FACTS:

The case involves a complaint filed by Belinda Santiago against Dr. Emmanuel Jarcia, Jr. and Dr. Marilou Bastan for their alleged neglect of professional duty which caused her son, Roy Alfonso Santiago, to suffer serious physical injuries. Roy Jr. was hit by a taxicab and was rushed to Manila Doctors Hospital for emergency medical treatment. Upon examination, an X-ray showed no fracture as read by Dr. Jarcia. Dr. Bastan entered the emergency room (ER) and informed Mrs. Santiago that there was no need to examine the upper leg since only the ankle was hit. Eleven days later, Roy Jr. developed fever, swelling of the right leg, and misalignment of the right foot. Another X-ray revealed a right mid-tibial fracture and a linear hairline fracture in the bone shaft. The National Bureau of Investigation (NBI) conducted an investigation and filed a criminal case for reckless imprudence resulting to serious physical injuries against Dr. Jarcia and Dr. Bastan. The Regional Trial Court (RTC) found the accused guilty beyond reasonable doubt of simple imprudence resulting to serious physical injuries and sentenced them to imprisonment and to indemnify Mrs. Santiago for medical expenses. The Court of Appeals (CA) affirmed the RTC decision. Dissatisfied, the accused appealed to the CA, which affirmed the RTC decision in its entirety.

The case involves an incident where a child named Roy sustained an injury to his leg after being hit by a vehicle. He was brought to the hospital for treatment, where he was attended to by accused-appellants, who were junior residents practicing general surgery.

The mother of the child testified that she questioned the accused-appellants about the extent of her son's injury and requested for an x-ray of the upper part of his leg. However, the accused-appellants refused to conduct the requested x-ray and stated that there was no need for it.

The prosecution argued that the accused-appellants' failure to correctly diagnose the fracture and provide proper medical attention caused prolonged pain and suffering for Roy. They invoked the doctrine of res ipsa loquitur, which allows an inference of negligence based on the nature of certain types of incidents.

The requisites for the application of the doctrine were discussed, particularly the element of control of the instrumentality that caused the damage. It was argued that the accused-appellants had control over the treatment and diagnostic procedures, and their refusal to conduct the requested x-ray constituted simple imprudence.

Based on the testimony of the mother and the arguments presented, the court found merit in the prosecution's claims and concluded that the accused-appellants failed to meet the required standard of care in treating Roy's injury.

This case involves accused-petitioners who are doctors and nurses in a hospital. The incident occurred when the accused-petitioners were passing by the emergency room (ER) for their lunch break. The patient was at that time in need of urgent medical attention. However, the accused-petitioners did not attend to the patient. The patient's condition deteriorated and eventually died. The accused-petitioners were charged with criminal negligence. The Court of Appeals did not acquit the accused-petitioners, leading to this appeal. The main issues presented are whether the doctrine of res ipsa loquitur is applicable and whether the accused-petitioners should be held liable for criminal negligence.

ISSUES:

1. Whether the doctrine of res ipsa loquitur is applicable in this case.

2. Whether Dr. Jarcia and Dr. Bastan are negligent in their treatment of the patient.

3. Whether the failure of the doctors to properly diagnose the specific injury of the patient constitutes medical negligence.

4. Whether the delay in the application of the cast to the patient's fractured leg aggravated his condition or caused further complications.

5. Whether the petitioners can be held civilly liable for their failure to attend to the victim's medical needs.

6. Whether the petitioners can pass on the liability to the taxi driver who hit the victim.

7. Whether a physician-patient relationship existed between the petitioners and the victim.

8. Whether the petitioners were negligent in their treatment of the victim.

9. Whether the petitioners are civilly liable for the damages suffered by the patient, Roy Jr.

10. Whether the petitioners are liable for actual, moral, and exemplary damages.

RULING:

1. The doctrine of res ipsa loquitur is not applicable in this case. The court held that the circumstances that caused the patient's injury and the series of tests that were supposed to be undergone by him were not under the exclusive control of the doctors. The doctrine of res ipsa loquitur can only be invoked when direct evidence is absent and not readily available.

2. The court is not convinced that Dr. Jarcia and Dr. Bastan are guilty of criminal negligence. While there was evidence of negligence, such as their failure to perform certain medical procedures, the court did not find sufficient proof beyond reasonable doubt to establish their guilt of reckless imprudence or simple negligence.

3. The court found that there was a failure to perform a thorough examination on the patient, indicating negligence on the part of the doctors. However, there was no precise evidence to show that the delay in diagnosis caused further complications or prolonged the pain of the patient.

4. The court ruled that there was no sufficient evidence to establish that the delay in applying the cast to the patient's fractured leg caused any aggravation of his condition or further complications. Therefore, the doctors cannot be held criminally liable.

5. The court found the petitioners civilly liable for their failure to sufficiently attend to the victim's medical needs. While a criminal conviction requires proof beyond reasonable doubt, only a preponderance of evidence is required to establish civil liability.

6. The court ruled that the petitioners cannot pass on the liability to the taxi driver. The fact that the vehicular accident was the immediate cause of the victim's injury does not excuse the petitioners from their duty to attend to the victim's medical needs.

7. The court held that a physician-patient relationship existed between the petitioners and the victim. The petitioners examined the victim, assured the mother, and agreed to attend to the victim's medical needs. These actions establish a physician-patient relationship.

8. The court found that the petitioners were negligent in failing to perform an extensive medical examination to determine the extent of the victim's injuries. They were remiss in their duties as members of the medical profession. They should have referred the patient to another doctor with sufficient training and experience instead of assuring him and his mother that everything was all right. However, the petitioners were only found civilly liable, not criminally liable.

9. The Court holds the petitioners civilly liable for the damages suffered by the patient, Roy Jr. Although no criminal negligence was found, their failure to administer necessary medical attention to Roy Jr. was deemed contributory to the resulting damages.

10. The Court finds the petitioners liable for actual damages in the amount of P3,850.00, which was adequately supported by receipts. The Court also awards moral damages in the amount of P100,000.00 to compensate for the physical suffering, mental anguish, and other injuries unjustly inflicted on Roy Jr. Furthermore, the petitioners are held liable for exemplary damages in the amount of P50,000.00, which may serve as an example or correction for the public good.

PRINCIPLES:

• The doctrine of res ipsa loquitur means that negligence of the alleged wrongdoer may be inferred from the mere fact that the accident happened, provided certain conditions are met.

• The requisites for the application of res ipsa loquitur are: (1) the accident was of a kind which does not ordinarily occur unless someone is negligent; (2) the instrumentality or agency which caused the injury was under the exclusive control of the person in charge; and (3) the injury suffered must not have been due to any voluntary action or contribution of the person injured.

• Negligence is the failure to observe the degree of care, precaution, and vigilance that the circumstances justly demand, resulting in injury to another person.

• Reckless imprudence consists of voluntarily doing or failing to do an act without malice, resulting in material damage due to an inexcusable lack of precaution.

• The elements of simple negligence are: (1) lack of precaution by the offender, and (2) the impending damage is not immediate or the danger is not clearly manifest.

• Failure to perform a thorough examination may be considered a form of medical negligence.

• In order to hold someone criminally liable for medical negligence, there must be evidence to show that the negligence caused further harm or complications to the patient.

• The accused has the right to be presumed innocent until proven guilty beyond reasonable doubt.

• A physician-patient relationship is established when a patient engages the services of a physician, and the physician assumes the duty to exercise care and skill in the treatment of the patient.

• A physician has the obligation to use at least the same level of care that any other reasonably competent physician would use to treat the condition under similar circumstances.

• Doctors cannot invoke the immediate cause of injury to avoid liability for failing to attend to a victim's medical needs in cases of hit-and-run or other crimes of violence.

• Issues raised for the first time on appeal cannot be considered as it is unfair to the other party and violates principles of fair play, justice, and due process.

• Negligence can lead to civil liability for damages even if criminal negligence is not established.

• Actual damages must be adequately supported by receipts.

• Moral damages are designed to compensate for physical suffering, mental anguish, and other injuries unjustly inflicted on a person.

• Exemplary damages may be imposed by way of example or correction for the public good.