By: Gregorio M. Batiller, Jr.

Very recently a major newspaper featured an article on malpractice by doctors of a government provincial hospital. A child was bought to the hospital, complaining of stomach pains. It was then prescribed that he needed to take some oral suspension. But no amount of coaxing could convince the child to take the medicine. So this doctor decides to introduce the suspension
intravenously as the child was then on dextrose. Thereafter, the child went into spasms and died. The doctor must have been under the (mis) impression that
oral intake is synonymous with intravenous application.

The case brings to mind the principle laid down by the Supreme Court in Ramos vs. Court of Appeals, 231 SCRA 584 on the application of the doctrine of
res ipsa loquitur (“the thing speaks for itself”) in medical malpractice cases.

“Thus, res ipsa loquitur has been applied when the
circumstances attendant upon the harm are themselves
of such a character as to justify an inference of
negligence as the cause of that harm.

Although generally, expert medical testimony is
relied upon in malpractice suits to prove that a
physician has done a negligent act or that he has
deviated from the standard medical procedure, when
the doctrine of res ipsa loquitur is availed by the plaintiff,
the need for expert medical testimony is dispensed with
because the injury itself provides the proof of
negligence. The reason is that the general rule on the
necessity of expert testimony applies only to such
matters clearly within the domain of medical science,
and not to matters than are within the common
knowledge of mankind which may be testified to by
anyone familiar with the facts.

Hence, in cases where the res ipsa loquitur is applicable, the court is permitted to find a physician negligent upon proper proof of injury to the patient, without
the aid of expert testimony, where the court from its fund of common knowledge can determine the proper standard of care. Where common knowledge and experience teach that a resulting injury would not have occurred to the patient if due care had been exercised, and inference of negligence may be drawn giving rise to an application of the doctrine of res ipsa loquitur.

When the doctrine is appropriate, all that the
patient must do is prove a nexus between the particular
act or omission complained of and the injury sustained
while under the custody and management of the
defendant without need to produce expert medical
testimony to establish the standard of care.

Thus, courts of other jurisdictions have applied the
doctrine in the following situations: leaving of a foreign
object in the body of the patient after an operation,
injuries sustained on a healthy part of the body which
was not under, or in the area of treatment, removal of
the wrong part of the body when another part was
intended, knocking out a tooth while patient’s jaw was
under anesthetic for the removal of his tonsils, and loss of
an eye while the patient plaintiff was under the
influence of anesthetic, during or following an operation
for appendicitis, among others.”

Significantly, the Supreme Court also found the anesthesiologist to be negligent because she failed to conduct a pre-operative evaluation of the patient prior to the administration of anesthesia considering that the operation was an elective surgery [as distinguished from an emergency case).