Lucas v. Tuaño, G.R. No. 178763, April 21, 2009

CASE: 4 TORTS AND DAMAGES
4. Lucas v. Tuaño, G.R. No. 178763, April 21, 2009

CHICO-NAZARIO, J
PLAINTIFF: PETER PAUL PATRICK LUCAS, FATIMA GLADYS LUCAS,

ABBEYGAIL LUCAS AND GILLIAN LUCAS
DEFENDANT: DR. PROSPERO MA. C. TUAÑO

FACTS
- August 1988, petitioner Peter Paul Patrick Lucas (Peter) contracted "sore
eyes" in his right eye.
On 2 September 1988, complaining of a red right eye and swollen eyelid,the

plaintiff visit Dr. Prospero Ma. C. Tuaño, M.D. (Dr. Tuaño), an ophthalmologist
at St. Luke’s Medical Center, for an eye consult.
After several visits and treatments of Maxitrol, it was found out by the wife by
reading the accompanying literature of Maxitrol and found therein the following
warning against the prolonged use of such steroids that it can results in
Glaucoma and increase in IOP
Claiming to have steroid-induced glaucoma and blaming Dr. Tuaño for the
same, Peter, joined by: Fatima, his spouse; Abbygail, his natural child; and
Gillian, his legitimate child48 with Fatima, instituted on 1 September 1992, a
civil complaint for damages against Dr. Tuaño,
A patient sues his ophthalmologist for negligence after losing vision in

his eye, but fails to provide sufficient evidence to prove the doctor's
wrongdoing.
ISSUE
Whether the Court of Appeals committed reversible error in affirming the judgment of
the RTC that petitioners failed to prove, by preponderance of evidence, their claim
for damages against Dr. Tuaño.
RULING
RTC: the RTC dismissed for insufficiency of evidence and lack preponderance of
evidence. The decretal part of said Decision reads:
Recognized standards of the medical community has not been established in this
case, much less has causation been established to render [Tuaño] liable.
CA: Affirmed the RTC Decision.Did not present any medical expert to testify that Dr.
Tuano’s prescription of Maxitrol and Blephamide for the treatment of EKC on Peter’s
right eye was not proper and that his palpation of Peter’s right eye was not enough to
detect adverse reaction to steroid. Testimony is deemed as hearsay
SC : Petition for Review via Certiorari Rule 45 DENIED for lack of merit.
Petitioners’ position, in sum, is that Peter’s glaucoma is the direct result of Dr.
Tuaño’s negligence in his improper administration of the drug Maxitrol; "thus, [the
latter] should be liable for all the damages suffered and to be suffered by
[petitioners]."75 Clearly, the present controversy is a classic illustration of a medical
negligence case against a physician based on the latter’s professional negligence. In
this type of suit, the patient or his heirs, in order to prevail, is required to prove by
preponderance of evidence that the physician failed to exercise that degree of skill,
care, and learning possessed by other persons in the same profession; and that as a
proximate result of such failure, the patient or his heirs suffered damages.
For lack of a specific law geared towards the type of negligence committed by
members of the medical profession, such claim for damages is almost always
anchored on the alleged violation of Article 2176 of the Civil Code
ART. 2176. Whoever by act or omission causes damage to another, there being fault
or negligence, is obliged to pay for the damage done. Such fault or negligence, if
there is no pre-existing contractual relation between the parties, is called a quasi-
delict and is governed by the provisions of this Chapter.
In medical negligence cases, also called medical malpractice suits, there exist a
physician-patient relationship between the doctor and the victim. But just like any
other proceeding for damages, four essential (4) elements i.e., (1) duty; (2) breach;
(3) injury; and (4) proximate causation,76 must be established by the plaintiff/s. All
the four (4) elements must co-exist in order to find the physician negligent and, thus,
liable for damages.
it is apparent that medical negligence cases are best proved by opinions of expert
witnesses belonging in the same general neighborhood and in the same general line
of practice as defendant physician or surgeon. The deference of courts to the expert
opinion of qualified physicians [or surgeons] stems from the former’s realization that
the latter possess unusual technical skills which laymen in most instances are
incapable of intelligently evaluating;84 hence, the indispensability of expert
testimonies.
However, as correctly pointed out by the Court of Appeals, "[t]he onus probandi was
on the patient to establish before the trial court that the physicians ignored standard
medical procedure, prescribed and administered medication with recklessness and
exhibited an absence of the competence and skills expected of general practitioners
similarly situated.
It must be remembered that a physician is not an insurer of the good result of

treatment. The mere fact that the patient does not get well or that a bad result occurs
does not in itself indicate failure to exercise due care.89 The result is not
determinative of the performance [of the physician] and he is not required to be
infallible.
A verdict in a malpractice action cannot be based on speculation or conjecture.

Causation must be proven within a reasonable medical probability based upon
competent expert testimony.

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CASE: 4 TORTS AND DAMAGES

4. Lucas v. Tuaño, G.R. No. 178763, April 21, 2009

PLAINTIFF: PETER PAUL PATRICK LUCAS, FATIMA GLADYS LUCAS,

DEFENDANT: DR. PROSPERO MA. C. TUAÑO

On 2 September 1988, complaining of a red right eye and swollen eyelid,the

A patient sues his ophthalmologist for negligence after losing vision in

It must be remembered that a physician is not an insurer of the good result of

A verdict in a malpractice action cannot be based on speculation or conjecture.

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