Appendectomy patient’s heart stopped during surgery; Doctors and hospital ordered to pay P2-M

The Court of Appeals (CA) has upheld the decision of a lower court in Cebu ordering two physicians and a community hospital to pay over P2 million in damages to an appendectomy patient whose heart stopped during surgery.

In a July 30 ruling released on today, the CA’s Special 18th Division through Associate Justice Gabriel Ingles affirmed the Lapu-Lapu City Regional Trial Court’s (RTC) decision finding Dr. Edgardo Tapang, Dr. Theodore Abrenilla, and the Mactan Community Hospital liable for P2.12 in damages plus interests to patient Rex Jonathan Uy.

On June 4, 1997, Uy was admitted to the MCHI for severe and persistent abdominal pain and vomiting. He was then diagnosed to be suffering from appendicitis and was scheduled for an emergency appendectomy.

The next day, after pre-operative preparations, Rex Jonathan was wheeled into the operating room. The appendectomy was to be performed by Abrenilla as the surgeon and Tapang as the anesthesiologist.

During the operation, Uy’s heart rate slowly began to drop and reached zero after Tapang administered the anesthetic drugs, and after Abrenilla started the skin incision on him. A cardiac standstill was then announced and Uy was intubated and was given cardiac massages. After about a couple of minutes of resuscitation, the heart rate and the blood pressure returned to normal.

After the operation, Uy showed signs of mild seizures upon extubation, so he was again reintubated for assisted or total ventilation. He was also given a long-acting muscle relaxant and sedative.

After several days, Rex Jonathan regained consciousness but suffered memory lapses, disorientation, and incoherence and tremors of his hand. On 17 June 1997, Rex Jonathan was discharged. Even then, Rex Jonathan still had to undergo more medication and treatments, rehabilitation, physical and occupation therapies, regular laboratory, and medical check-ups prompting him to sue for negligence.

The CA said the physicians failed to follow preoperative procedures by not reading thoroughly and diligently ascertaining all the preoperative data of the patient in relation to anesthesia administration.
The lower court had originally excused the hospital from liability, citing that it was not shown that it was monitoring, supervising, or directing the two physicians in the procedure.

It also cited that there is no employer-employee relationship between the MCHI and the two doctors as these are independent contractors.

However, the CA, citing the “doctrine of apparent authority”, said the hospital may be held liable if the physician is the “ostensible agent” or a person who has been given the appearance of being an employee as an agent for the hospital.

“In the case at hand, MCHI impliedly clothed Dr. Abrenilla and Dr. Tapang with apparent authority leading Rex Jonathan to believe that the former are employees or agents of the hospital. Based on the records, Rex Jonathan went to MCHI for treatment because he was experiencing abdominal pains. It was not shown that he specifically went to MCHI because of Dr. Ybañez or Dr. Abrenilla or Dr. Tapang,” the court noted.

Associate Justices Pamela Ann Maxino and Marilyn B. Lagura-Yap concurred in the decision.* (Benjamin Pulta)