Ilao-Oreta vs. Ronquillo

Mere failure to consider time-zone difference in scheduling an elective medical procedure, absent conscious indifference to consequences and accompanied by good-faith efforts to perform and to rectify, constitutes only ordinary negligence and does not justify awards of moral damages, exemplary damages, or attorney's fees; only actual damages duly proved as natural and probable consequences of the breach are recoverable.

Spouses Eva Marie Ronquillo and Noel Benedicto Ronquillo, childless despite several years of marriage, consulted Dr. Concepcion Ilao-Oreta for infertility. Dr. Ilao-Oreta was an obstetrician-gynecologist-consultant at St. Luke's Medical Center and, at the time material to the case, chief of its Reproductive Endocrinology and Infertility Section. Upon her advice, Eva Marie agreed to undergo a laparoscopic procedure to obtain a direct view of her internal reproductive organ to determine the real cause of infertility.

Spouses Eva Marie and Noel Ronquillo consulted Dr. Concepcion Ilao-Oreta after years of childless marriage. Upon the doctor's advice, Eva Marie agreed to undergo a laparoscopic procedure in which a laparascope would be inserted through the abdominal wall to view her internal reproductive organ to determine the cause of infertility. The procedure was scheduled for April 5, 1999 at 2:00 p.m. to be performed by Dr. Ilao-Oreta at St. Luke's Medical Center.

At around 7:00 a.m. on April 5, 1999, Eva Marie, accompanied by Noel, checked in at St. Luke's and underwent pre-operative procedures including administration of intravenous fluid and enema. Dr. Ilao-Oreta did not arrive at the scheduled time, and no prior notice of cancellation was received. She was then on a return flight from her honeymoon in Hawaii and arrived in Manila only at 10:00 p.m. on April 5, 1999.

According to Dr. Ilao-Oreta, she had left Hawaii on April 4, 1999 expecting about 12 hours of travel inclusive of a Narita stop-over, and believed in utmost good faith she would be in Manila early morning of April 5 in time for the 2:00 p.m. procedure, but failed to consider the time difference between Hawaii and the Philippines. Before leaving, she left an admitting order with her secretary, apprised Eva Marie of necessary preparations, and instructed hospital staff to perform pre-operative treatments. Upon arrival at 10:00 p.m., she immediately called the hospital and learned the patient had left at around 7:00 p.m.; the following morning she retrieved the chart for the telephone number, reached Noel, apologized, offered to perform the case that same day without requiring another barium enema, and asked to apologize personally to Eva Marie, but re-scheduling was refused. Noel admitted the call took place.

Thereafter, on May 18, 1999, the spouses filed a complaint for breach of professional and service contract and damages against Dr. Ilao-Oreta and St. Luke's, praying for actual damages including Noel's alleged loss of income, moral and exemplary damages, litigation costs, attorney's fees and other relief. St. Luke's contended it had no cause of action against it as it performed pre-operative procedures without delay. The trial court found the failure not intentional and awarded ₱9,939 actual damages, while the Court of Appeals found gross negligence and increased the awards as stated above.

• Gross Negligence and Moral Damages: Petitioner argued that the court a quo erred in finding gross negligence and awarding moral damages, maintaining that failure to consider the time difference did not present clear and apparent harm perceivable even by a careless person, involved an elective procedure only to determine infertility and not to treat a life-threatening disease, and was not conduct that would probably and naturally result in injury.
• Exemplary Damages: Petitioner argued that the court a quo erred in awarding exemplary damages, there being no showing of wanton, fraudulent, reckless, oppressive or malevolent manner.
• Attorney's Fees: Petitioner argued that the court a quo erred in awarding attorney's fees, the spouses not having exerted enough efforts to settle before going to court and having admitted making no demand on the doctor before filing.
• Actual Damages: Petitioner argued that the court a quo erred in increasing actual damages, since expenses incurred prior to April 5, 1999 were included and fuel and food expenses of ₱300 and ₱500 were unsubstantiated except by an unsigned listing.

• Gross Negligence and Moral Damages: Whether petitioner acted with gross negligence so as to justify moral damages.
• Exemplary Damages: Whether exemplary damages were properly awarded.
• Attorney's Fees: Whether attorney's fees were properly awarded on the ground that respondents were compelled to litigate.
• Actual Damages: Whether the increased award of actual damages was proper and duly proved.

• Gross Negligence and Moral Damages: No. The lapse was only ordinary negligence, there being earnest intention to perform and absence of willful, intentional conscious indifference, so moral damages are not recoverable.
• Exemplary Damages: No. Exemplary damages were deleted, there being no showing that petitioner acted in a wanton, fraudulent, reckless, oppressive or malevolent manner as required by Article 2232.
• Attorney's Fees: No. The award was deleted, respondents having admitted making no demand on petitioner before suit and not having exerted enough efforts to settle.
• Actual Damages: No. The award was reduced to ₱2,288.70, only duly proved hospital charges constituting natural and probable consequences of the breach being recoverable, with interest at 6% per annum from filing and 12% per annum from finality until satisfaction.

• Gross Negligence and Moral Damages: Gross negligence implies want or absence of or failure to exercise slight care, evincing thoughtless disregard without effort to avoid consequences, characterized by want of even slight care and willful, intentional conscious indifference where there is duty to act. Applied here, earnest intention to perform was shown by leaving an admitting order, apprising the patient of preparations, and instructing staff on pre-operative treatments, and by immediate rectification efforts upon arrival through calls, apology, and offer to re-perform without another barium enema. The mis-scheduling stemmed from failure to consider the Hawaii-Philippines time difference while newly married and preparing for honeymoon, attributable partly to human frailty and excitement, without consciousness of foreseeable danger from fixing a date for an elective diagnostic procedure. Thus gross negligence was not established and moral damages could not be sustained.
• Exemplary Damages: In contracts and quasi-contracts, exemplary damages may be awarded only if defendant acted in a wanton, fraudulent, reckless, oppressive, or malevolent manner. No such manner was shown, the negligence not being gross and rectification having been promptly attempted, so the award was deleted.
• Attorney's Fees: Although the Court of Appeals found respondents were compelled to litigate, the record showed they did not exert enough efforts to settle before court action, Eva Marie having testified she made no demand on Dr. Ilao-Oreta before filing and spoke only with Dr. Augusto Reyes about a meeting and reimbursement. Hence attorney's fees were deleted.
• Actual Damages: Under Article 2201, a good-faith obligor is liable only for damages that are natural and probable consequences of breach and foreseen or reasonably foreseeable at constitution of obligation. Expenses incurred prior to the April 5, 1999 breach were improperly included, and ₱300 fuel and ₱500 food expenses rested only on an unsigned listing without independent competent proof or receipts that should issue in ordinary business transactions. Under Article 2199, only pecuniary loss duly proved is compensable, and bare assertions require extreme caution. The Statement of Account showed gross hospital charges of ₱2,416.50 less unused medicines of ₱127.80, leaving ₱2,288.70 debited from the ₱5,000 deposit, with ₱2,711.30 refundable and erroneously denominated as confinement fee. Interest was imposed pursuant to Eastern Shipping Lines, Inc. vs. Court of Appeals at 6% per annum from filing on May 18, 1999 and 12% per annum from finality until satisfaction.

• Gross negligence — Defined as want or absence of or failure to exercise slight care or diligence, or entire absence of care, evincing thoughtless disregard of consequences without exerting any effort to avoid them; characterized by want of even slight care, acting or omitting to act where there is duty to act, not inadvertently but willfully and intentionally with conscious indifference to consequences as to others. Applied here, miscalculation of travel time despite preparatory and remedial acts, without consciousness of foreseeable danger from an elective diagnostic scheduling, was held ordinary negligence only.
• Moral damages in breach of contract — Not recoverable where negligence is not gross and the requisite wanton, oppressive or malevolent conduct is absent. Applied here, deletion followed from finding of only ordinary negligence.
• Exemplary damages in contracts and quasi-contracts — Under Article 2232, recoverable only where defendant acted in a wanton, fraudulent, reckless, oppressive, or malevolent manner. Applied here, absence of such showing required deletion.
• Actual damages — proof and foreseeability — Under Article 2199, adequate compensation only for pecuniary loss duly proved by competent proof and best evidence obtainable, not mere assertions, speculations or unsigned listings; under Article 2201, a good-faith obligor answers only for natural and probable consequences foreseen or reasonably foreseeable at constitution. Applied here, pre-breach expenses and unreceipted fuel and food items were disallowed, leaving only ₱2,288.70 documented hospital charges.
• Interest on damages — Pursuant to Eastern Shipping Lines, Inc. vs. Court of Appeals, monetary awards bear 6% per annum from filing of complaint and, upon finality, 12% per annum until satisfaction. Applied here to the reduced actual damages from May 18, 1999 and from finality respectively.

• "Gross negligence" implies a want or absence of or failure to exercise slight care or diligence, or the entire absence of care. It evinces a thoughtless disregard of consequences without exerting any effort to avoid them." — States the controlling definition used to distinguish gross from ordinary negligence and to deny moral damages.
• "It is characterized by want of even slight care, acting or omitting to act in a situation where there is a duty to act, not inadvertently but willfully and intentionally with a conscious indifference to consequences in so far as other persons may be affected." — Supplies the willfulness and conscious-indifference element found absent in petitioner's time-difference miscalculation.
• "the claim for actual damages should be received with extreme caution since it is only based on bare assertion without support from independent evidence" — Quoted from Premiere Development Bank vs. Court of Appeals to reject unreceipted fuel, food and other unsubstantiated expenses.
• "The list of expenses cannot replace receipts when they should have been issued as a matter of course in business transactions" — States the evidentiary rule applied to disallow the unsigned listing for gasoline and food purchases.

• Phil. Aeolus Automotive United Corporation vs. NLRC, 387 Phil. 250, 263 (2000) — Cited as source of definition of gross negligence as want or absence of slight care and thoughtless disregard of consequences.
• De la Victoria vs. Mongaya, 404 Phil. 609, 619-620 (2001) — Cited as source of characterization of gross negligence as willful, intentional conscious indifference.
• Premiere Development Bank vs. Court of Appeals, G.R. No. 159352, April 14, 2004, 427 SCRA 686 — Followed on requirement of competent proof for actual damages and caution against bare assertions and ordinary private writings.
• People vs. Matore, 436 Phil. 421, 433 (2002) — Cited for rule that lists cannot replace receipts that should issue in ordinary business transactions.
• Eastern Shipping Lines, Inc. vs. Court of Appeals, G.R. No. 97412, July 12, 1994, 234 SCRA 78, 95-97 — Followed as basis for imposing 6% interest from filing and 12% interest from finality until satisfaction.

• Article 2201, Civil Code — Limits good-faith obligor in contracts and quasi-contracts to damages that are natural and probable consequences of breach and foreseen or reasonably foreseeable at constitution; applied to exclude pre-breach expenses.
• Article 2232, Civil Code — Allows exemplary damages in contracts and quasi-contracts only if defendant acted in wanton, fraudulent, reckless, oppressive, or malevolent manner; applied to delete exemplary damages for lack of such showing.
• Article 2199, Civil Code — Entitles one to adequate compensation only for pecuniary loss duly proved except as provided by law or stipulation; applied to disallow unsubstantiated fuel and food expenses.

Leonardo A. Quisumbing, Chairperson, Antonio T. Carpio, Dante O. Tinga, and Presbitero J. Velasco, Jr., Associate Justices, concurred. No separate concurring opinions with additional reasoning appear in the text.