Mercury Drug Corporation vs. De Leon

A druggist's mistake in dispensing medicine constitutes negligence, and care is no defense. The profession of pharmacy demands the highest degree of care and diligence known to practical men, and a pharmacist who gives a customer the wrong medicine cannot escape liability by claiming the mistake was accidental or by shifting blame to the customer for failing to read the label.

Respondent Raul T. De Leon was the presiding judge of Branch 258, Regional Trial Court (RTC) in Parañaque. Petitioner Mercury Drug Corporation is a drugstore chain, and petitioner Aurmela Ganzon was a pharmacist assistant at its Betterliving, Parañaque branch. The case involves the standard of care required of druggists in dispensing prescription medicines to the public, a business imbued with public interest given the potentially life-threatening consequences of errors in dispensing drugs.

Respondent Raul T. De Leon was the presiding judge of Branch 258, Regional Trial Court in Parañaque. On October 17, 1999, he noticed that his left eye was reddish and he had difficulty reading. That same evening, he met a friend, Dr. Charles Milla, for dinner at the Foohyui Restaurant. De Leon consulted Dr. Milla about his irritated left eye, and the latter prescribed the drugs "Cortisporin Opthalmic" and "Ceftin" to relieve his eye problems.

Before heading to work the following morning, De Leon went to the Betterliving, Parañaque branch of Mercury Drug Store Corporation to buy the prescribed medicines. He showed his prescription to petitioner Aurmela Ganzon, a pharmacist assistant. Subsequently, he paid for and took the medicine handed over by Ganzon. At his chambers, De Leon requested his sheriff to assist him in using the eye drops. As instructed, the sheriff applied 2-3 drops on respondent's left eye. Instead of relieving his irritation, respondent felt searing pain. He immediately rinsed the affected eye with water, but the pain did not subside. Only then did he discover that he was given the wrong medicine, "Cortisporin Otic Solution."

De Leon returned to the same Mercury Drug branch, with his left eye still red and teary. When he confronted Ganzon why he was given ear drops instead of the prescribed eye drops, she did not apologize and instead brazenly replied that she was unable to fully read the prescription. It was her supervisor who apologized and informed De Leon that they did not have stock of the needed Cortisporin Opthalmic. De Leon wrote Mercury Drug, through its president, Ms. Vivian K. Askuna, about the day's incident, but it did not merit any response. Instead, two sales persons went to his office and informed him that their supervisor was busy with other matters. Having been denied his simple desire for a written apology and explanation, De Leon filed a complaint for damages against Mercury Drug.

Mercury Drug denied that it was negligent and therefore liable for damages. It pointed out that the proximate cause of De Leon's unfortunate experience was his own negligence — he should have first read and checked to see if he had the right eye solution before he used any on his eye, and he could have requested his sheriff to do the same. Mercury Drug also explained that there is no available medicine known as "Cortisporin Opthalmic" in the Philippine market, and what was written on the piece of paper De Leon presented to Ganzon was "Cortisporin Solution." Accordingly, she gave him the only available "Cortisporin Solution" in the market. Moreover, even the piece of paper De Leon presented upon buying the medicine could not be considered a proper prescription, as it lacked the required information concerning the attending doctor's name and license number. According to Ganzon, she entertained De Leon's purchase request only because he was a regular customer of their branch.

The RTC ruled in favor of De Leon, finding that the proximate cause of his injury was Ganzon's negligent exercise of discretion. The trial court held that although De Leon may have been negligent by failing to read the medicine's label or to instruct his sheriff to do so, Mercury Drug was first to be negligent — Ganzon dispensed a drug without the requisite prescription and did so without fully reading what medicine was exactly being bought, presuming that since what was available was the drug Cortisporin Otic Solution, it was what De Leon was attempting to buy.

• Procedural Compliance: Petitioners argued that the Court of Appeals erred in dismissing their appeal based on the cases of De Liana vs. CA and Heirs of Palominique vs. CA, and that they substantially complied with Section 1(f), Rule 50 and Section 13, Rule 44 of the Rules of Court despite the absence of page references to the records.

• Substantial Justice: Petitioners argued that the Court of Appeals erred when it favored mere technicality over substantial justice, which would cause grave injustice and great prejudice to them considering that the assailed decision on appeal was clustered with errors and in contrast with the decisions of the Supreme Court.

• Contributory Negligence: Petitioners denied that they were negligent and pointed out that De Leon's own negligence was the proximate cause of his injury — any injury would have been averted had De Leon exercised due diligence before applying the medicine on his eye, and had he cautiously read the medicine bottle label, he would have known that he had the wrong medicine.

• No Available Medicine: Mercury Drug explained that there is no available medicine known as "Cortisporin Opthalmic" in the Philippine market, and what was written on the piece of paper De Leon presented was "Cortisporin Solution," so Ganzon gave him the only available "Cortisporin Solution" in the market.

• Improper Prescription: Petitioners argued that the piece of paper De Leon presented upon buying the medicine could not be considered a proper prescription, as it lacked the required information concerning the attending doctor's name and license number.

• Motion to Dismiss Appeal: Respondent moved for the dismissal of the appeal on technical grounds, pointing out that the Statement of Facts, Statement of the Case, Assignment of Errors/Issues, and Arguments/Discussions in the Brief made no references to the pages of the records, warranting dismissal pursuant to Section 1(f), Rule 50 of the 1997 Rules of Civil Procedure.

• Dismissal of Appeal: Whether the Court of Appeals erred in dismissing petitioners' appeal based on the absence of page references to the records in their brief.
• Substantial Compliance: Whether petitioners substantially complied with Section 1(f), Rule 50 and Section 13, Rule 44 of the Rules of Court despite the lack of page references.
• Technicality vs. Substantial Justice: Whether the Court of Appeals erred in favoring mere technicality over substantial justice.
• Negligence and Liability: Whether Mercury Drug and Ganzon were negligent and liable for damages for dispensing the wrong medicine to De Leon.
• Award of Damages: Whether the amounts of moral and exemplary damages awarded by the trial court were proper.

• Dismissal of Appeal: No. The dismissal of an appeal under Rule 50 is discretionary upon the appellate court, and the failure to properly cite references to the original records is not a fatal procedural lapse when the citations enable the court to expeditiously locate the portions of the record referred to.
• Substantial Compliance: Yes. Although there were no page references to the records, Mercury Drug and Ganzon referred to the exhibits, TSN, and attachments of the case, and their brief was sufficient in form and substance to apprise the appellate court of the essential facts, nature of the case, the issues raised, and the laws necessary for the disposition of the same.
• Technicality vs. Substantial Justice: Yes. Rules of procedure are intended to promote, not to defeat, substantial justice, and should not be applied in a very rigid and technical sense; however, brushing aside technicalities, petitioners are still liable for their negligence.
• Negligence and Liability: Yes. Mercury Drug and Ganzon failed to exercise the highest degree of diligence expected of them as pharmacy professionals; they were grossly negligent in dispensing ear drops instead of the prescribed eye drops to De Leon.
• Award of Damages: Partially. The award of damages is proper but shall be reduced considering the peculiar facts of the case — moral damages reduced from ₱100,000.00 to ₱50,000.00, and exemplary damages reduced from ₱300,000.00 to ₱25,000.00.

• Dismissal of Appeal: The Supreme Court noted that the grounds for dismissal of an appeal under Section 1 of Rule 50 are discretionary upon the appellate court, as the very wording of the rule uses the word "may" instead of "shall," indicating that it is only directory and not mandatory. Sound discretion must be exercised in consonance with the tenets of justice and fair play, keeping in mind the circumstances obtaining in each case. The Court distinguished the present case from De Liano vs. Court of Appeals, where the appellant's brief lacked a Subject Index and a Table of Cases and Authorities, and the Statement of the Case, Statements of Facts, and Statements of Arguments had no page references to the record, and the defendants-appellants failed to amend their brief when notified of such defects. The Court also distinguished Heirs of Palomique vs. Court of Appeals, where the appellant's brief did not at all contain a separate statement of facts. In the instant case, although there were no page references to the records, Mercury Drug and Ganzon referred to the exhibits, TSN, and attachments of the case, and their brief was sufficient in form and substance.

• Substantial Compliance: The Court cited De Leon vs. CA and Yuchengco vs. Court of Appeals to support the proposition that when citations found in the appellant's brief enable the court to expeditiously locate the portions of the record referred to, there is substantial compliance with the requirements of Section 13(c), (d), and (f) of Rule 44. The absence of page reference to the record is a ground for dismissal, but such dismissal is not mandatory but discretionary on the part of the appellate court.

• Technicality vs. Substantial Justice: The Court emphasized that rules of procedure are intended to promote, not to defeat, substantial justice, and should not be applied in a very rigid and technical sense. For reasons of justice and equity, the Court has allowed exceptions to the stringent rules governing appeals and has, in the past, refused to sacrifice justice for technicality.

• Negligence and Liability: The Court held that Mercury Drug and Ganzon failed to exercise the highest degree of diligence expected of them as pharmacy professionals. Citing Tombari vs. Conners, the Court ruled that the profession of pharmacy demands care and skill, and druggists must exercise care of a specially high degree — the highest degree of care known to practical men. In Fleet vs. Hollenkemp, the US Supreme Court ruled that a druggist who sells one drug for another cannot escape responsibility upon the alleged pretext that it was an accidental or innocent mistake; his mistake, under the most favorable aspect for himself, is negligence. The Court also cited Smith's Admrx vs. Middelton for the proposition that one holding himself out as competent to handle drugs cannot be heard to say that his mistake in furnishing a customer the most deadly of drugs for those comparatively harmless is not in itself gross negligence. In our own jurisdiction, the Court cited United States vs. Pineda and Mercury Drug Corporation vs. Baking as illustrative. In Mercury Drug, involving no less than the same petitioner corporation, a pharmacist misread a prescription for Diamicron as Dormicum, and the Court held that the proximate cause of the accident was the gross negligence of the pharmacist who gave the wrong medicine. The Court reiterated that in cases where an injury is caused by the negligence of an employee, there instantly arises a presumption of law that there was negligence on the part of the employer, either in the selection or supervision of one's employees, which may be rebutted by a clear showing that the employer exercised the care and diligence of a good father of the family. Mercury Drug failed to overcome such presumption. The Court also noted that in the purchase and sale of drugs, the buyer and seller do not stand at arms length — there exists an imperative duty on the seller or the druggist to take precaution to prevent death or injury to any person who relies on one's absolute honesty and peculiar learning. The nature of drugs is such that examination would not avail the purchaser anything, and it would be idle mockery for the customer to make an examination of a compound of which he can know nothing. The Court rejected the defense that Ganzon gave the only available Cortisporin solution in the market, noting that she could have easily verified whether the medicine she gave De Leon was, indeed, the prescribed one or, at the very least, consulted her supervisor, and absent the required certainty, she could have refused De Leon's purchase of the drug.

• Award of Damages: The Court found the amounts awarded by the trial court to be excessive. Following the precedent case of Mercury Drug, the Court reduced moral damages from ₱100,000.00 to ₱50,000.00. The Court also reduced exemplary damages from ₱300,000.00 to ₱25,000.00, citing Article 2229 of the Civil Code which allows the grant of exemplary damages by way of example or correction for the public good. The Court noted that the drugstore business is affected by public interest, and due to the sensitive nature of its business, petitioner must at all times maintain a high level of meticulousness.

• Highest Degree of Care for Druggists — The profession of pharmacy demands care and skill, and druggists must exercise care of a specially high degree — the highest degree of care known to practical men. Druggists must exercise the highest practicable degree of prudence and vigilance, and the most exact and reliable safeguards consistent with the reasonable conduct of the business, so that human life may not constantly be exposed to the danger flowing from the substitution of deadly poisons for harmless medicines. The Court applied this doctrine in finding Mercury Drug and Ganzon grossly negligent in dispensing ear drops instead of the prescribed eye drops.

• Mistake is Negligence — For a druggist, mistake is negligence and care is no defense. A druggist who sells to a purchaser one drug for another cannot escape responsibility upon the alleged pretext that it was an accidental or innocent mistake; his mistake, under the most favorable aspect for himself, is negligence. The Court applied this doctrine to reject petitioners' defense that the wrong medicine was given by mistake.

• Presumption of Employer Negligence — In cases where an injury is caused by the negligence of an employee, there instantly arises a presumption of law that there was negligence on the part of the employer, either in the selection or supervision of one's employees. This presumption may be rebutted by a clear showing that the employer has exercised the care and diligence of a good father of the family. The Court held that Mercury Drug failed to overcome such presumption.

• Buyer and Seller of Drugs Do Not Stand at Arms Length — In the purchase and sale of drugs, the buyer and seller do not stand at arms length. There exists an imperative duty on the seller or the druggist to take precaution to prevent death or injury to any person who relies on one's absolute honesty and peculiar learning. The nature of drugs is such that examination would not avail the purchaser anything, and it would be idle mockery for the customer to make an examination of a compound of which he can know nothing.

• Discretionary Dismissal of Appeals — The grounds for dismissal of an appeal under Section 1 of Rule 50 are discretionary upon the appellate court, as the very wording of the rule uses the word "may" instead of "shall," indicating that it is only directory and not mandatory. The failure to properly cite references to the original records is not a fatal procedural lapse when citations found in the appellant's brief enable the court to expeditiously locate the portions of the record referred to.

• "IN REALITY, for the druggist, mistake is negligence and care is no defense." — This opening statement, quoting United States v. Pineda, articulates the core principle of the case: a druggist's error in dispensing medicine constitutes negligence regardless of intent or care exercised.

• "The profession of pharmacy demands care and skill, and druggists must exercise care of a specially high degree, the highest degree of care known to practical men. In other words, druggists must exercise the highest practicable degree of prudence and vigilance, and the most exact and reliable safeguards consistent with the reasonable conduct of the business, so that human life may not constantly be exposed to the danger flowing from the substitution of deadly poisons for harmless medicines." — This passage, quoting Tombari v. Conners, defines the standard of care required of druggists and is the controlling doctrine for determining negligence in pharmaceutical dispensing.

• "His mistake, under the most favorable aspect for himself, is negligence. And such mistake cannot be countenanced or tolerated, as it is a mistake of the gravest kind and of the most disastrous effect." — This passage, quoting Fleet v. Hollenkemp, establishes that a druggist's mistake in dispensing is per se negligence and cannot be excused.

• "The nature of drugs is such that examination would not avail the purchaser anything. It would be idle mockery for the customer to make an examination of a compound of which he can know nothing. Consequently, it must be that the druggist warrants that he will deliver the drug called for." — This passage, quoting United States v. Pineda, explains why the buyer of drugs cannot be expected to verify the medicine and why the druggist bears the responsibility for ensuring the correct drug is dispensed.

• United States vs. Pineda, 37 Phil. 456 (1918) — Controlling precedent establishing that for a druggist, mistake is negligence and care is no defense; cited for the principle that the buyer and seller of drugs do not stand at arms length and that the druggist warrants delivery of the drug called for.

• Mercury Drug Corporation vs. Baking, G.R. No. 156037, May 25, 2007, 523 SCRA 184 — Controlling precedent involving the same petitioner corporation, where a pharmacist misread a prescription for Diamicron as Dormicum; cited for the standard of care required of druggists, the presumption of employer negligence, and the proper amounts of moral and exemplary damages.

• De Leon vs. Court of Appeals, 432 Phil. 775 (2002) — Followed for the proposition that citations in an appellant's brief that sufficiently enable the appellate court to expeditiously locate the portions of the record referred to constitute substantial compliance with the rules.

• Yuchengco vs. Court of Appeals, G.R. No. 165793, October 27, 2006, 505 SCRA 716 — Followed for the proposition that an appellant's brief that refers to Exhibits and Transcript of Stenographic Notes and attachments substantially complies with the requirements of Section 13(c) and (d) of Rule 44.

• De Liano vs. Court of Appeals, G.R. No. 142316, November 22, 2001, 370 SCRA 349 — Distinguished; in that case, the appellant's brief lacked a Subject Index and a Table of Cases and Authorities, and the defendants-appellants failed to amend their brief when notified of defects, justifying dismissal.

• Heirs of Palomique vs. Court of Appeals, G.R. Nos. L-39288-89, January 31, 1985, 134 SCRA 331 — Distinguished; in that case, the appellant's brief did not at all contain a separate statement of facts, a critical omission that justified dismissal.

• Tombari vs. Conners, 85 Conn. 231 (1912) — Cited as a US case establishing that the profession of pharmacy demands care and skill, and druggists must exercise the highest degree of care known to practical men.

• Fleet vs. Hollenkemp, 56 Am. Dec. 563 (1852) — Cited as a US case ruling that a druggist who sells one drug for another cannot escape responsibility upon the pretext that it was an accidental or innocent mistake.

• Smith's Admrx vs. Middelton, 56 L.R.A. 484 (1902) — Cited as a US case teaching that one holding himself out as competent to handle drugs cannot be heard to say that his mistake in furnishing a customer the most deadly of drugs for those comparatively harmless is not in itself gross negligence.

• Section 1(f), Rule 50, 1997 Rules of Civil Procedure — Provides that an appeal may be dismissed by the Court of Appeals for absence of specific assignment of errors in the appellant's brief, or of page references to the record as required in Section 13, paragraphs (a), (c), (d) and (f) of Rule 44; the Court held that dismissal under this rule is discretionary, not mandatory.

• Section 13, Rule 44, 1997 Rules of Civil Procedure — Requires page references to the record in the appellant's brief; the Court held that substantial compliance exists when citations enable the appellate court to expeditiously locate the portions of the record referred to.

• Article 2180, Civil Code — Provides that owners and managers of an establishment or enterprise are responsible for damages caused by their employees in the service of the branches in which the latter are employed or on the occasion of their functions; the Court applied this provision to hold Mercury Drug liable for Ganzon's negligence, noting that the presumption of employer negligence may be rebutted by a clear showing that the employer exercised the care and diligence of a good father of the family.

• Article 2217, Civil Code — Defines moral damages as including physical suffering, mental anguish, fright, serious anxiety, besmirched reputation, wounded feelings, moral shock, social humiliation, and similar injury; the Court applied this provision in affirming the award of moral damages, though reduced in amount.

• Article 2229, Civil Code — Allows the grant of exemplary damages by way of example or correction for the public good; the Court applied this provision in affirming the award of exemplary damages, reduced to ₱25,000.00, given that the drugstore business is affected by public interest.

Consuelo Ynares-Santiago, Ma. Alicia Austria-Martinez, Minita V. Chico-Nazario, Adolfo S. Azcuna, and Antonio Eduardo B. Nachura.