Medical Negligence & Malpractice
Medical Negligence
- often confused for medical malpractice - the act or omission in treatment of a patient by a medical professional, which deviates from the accepted medical standard of care. - does not imply or necessarily result in injury
Medical Malpractice
- a form of negligence whereby a doctor's negligent treatment causes undue injury to the patient - elements: 1. A duty of care was owed by the physician; 2. The physician violated the applicable standard of care; 3. The person suffered a compensable injury; and 4. The injury was caused in fact and proximately caused by the substandard conduct. - The burden of proving these elements is on the plaintiff in a malpractice lawsuit.
History of Medical Malpractice Law in the Philippines
Medical Malpractice Act of 2002
- House Bill No. 4955 is the first legislative bill addressing medical malpractice - introduced by Rep. Oscar S. Rodriguez of Pampanga and Rep. Ted Failon of Tacloban - objective of the bill is to strengthen the right of a patient to quality medical care and to provide penalties for health practitioners for gross negligence. - defines "malpractice" as any personal injury, including death, caused by the negligent or wrongful act or omission of any medical practitioner - Penalties: prision mayor or fine ranging from P500,000 to P1,000,000, or both, plus cancellation of the license to practice medicine.
The Health Care Liability Law of 2002
- House Bill 5293 sought to ensure the safety and well-being of patients by creating an environment wherein incompetent and negligent medical practitioners shall not go unpunished. - medical practitioners demonstrated their opposition through adialogue where the former overwhelmed the congressman with questions on what they coin as an anti-doctors bill. - dropped the bill.
Various Senate Bills
SBN 3 An Act Declaring the Rights and Obligations of Patients and Establishing a Grievance Mechanism for Violations Thereof and for Other Purposes (Sen. Flavier) SBN 121 An Act toReduce MedicalMistakes and Medication-Related Errors(Sen. EjercitoEstrada) SBN 588 An Act Declaring the Rights of Patients and Prescribing Penalties for Violations Thereof(Sen. Villar, Jr.) SBN 1720 An Act to ProtectPatients against Medical Malpractice, Punishing the Malpractice of Any Medical Practitioner and Requiring Them to Secure Malpractice Insurance and for Other Purposes(Sen. Osmea)
Pertinent Judicial Doctrines
Captain of the Ship
- holds the surgeon in charge of an operation liable for the negligence of his assistants during the time when those assistants are under the surgeons control (Cantre vs. Sps. Go, G.R. 160889) - the operating surgeon is the person in complete charge of the surgery room and all personnel connected with the operation. Their duty is to obey his orders. (Ampil vs. Agana, G.R.No.127590)
Borrowed Servant Rule
- provides that once a surgeon enters the operating room and takes charge of the proceedings, the acts or omission of operating room personnel, and any negligence associated with such acts or omissions, are imputable to the surgeon (Nogales vs. Capitol Medical Center, G.R. No. 142625)
Vicarious Liability: Respondeat Superior
- literally let the superior make answer" - holds a superior officer jointly and severally accountable for damages, including moral and exemplary, with his subordinates who committed such transgressions (Aberca vs. Ver, G.R. No. L-69866).
Vicarious Liability: Ostensible Agency
- a.k.a.doctrine of apparent authority. - a hospital can be held vicariously liable for the negligent acts of a physician providing care at the hospital, regardless of whether the physician is an independent contractor, unless the patient knows, or should have known, that the physician is an independent contractor. -occurs when a hospital holds out itself as a provider of emergency room care without informing the patient that the care is provided by independent contractors.
Res Ipsa Loquitur
- literally the thing or transaction speaks for itself - requisites: The accident was of such character as to warrant an inference that it would not have happened except for the defendants negligence; The accident must have been caused by an agency or an instrumentality within the exclusive management nor control of the person charged with the negligence complained of; The accident must not have been due to any voluntary action or contribution on the part of the person injured (Windvalley Shipping Co., Ltd. vs. Court of Appeals, 342 SCRA 214).
Remedies: Civil, Criminal and Administrative
Civil action
- Art. 2176. Whoever by act or omission causes damage to another, there being fault or negligence, is obliged to pay for the damage done. Such fault or negligence, if there is no pre-existing contractual relation between the parties, is called a quasi-delict and is governed by the provisions of this Chapter. (Civil Code) - Jurisdiction: MTC / RTC, depending on amount of damages being claimed
Criminal action
- Art. 365. Imprudence and negligence. Any person who, by reckless imprudence, shall commit any act which, had it been intentional, would constitute a grave felony, shall suffer the penalty of arresto mayor in its maximum period to prision correccional in its medium period; if it would have constituted a less grave felony, the penalty of arresto mayor in its minimum and medium periods shall be imposed; if it would have constituted a light felony, the penalty of arresto menor in its maximum period shall be imposed. (Revised Penal Code) - Jurisdiction: MTC/RTC, depending on the gravity of the felony committed
Administrative action
PRC
Functions of the Professional Regulatory Board: Investigate violations of set professional standards and adjudicate administrative and other cases against erring registrants Suspend, revoke, or reissue Certificate of Registration for causes provided by law Formal complaintsshould be submitted in person at the PRC office. Formal complaints undergo four stages: Docketing and Calendar- this starts from the date of filing of the complaint to when the notice of pre-trial is sent to the parties. Pre-trial and Depositions covers the pre-trial, depositions, and other practices designed to dispense with, or limit time for the reception of evidence Reception of Evidence evidence for both the complainant and for the respondent are presented as well as the rebuttal evidence. Decision-making discussions and vote on the case and the preparation and signing of the decision.
Administrative action
Administrative Code of Philippine Medical Association Termination 4.1. Membership in the Association may be terminated for any of the following causes: 4.1.1. Non-payment of dues for three (3) consecutive years, and failure to pay such dues within sixty (60) days of receipt of notice; 4.1.2. Any act inimical to the profession as provided for in the Code of Medical Ethics, and/or any act inimical to the Association; 4.1.3. Revocation of member's license to practice medicine by the Professional Regulations Commission, Board of Medicine; and 4.1.4. Voluntary resignation from the Association. Administrative Code of Philippine Nursing Association Section 5. Termination of Membership Membership to the Association maybe terminated on the following: non-payment of annual dues; and violation of the Philippine Nurses Association By-laws violation of the Nursing Law
