Legmed Finals

Apparent authority, or what is sometimes referred to as the “holding out” theory, or doctrine of ostensible agency or
agency by estoppel, has its origin from the law of agency. It imposes liability, not as the result of the reality of a
contractual relationship, but rather because of the actions of a principal or an employer in somehow misleading the
public into believing that the relationship or the authority exists. xxx In this case, PSI publicly displays in the lobby of
the Medical City Hospital the names and specializations of the physicians associated or accredited by it, including
those of Dr. Ampil and Dr. Fuentes. We concur with the Court of Appeals’ conclusion that it “is now estopped from
passing all the blame to the physicians whose names it proudly paraded in the public directory leading the public to
believe that it vouched for their skill and competence.” Indeed, PSI’s act is tantamount to holding out to the public
that Medical City Hospital, through its accredited physicians, offers quality health care services. By accrediting Dr.
Ampil and Dr. Fuentes and publicly advertising their qualifications, the hospital created the impression that they were
its agents, authorized to perform medical or surgical services for its patients. As expected, these patients, Natividad
being one of them, accepted the services on the reasonable belief that such were being rendered by the hospital or
its employees, agents, or servants. ART 2176 IN CONNECTION TO ART 1431 AND ART 1869
Under the “Captain of the Ship” rule, the operating surgeon is the person in complete charge of the surgery room and
all personnel connected with the operation. Their duty is to obey his orders. As stated before, Dr. Ampil was the lead
surgeon. In other words, he was the “Captain of the Ship.” That he discharged such role is evident from his following
conduct: (1) calling Dr. Fuentes to perform a hysterectomy; (2) examining the work of Dr. Fuentes and finding it in
order; (3) granting Dr. Fuentes’ permission to leave; and (4) ordering the closure of the incision. To our mind, it was
this act of ordering the closure of the incision notwithstanding that two pieces of gauze remained unaccounted for,
that caused injury to Natividad’s body. Clearly, the control and management of the thing which caused the injury was
in the hands of Dr. Ampil, not Dr. Fuentes.
3 legal relationships that exist in the conduct of hospital business, w/c can be source of hospital liability
1. Legal relationship between the hospital and doctor practicing within its premises
2. Legal relationship between the hospital and the patient being confined, treated or examined within its
premises
3. Legal relationships between the patient and the doctor
The corporate duties of a hospital to its patient are the ff

1. To provide comprehensive medical services to their patients
2. To exercise reasonable care to protect the patients from harm
3. To oversee and supervise all persons who practiced medicine within its walls
4. To take active steps in fixing any form of negligence committed within its premises. This duty is non delegable.
Elements of reckless imprudence in a civil case against a physician:
1. The duty of the physician to his patient
2. There is dereliction of duty
3. Damages were sustained by the patient
4. Proximate cause between the negligence committed and the injury suffered by the patient.
DOCTRINE OF STATE NECESSITY TO EXEMPT THE DOCTOR AND THE HOSPITAL FROM LIABILITY
1. THE EVIL SOUGHT TO BE AVOIDED ACTUALLY EXISTS
2. THE INJURY FEARED IS GREATER THAN THE ONE DONE TO AVOID IT
3. THERE BE NO OTHER PRACTICAL AND LESS HARMFUL MEANS OF PREVENTING IT.
CHARACTERISTICS OF HOSPITAL DETENTION OF A PATIENT FOR LIABILITY TO EXIST
1. RESTRAINT MUST BE TOTAL
2. MOVEMENT MUST BE RESTRAINED IN ALL DIRECTIONS
INSTANCES WHEN THE HOSPITAL MAY LEGALLY DETAIN A PATIENT AGAINST HIS WILL
1. WHEN HE IS DETAINED OR A CONVICTED PRISONER
2. WHEN THE PATIENT IS SUFFERING FROM A VERY CONTAGIOUS DISEASE WHERE HIS RELEASE WILL BE
PREJUDICIAL TO PUBLIC HEALTH
3. WHEN THE PATIENT IS MENTALLY ILL SUCH THAT HIS RELEASE WILL ENDANGER PUBLIC SAFETY
4. OTHER EXIGENT CASES AS MAY BE PROVIDED BY LAW
HOSPITAL DETENTION OCCURS WHEN ALL OF THE FF ARE PRESENT
1. The patient who is partially or fully recovered has expressed his intention to leave the hospital or the
attending physician has issued a discharge order
2. The patient is not confined in a private room and is incapable to financially settle in part or in full the hospital
bills
3. Patient has executed a promissory note which is secured by either a mortgage or guarantee of a co-maker
4. The officer or employee of the hospital responsible for releasing the patient has restrained him from leaving
the hospital premises
DETENTION OF A DECEASED PATIENT
1. The medical officer has made a pronouncement of death
2. Any of the surviving relatives is incapable to pay the corresponding hospital bills
3. Any of the surviving relatives has executed a promissory note which is secured by either a mortgage or
guarantee of a co-maker
4. The officer or employee of the hospital responsible for releasing the deceased patient has restrained him from
leaving the hospital premises
A hospital defendant can prove his non liability for the negligence of the physicians when:
1. The physician was not an employee under the hospitals control and supervision
2. The physician was not acting within his scope of employment
3. The hospital took reasonable precautions to limit the physicians offending behavior by providing proper
training
Section 3. Original document must be produced; exceptions. — When the subject of inquiry is the contents of a
document, no evidence shall be admissible other than the original document itself, except in the following cases:
(a) When the original has been lost or destroyed, or cannot be produced in court, without bad faith on the part of the
offeror;
(b) When the original is in the custody or under the control of the party against whom the evidence is offered, and
the latter fails to produce it after reasonable notice;
(c) When the original consists of numerous accounts or other documents which cannot be examined in court without
great loss of time and the fact sought to be established from them is only the general result of the whole; and
(d) When the original is a public record in the custody of a public officer or is recorded in a public office.
THE ESSENCE OF EVIDENT PREMEDITATION, on the other hand, is that
the execution of the criminal act must be preceded by cool thought and reflection upon the resolution to carry out
the criminal intent during a space of time sufficient to arrive at a calm judgment. For it to be appreciated, the
following must be proven beyond reasonable doubt:
ELEMENTS:
(1) the time WHEN the accused determined to commit the crime;
(2) an act manifestly indicating that the accused CLUNG to his determination; and
(3) sufficient LAPSE OF TIME between such determination and execution to allow him to reflect upon the
circumstances of his act.
The crime of Homicide is defined and penalized under Article 249 of the RPC, which reads:
“Art. 249. Homicide. – Any person who, not falling within the provisions of Article 246, shall kill another, without the
attendance of any of the circumstances enumerated in the next preceding article, shall be deemed guilty of homicide
and be punished by reclusion temporal.”
The elements of Homicide are the following:
(a) a person was killed;
(b) the accused killed him without any justifying circumstance;
(c) the accused had the intention to kill, which is presumed; and
(d) the killing was not attended by any of the qualifying circumstances of Murder, or by that of Parricide or
Infanticide.
On the other hand, Murder is defined and penalized under Article 248 of the Revised Penal Code (RPC), as amended,
which provides:
“ART. 248. Murder. Any person who, not falling within the provisions of Article 246, shall kill another, shall be guilty of
murder and shall be punished by reclusion perpetua, to death if committed with any of the following attendant
circumstances:
With treachery, taking advantage of superior strength, with the aid of armed men, or employing means to weaken
the defense, or of means or persons to insure or afford impunity;
In consideration of a price, reward, or promise;
By means of inundation, fire, poison, explosion, shipwreck, stranding of a vessel, derailment or assault upon a
railroad, fall of an airship, by means of motor vehicles, or with the use of any other means involving great waste and
ruin;
On occasion of any calamities enumerated in the preceding paragraph, or of an earthquake, eruption of a volcano,
destructive cyclone, epidemic, or any other public calamity;
With evident premeditation;
With cruelty, by deliberately and inhumanly augmenting the suffering of the victim, or outraging or scoffing at his
person or corpse.
Generally, the elements of murder are:
1) That a person was killed;
2) That the accused killed him;
3) That the killing was attended by any of the qualifying circumstances mentioned in Art. 248; and
4) That the killing is not parricide or infanticide.

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Apparent authority, or what is sometimes referred to as the “holding out” theory, or doctrine of ostensible agency or

The corporate duties of a hospital to its patient are the ff

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