2 docs fined, jailed for wrong diagnosis

Two physicians were sentenced Friday to four years in prison and ordered to pay a total of P1.25 million for negligence in treating a 10-year-old boy who later died of acute appendicitis.

Doctors Antonio Cabu-gao and Clenio Ynzon failed to perform surgery, which could have saved Rodolfo Palma Jr., because of their "gross negligence, carelessness and imprudence," prosecutors said.

Aside from the prison sentence and P50,000 indemnity, Cabugao and Ynzon were also ordered by the Dagupan City Regional Trial Court in Pangasinan to pay the boy’s family a total of P100,000 in actual damages, P1 million in moral damages and P100,000 in exemplary damages.

It was not immediately known if the two will appeal the court’s decision. The two doctors are still facing an administrative case filed by the boy’s family with the Professional Regulation Commission.

Court records show that on June 14, 2000, Palma was brought to Cabugao’s cli- nic complaining of severe abdominal pain. He was prescribed medication and sent home.

On the following day, Palma was brought to Cabugao again and the doctor ordered the patient confined at Nazareth General Hospital.

After reading the results of a blood test and an ultrasound, Cabugao referred Palma to Ynzon, who administered antibiotics and painkiller and put the boy under observation for 24 hours.

On the next day, Palma thrice vomited green fluid but the two doctors ruled out surgery. Palma later died that day.

Citing the testimonies of expert witnesses for both the prosecution and the defense, prosecutors said the two doctors failed to accurately diagnose Palma’s condition.

The witnesses said medical tests showed that the boy was suffering from a massive infection and an inflammation in the abdomen.

During the 24-hour observation period, that the patient’s condition was monitored by a "resident physician on residency training" while the two doctors saw the boy "only during their regular daily rounds each day," prosecutors said.

The two accused also ordered medication administered by phone when the boy’s condition worsened, prosecutors added.

They argued that "because of the inordinate concentration on the symptoms, the accused miserably failed to diagnose the true disease of acute appendicitis (of the patient) and consequently through gross negligence, careless and imprudence failed to perform the necessary surgery."

Cabugao and Ynzon chose not to take the witness stand to defend themselves.

Defense witnesses said the two doctors did suspect appendicitis but there were "other possible diseases that could and should be considered, and ruled out before focusing solely on the appendix."

"Electrolyte imbalance could cause abdominal pain due to paralysis of the intestines. Electrolyte imbalance can be eliminated as a disease without surgery," court records quoted one of the witnesses as saying.

In finding the two doctors guilty of reckless imprudence resulting in homicide, Judge Crispin Laron said Cabugao and Ynzon "left the monitoring and actual observation to resident physicians who are just on residency training and, in doing so, they substituted their own expertise, skill and competence with those of physicians who are merely new doctors still on training."

"Not having personally observed (Palma) during this 24-hour critical period of observation, the accused relinquished their duty and thereby were unable to give the proper and correct evaluation as to the real condition of (the patient)," Laron saidi n his seven-page decision .

"Compounding the lack of personal observation of (the patient) on the part of the accused was the infrequency of their visit which was limited to only their regular once a day morning rounds done as a matter of course," he said.

Cabugao and Ynzon "imprudently failed to consider the seriousness of the condition of (Palma) which they ought to know had they exercised a reasonable degree of their expertise, skill and competence gained throughout their years of practice as veteran practicing physicians," Laron added.