G.R. No. 165279 June 7, 2011DR. RUBI LI,Petitioner,vs.SPOUSES
REYNALDO and LINA SOLIMAN, as parents/heirs of deceased Angelica
Soliman,Respondents.FACTS:
On July 7, 1993, respondents' 11-year old daughter, Angelica
Soliman, underwent a biopsy of the mass located in her lower
extremity at the St. Luke's Medical Center (SLMC). Results showed
that Angelica was suffering fromosteosarcoma,osteoblastic type,a
high-grade cancer of the bone which usually afflicts teenage
children. Following this diagnosis and as primary intervention,
Angelica's right leg was amputated by Dr. Jaime Tamayo in order to
remove the tumor. As adjuvant treatment to eliminate any remaining
cancer cells, and hence minimize the chances of recurrence and
prevent the disease from spreading to other parts of the patient's
body (metastasis), chemotherapy was suggested by Dr. Tamayo. Dr.
Tamayo referred Angelica to another doctor at SLMC, herein
petitioner Dr. Rubi Li, a medical oncologist.
On August 18, 1993, Angelica was admitted to SLMC. However, she
died on September 1, 1993, just eleven (11) days after the
administration of the first cycle of the chemotherapy regimen. On
February 21, 1994, respondents filed a damage suit against
petitioner, Dr. Leo Marbella, Mr. Jose Ledesma, a certain Dr.
Arriete and SLMC. Respondents charged them with negligence and
disregard of Angelica's safety, health and welfare by their
careless administration of the chemotherapy drugs, their failure to
observe the essential precautions in detecting early the symptoms
of fatal blood platelet decrease and stopping early on the
chemotherapy, which bleeding led to hypovolemic shock that caused
Angelica's untimely demise. Further, it was specifically averred
that petitioner assured the respondents that Angelica would recover
in view of 95% chance of healing with and when asked regarding the
side effects, petitioner mentioned only slight vomiting, hair loss
and weakness. Respondents thus claimed that they would not have
given their consent to chemotherapy had petitioner not falsely
assured them of its side effects.In dismissing the complaint, the
trial court held that petitioner was not liable for damages as she
observed the best known procedures and employed her highest skill
and knowledge in the administration of chemotherapy drugs on
Angelica but despite all efforts said patient died.
ISSUE:Whether or not Dr. Rubi Li is negligent and is liable for
damages.
HELD:NO. There are four essential elements a plaintiff must
prove in a malpractice action based upon the doctrine of informed
consent: "(1) the physician had a duty to disclose material risks;
(2) he failed to disclose or inadequately disclosed those risks;
(3) as a direct and proximate result of the failure to disclose,
the patient consented to treatment she otherwise would not have
consented to; and (4) plaintiff was injured by the proposed
treatment." The gravamen in an informed consent case requires the
plaintiff to "point to significant undisclosed information relating
to the treatment which would have altered her decision to undergo
it.
Examining the evidence on record, the Court held that there was
adequate disclosure of material risks inherent in the chemotherapy
procedure performed with the consent of Angelica's parents.
Respondents could not have been unaware in the course of initial
treatment and amputation of Angelica's lower extremity, that her
immune system was already weak on account of the malignant tumor in
her knee.On the other hand, it is difficult to give credence to
respondents' claim that petitioner told them of 95% chance of
recovery for their daughter, as it was unlikely for doctors like
petitioner who were dealing with grave conditions such as cancer to
have falsely assured patients of chemotherapy's success rate.
Besides, informed consent laws in other countries generally require
only a reasonable explanation of potential harms, so specific
disclosures such as statistical data, may not be legally
necessary.
