People vs. Umaguing

Where a person commits a wrongful act that is the natural and probable cause of another's death, criminal intent is presumed, and the accused bears the burden of rebutting that presumption; if the fatal result is interrupted by causes independent of the accused's acts, the crime is only attempted.

Amparo Lazo y Villaflor, a 76-year-old resident of Cubao, Quezon City, suffered a cerebral hemorrhage on the evening of January 8, 1977, and was brought to the Polymedic General Hospital in Mandaluyong, where Angelo Umaguing was employed as a janitor. The patient was in a coma and required an endotracheal tube to assist with ventilation. Umaguing, as a janitor, had no medical duties or authority over the patient's treatment.

On the evening of January 8, 1977, Amparo Lazo y Villaflor, a 76-year-old woman from Cubao, Quezon City, suffered a severe headache and vomiting followed by cerebral hemorrhage, which rendered her comatose. Her relatives and two boarders rushed her to the Polymedic General Hospital on E. de los Santos Avenue, Mandaluyong, where she arrived at the emergency room at approximately 7:45 p.m. She was unconscious, had difficulty breathing, and registered a blood pressure of 200/100 with a pulse rate of 100 per minute. The nurse on duty administered oxygen inhalation, dextrose, penicillin, solu-cortef, serpasil, decadron, and sodium bicarbonate, and a vein was cut to reduce blood pressure.

Because the patient experienced apnea, Dr. Emmanuel Favila called other resident physicians for consultation. At about 8:30 p.m., Dr. Estacio, an anesthesiologist, inserted an endotracheal rubber tube — approximately six inches long and half an inch in diameter, attached to a plastic ventilator — into the patient's mouth and windpipe, taping it in place with plaster to facilitate ventilation and the excretion of carbon dioxide. Angelo Umaguing, a 29-year-old hospital janitor who had been working at the hospital since 1976 and was a member of the Bahala na Gang, was present in the emergency room. Without any justification and for reasons known only to himself, Umaguing attempted to remove the plaster holding the tube in place. Dr. Estacio shooed him away, and the incident was witnessed by Dr. Favila.

A few minutes later, after the doctors had left the emergency room and while the nurse's back was turned, Umaguing returned to the patient's bed and removed the endotracheal tube entirely. This act was witnessed by Jojo Cruz, the patient's 16-year-old grandson, and Adelaida Apostol, the patient's niece. According to Adelaida, the removal caused the patient to bleed from the mouth and to suffer a convulsion; Umaguing even closed the patient's eyes. The nurse was alerted and called the doctors back. Dr. Ramon Sison, the chief resident physician, reinserted the endotracheal tube; the patient was still breathing. The security guard was directed to detain Umaguing, and a relative called a policeman. Umaguing was arrested and brought to the Mandaluyong police station, where the incident was investigated and statements were taken from Jojo Cruz, Gloria Apostol, Adelaida Apostol, and the nurse, all identifying Umaguing as the person who removed the tube. Umaguing, who was present when the statements were taken, did not controvert the accusation or execute any sworn statement in his defense.

The removal of the tube prompted the patient's relatives to transfer her to the Cardinal Santos Hospital by ambulance. She died there the following morning at 4:15 a.m. The cause of death was cardio-respiratory arrest brought about by cerebro-vascular hemorrhage and hypertension. At trial, Umaguing testified that at past nine o'clock, Dr. Sison had ordered him to remove the endotracheal tube and other instruments because the old woman's case was hopeless. He demonstrated in court how Sison allegedly gave the signal by sitting on the floor, his left elbow on the witness stand, and making a hand sign indicating there was no more hope. Dr. Sison, however, was subpoenaed and denied giving any such order or signal. Umaguing admitted that removing the tube was a mistake, that he ran because he was nervous, and that he did not tell the police during the investigation that Dr. Sison had ordered him to remove the tube. His counsel de oficio conceded that there was no dispute that Umaguing removed the endotracheal tube.

• Causation of Death: Umaguing's counsel de oficio argued that the trial court erred in finding that the removal of the endotracheal tube shortened the old woman's life or caused her death, contending that because of the patient's critical condition she was sure to die a natural death, that the tube was inserted merely to lessen her suffering, and that she did not die immediately after the tube's removal.
• Lack of Intent: Counsel contended that the accused accidentally removed the tube while cleaning the emergency room and therefore did not deliberately intend to kill the old woman, making him incapable of murder.

• Proximate Cause and Lack of Intent: The Solicitor General recommended acquittal, arguing that the proximate cause of the patient's death was not the removal of the endotracheal tube but cardio-respiratory arrest, and that it was not shown that the accused acted with criminal intent.

• Criminal Intent: Whether the accused acted with criminal intent in removing the endotracheal tube, or whether his act was accidental and without felonious purpose.
• Stage of the Crime: Whether the accused is guilty of consummated murder or only of attempted murder.

• Criminal Intent: Yes. Criminal intent was presumed from the wrongful act of removing the tube, pursuant to Rule 131, Section 5(b) of the Rules of Court, and the accused failed to rebut that presumption.
• Stage of the Crime: Attempted murder. The accused did not perform all the acts of execution necessary to consummate the crime because the tube was reinserted, the patient was transferred to another hospital, and the accused was immediately apprehended.

• Criminal Intent: As a janitor, Umaguing had no compelling reason to be in the emergency room while medical assistance was being administered to the patient. His presence there was for some ulterior motive, which became evident when he removed the tube. The removal was not accidental: Umaguing himself testified that he removed the tube because he was ordered to do so by Dr. Sison — a claim Dr. Sison denied. Since the act of removing the tube was wrongful, a presumption of evil intent arose under Section 5(b), Rule 131 of the Rules of Court, which provides that a person is presumed to intend the natural consequences of their wrongful act. Umaguing failed to rebut this presumption satisfactorily. His testimony that Dr. Sison ordered the removal was contradicted by Sison himself, and Dr. Favila testified that the removal of the tube was a serious matter. The patient's relatives perceived his act as an attempt to kill the old woman, prompting them to call a policeman immediately.

• Stage of the Crime: The trial court convicted Umaguing of consummated murder, but the overt acts committed by the accused constituted only attempted murder. He was not able to perform all the acts of execution necessary to consummate the crime because the victim was transferred to another hospital and the accused was immediately apprehended. Moreover, the endotracheal tube was reinserted into the victim's mouth by Dr. Sison. The patient's death the following morning was attributed to cardio-respiratory arrest brought about by cerebro-vascular hemorrhage and hypertension — her underlying condition — rather than directly to the removal of the tube. No aggravating circumstances were found, as the trial court's qualifiers (treachery, abuse of superiority, nocturnity, disregard of old age, and ignominy) were not sustained.

• Presumption of Criminal Intent from a Wrongful Act — Under Section 5(b), Rule 131 of the Rules of Court, a person is presumed to intend the natural consequences of their wrongful act. Where the act itself is wrongful or felonious, criminal intent is presumed and the burden shifts to the accused to rebut that presumption. The Court applied this presumption to Umaguing's unauthorized removal of the endotracheal tube: because as a janitor he had no business interfering with the patient's medical treatment, his wrongful act gave rise to a presumption of evil intent, which he failed to overcome.

• Attempted Murder — Murder is attempted when the offender commences the commission of the felony directly by overt acts but does not perform all the acts of execution that would produce the felony by reason of some cause or accident other than the offender's spontaneous desistance. The Court found the crime was only attempted because the tube was reinserted, the patient was transferred to another hospital, and the accused was apprehended — all of which interrupted the causal chain before death could be attributed to the accused's act.

• "As his act of removing the tube was wrongful, it is to be presumed that he did so with an evil intent (See 5[b], Rule 131, Rules of Court; U.S. vs. Apostol, 14 Phil. 92; U.S. vs. Tria, 17 Phil. 303; U.S. vs. Ballesteros, 25 Phil. 634; People vs. Sia Teb Ban, 54 Phil. 52; People vs. Cubelo 106 Phil. 496)." — This passage articulates the ratio decidendi on criminal intent: the presumption under Rule 131 that a wrongful act is done with evil intent, supported by a chain of early Philippine and American-period precedents.

• "The overt acts committed by the accused constitute attempted murder. He was not able to perform all the acts of execution necessary to consummate the crime because the victim was transferred to another hospital and the accused was immediately apprehended. Moreover, the tube was reinserted into the victim's mouth." — This passage states the Court's holding on the stage of the crime, explaining why the felony was only attempted rather than consummated.

• U.S. vs. Apostol, 14 Phil. 92 — Cited in support of the presumption that a wrongful act is done with criminal intent.
• U.S. vs. Tria, 17 Phil. 303 — Cited in support of the same presumption of criminal intent from a wrongful act.
• U.S. vs. Ballesteros, 25 Phil. 634 — Cited in support of the same presumption of criminal intent from a wrongful act.
• People vs. Sia Teb Ban, 54 Phil. 52 — Cited in support of the same presumption of criminal intent from a wrongful act.
• People vs. Cubelo, 106 Phil. 496 — Cited in support of the same presumption of criminal intent from a wrongful act.

• Section 5(b), Rule 131, Rules of Court — Provides that a person is presumed to intend the natural consequences of their wrongful act. The Court relied on this presumption to establish criminal intent in Umaguing's unauthorized removal of the endotracheal tube, shifting the burden to him to rebut it, which he failed to do.

Fernando, C.J., Teehankee, Barredo, Makasiar, Concepcion Jr., Fernandez, Guerrero, De Castro, and Melencio-Herrera, JJ., concurred. Abad Santos, J., was on leave.