MEDICAL NEGLIGENCE DOCTRINES at the time of his or her injury.

The doctrine of
assumption of risk is also known as volenti non fit
*Applicable to both patient and physician injuria
tortfeasors
a. Express Agreement / Implied Acceptance of Risk
1. Doctrine of Common Fault
a. Doctrine of Contributory Negligence b. Knowledge of Risk
b. Doctrine of Comparative Negligence
2. Doctrine of Assumption of Risk c. Voluntary Assumption
3. Doctrine of Last Clear Chance
d. Injury

III. DOCTRINE OF LAST CLEAR CHANCE

I. DOCTRINE OF COMMON FAULT
The act or omission amounting to want of ordinary
care in the part of the complainant or plaintiff,
which, concurring with the negligence of the
accused or the defendant is the proximate cause of
the injury.
The liability of the defendant is mitigated or the
defendant will not be held liable at all.
*Doctrine of Discovered Peril
*Humanitarian Doctrine
*Doctrine of Supervening Negligence
Under this doctrine, a negligent plaintiff can
nonetheless recover if he is able to show that the
defendant or another person had the last
opportunity to avoid the accident.

a. Doctrine of Contributory Negligence Where both parties are negligent in such a way that
it would be impossible to determine whose
Art. 2179. When the plaintiff's own negligence was
negligence was the proximate cause of the accident,
the immediate and proximate cause of his injury, he
the party who had the last clear chance to avoid the
cannot recover damages. But if his negligence was
accident by the use of proper care but failed to do so
only contributory, the immediate and proximate
is considered in law solely responsible for the
cause of the injury being the defendant's lack of due
consequences of the accident.
care, the plaintiff may recover damages, but the
courts shall mitigate the damages to be awarded. APPLICABLE TO PHYSICIAN TORT FEASORS
(n)
1. Doctrine of Independent Contractor
b. Doctrine of Comparative Negligence 2. Doctrine of Res Ipsa Loquitur
3. Doctrine of Foreseeability
The degree of negligence of the plaintiff-patient is
compared to the degree of negligence of the
defendant-physician.
I. DOCTRINE OF INDEPENDENT
Art. 2179. When the plaintiff's own negligence was CONTRACTOR
the immediate and proximate cause of his injury, he
cannot recover damages. But if his negligence was *Under this doctrine each and every person is
only contributory, the immediate and proximate responsible for his own torts.
cause of the injury being the defendant's lack of due
*This is direct or primary liability, based upon one’s
care, the plaintiff may recover damages, but the
own conduct.
courts shall mitigate the damages to be awarded.
*There is no employer-employee relationship in an
Art. 2214. In quasi-delicts, the contributory
independent contractor, hence the physician is
negligence of the plaintiff shall reduce the damages
solely liable.
that he may recover.
It has been consistently held that in determining
II. DOCTRINE OF ASSUMPTION OF RISK
whether an employer-employee relationship exists
Assumption of risk is a defense in the law of torts, between the parties, the following elements must be
which bars or reduces a plaintiff's right to recovery present:
against a negligent tortfeasor if the defendant can
(1) selection and engagement of services;
demonstrate that the plaintiff voluntarily and
knowingly assumed the risks at issue inherent to (2) payment of wages;
the dangerous activity in which he was participating
(3) the power to hire and fire; and
(4) the power to control not only the end to be
achieved, but the means to be used in reaching such
an end
RAMOS vs CA
1. Private respondent De Los Santos Medical Center
is hereby absolved from liability arising from the
injury suffered by petitioner Erlinda Ramos on June
17, 1985;
2. Private respondents Dr. Orlino Hosaka and Dr.
Perfecta Gutierrez are hereby declared to be
solidarily liable for the injury suffered by petitioner
Erlinda on June 17, 1985 and are ordered to pay
petitioners—
(a) P1,352,000.00 as actual damages;
(b) P2,000,000.00 as moral damages;
(c) P100,000.00 as exemplary damages;
(d) P100,000.00 as attorney’s fees; and
(e) the costs of the suit.
RAMOS vs. CA
1. Private respondent De Los Santos Medical Center
is hereby absolved from liability arising from the
injury suffered by petitioner Erlinda Ramos on June
17, 1985;
2. Private respondents Dr. Orlino Hosaka and Dr.
Perfecta Gutierrez are hereby declared to be
solidarily liable for the injury suffered by petitioner
Erlinda on June 17, 1985 and are ordered to pay
petitioners—
(a) P1,352,000.00 as actual damages;
(b) P2,000,000.00 as moral damages;
(c) P100,000.00 as exemplary damages;
(d) P100,000.00 as attorney’s fees; and
(e) the costs of the suit.
II. DOCTRINE OF RES IPSA LOQUITUR
*Latin term which means “The thing speaks for
itself.”
This Doctrine as a rule of evidence is peculiar to the
law of negligence which recognizes that prima facie
negligence may be established even in the absence
of a direct proof and furnishes a substitute for
specific proof of negligence.
This doctrine is not a rule of substantive law , but
merely a mode of proof or a mere procedural
convenience.
Mere invocation of this doctrine and application of
the doctrine does not dispense with the
requirement of proof of negligence.
Requisites:
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
defendants; and
3. No contributing negligence from the plaintiff.
In the above requisites, the fundamental element is
the control of the instrumentality which caused the
damage.
III. DOCTRINE OF FORESEEABILITY
A physician cannot be held liable for negligence if
the injury sustained by the patient is on account of
unforeseen conditions, after the exercise of due care
and diligence.
APPLICABLE TO PHYSICIANS AND THIRD PARTY
TOTRFEASORS
1. Doctrine of Vicarious Liability
2. Doctrine of Ostensible Agent
3. Captain of the Ship
4. Borrowed Servant Doctrine
I. DOCTRINE OF VICARIOUS LIABILITY
*Imputed Negligence
*Doctrine of Respondeat Superior
*Latin term for “let the master answer”
This Doctrine is an exception to the general rule
that every person is responsible for his or her own
torts.
This is based upon a relationship rather that upon
conduct.
Vicarious liability is a legal doctrine that assigns
liability for an injury to a person who did not cause
the injury but who has a particular legal
relationship to the person who did act negligently.
The doctrine makes the employer responsible for a
lack of care on the part of an employee in relation to
those to whom the employer owes a duty of care.
For respondeat superior to apply, the employee's
negligence must occur within the scope of her
employment.
The employer is charged with legal responsibility
for the negligence of the employee because the
employee is held to be an agent of the employer.
Art. 2181. Whoever pays for the damage caused by
his dependents or employees may recover from the
latter what he has paid or delivered in satisfaction
of the claim.
II. DOCTRINE OF OSTENSIBLE AGENT
*Doctrine of Apparent Authority
*Doctrine of Apparent Agency
Apparent authority results from a manifestation by
the principal to a third person that another is his
agent.
A principle under which the party usually liable for
a person's actions is absolved of that responsibility
when that person is asked to do something which is
outside of the bounds of hospital policy.
The fact that the resident physician, nurse, or
operating room assistant is usually a hospital
employee does not change the outcome of
negligence cases, for courts employ the legal fiction
called the borrowed servant rule to transfer
hospital liability to physicians.
DEFENSE DOCTRINES
1. There is no Physician-Patient Relationship
2. Elements of Medical Negligence are absent
3. Doctrine of Common Fault
a. Contributory Negligence
b. Comparative Negligence
4. Doctrine of Assumption of Risk
5. Doctrine of Last Clear Chance
6. Rescue Doctrine
7. Exercise The Diligence of a Good Father
Doctrine

The manifestation may be made directly to the third

person or to the community at large by signs or
advertising.

Apparent authority exists only to the extent that it

is reasonable for the third person dealing with the
agent to believe the agent is authorized.

The existence of actual authority between principal

and agent is "not a prerequisite to establishing
apparent authority. The acts or silence of the
principal led another person to believe that the
person is its agent.

III. CAPTAIN OF THE SHIP DOCTRINE

*Command Responsibility Doctrine

Under this doctrine, courts assume that the

physician is in control of everyone and everything
in an operating room and thus is liable for anything
that goes wrong no matter who was responsible for
the conduct.

An adaptation from the 'borrowed servant rules', as

applied to an operating room, holding the person in
charge–eg, a surgeon responsible for all under his
supervision, regardless of whether the 'captain' is
directly responsible for an alleged error or act of
alleged negligence, and despite the assistants'
positions as hospital employees.

IV. BORROWED SERVANT DOCTRINE