

-proof beyond reasonable doubt (moral certainty)
a. DOJ (prem investigation, for determination of probable cause)
b. Courts (determine if negligent)- CA-SC
 *lack of skill, lack of foresight which causes injury to the patient (reckless
imprudence) Art 365 RPC (RIRI)

Valid Ground. Section 24 (License revocation)

Doctors can advertise as long as not extravagant and not fraud

*Abortion
*Doctor guilty of murder- if appealable, hindi pa, once decision is final, doctor goes to
prison hence prohibited na.
Another, SC decision, punta sa BOM para marevoke, (hindi siya automatic)

MARCH 11 DISCUSSION
Medical Negligence (no specific law)
Elements to prove
a. Duty -required ordinary diligence only
b. Breach of Duty (Standard of care)
*expert of witness must be of the same field (ex. Anesthesiologist)
-preferably same locality
c. Injury
d. Proximate Causation

Doctrine of Informed Consent (malpractice act)

Elements need to be proven
“(1) the physician had a duty to disclose material risks;
(2) he failed to disclose or inadequately disclosed those risks;
(3) as a direct and proximate result of the failure to disclose, the patient consented to
treatment she otherwise would not have consented to; and
(4) plaintiff was injured by the proposed treatment.”

re ipsa loquitur- the thing speaks for itself

-shift the burden to the doctor. The law presumed that the doctor is already
negligent. Si doctor ang magpapatunay na hindi siya negligent.
Ex. May gasa na naiwan sa loob, opera sa appendix pero bungi nung lumabas.
(No need for witnesses, the injury speaks for itself) It does not happen without
negligence
*NOT COVERED BY re ipsa loquitur
1. Honest mistake- mali ung prescription

Hospital Liability
Can the hospital be liable for the patient injury? Depends
H cannot be held administratively, and criminally liability. Only to civil liabilities
Hospital-patient relationship: H ensures the safety of the patient not only to the medical
aid needed but also up to the equipment of the H (wheelchair, bed, etc)
1. Vicarious Liability- Art 2180 CC, employer liable to the acts of the employee
-GR: doctors are not covered due to the absence of EE relationship
Exc: empleyado ang doc tor
2. Corporate Negligence – basis is Hospital-Patient relationship
-arise from the contract of the patient with the H

3. Ostensible Agency- doctor is an agent, then H is liable for being liable in the
acts of the doctor.
-principal-agent relationship
CASES
Borromeo vs. Family Care Hospital Element of expert witness is not
presented. Doctor is not liable for medical
negligence.

Witness presented a witness not an

expert in the field of pathology
Casumpang vs. Cortejo No expert witness presented

Ramos vs. Court of Appeals
Professional Services vs. Agana
Li vs. Soliman
HUMAN BODY
*There was no reasonable indication in
Ramos and Cereno that the expert
witnesses possess a sufficient familiarity
with the standard of care applicable to the
physicians' specialties.
Re ipsa loquitur
*Fit ung patient pumasok then after OR
comatose na ung patient
Exper witness- anesthesiologist but the
opposing party presented a pulmonologist
*Nakaiwan ng gasa sa loob
*Hospital is liable due to corporate
negligence and ostensible agency. Doctor
is an agent of the H. (Estopped)
Case: Right leg to be amputated but later
on died due to the serious effects of
medicine used during surgery
*Doctrine of informed consent
Doctor is not liable since there is a
reasonable effort to inform the parents of
the patient of the seriousness of the injury
Trunk
Chest, Abdomen, Back Regions

Abdominal regions
-Ambilicus (puso)_Landmark case

2 ways to divide AR
1. 4 parts (quadrant) (common way)
2. 9 parts (abdominapelvic region)
Extremities

Post-mortem examination -pag patay na ung ineexamine (surface lang)

Autopsy- (pag inside kasama)
INSIDE THE BODY

1. HEAD
-Cerebrum (biggest)
-divided by different lobes
a. frontal lobe – voluntary movement (ex. Stroke)
b. parietal lobe- sensation (what you feel, kinurot masakit)
c. occipital – sight
-cerebellum (small)
* for balance (pag mataas alcohol, tatagos sa utak)
-brainstem (connector)
*Control the activity of the heart and respiratory system
-injury to the brainstem is fatal
-spinal cord

*sagittal section- hinati utak

2. CHEST
-heart is on the left side

3. LUNGS
-get oxygen and out carbon dioxide
INJURIES

4. ABDOMEN
-stomach- contains acid
-small intestine- absorbs food and water
A. duodenum
 b. jejunum
c. ileum
-large intestine (colon)- waste food and water
a. ascending c
b. transverse c
c. descending c
d. sigmoid c
e. appendix
-anus
*injury causes spillage of the contents

LIVER (Right Upper Quadrant)

-rich in blood vessels
-loss of blood injury leading to death

SPLEEN (Left Upper Quadrant)

-same as liver

APRIL 22 NOTES
Wound Classification
1. Abrasion
2. Contusion
3. Hematoma
4. Laverated
5. Incised wound
6. Stab wound
7. Punctured wound
8. Burns

Epidermis- virus cant penetrate

Derma
Fat
Muscle
First degree burn- epidermis (sunburn)
Second degree burn- dermis (butlig butlig)
Third degree burn- skin
*Rule of 9
RULE OF 9
Sharp edges,vs laceration
GUN SHOT WOUNDS
Flame- burning of the hair or singeing
Smoke- leave smoke marks or smudging
Unburned powder- tattooing
SIGN OF DEATH