Air France vs Carrascoso

In March 1958, Rafael Carrascoso and several other Filipinos ISSUE 2: Whether or not the testimony of Carrasoso regarding
were tourists en route to Rome from Manila. Carrascoso was the note which was not presented in court is admissible in
issued a first class round trip ticket by Air France. But during a evidence.
stop-over in Bangkok, he was asked by the plane manager of
HELD 1: Yes. It appears that Air France’s liability is based on
Air France to vacate his seat because a white man allegedly
culpa-contractual and on culpa aquiliana.
has a “better right” than him. Carrascoso protested but when
things got heated and upon advise of other Filipinos on board, Culpa Contractual
Carrascoso gave up his seat and was transferred to the
plane’s tourist class. There exists a contract of carriage between Air France and
Carrascoso. There was a contract to furnish Carrasocoso a
After their tourist trip when Carrascoso was already in the first class passage; Second, That said contract was breached
Philippines, he sued Air France for damages for the when Air France failed to furnish first class transportation at
embarrassment he suffered during his trip. In court, Bangkok; and Third, that there was bad faith when Air
Carrascoso testified, among others, that he when he was France’s employee compelled Carrascoso to leave his first
forced to take the tourist class, he went to the plane’s pantry class accommodation berth “after he was already, seated” and
where he was approached by a plane purser who told him that to take a seat in the tourist class, by reason of which he
he noted in the plane’s journal the following: suffered inconvenience, embarrassments and humiliations,
thereby causing him mental anguish, serious anxiety,
First-class passenger was forced to go to the tourist class
wounded feelings and social humiliation, resulting in moral
against his will, and that the captain refused to intervene
damages.
The said testimony was admitted in favor of Carrascoso. The
The Supreme Court did not give credence to Air France’s
trial court eventually awarded damages in favor of Carrascoso.
claim that the issuance of a first class ticket to a passenger is
This was affirmed by the Court of Appeals.
not an assurance that he will be given a first class seat. Such
Air France is assailing the decision of the trial court and the claim is simply incredible.
CA. It avers that the issuance of a first class ticket to
Culpa Aquiliana
Carrascoso was not an assurance that he will be seated in first
class because allegedly in truth and in fact, that was not the Here, the SC ruled, even though there is a contract of carriage
true intent between the parties. between Air France and Carrascoso, there is also a tortuous
act based on culpa aquiliana. Passengers do not contract
Air France also questioned the admissibility of Carrascoso’s
merely for transportation. They have a right to be treated by
testimony regarding the note made by the purser because the
the carrier’s employees with kindness, respect, courtesy and
said note was never presented in court.
due consideration. They are entitled to be protected against
ISSUE 1: Whether or not Air France is liable for damages and personal misconduct, injurious language, indignities and
on what basis. abuses from such employees. So it is, that any rule or
discourteous conduct on the part of employees towards a
passenger gives the latter an action for damages against the which would make the plaintiff responsible is eliminated. In the
carrier. Air France’s contract with Carrascoso is one attended case at bar, the gasoline station, with all its appliances,
with public duty. The stress of Carrascoso’s action is placed equipment and employees, was under the control of
upon his wrongful expulsion. This is a violation of public duty
respondents. A fire occurred therein and spread to and burned
by the Air France — a case of quasi-delict. Damages are
proper. the neighboring houses. The persons who knew or could have
known how the fire started were respondents and their
Africa vs Caltex employees, but they gave no explanation thereof whatsoever.
Facts: In the afternoon of March 18, 1948, a fire broke out at It is a fair and reasonable inference that the incident happened
the Caltex service station at the corner of Antipolo St. and because of want of care. The negligence of the employees
Rizal Avenue, Manila. It started while gasoline was being was the proximate cause of the fire, which in the ordinary
hosed from a tank truck into the underground storage, right at course of things does not happen. Therefore, the petitioners
the opening of the receiving tank where the nozzle of the hose are entitled to the award for damages.
was inserted. The fire spread to and burned several houses.
The owners, among them petitioner spouses Africa and heirs
of Ong, sued respondents Caltex Phil., Inc., the alleged owner Espiritu vs. Philippine Power and Development Co.
of the station, and Mateo Boquiren, the agent in charge of its (CA-G.R. No. 3240-R, September 20, 1949)Reyes, JBL
operation, for damages. The CFI and CA found that the :In the afternoon of May 5, 1946while the plaintiff-
petitioners failed to prove negligence of the respondents, and appellee and other companions were loading grass,an
that there was due care in the premises and with respect to electric transmission wire, installed and maintained by the
the supervision of their employees. defendant Philippine Power andDevelopment Co., Inc.,
alongside the road suddenly parted, and one of the broken
Issue: Whether or not, without proof as to the cause and origin ends hit the head of the plaintiff as he was about to board
of the fire, the doctrine of res ipsa loquitur should apply so as
the truck. As a result, plaintiff received the full shock
to presume negligence on the part of the respondents.
of 4,400volts of the wire. The electric charge coursed
Held: Yes. Res ipsa loquitur literally means “the thing or through his body and caused extensive and seriousmultiple
transaction speaks for itself.” For the doctrine of res ipsa burns from skull to eyes, leaving the bone exposed in some
loquitur to apply, the following requisites should be present: (a) parts and causing intense pain andwounds that were not
the accident is of a kind which ordinarily does not occur in the completely healed when the case was tried on June 18,
absence of someone’s negligence; (b) it is caused by an 1947, over one year afterthe incident. Defendant
instrumentality within the exclusive control of the defendant or disclaimed such liability on the ground that the plaintiff
defendants; and (c) the possibility of contributing conduct had failed to show anyspecific act of negligence.
 there are any facts inconsistent with negligence, it is for the
The appellate court, in overruling this defense, held: “While it is the defendant to prove.
rule, as contended by the appellant,
that in case of non-contractual negligence, or culpa Ramos vs Court of Appeals
aquiliana, the burden of proof is on the plaintiff GR No. 124354 December 29, 1999
toestablish that the proximate cause of injury was the
Facts: Plaintiff Erlinda Ramos was, until the afternoon of June 17,
negligence of the defendant, it is also a recognized principle 1985 a 47-year old robust woman. Except for occasional complaints
that ‘where the thing that causes injury, without fault of the injured of discomfort due to pains allegedly caused by presence of a stone in
person, is under the exclusive control of the defendant and her gall bladder, she was as normal as any other woman. Married to
the injury is such as in the ordinary course of things does Rogelio Ramos, an executive of Philippine Long Distance Telephone
notoccur as if he having such control used proper care, it Company (PLDT), she has three children whose names are Rommel,
Roy Roderick, and Ron Raymond. Because of the discomforts
affords reasonable evidence, in the absence of the somehow interfered with her normal ways, she sough professional
explanation, that the injury arose from the defendant’s advice. She was told to undergo an operation for the removal of a
want of care.’ And the burden of evidence is shifted to him stone in her gall bladder. She underwent series of examination which
to establish that he had observed due diligence and care. revealed that she was fit for the said surgery. Through the
intercession of a mutual friend, she and her husband met Dr. Osaka
This rule is known by the nameof res ipsa loquitur (the
for the first time and she was advised by Dr. Osaka to go under the
thing or transaction speaks for itself), and is peculiarly operation called cholecystectomy and the same was agreed to be
applicable to the case atbar, where it is unquestioned that scheduled on June 17,1985 at 9:00am at the Delos Santos Medical
the plaintiff had every night to be on the highway, and the Center. Rogelio asked Dr. Osaka to look for a good anesthesiologist
electricwire was under the sole control of the defendant to which the latter agreed to. A day before the scheduled operation,
she was admitted at the hospital and on the day of the operation,
company. In the ordinary course of events, electricwires do
Erlinda’s sister was with her insider the operating room. Dr. Osaka
not part suddenly in fair weather and injure people, unless arrived at the hospital late, Dr. Guttierez, the anesthesiologist, started
they are subject to unusual strainand stress or there are to intubate Erlina when Herminda heard her say that intubating
defects in their installation, maintenance and supervision, Erlinda is quite difficult and there were complications. This prompt
just as barrels do notordinarily roll out of the warehouse Dr. Osaka to order a call to another anesthesiologist, Dr. Caldron
who successfully intubated Erlina. The patient’s nails became bluish
windows to injure passers-by, unless someone is negligent and the patient was placed in a trendelenburg position. After the
(which isadmittedly not present), the fact that the wire operation, Erlina was diagnosed to be suffering from diffuse cerebral
snapped suffices to raise a reasonable presumption of parenchymal damage and that the petitioner alleged that this was due
negligence in its installation, care and maintenance. to lack of oxygen supply to Erlinda’s brain which resulted from the
intubation.
Thereafter, as observed by Chief Baron Pollock “if
Issue: Whether or not the doctors and the hospital are liable for meet the contingency brought about by the perceived atomic
damages against petitioner for the result to Erlinda of the said variations in the patient’s neck and oral area; defects which could
operation. have been easily overcome by a prior knowledge of those variations
together with a change in technique. In other words, an experienced
Held: Yes. The private respondents were unable to disprove the anesthesiologist, adequately alerted by a thorough pre-operative
presumption of negligence on their part in the care of Erlinda and evaluation, would have had little difficulty going around the short
their negligence was the proximate case of her piteous condition. neck and potruding teeth. Having failed to observe common medical
standards in pre-operative management and intubation, respondent
Nevertheless, despite the fact that the scope of res ipsa liquitor has Dra. Guttierez negligence resulted in cerebral anoxia and eventual
been measurably enlarged, it does not automatically follow that it coma of Erlinda
apply to all cases of medical negligence as to mechanically shift the
burden of proof to the defendant to show that he is not guilty of the Li vs Spouses Soliman
ascribed negligence. Res ipsa liquitor is not a rigid or ordinary GR No. 165279 June 7, 2011
doctrine to be perfunctorily used but a rule to be cautiously applied,
depending upon the circumstances of each case. It is generally Facts: On July 7, 1993, respondents 11 year old daughter, Angelica
restricted to situations in malpractice cases where a layman is able to Soliman underwent a biopsy of the mass located in her lower
say, as a matter of common knowledge and observation, that the extremity at the St. Lukes Medical Center (SLMC). Results showed
consequences of professional care were not as such as would that Angelica was suffering from osteosaucoma, ostiobiostic type, a
ordinarily have followed if due care had been exercised. A high-grade (highly malignant) cancer of the bone which usually
distinction must be made between the failure to secure results, and affects teenage children. Following this diagnosis, Angelica’s right
the occurrence of something more unusual and not ordinarily found leg was amputated by Dr. Tamayo in order to remove the tumor. As
if the service or treatment rendered followed the usual procedure of a adjuvant treatment to eliminate any remaining cancer cells, and
those skilled in that particular practice. It must be conceded that the hence minimizing the chances of recurrence and prevent the decease
doctrine of res ipsa liquitor can have no application in a suit against from spreading to other parts of the patient’s body, chemotherapy
a physician or surgeon which involves the merits of a diagnosis or of was suggested by Dr. Tamayo and referred Angelica to another
a scientific treatment. doctor at SLMC, herein petitioner Dr. Rubi Li, a medical oncologist.

Scientific studies point out that intubation problems are responsible On July 23, 1993, petitioner saw the respondents at the hospital after
for 1/3 of deaths and serious injuries associated with anesthesia. Angelica’s surgery and discussed with them Angelica’s condition.
Nevertheless, 98% or the vast majority of difficult intubation may be Petitioner told respondents that Angelica should be given 2-3 weeks
anticipated by performing a thorough evaluation of the patient’s to recover from the operation before starting the chemotherapy.
airway prior to the operation. As stated beforehand, respondent, Dra. Respondents were apprehensive due to financial constraints as
Guttierez failed to observe the proper pre-operative protocol which Reynaldo earns only from P70,000-150,000 a year from his jewelry
could have prevented this unfortunate incident. Had appropriate and watching repair business. Petitioner, however, assured them not
diligence and reasonable care been used in the pre-operative to worry about her professional fee and told them to just save up for
evaluation, respondent physician could have been more prepared to medicines to be used.
As the chemotherapy session started, day by day, Angelica Medical negligence cases are best proved by opinions of expert
experience worsening condition and other physical effect on the witnesses belonging in the same general neighborhood and in the
body such as discoloration, nausea, and vomiting. same general line of practice as defendant physician or surgeon. The
deference of courts to the expert opinion of qualified physicians
Petitioner claimed, that she explained to respondents that even when stems from the former’s realization that the latter possess unusual
a tumor is removed, there are still small lesions undetectable to the technical skills which layman in most instances are incapable of
naked eye and that adjuvant chemotherapy is needed to clean out the intelligently evaluating, hence the indispensability of expert
small lesions in order to lessen the chance of cancer to recur. She did testimonies.
not give the respondents any assurance that chemotherapy will cure
Angelica’s cancer. During these consultations with respondents, she The doctrine of informed consent within the context of physician-
explained the following side effects of chemotherapy treatment to patient relationships goes as far back into english common law. As
respondents: 1.) Falling hair; 2.) nausea and vomiting; 3.) loss of early as 1767, doctors were charged with the tort of battery if they
appetite; 4.) low count of WBC, RBC, and platelets; 5.) possible have not gained the consent of their patients prior to performing a
sterility due to the effects on Angelica’s ovary; 6.) Damage to kidney surgery or procedure. In the United States, the seminal case was
and heart; 7.) darkening of the skin especially when exposed to Schoendorff vs Society of New York Hospital which involved
sunlight. She actually talked to the respondents four times, once at unwanted treatment performed by a doctor. Justice Bejamin Cardozo
the hospital after the surgery, twice at her clinic and fourth when oft-quoted opinion upheld the basic right of a patient to give consent
Angelica’s mother called her through long distance. This was to any medical procedure or treatment; every human being of adult
disputed by respondents who countered that petitioner gave them year and sound mind has a right to determine what shall be done with
assurance that there is 95% chance of healing for Angelica if she his own body; and a surgeon who performs an operation without his
undergoes chemotherapy and that the only side effects were nausea, patient’s consent commits an assault, for which he is liable in
vomiting and hair loss. Those were the only side effects of damages. From a purely ethical norm, informed consent evolved into
chemotherapy mentioned by petitioner. a general principle of law that a physician has a duty to disclose what
a reasonably prudent physician in the medical community in the
Issue: Whether or not petitioner committed medical malpractice. exercise of reasonable care would disclose to his patient as to
whatever grave risk of injury might be incurred from a proposed
Held: No. The type of lawsuit which has been called medical course of treatment, so that a patient, exercising ordinary care for her
malpractice or more appropriately, medical negligence, is that type own welfare and faced with a choice of undergoing the proposed
of claim which a victim has available to him or her to redress a treatment, as alternative treatment, or none at all, may intelligently
wrong committed by a medical professional which has caused bodily exercise his judgement by reasonably balancing the probable risk
harm. In order to successfully pursue such claim, a patient must against the probable benefits.
prove that a health care provider in most cases a physician, either
failed to do something which a reasonably prudent health care There are four essential elements a plaintiff must proved in a
provider would have done or that he or she did something that a malpractice action based upon the doctrine of informed consent: 1.)
reasonably health care provider would not have done; and that failure the physician had a duty to disclose material risks; 2.) he failed to
or action caused injury to the patient. disclose or inadequately disclosed those risks; 3.) as a direct and
proximate result of the failure to disclose, the patient consented to
treatment she otherwise would not have consented to; and 4.)
plaintiff was injured by the proposed treatment. The gravamen in an
informed consent requires the plaintiff to point to significant
undisclosed information relating to the treatment which could have
altered her decision to undergo it.

Examining the evidence, we hold that there was adequate disclosure

of material risks inherent in chemotherapy procedure performed with
the consent of Angelica’s parents. Respondents could not have been
unaware in the course of initial treatment and amputation of
Angelica’s lower extremity that her immune system was already
weak on account of the malignant tumor in her knee. When
petitioner informed the respondents beforehand of the side effects of
chemotherapy which includes lowered counts of white and red blood
cells, decrease in blood platelets, possible kidney or heart damage
and skin darkening, there is reasonable expectation on the part of the
doctor that the respondents understood very well that the severity of
these side effects will not be the same for all patients undergoing the
procedure. In other words, by the nature of the disease itself, each
patients reaction to the chemical agents even with pre-treatment
laboratory tests cannot be precisely determined by the physician.
That death can possibly result from complications of the treatment or
the underlying cancer itself, immediately or sometime after the
administration of chemotherapy drugs, is a risk that cannot be ruled
out, as with most other major medical procedures, but such
conclusion can be reasonably drawn from the general side effects of
chemotherapy already disclosed