Cereno v. CA

DR. PEDRO DENNIS CERENO v. CA, GR No.
167366, 2012-09-26
Facts:
Raymond S. Olavere (Raymond), a victim of a stabbing incident, was rushed to the emergency
room of the Bicol Regional Medical Center (BRMC)... attended to by Nurse Arlene Balares
(Nurse Balares) and Dr. Ruel. Levy Realuyo (Dr. Realuyo) the parents of Raymond the spouses
Deogenes Olavere (Deogenes) and Fe R. Serrano arrived at the BRMC. Dr. Realuyo
recommended that the patient undergo "emergency exploratory laparotomy." Dr. Realuyo then
requested the parents of Raymond to procure 500 cc of type "O" blood needed for the operation.
Went to the Philippine National Red Cross to secure the required blood. At 10:30 P.M.,
Raymond was wheeled inside the operating room the hospital surgeons, Drs. Zafe and Cereno,
were busy operating on gunshot victim Charles Maluluy-on. Assisting them in the said operation
was Dr. Rosalina Tatad (Dr. Tatad), who was the only senior anesthesiologist another emergency
case involving Lilia Aguila, a woman who was giving birth to triplets, was brought to the
operating room.At 10:59 P.M., the operation on Charles Maluluy-on was finished.
By that time, however, Dr. Tatad was already working with the obstetricians who will perform
surgery on Lilia Aguila... no other available anesthesiologist to assist them, Drs. Zafe and
Cereno... decided to defer the operation on Raymond. Proceeded to examine Raymond and they
found that the latter's blood pressure was normal and "nothing in him was significant." the fluid
inside the thoracic cavity of Raymond was minimal at around 200-300 cc. Upon opening of
Raymond's thoracic cavity, they found that 3,200 cc of blood was stocked therein. The blood was
evacuated and petitioners found a puncture at the inferior pole of the left lung. Dr. Cereno he did
not immediately transfuse blood because he had to control the bleeders first. At 1:45 A.M., while
the operation was on-going, Raymond suffered a cardiac arrest. The operation ended at 1:50
A.M. and Raymond was pronounced dead at 2:30 A.M.
Raymond's death certificate indicated that the immediate cause of death was
"hypovolemic shock" or the cessation of the functions of the organs of the body due to loss of
blood complaint for damages against Nurse Balares, Dr. Realuyo and attending surgeons
Ordering defendants Dr. Santos Zafe and Dr. Dennis Cereno to pay the heirs of Raymond
Olavere. The trial court found petitioners negligent in not immediately conducting surgery on
Raymond... had the surgery been performed promptly, Raymond would not have lost so much
blood and, therefore, could have been saved. The non-availability of Dr. Tatad after the operation
on Maluluy-on was not a sufficient excuse for the petitioners to not immediately operate on
Raymond
Issue:
THAT PETITIONERS WERE GROSSLY NEGLIGENT IN THE PERFORMANCE OF THEIR
DUTIES
Ruling:
Medical negligence, is that type of claim which a victim has available to him or her to redress a
wrong committed by a medical professional which has caused bodily harm. A patient must prove
that a health care provider, in most cases a physician, either failed to do something which a
reasonably prudent health care provider would have done, or that he or she did something that a
reasonably prudent provider would not have done; and that the failure or action caused injury to
the patient. (1) that the health care provider, either by his act or omission, had been negligent,
and (2) that such act or omission proximately caused the injury complained of. The best way to
prove these is through the opinions of expert witnesses belonging in the same neighborhood and
in the same general line of practice as defendant physician or surgeon. Possess unusual technical
skills which laymen in most instances are incapable of intelligently evaluating, hence, the
indispensability of expert testimonies.
Petitioners Not Negligent
It rejected as an excuse the non-availability of Dr. Tatad.
The trial court relied on the testimony of Dr. Tatad about a "BRMC protocol" that
introduces the possibility that a standby anesthesiologist could have been called upon. There is
nothing in the testimony of Dr. Tatad, or in any evidence on the record for that matter, which
shows that the petitioners were aware of the "BRMC protocol" that the hospital keeps a standby
anesthesiologist available on call. Indeed, other... than the testimony of Dr. Tatad, there is no
evidence that proves that any such "BRMC protocol" is being practiced by the hospital's
surgeons at all.
Without any prior knowledge of the "BRMC protocol," We find that it is quite reasonable
for the petitioners to assume that matters regarding the administration of anesthesia and the
assignment of anesthesiologists are concerns of the Anesthesiology . Department, while matters
pertaining to the surgery itself fall under the concern of the surgeons. Their failure to request for
the assistance of the standby anesthesiologist to be reasonable when taken in the proper...
context. The matter of requesting for a standby anaesthesiologist is not within the full discretion
of petitioners. The "BRMC protocol" described in the testimony requires the petitioners to
course such request to Dr. Tatad who, as head of the Department of Anesthesiology, has the final
say of calling the standby anesthesiologist.
Given that Dr. Tatad was already engaged in another urgent operation and that Raymond
was not showing any symptom of suffering from major blood loss requiring an immediate
operation, We find it reasonable that petitioners decided to wait for Dr. Tatad to finish her
surgery and not to call the standby anesthesiologist anymore. There were no expert witnesses
presented to testify that the course of action taken by petitioners were not in accord with those
adopted by other reasonable surgeons in similar situations.
Neither was there any testimony given, except that of Dr. Tatad's, on which it. may be
inferred that petitioners failed to exercise the standard of care, diligence, learning and skill
expected from practitioners of their profession. Her expertise is in the administration of
anesthesia and not in the determination of whether surgery ought or not ought to be performed.
Principles:
Medical negligence, is that type of claim which a victim has available to him or her to redress a
wrong committed by a medical professional which has caused bodily harm the complainant must
prove: (1) that the health care provider, either by his act or omission, had been negligent, and (2)
that such act or omission proximately caused the injury complained of.

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DR. PEDRO DENNIS CERENO v. CA, GR No.

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