Mendoza v. Casumpang
REITERATIONFacts
The Antecedents: Josephine Casumpang underwent hysterectomy and myomectomy performed by Dr. Mariter Mendoza. Post-operation, Josephine experienced recurring fever, nausea, and vomiting. Three months later, she discovered a rolled gauze protruding from her cervix. She consulted another physician who extracted the gauze. Procedural History: Josephine filed an action for damages against Dr. Mendoza. She died before the trial concluded, and her husband and children substituted her. The Regional Trial Court (RTC) initially found Dr. Mendoza guilty of neglect but later reversed itself and dismissed the complaint. The Court of Appeals (CA) reinstated the RTC's original decision, holding Dr. Mendoza breached her duty. The CA denied Dr. Mendoza's motion for reconsideration. The Petition: Dr. Mendoza filed a petition for review on certiorari before the Supreme Court, claiming no gauze was left in Josephine's body, citing the hospital's surgical sponge count. The Court noted that this raised a question of fact, which is generally binding on the CA, and exceptions did not apply.
Issue(s)
Whether the Court of Appeals erred in finding Dr. Mendoza guilty of negligence despite the hospital's surgical sponge count. Whether the award of damages, including exemplary damages, civil indemnity for death, and attorney's fees, is proper.
Ruling
The Supreme Court affirmed the decision of the Court of Appeals with modifications, ordering petitioner Mariter Mendoza to pay respondents Adriano, Jennifer Adriane and John Andre, all surnamed Casumpang, an additional ₱50,000.00 as exemplary damages, additional ₱30,000.00 as attorney's fees, and civil indemnity arising from death in the amount of ₱50,000.00.
Ratio Decidendi
On the issue of negligence: The Court held that the presence of a gauze in the patient's body after surgery is at least prima facie negligence, and even considered negligence per se by many authorities. The Court emphasized that an operation is not complete until all sponges are removed, and the surgeon has a duty to personally ascertain the correct count of instruments and materials before closing the incision. The hospital record of sponge count, while presented, was not given determinative weight against the physical evidence of the gauze found in the patient's cervix, especially since Josephine did not undergo any other surgical procedure. The Court found it highly unlikely for the patient to have introduced the gauze herself. On the issue of damages: The Court found it proper to award exemplary damages under Article 2229 of the Civil Code, by way of example or correction for the public good, especially in cases of gross negligence, to stress the need for vigilance in attending to a patient's health. Furthermore, civil indemnity for death under Article 2206 of the Civil Code was awarded, fixed by prevailing jurisprudence at ₱50,000.00. The Court also deemed it just and equitable to increase the award of attorney's fees from ₱20,000.00 to ₱50,000.00 under Article 2208 of the Civil Code.
Main Doctrine
The presence of a foreign object like gauze in a patient's body after surgery, despite hospital records indicating a correct sponge count, constitutes at least prima facie negligence on the part of the operating surgeon, and may even be considered negligence per se. The surgeon has a non-delegable duty to personally ensure the accuracy of instrument and material counts before closing an incision.