Rosit v. Davao Doctors Hospital
REITERATIONFacts
1. The Antecedents: Nilo B. Rosit suffered a fractured jaw after a motorcycle accident. He underwent surgery performed by Dr. Rolando G. Gestuvo at Davao Doctors Hospital, during which a metal plate and screws were used to immobilize his mandible. Dr. Gestuvo, aware of the availability of smaller titanium screws, opted to cut the screws he had on hand to fit, without informing the patient of the alternative. Following the surgery, Rosit experienced pain and difficulty opening his mouth, leading to a diagnosis that a corrective surgery was necessary. 2. Procedural History: Rosit filed a civil case for damages against Dr. Gestuvo and Davao Doctors Hospital. The Regional Trial Court (RTC) found Dr. Gestuvo negligent and awarded damages to Rosit, while absolving the hospital. Both parties appealed. The Court of Appeals (CA) reversed the RTC's decision, deleting the monetary awards and absolving Dr. Gestuvo, ruling that expert testimony was necessary and that the doctrine of res ipsa loquitur was inapplicable. Rosit's motion for reconsideration was denied, prompting this petition for review on certiorari. 3. The Petition: This petition, filed under Rule 45 of the Rules of Court, assails the CA's decision and resolution. The petitioner argues that the CA erred in absolving Dr. Gestuvo by incorrectly disregarding the applicability of the doctrine of res ipsa loquitur and the principle of informed consent. The petitioner contends that the injury itself, specifically the screw impinging on his molar, and Dr. Gestuvo's failure to disclose the availability and risks associated with smaller titanium screws, constitute clear evidence of negligence, obviating the need for expert medical testimony.
Issue(s)
Whether the Court of Appeals correctly absolved Dr. Gestuvo from liability for medical negligence, and the applicability of res ipsa loquitur. Whether Dr. Gestuvo breached his duty to obtain informed consent from Rosit regarding the surgical procedure and materials used. Whether Dr. Pangan's affidavit was admissible as evidence. Whether the damages awarded by the RTC were proper.
Ruling
The Supreme Court GRANTED the petition, REVERSED and SET ASIDE the Court of Appeals Decision and Resolution, and REINSTATED and AFFIRMED the Decision of the Regional Trial Court. Dr. Rolando G. Gestuvo was found liable for medical negligence.
Ratio Decidendi
On the applicability of res ipsa loquitur and the necessity of expert testimony: The Court held that the appellate court erred in absolving Dr. Gestuvo. It reiterated that while expert testimony is generally required in medical negligence cases, an exception exists when the doctrine of res ipsa loquitur is applicable. The Court found that the essential requisites for res ipsa loquitur were present: (1) the accident (a screw striking the patient's molar) does not ordinarily occur unless someone is negligent; (2) the instrumentality (the screw placement during surgery) was under Dr. Gestuvo's exclusive control; and (3) the injury was not due to Rosit's voluntary action. The Court emphasized that Dr. Gestuvo's act of cutting screws and negligently placing one such that it struck Rosit's molar clearly demonstrated negligence, making expert testimony unnecessary. The CA's reliance on Dr. Pangan's letter was deemed improper due to hearsay. On the breach of the doctrine of informed consent: The Court found Dr. Gestuvo guilty of negligence for failing to inform Rosit about the availability of smaller titanium screws and the risks associated with using the larger, cut screws. Dr. Gestuvo admitted he did not inform Rosit, believing Rosit could not afford them. The Court applied the four elements of a malpractice action based on informed consent: (1) Dr. Gestuvo had a duty to disclose material risks; (2) he failed to disclose these risks; (3) Rosit consented to treatment he otherwise would not have consented to had he known the risks; and (4) Rosit was injured by the proposed treatment (pain, need for corrective surgery). The Court noted that Rosit was able to afford the titanium screws used in the corrective surgery, undermining Dr. Gestuvo's assumption. On the admissibility of Dr. Pangan's affidavit: The Court ruled that Dr. Pangan's letter, presented as an affidavit, was inadmissible hearsay because Dr. Pangan did not take the witness stand to affirm its contents. Therefore, the CA erred in considering it as expert testimony. Even if admissible, the Court is not bound by expert testimony and must weigh it against other evidence. On the award of damages: The Court affirmed the RTC's award of actual damages, finding they were the natural and probable consequences of Dr. Gestuvo's negligence and were adequately proven. Moral damages were also affirmed due to the unnecessary physical suffering Rosit endured for a month. Attorney's fees and costs of suit were justified as Rosit was compelled to litigate. Exemplary damages were upheld because Dr. Gestuvo acted with bad faith and in a wanton, reckless, and oppressive manner by breaching the doctrine of informed consent and concealing material information.
Main Doctrine
The doctrine of res ipsa loquitur is applicable in medical negligence cases when the injury itself provides proof of negligence, dispensing with the need for expert testimony, provided that the accident does not ordinarily occur without negligence, the instrumentality causing injury was under exclusive control, and the injury was not due to the patient's voluntary action. Furthermore, a physician has a duty to disclose material risks of a proposed treatment under the doctrine of informed consent, and failure to do so, resulting in injury, constitutes negligence.