Hospitals are liable for doctors' negligence

The Supreme Court, in at least two decisions, has declared that when a patient dies or suffers serious injuries due to the medical malpractice, gross negligence or fault of an attending physician, surgeon, anesthesiologist and other medical and para-medical service providers, those practitioners may be held liable for damages.

They may even lose their license for such negligence or fault may be held as a medical malpractice. The hospitals too, cannot escape liability by merely alleging that the doctors are not their employees but are allegedly, independent practitioners of medicine and surgery. The hospitals’ liability is based on the legal doctrine of “RESPONDEAT SUPERIOR’’, and other principle in the Civil Code on damages. There are many other cases of similar import.

In one case, (Ramos vs CA, GR 124354, 29 Dec 1999, 321 SCRA 584), a lady who entered a hospital walking, ended up comatose with serious brain injury, secondary to some palpable mistakes in the administration of anesthesia. In another case,( PSI vs CA, GR 126297, GR 121467, GR 127590, 02 Feb 2010 ), some surgeons left two pieces of gauzes inside the body of a patient and closed the incision in a surgical operation. The patient had to go to the US to undergo a corrective medical procedure. In the Ramos case, the doctors and the hospital were held solidarily liable for actual damages of 1.352 million plus 8 thousand pesos every month for the entire lifetime of the comatose victim, moral damages of 2 million, temperate damages of 1.5 million, exemplary damages of 100 thousand, and attorneys’ fees and cost of litigation. In the PSI case, a huge amount was also awarded as damages.

The Supreme Court, in both cases, admonishes hospitals to exercise utmost care in undertaking one of mankind’s most important and delicate endeavors, the practice of medicine and surgery, because no matter how technical, complex, and esoteric, the services of doctors and surgeons are, the standards of care and diligence must be raised to the level commensurate with that extremely vital task of preserving health and lives. In holding hospitals liable for their doctors’ negligence, the High Tribunal cited Article 2176 of the Civil Code, which provides that whoever, by act or omission, causes damage to another, there being fault or negligence, is obliged to pay for the damage done. That is for the doctors to pay. For the hospitals, Article 2180 of the same Code provides that the obligation is demandable not only for one’s own acts or omissions but also for the fault or negligence  of one’s employees and agents.

The hospital, as principal, is bound by the acts of its doctors with the apparent authority which the hospital management knowingly permits them to assume. The question in every case is: did the Hospital, as principal by its act, placed the agent in such situation, where the public is justified to presume that the  doctor has authority  and the competence to undertake the action which ultimately became the proximate cause of the damage suffered by the patient? This is what the law considers as agency by implication or agency by estoppel, as provided in Article 1869 of the Civil Code. When the hospital publicly displays in its lobby the names and specialization of the doctors, said hospital is deemed to have guaranteed their skills and competence. The hospital thus is estopped from passing all the blame to the doctors. And the absence of employer-employee relationship is not a valid defense to free the hospital from liability.

There is also a legal doctrine of hospitals’ corporate negligence. Under this legal precept, since hospitals act only through medical practitioners, the corporate entity that owns and operates said hospital must be held liable for their acts, omissions and negligence. Hospitals are the ones who hired them, supervised them and have powers of control and dismissal over them. If doctors do their jobs well, hospitals do succeed and gain patronage and profit financially. Where negligence mars the quality of medical services, hospitals should not be allowed to escape liability. These are the pronouncements of the highest court of the land. There are many hospitals in the country, in Manila specifically, and  in Cebu. Management should take these words very seriously.

The Court stressed that hospitals have three specific responsibilities. First, in choosing doctors, they must assure the public that they have all the qualifications, training, experience, residency, accreditation, diplomate, and fellowships. Second, hospitals must exercise control and supervision over their doctors, not only as the results of their tasks but the manner of achieving the expected results. Third, hospital management must provide all the needed manpower and facilities, supplies and equipment and must closely monitor and oversee the treatment administered by all physicians practicing in its premises. The Hippocratic Oath mandates physicians to give primordial consideration to their patients and to exercise extraordinary diligence in performing their tasks. Failing in which, they are liable for damages. And in cases of fault and negligence, the hospitals are solidarily liable with them.