The doctrine of res ipsa loquitor

Dear PAO,

Last month, a tumor was discovered in my niece’s brain, which necessitated her undergoing brain surgery. During the operation, she suffered hypothermia. Consequently, the designated anesthesiologist allegedly ordered the application of a water bag. Unfortunately, the water bag ruptured, which resulted in third-degree burns to some parts of my niece’s body. Is the doctrine of res ipsa loquitor applicable to hold the doctor liable?

Samson

Dear Samson,

“Res ipsa loquitor” literally means “the thing speaks for itself.” It is a rule of necessity which may be resorted to where evidence is absent, or not readily available, but that which caused the injury was under exclusive control of the defendant, and that injury would not have happened had the defendant observed due care and management. However, where the defendant’s alleged failure to observe due care is not immediately apparent to a layman, res ipsa loquitor is not applicable. This finds support in the latest decision of the Supreme Court in the case of Spouses Nuñez vs. Dr. Henry Daz, GR 246489, Jan. 29, 2024, penned by Associate Justice Maria Filomena Singh, which held that:

“Res Ipsa Loquitor literally means ‘the thing or the transaction speaks for itself’. It is not a tool which automatically points liability to a party, but a mere mode of proof or procedural convenience. The doctrine can be invoked only when, under the circumstances involved, direct evidence is absent and not readily available.

“Its elements are: (1) the accident was of a kind that does not ordinarily occur unless someone is negligent; (2) the instrumentality or agency that caused the injury was under the exclusive control of the person charged; and (3) the injury suffered must not have been due to any voluntary action or contribution of the person injured.

“As a general rule, expert testimony in malpractice suits is necessary in proving that a physician has done a negligent act or has deviated from a standard medical procedure. However, res ipsa loquitor has been invoked in medical malpractice cases where the circumstances attendant upon the harm are, themselves, of such a character as to justify an inference of negligence as the cause of that harm. Where common knowledge and experience teach that a patient’s resulting injury would not have occurred had due care been exercised, an inference of negligence may be drawn giving rise to the application of the doctrine of res ipsa loquitor, without medical evidence, which is ordinarily required to show not only what occurred but how and why it occurred.

“In this case, the first element is absent. As earlier explained, the prosecution failed to prove that Dr. Daz is negligent, nor was it shown that he lacked due care.

“The second element, like, is not present. While it is true that Dr. Daz was the anesthesiologist who allegedly had the duty to address the hypothermia, it was never proved that he was the one who prepared and applied the water bag that ruptured. Again, there were several nurses present during the operation. Thus, the fact that the water bag may have ruptured cannot be exclusively attributed to Dr. Daz. It would be difficult to perceive that when the hypothermia occurred, it would still be Dr. Daz who had to prepare the hot water bag, leaving the patient out of his sight and care. Necessarily, he would need the assistance of the nurses present during the operation, i.e. the preparation of the hot water bag.

“Again, res ipsa loquitor is not applicable in cases where the defendant’s alleged failure to observe due care is not immediately apparent to a layman.”

Applying the aforementioned decision to your case, it is clear that where the anesthesiologist’s negligence is not immediately apparent from the point of view of a layman, the doctrine of res ipsa loquitor may not be resorted to. Thus, you need expert testimony to prove the propriety of hot water bag application, the negligence of the person who prepared the same, the specific area where it was applied, and the like.

We hope that we were able to answer your queries. This advice is based solely on the facts you have narrated and our appreciation of the same. Our opinion may vary when other facts are changed or elaborated on.

Editor’s note: Dear PAO is a daily column of the Public Attorney’s Office. Questions for Chief Acosta may be sent to [email protected]