Ocean Builders Construction Corp., and/or Dennis Hao vs. Spouses Antonio and Anicia Cubacub

An employer is not negligent under Article 161 of the Labor Code where it advises a sick employee to rest and has him brought to the nearest hospital in an emergency; such acts constitute the necessary assistance for adequate and immediate medical attendance, and absent a showing that they played a substantial part in causing death, they are not the proximate cause.

Ocean Builders Construction Corp. employed Bladimir Cubacub as a maintenance man at its Caloocan City office, with Dennis Hao as the company's general manager. The case concerns the employer's statutory duty under the Labor Code to provide medical assistance to a sick employee in an emergency, specifically Article 161, read with Article 157 on emergency medical and dental services. The action for damages was anchored on torts, with the employer-employee relationship merely incidental.

Bladimir Cubacub was employed as a maintenance man by petitioner company Ocean Builders Construction Corp. at its office in Caloocan City. Dennis Hao was the company's general manager. On April 9, 1995, Bladimir was afflicted with chicken pox. He was advised by Hao to rest for three days, which he did at the company's "barracks" where he lived free of charge.

Three days later, on April 12, 1995, Bladimir went about his usual chores of manning the gate of the company premises and even cleaned the company vehicles. Later in the afternoon, he asked a co-worker, Ignacio Silangga, to accompany him to his house in Capas, Tarlac so he could rest. Informed by Silangga of Bladimir's intention, Hao gave Bladimir ₱1,000.00 and ordered Silangga to instead bring Bladimir to the nearest hospital. Along with co-workers Narding and Tito Vergado, Silangga brought Bladimir to Caybiga Community Hospital, a primary-care hospital around one kilometer away from the company office.

The hospital did not allow Bladimir to leave. He was confined, with Narding keeping watch over him. The next day, April 13, 1995, a doctor of the hospital informed Narding that they needed to talk to Bladimir's parents; on Silangga's request, co-workers June Matias and Joel Edrene fetched Bladimir's parents from Tarlac. At about 8 o'clock in the evening of the same day, Bladimir's parents, respondent spouses Antonio and Anicia Cubacub, with their friend Dr. Hermes Frias, arrived at Caybiga Hospital and transferred Bladimir to Quezon City General Hospital, where he was placed in the intensive care unit and died the following day, April 14, 1995.

The death certificate issued by Quezon City General Hospital recorded Bladimir's immediate cause of death as cardio-respiratory arrest and the antecedent cause as pneumonia. The death certificate issued by Dr. Frias recorded the causes of death as cardiac arrest, multiple organ system failure, septicemia, and chicken pox.

Bladimir's parents later filed a complaint for damages against petitioners, alleging that Hao was guilty of negligence which resulted in the deterioration of Bladimir's condition leading to his death. The RTC found that Hao was not negligent, that he was not under any obligation to bring Bladimir to better tertiary hospitals, and that if Bladimir died of chicken pox aggravated by pneumonia or other complications due to lack of adequate facilities at the hospital, the same could not be attributed to Hao. The Court of Appeals reversed, finding that Hao's failure to bring Bladimir to a better-equipped hospital violated Article 161 of the Labor Code and that he should have foreseen that Bladimir, an adult, could suffer complications from chicken pox.

• Diligence of Employer: Petitioners maintained that Hao exercised diligence more than what the law requires, hence they are not liable for damages.

• Negligence and Employer's Statutory Duty: Whether petitioners are liable for damages based on torts for Bladimir's death, specifically whether Hao breached the duty under Article 161 of the Labor Code to provide necessary assistance to ensure adequate and immediate medical attendance.
• Proximate Cause: Whether Hao's alleged negligence was the proximate cause of Bladimir's death.
• Credibility of Death Certificates: Whether the death certificate issued by Dr. Frias is more credible than the Quezon City General Hospital death certificate on the cause of Bladimir's death.

• Negligence and Employer's Statutory Duty: No. Hao's advice for Bladimir to take a 3-day rest and to have him brought to the nearest hospital constituted the adequate and immediate medical attendance required under Article 161; no full-time nurse was required absent a showing of a hazardous workplace or more than 50 employees.
• Proximate Cause: No. The alleged negligence of Hao cannot be considered the proximate cause of Bladimir's death; it did not play a substantial part in bringing about the injury, and the death was not a direct or reasonably probable consequence of his act or omission.
• Credibility of Death Certificates: The Quezon City General Hospital death certificate is more credible. It is a public document whose entries are presumed correct unless positive evidence establishes inaccuracy; no conflict exists on the immediate cause of death, and Dr. Frias was not the attending physician and was not around at the time of death.

• Negligence and Employer's Statutory Duty: The action is one for damages based on torts, with the employer-employee relationship merely incidental. To successfully prosecute an action anchored on torts, three elements must be present: (1) duty, (2) breach, and (3) injury and proximate causation. The Court of Appeals held that it was the duty of petitioners to provide adequate medical assistance to employees under Article 161 of the Labor Code, failing which a breach is committed. Article 161 provides that it shall be the duty of any employer to provide all the necessary assistance to ensure the adequate and immediate medical and dental attendance and treatment to an injured or sick employee in case of emergency. The Implementing Rules of the Code do not enlighten what the phrase "adequate and immediate" medical attendance means in relation to an "emergency." The determination of what it means is left to the employer, except when a full-time registered nurse or physician are available on-site as required under Article 157 of the Labor Code. In the present case, there is no allegation that the company premises are hazardous. Neither is there any allegation on the number of employees the company has. If Hao's testimony would be believed, the company had only seven regular employees and 20 contractual employees — still short of the minimum 50 workers that an establishment must have for it to be required to have a full-time registered nurse. The Court can thus only determine whether the actions taken by petitioners when Bladimir became ill amounted to the "necessary assistance" to ensure "adequate and immediate medical . . . attendance" to Bladimir as required under Article 161. As found by the trial court and borne by the records, Hao's advice for Bladimir to, as he did, take a 3-day rest and to later have him brought to the nearest hospital constituted "adequate and immediate medical" attendance that he is mandated, under Article 161, to provide to a sick employee in an emergency. Chicken pox is self-limiting. Hao does not appear to have a medical background. He may not be thus expected to have known that Bladimir needed to be brought to a hospital with better facilities than the Caybiga Hospital, contrary to the appellate court's ruling.
• Proximate Cause: At all events, the alleged negligence of Hao cannot be considered as the proximate cause of the death of Bladimir. Proximate cause is that which, in natural and continuous sequence, unbroken by an efficient intervening cause, produces injury, and without which, the result would not have occurred. An injury or damage is proximately caused by an act or failure to act whenever it appears from the evidence in the case that the act or omission played a substantial part in bringing about or actually causing the injury or damage, and that the injury or damage was either a direct result or a reasonably probable consequence of the act or omission. The issue in this case is essentially factual in nature. The dissent, apart from adopting the appellate court's findings, finds that Bladimir contracted chicken pox from a co-worker and Hao was negligent in not bringing that co-worker to the nearest physician, or isolating him as well. This finding is not, however, borne by the records. Nowhere in the appellate court's or even the trial court's decision is there any such definite finding that Bladimir contracted chicken pox from a co-worker. At best, the only allusion to another employee being afflicted with chicken pox was when Hao testified that he knew it to heal within three days as was the case of another worker, without reference, however, as to when it happened.
• Credibility of Death Certificates: On the issue of which of the two death certificates is more credible, the dissent, noting that Dr. Frias attended to Bladimir during his "last illness," holds that the certificate which he issued — citing chicken pox as antecedent cause — deserves more credence. There appears, however, to be no conflict in the two death certificates on the immediate cause of Bladimir's death since both cite cardio-respiratory arrest due to complications — from pneumonia per Quezon City General Hospital, septicemia and chicken pox per Dr. Frias'. In fact, Dr. Frias admitted that the causes of death in both certificates were the same. Dr. Frias could not be considered as Bladimir's attending physician, he having merely ordered Bladimir's transfer to Quezon City General Hospital after seeing him at Caybiga Hospital. He thereafter left Bladimir to the care of doctors at Quezon City General Hospital, returning to Capas, Tarlac at 4 o'clock the following morning or eight hours after seeing Bladimir. As he himself testified upon cross-examination, he did not personally attend to Bladimir anymore once the latter was brought to the ICU at Quezon City General Hospital. It bears emphasis that a duly-registered death certificate is considered a public document and the entries therein are presumed correct, unless the party who contests its accuracy can produce positive evidence establishing otherwise. The Quezon City General Hospital death certificate was received by the City Civil Registrar on April 17, 1995. Its credibility, more than that issued by Dr. Frias, becomes more pronounced as note is taken of the fact that he was not around at the time of death. In fine, petitioner company and its co-petitioner manager Dennis Hao are not guilty of negligence.

• Employer's duty under Article 161 of the Labor Code — It shall be the duty of any employer to provide all the necessary assistance to ensure the adequate and immediate medical and dental attendance and treatment to an injured or sick employee in case of emergency. The determination of what "adequate and immediate" medical attendance means is left to the employer, except when a full-time registered nurse or physician are available on-site as required under Article 157. In this case, the employer's advice to rest and referral to the nearest hospital satisfied the duty.
• Elements of a tort action for damages — To successfully prosecute an action anchored on torts, three elements must be present: (1) duty, (2) breach, and (3) injury and proximate causation. The employer-employee relationship is merely incidental. The Court applied this framework in dismissing the complaint.
• Proximate cause — That which, in natural and continuous sequence, unbroken by an efficient intervening cause, produces injury, and without which, the result would not have occurred. An injury or damage is proximately caused by an act or failure to act whenever it appears from the evidence that the act or omission played a substantial part in bringing about or actually causing the injury or damage, and that the injury or damage was either a direct result or a reasonably probable consequence of the act or omission. The alleged negligence of Hao was held not to be the proximate cause of Bladimir's death.
• Presumption of correctness of a duly registered death certificate — A duly-registered death certificate is considered a public document and the entries therein are presumed correct, unless the party who contests its accuracy can produce positive evidence establishing otherwise. The Quezon City General Hospital death certificate was held more credible than the certificate issued by Dr. Frias.

• "To successfully prosecute an action anchored on torts, three elements must be present, viz: (1) duty (2) breach (3) injury and proximate causation." — This states the elements the Court used to frame the negligence action, with the employer-employee relationship treated as merely incidental.
• "As found by the trial court and borne by the records, petitioner Hao’s advice for Bladimir to, as he did, take a 3-day rest and to later have him brought to the nearest hospital constituted "adequate and immediate medical" attendance that he is mandated, under Art. 161, to provide to a sick employee in an emergency." — This is the ratio on the employer's statutory duty under Article 161 of the Labor Code.
• "AT ALL EVENTS, the alleged negligence of Hao cannot be considered as the proximate cause of the death of Bladimir." — This is the core holding on proximate cause, rejecting the appellate court's finding of liability.
• "It bears emphasis that a duly-registered death certificate is considered a public document and the entries therein are presumed correct, unless the party who contests its accuracy can produce positive evidence establishing otherwise." — This states the evidentiary rule applied to prefer the Quezon City General Hospital death certificate over Dr. Frias' certificate.

• Lasam vs. Sps. Ramolete, G.R. No. 159132, Dec. 18, 2008, 574 SCRA 439 — Cited for the definition of proximate cause and the rule that an act or omission must play a substantial part in bringing about the injury or damage.
• Philamlife vs. CA, 398 Phil. 599 (2000) — Cited for the rule that a duly-registered death certificate is a public document whose entries are presumed correct unless the contesting party produces positive evidence establishing otherwise.

• Article 161, Labor Code — Provides that it shall be the duty of any employer to provide all the necessary assistance to ensure the adequate and immediate medical and dental attendance and treatment to an injured or sick employee in case of emergency. The Court held that Hao's advice to rest and referral to the nearest hospital satisfied this duty.
• Article 157, Labor Code — Governs emergency medical and dental services, including the requirement of a full-time registered nurse when the number of employees exceeds fifty but not more than two hundred, and other services depending on employee count and hazardous workplaces. The Court noted that there was no showing of a hazardous workplace or the number of employees; if Hao's testimony of seven regular and twenty contractual employees were believed, the company was short of the minimum fifty workers required for a full-time registered nurse.

The majority decision lists as concurring: Arturo D. Brion, Lucas P. Bersamin, Martin S. Villarama, Jr., and Maria Lourdes P. A. Sereno. The source text also includes a separate dissenting opinion attributed to Justice Bersamin.

• Justice Lucas P. Bersamin — Dissented. He would deny the petition and affirm the Court of Appeals. He found petitioners guilty of the wrongful death of Bladimir, maintaining that they violated the Labor Code and its implementing rules requiring a graduate first-aider; that Bladimir contracted chicken pox from a co-worker and was forced to continue working despite his illness instead of being allowed complete bed rest; that Hao's acts after Bladimir collapsed were superficial, too little, and too late; and that Dr. Frias' death certificate was more reliable on the cause of death because Dr. Frias attended to Bladimir during his last illness, whereas the Quezon City General Hospital physician did not.