Tuano Case

Tuano case
In the case "Tuano" , Dr. Prospero Ma.C.Tuano, M.D ( Dr.Tuano) is an opthalmologist at St.Luke's
Medical center. There were petitioners named Peter Paul Patrick Lucas ( Peter) and his spouse Fatima
Glady Lucas. Actually on August 1998, petitioner Peter was contracted with " sore eyes" in his right eye .
On September 2,1998 he consulted Dr.Tuano complaining of red right eye and swollen eyelid and Peter
said that it has been since 9 days the problem started and he was already taking Maxitrol to address the
problem in his eye. However, after doing routine ocular examination on Peter's eyes, Dr. Tuano
diagnosed that Peter was suffering from conjunctivitis and prescribed Spersacet-C eye drops and said to
follow up. In the next follow-up consult, Dr. Tuano told Peter that his right eye has developed Epidemic
Kerato Conjunctivitis, a viral infection and prescribed to the former a steroid- based eye drop called
Maxitrol a dosage of 6 drops per day and the doctor cautioned Peter that being a steroid, Maxitrol had
to be withdrawn gradually otherwise it would again cause EKC and he lowered the dosage of Maxitrol in
the next follow-up as EKC has resolved. But in the next check up, Peter again developed EKC in his same
right eye and the Dr. Tuano instructed him to resume his Maxitrol use but, this time as Maxitrol was out
of stock Dr. Tuano instructed Peter to use Blephamide which is used 3 times a day for 5 days, 2 times a
day from 5 days and next once a day. But in the next follow up Peter has developed the symptoms of
headche and blurred vision.Dr. Tuano noted hardness of eye during this visit and he prescribed Diamox
and Normoglaucon and told Peter to stop using Maxitrol . He consulted other doctor for reference and
Dr.Tuano also referred Peter to Dr. Agulto , another opthalmologist who is specialized in the treatment
of glaucoma. Then Dr. Agulto also prescribed the same medications which were given by Dr. Thank and
he mentioned that the vision of Peter's right eye was 20/25R and if there was further loss in visual fields
he nee to undergo trabeculoplasty. Thus the treatment continued and atlast Peter underwent 2
procedures of laser trabeculoplasty to control the high intraocular pressure of his right eye.
On september 1, 1992 Peter filed a civil complaint for damages against Dr. Tuano , before the RTC,
Branch150, Quezon city claiming to have steroid induced glaucoma.In the claim they stated that
prolonged use of Maxitrol has made Peter to suffer from steroid induced glaucoma which caused the
elevation of his intra ocular pressure and the IOP of Peter's right eye caused impairment of his vision
which inturn leads to total blindness. But the RTC and Supreme Court have dismissed the civil Case No :
92-2482 for insufficiency of evidence. In this case the Doctrine of Res Ipsa Loquitor was used in
making the decision of the case. According to this doctrine , the patient was injured in a manner that
would not normally occur but for a breach of the applicable standard care. In this type of suit, the
patient or his heirs , in order to prevail, is required to prove the evidence that the physician has failed to
exercise that degree of skill, care and learning possessed by other personas and that as a proximate
result of such failure, the patient or his heirs suffered damages. But in this case, the petitioners failed to
present any testimony , like Dr.Tuano failed in his duty to exercise said standard of care that any other
competent physicians would use in treating the same condition as Peter's under similar circumstances
and the injury or damage to Peter's right eye was the result of his use of Maxitrol, as prescribed by
Dr.Tuano. the critical and clinching factor on aedical negligence case is a proof of the casual connection
between the negligence or said beech and the resulting injuries or the plaintiff. The plaintiff must prove
not only that he has been injured but also the defendant's fault which caused him the injury. Here as
Dr.Tuano agree that the use of Maxitrol involves the risk of increased intraoculae pressure and this is
the reason why he made it to a point to palpate Peter's eyes. A verdict in malpractice action in not be
based on speculation but in this case as the petitioners does not provide any testimony of expert the
medication conclusively caused Peter's glaucoma is purely speculative in which the other possible
causes are sufficiently eliminated and the jury could reasonably conclude that the negligence was more
probably based on the proper evidence of testimony which was mentioned in this doctrine.

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