doing business under the name
and
style COMMUNITY DIAGNOSTIC
CENTER and BU CASTRO,[1]
Petitioners, Present:
Ynares-Santiago, J. (Chairperson),
- versus - Austria-Martinez,
Callejo,
Sr.,
Chico-Nazario, and
Nachura, JJ.
RANIDA D. SALVADOR and
RAMON
Respondents.
March
20, 2007
x
----------------------------------------------------------------------------------------
x
YNARES-SANTIAGO, J.:
This is a petition for review[2]
under Rule 45 of the Rules of Court assailing the February 27, 2004 Decision[3] of
the Court of Appeals in CA-G.R. CV No. 58668 finding petitioner Orlando D.
Garcia liable for gross negligence; and its June 16, 2005 Resolution[4]
denying petitioner’s motion for reconsideration.
On
When Ranida submitted the test result to Dr. Sto. Domingo, the Company
physician, the latter apprised her that the findings indicated that she is
suffering from Hepatitis B, a liver disease.
Thus, based on the medical report[6] submitted
by Sto. Domingo, the Company terminated Ranida’s employment for failing the
physical examination.[7]
When Ranida informed her father,
Ramon, about her ailment, the latter suffered a heart attack and was confined
at the
Thus, Ranida went back to CDC for
confirmatory testing, and this time, the Anti-HBs test conducted on her
indicated a “Negative” result.[9]
Ranida also underwent another HBs Ag
test at the
Ranida submitted the test results from
Thereafter, the Company rehired Ranida.
On
On
Garcia denied the allegations of gross
negligence and incompetence and reiterated the scientific explanation for the
“false positive” result of the first HBs Ag test in his
For his part, Castro claimed that as pathologist, he rarely went to CDC
and only when a case was referred to him; that he did not examine Ranida; and
that the test results bore only his rubber-stamp signature.
On
Respondents appealed to the Court of
Appeals which reversed the trial court’s findings, the dispositive portion of
which states:
WHEREFORE, the decision appealed from is REVERSED and SET
ASIDE and another one entered ORDERING defendant-appellee Orlando D. Garcia,
Jr. to pay plaintiff-appellant Ranida D. Salvador moral damages in the amount of
P50,000.00, exemplary damages in the amount of P50,000.00 and attorney’s fees
in the amount of P25,000.00.
SO ORDERED.[18]
The appellate court found Garcia
liable for damages for negligently issuing an erroneous HBs Ag result. On the other hand, it exonerated Castro for
lack of participation in the issuance of the results.
After the denial of his motion for reconsideration, Garcia filed the
instant petition.
The main issue for resolution is
whether the Court of Appeals, in reversing the decision of the trial court,
correctly found petitioner liable for damages to the respondents for issuing an
incorrect HBsAG test result.
Garcia
maintains he is not negligent, thus not liable for damages, because he followed
the appropriate laboratory measures and procedures as dictated by his training
and experience; and that he did everything within his professional competence
to arrive at an objective, impartial and impersonal result.
At the outset, we note that the
issues raised are factual in nature. Whether a person is negligent or not
is a question of fact which we cannot pass upon in a petition for review on certiorari
which is limited to reviewing errors of law.[19]
Negligence is the failure to
observe for the protection of the interest of another person that degree of
care, precaution and vigilance which the circumstances justly demand,[20]
whereby such other person suffers injury.
For health care providers, the test of the existence of negligence is:
did the health care provider either fail to do something which a reasonably
prudent health care provider would have done, or that he or she did something
that a reasonably prudent health care provider would not have done; and that
failure or action caused injury to the patient;[21]
if yes, then he is guilty of negligence.
Thus, the elements of an actionable
conduct are: 1) duty, 2) breach, 3) injury, and 4) proximate causation.
All the elements are present in the
case at bar.
Owners and operators of clinical
laboratories have the duty to comply with statutes, as well as rules and
regulations, purposely promulgated to protect and promote the health of the
people by preventing the operation of substandard, improperly managed and
inadequately supported clinical laboratories and by improving the quality of
performance of clinical laboratory examinations.[22]
Their business is impressed with public interest, as such, high standards of
performance are expected from them.
In F.F. Cruz and Co., Inc. v.
Court of Appeals, we found the owner of a furniture shop liable for the
destruction of the plaintiff’s house in a fire which started in his
establishment in view of his failure to comply with an ordinance which required
the construction of a firewall. In Teague
v. Fernandez, we stated that where the very injury which was intended to be
prevented by the ordinance has happened, non-compliance with the ordinance was
not only an act of negligence, but also the proximate cause of the death.[23]
In fine, violation of a statutory
duty is negligence. Where the law
imposes upon a person the duty to do something, his omission or non-performance
will render him liable to whoever may be injured thereby.
Section 2 of Republic Act (R.A.) No.
4688, otherwise known as The Clinical Laboratory Law, provides:
Sec.
2. It shall be unlawful for any person to
be professionally in-charge of a registered clinical laboratory unless he is a
licensed physician duly qualified in laboratory medicine and authorized by the
Secretary of Health, such authorization to be renewed annually.
No
license shall be granted or renewed by the Secretary of Health for the
operation and maintenance of a clinical laboratory unless such laboratory is
under the administration, direction and supervision of an authorized physician,
as provided for in the preceding paragraph.
Corollarily, Sections 9(9.1)(1), 11
and 25(25.1)(1) of the DOH Administrative Order No. 49-B Series of 1988,
otherwise known as the Revised Rules and Regulations Governing the
Registration, Operation and Maintenance of Clinical Laboratories in the Philippines,
read:
Sec.
9. Management of the Clinical
Laboratory:
9.1
Head of the Clinical Laboratory: The head is that person who assumes technical
and administrative supervision and control of the activities in the laboratory.
For
all categories of clinical laboratories, the head shall be a licensed physician
certified by the Philippine Board of Pathology in either Anatomic or Clinical
Pathology or both provided that:
(1)
This shall be mandatory for all categories of
free-standing clinical laboratories; all tertiary category hospital
laboratories and for all secondary category hospital laboratories located in
areas with sufficient available pathologist.
x
x x x
Sec.
11. Reporting: All laboratory requests shall be considered
as consultations between the requesting physician and pathologist of the
laboratory. As such all laboratory
reports on various examinations of human specimens shall be construed as
consultation report and shall bear the name of the pathologist or his
associate. No person in clinical laboratory
shall issue a report, orally or in writing, whole portions thereof without a
directive from the pathologist or his authorized associate and only to the
requesting physician or his authorized representative except in emergencies
when the results may be released as authorized by the pathologist.
x
x x x
Sec.
25. Violations:
25.1 The license to operate a clinical
laboratory may be suspended or revoked by the Undersecretary of Health for
Standards and Regulation upon violation of R.A. 4688 or the rules and
regulations issued in pursuance thereto or the commission of the following acts
by the persons owning or operating a clinical laboratory and the persons under
their authority.
(1) Operation
of a Clinical Laboratory without a certified pathologist or qualified licensed
physician authorized by the Undersecretary of Health or without employing a
registered medical technologist or a person not registered as a medical
technologist in such a position.
And Section 29(b) of R.A. No. 5527,
otherwise known as The Philippine Medical Technology Act of 1969, reads:
Section 29. Penal Provisions.- Without
prejudice to the provision of the Medical Act of 1959, as amended relating to
illegal practice of Medicine, the following shall be punished by a fine of not
less than two thousand pesos nor more than five thousand pesos, or imprisonment
for not less than six months nor more than two years, or both, in the
discretion of the court:
x x x x
(b) Any medical technologist, even if duly
registered, who shall practice medical technology in the
From the foregoing laws and rules,
it is clear that a clinical laboratory must be administered, directed and
supervised by a licensed physician authorized by the Secretary of Health, like
a pathologist who is specially trained in methods of laboratory medicine; that
the medical technologist must be under the supervision of the pathologist or a
licensed physician; and that the results of any examination may be released
only to the requesting physician or his authorized representative upon the
direction of the laboratory pathologist.
These rules are intended for the
protection of the public by preventing performance of substandard clinical
examinations by laboratories whose personnel are not properly supervised. The public demands no less than an effective
and efficient performance of clinical laboratory examinations through
compliance with the quality standards set by laws and regulations.
We find that petitioner Garcia failed
to comply with these standards.
First, CDC is
not administered, directed and supervised by a licensed physician as required
by law, but by Ma. Ruby C. Calderon, a licensed Medical Technologist.[24] In the License to Open and Operate a Clinical
Laboratory for the years 1993 and 1996 issued by Dr. Juan R. Nañagas, M.D.,
Undersecretary for Health Facilities, Standards and Regulation,
defendant-appellee Castro was named as the head of CDC.[25] However, in his Answer with Counterclaim, he
stated:
3.
By way of affirmative and special defenses, defendant
pathologist further avers and plead as follows:
Defendant
pathologist is not the owner of the
Castro’s infrequent visit to the
clinical laboratory barely qualifies as an effective administrative supervision
and control over the activities in the laboratory. “Supervision and control” means the authority
to act directly whenever a specific function is entrusted by law or regulation
to a subordinate; direct the performance of duty; restrain the commission of
acts; review, approve, revise or modify acts and decisions of subordinate
officials or units.[27]
Second, Garcia
conducted the HBsAG test of respondent Ranida without the supervision of
defendant-appellee Castro, who admitted that:
[He]
does not know, and has never known or met, the plaintiff-patient even up to
this time nor has he personally examined any specimen, blood, urine or any
other tissue, from the plaintiff-patient otherwise his own handwritten
signature would have appeared in the result and not merely stamped as shown in
Annex “B” of the Amended Complaint.[28]
Last, the
disputed HBsAG test result was released to respondent Ranida without the
authorization of defendant-appellee Castro.[29]
Garcia may not have intended to
cause the consequences which followed after the release of the HBsAG test
result. However, his failure to comply
with the laws and rules promulgated and issued for the protection of public
safety and interest is failure to observe that care which a reasonably prudent
health care provider would observe.
Thus, his act or omission constitutes a breach of duty.
Indubitably, Ranida suffered injury
as a direct consequence of Garcia’s failure to comply with the mandate of the
laws and rules aforequoted. She was
terminated from the service for failing the physical examination; suffered
anxiety because of the diagnosis; and was compelled to undergo several more
tests. All these could have been avoided
had the proper safeguards been scrupulously followed in conducting the clinical
examination and releasing the clinical report.
Article 20 of the New Civil Code
provides:
Art.
20. Every person who, contrary to law,
willfully or negligently causes damage to another, shall indemnify the latter
for the same.
The foregoing provision provides
the legal basis for the award of damages to a party who suffers damage whenever
one commits an act in violation of some legal provision.[30] This was incorporated by the Code Commission to
provide relief to a person who suffers damage because another has violated some
legal provision.[31]
We find the Court of Appeals’ award
of moral damages reasonable under the circumstances bearing in mind the mental
trauma suffered by respondent Ranida who thought she was afflicted by Hepatitis
B, making her “unfit or unsafe for any type of employment.”[32] Having established her right to moral
damages, we see no reason to disturb the award of exemplary damages and
attorney’s fees. Exemplary damages are
imposed, by way of example or correction for the public good, in addition to
moral, temperate, liquidated or compensatory damages,[33]
and attorney’s fees may be recovered when, as in the instant case, exemplary
damages are awarded.[34]
WHEREFORE, the Decision of the Court of Appeals in CA-G.R. CV
No. 58668 dated P50,000.00 as moral damages, P50,000.00 as exemplary
damages, and P25,000.00
as attorney’s fees, is AFFIRMED.
SO ORDERED.
CONSUELO
YNARES-SANTIAGO
Associate Justice
WE CONCUR:
MA. ALICIA AUSTRIA-MARTINEZ
Associate Justice
ROMEO J. CALLEJO, SR. MINITA V.
CHICO-NAZARIO
Associate Justice Associate Justice
ANTONIO
EDUARDO B. NACHURA
Associate Justice
ATTESTATION
I attest that the conclusions in the above decision were
reached in consultation before the case was assigned to the writer of the
opinion of the Court’s Division.
CONSUELO YNARES-SANTIAGO
Associate Justice
Chairperson, Third Division
CERTIFICATION
Pursuant to Section 13, Article VIII of the Constitution
and the Division Chairperson’s Attestation, it is hereby certified that the
conclusions in the above Decision were reached in consultation before the case
was assigned to the writer of the opinion of the Court’s Division.
REYNATO
S. PUNO
Chief Justice
[1]
Did not appeal from the Decision of the Court of Appeals.
[2] Rollo, pp. 7-45.
[3]
[4]
[5]
Records, p. 186.
[6]
[7]
[8]
[9]
[10]
[11]
[12]
[13]
[14]
[15]
[16] CA Rollo, pp. 51-61. Penned by Judge Lorenzo R. Silva, Jr.
[17]
[18] Rollo, p. 63.
[19] Estacion v. Bernardo, G.R. No. 144723, February 27, 2006, 483 SCRA 222, 231.
[20] Child
Learning Center, Inc. v. Tagorio, G.R. No. 150920,
[21] Garcia-Rueda
v. Pascasio, 344 Phil. 323,
331 (1997).
[22]
Department of Health (DOH) Administrative Order 49-B (1988), Sec. 3.
[23] Cipriano
v. Court of Appeals, 331 Phil. 1019, 1025 (1996).
[24]
Records, p. 193.
[25]
[26]
[27] Jalandoni
v. Drilon, 383 Phil. 855, 868 (2000).
[28]
Records, p. 73.
[29]
[30] Carpio
v. Valmonte, G.R. No. 151866,
[31]
Sanco, Cezar S., Torts and Damages (1994), Volume II, p. 748.
[32]
Records, p. 199.
[33]
Civil Code, Article 2229.
[34]
Civil Code, Article 2208.