Rogelio P. Nogales vs. Capitol Medical Center , GR No.
142625 December 19, 2006
FACTS:
Corazon Nogales was pregnant of her 4th child and was under the exclusive prenatal care of Dr.
Estrada. On her last trimester of pregnancy, Dr. Estrada noted an increase in Corazon’s blood
pressure and development of leg edema which may lead to a dangerous complication of
pregnancy. When Corazon started experiencing mild labor pains, she and the complainant opted
to see Dr. Estrada for examination, and the latter advised them to admit Corazon to the Capitol
Medical Center. Short after Corazon’s bag of water ruptured, she started to experience
convulsions. Dr. Estrada and another physician in the name of Dr. Villaflor began extracting the
baby, which allegedly torn a piece of cervical tissue of the patient. After the baby was taken out
of the womb, Corazon began to manifest moderate vaginal bleeding which rapidly became
profuse. Despite efforts to revive the patient, Corazon died. The cause of which was
“hemorrhage, post-partum.” The petitioners filed a complaint for damages against CMC, Dr.
Estrada, and the other involved medical personnel of the hospital for the death of Corazon,
charging CMC with negligence in the selection and supervision of defendant physicians and
hospital staff.
The RTC (Manila) rendered judgment finding Dr. Estrada solely liable for damages. In ruling the
same, the Court finds no legal justification to find the other impleaded physicians and hospital
personnel civilly liable.
Upon appeal, petitioners claimed that aside from Dr. Estrada, the remaining respondents should
be held equally liable for negligence, pointing out the extent of each respondent’s alleged
liability.
The CA affirmed the decision of the trial court and on ruling the same, the Court of Appeals
applied the “borrowed servant” doctrine considering that Dr. Estrada was an independent
contractor who was merely exercising hospital privileges. This doctrine provides that once the
surgeon enters the operating room and takes charge of the proceedings, the acts or omissions
of operating room personnel, and any negligence associated with such acts or omissions, are
imputable to the surgeon. While the assisting physicians and nurses may be employed by the
hospital, or engaged by the patient, they normally become the temporary servants or agents of
the surgeon in charge while the operation is in progress, and liability may be imposed upon the
surgeon for their negligent acts under the doctrine of respondeat superior. Hence, the petition.
ISSUE:
Whether CMC is vicariously liable for the negligence of Dr. Estrada.
HELD:
YES. Art. 2180. The obligation imposed by article 2176 is demandable not only for one’s own
acts or omissions, but also for those of persons for whom one is responsible.
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Employers shall be liable for the damages caused by their employees and household helpers
acting within the scope of their assigned tasks, even though the former are not engaged in any
business or industry.
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The responsibility treated of in this article shall cease when the persons herein mentioned prove
that they observed all the diligence of a good father of a family to prevent damage.
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.
In general, a hospital is not liable for the negligence of an independent contractor-physician.
There is, however, an exception to this principle. The hospital may be liable if the physician is
the “ostensible” agent of the hospital. This is known as the “doctrine of apparent authority.” In
Gilbert v. Sycamore Municipal Hospital, the Illinois Supreme Court explained the doctrine of
apparent authority in this wise:
[U]nder the 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. The elements of the action have been set out as follows:
“For a hospital to be liable under the doctrine of apparent authority, a plaintiff must show that:
(1) the hospital, or its agent, acted in a manner that would lead a reasonable person to conclude
that the individual who was alleged to be negligent was an employee or agent of the hospital;
(2) where the acts of the agent create the appearance of authority, the plaintiff must also prove
that the hospital had knowledge of and acquiesced in them; and (3) the plaintiff acted in
reliance upon the conduct of the hospital or its agent, consistent with ordinary care and
prudence.”
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The doctrine of apparent authority essentially involves two factors to determine the liability of
an independent-contractor physician: The first factor focuses on the hospital’s manifestations
and is sometimes described as an inquiry whether the hospital acted in a manner which would
lead a reasonable person to conclude that the individual who was alleged to be negligent was an
employee or agent of the hospital. In this regard, the hospital need not make express
representations to the patient that the treating physician is an employee of the hospital; rather
a representation may be general and implied. The second factor focuses on the patient’s
reliance. It is sometimes characterized as an inquiry on whether the plaintiff acted in reliance
upon the conduct of the hospital or its agent, consistent with ordinary care and prudence.
