Ramos vs. CA (1999)

USA College of Law
Laspiñas-3C
Case Name ROGELIO E. RAMOS and ERLINDA RAMOS, et.al. v. CA, et.al.
Topic Damages: Factors to Consider in Determining Amount (as per book of Aquino)
Case No. | Date G.R. No. 124354 | December 29, 1999
Ponente Kapunan, J.
Doctrine The extent of pain and suffering determines the award
RELEVANT FACTS
§ In 1985, Petitioner Erlinda Ramos was to undergo general surgery operation for the removal of stones in her gall
bladder but has been in a comatose condition because of an alleged negligence on the part of private respondents
Dr. Hosaka and Dr. Gutierrez during the anesthesia phase of the operation.
§ A civil case for damages was filed by the petitioners before the RTC against the private respondents alleging
negligence in the management and care of Erlinda Ramos. Evidence were presented to prove that the condition of
Erlinda was due to lack of oxygen in her brain caused by the faulty management of her airway by private
respondents during the anesthesia phase. Private respondents, on the other hand, relying on an expert witness,
asserted that the cause of brain damage was Erlinda's allergic reaction to the anesthetic agent, Thiopental Sodium
(Pentothal).
§ The RTC ruled in favor of the petitioners and ordered private respondents to pay jointly and severally sums of
money including attorney’s fees, moral damages, exemplary damages, and costs of suit.
§ Upon appeal by the private respondents before the CA, the decision of the RTC was reversed and the case was
dismissed. Hence, a petition before the Supreme Court assailing the decision of the CA.
ISSUE (includes all issues related to Torts and Damages):

(1) Whether the doctrine of res ipsa loquitor applies on the case at bar?
(2) Whether private respondents were negligent? If yes, whether their negligence was the proximate cause of
the comatose condition of petitioner Erlinda Ramos?
(3) The necessary damages to be paid if there is indeed negligence.
RULING:
(1) Yes. The damage sustained by petitioner Erlinda in her brain prior to a scheduled gall bladder operation
presents a case for the application of res ipsa loquitur. For the said doctrine to be applied, the following requisites
should be present:
1. The accident is of a kind which ordinarily does not occur in the absence of someone's negligence;
2. It is caused by an instrumentality within the exclusive control of the defendant or defendants; and
3. The possibility of contributing conduct which would make the plaintiff responsible is eliminated.
In the present case, Erlinda submitted herself for cholecystectomy and expected a routine general surgery to be
performed on her gall bladder. On that fateful day she delivered her person over to the care, custody and control
of private respondents who exercised complete and exclusive control over her. At the time of submission, Erlinda
was neurologically sound and, except for a few minor discomforts, was likewise physically fit in mind and body.
However, during the administration of anesthesia and prior to the performance of cholecystectomy she suffered
irreparable damage to her brain. Thus, without undergoing surgery, she went out of the operating room already
decerebrate and totally incapacitated. Obviously, brain damage, which Erlinda sustained, is an injury which does
not normally occur in the process of a gall bladder operation. In fact, this kind of situation does not in the absence
USA College of Law
Laspiñas-3C
of negligence of someone in the administration of anesthesia and in the use of endotracheal tube. Normally, a
person being put under anesthesia is not rendered decerebrate as a consequence of administering such
anesthesia if the proper procedure was followed. Furthermore, the instruments used in the administration of
anesthesia, including the endotracheal tube, were all under the exclusive control of private respondents, who are
the physicians-in-charge. Likewise, petitioner Erlinda could not have been guilty of contributory negligence
because she was under the influence of anesthetics which rendered her unconscious.
(2) Yes. Dr. Gutierrez was negligent when she failed to perform a pre-operative evaluation of the patient which, in
turn, resulted to a wrongful intubation. Supreme Court emphasized that the operation for Erlinda was an elective
surgery and she had all the time to make a thorough evaluation of Erlinda's case prior to the operation and
prepare her for anesthesia but failed to take advantage of the said opportunity. The faulty intubation was also
the proximate cause of the comatose condition of Erlinda because of the failure to observe proper pre-operative
protocol which could have prevented the incident. Had appropriate diligence and reasonable care been used in
the pre-operative evaluation, respondent physician could have been much more prepared to meet the
contingency brought about by the perceived anatomic variations in the patient's neck and oral area, defects
which would have been easily overcome by a prior knowledge of those variations together with a change in
technique.
(3) An award of P1,500,000.00 in temperate damages for the cost of proper hospice care for Erlinda who is in a
comatose condition. Temperate damages can and should be awarded on top of actual or compensatory damages
in instances where the injury is chronic and continuing.
An award of P2,000,000.00 in moral damages for the family's moral injury and suffering. The husband and the
children, all petitioners in this case, will have to live with the day to day uncertainty of the patient's illness,
knowing any hope of recovery is close to nil. They have fashioned their daily lives around the nursing care of
petitioner, altering their long term goals to take into account their life with a comatose patient. They, not the
respondents, are charged with the moral responsibility of the care of the victim.
Finally, by way of example, exemplary damages in the amount of P100,000.00 are hereby awarded. Considering
the length and nature of the instant suit we are of the opinion that attorney's fees valued at P100,000.00 are
likewise proper.
RULING
The decision of the CA was modified in favor of the petitioners and ordered private respondents to solidarily pay the
sums of damages.

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ISSUE (includes all issues related to Torts and Damages):

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