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Definition of Medical Negligence

Medical negligence, also known as medical malpractice, constitutes actionable malpractice in healthcare where injury is inflicted or health is impaired. It is a form of negligence committed by a licensed physician. Under Article 365 of the Revised Penal Code, reckless imprudence resulting in homicide or serious physical injuries can be committed by medical practitioners. While negligence in general is the failure to observe the required degree of care, precaution, and vigilance which the circumstances justly demand, medical negligence specifically involves a physician failing to exercise due care and diligence in the practice of their profession. The crime of homicide through reckless imprudence can be committed by a licensed physician who fails to exercise due care and diligence from the practice of their profession.

Elements of Medical Negligence

To successfully prosecute medical negligence, the patient must prove four elements:

1. The duty owed by the physician to the patient. This duty is created by the physician-patient relationship and requires the physician to act in accordance with the specific norms or standards established by their profession. The physician-patient relationship is established when a patient engages the services of a physician. The physician has a duty to use at least the same level of care that any other reasonably competent doctor would use to treat a condition under similar circumstances.
2. The breach of the duty, which is the physician's failure to act in accordance with the applicable standard of care. The standard of care is measured by the professional standards that a reasonably prudent physician would observe under the same or similar circumstances. Determining the standard of care involves a question of fact and is judged based on the recognized standards of the medical community in the particular kind of case. Expert testimony is often required to establish the standard of care and whether the physician deviated from it.
3. The causation, specifically proximate causation, meaning there is a reasonably close and causal connection between the negligent act or omission and the resulting injury suffered by the patient. The injury or damage must be proximately caused by the physician's negligence, appearing based on evidence and expert testimony. The connection must be a direct and natural sequence of events, unbroken by intervening efficient causes.
4. The damages suffered by the patient (the injury). The injury must result from the breach of professional duty.

Doctrine of Res Ipsa Loquitur

The doctrine of res ipsa loquitur, meaning "the thing or transaction speaks for itself," is a rule of evidence applicable in negligence cases. In medical negligence cases, this doctrine may be applied to establish prima facie evidence of negligence without direct proof, provided certain requisites are met. These requisites are: (1) the accident is of such character that it would not have happened without negligence; (2) the accident is caused by an agency or instrumentality within the exclusive management or control of the person charged with the negligence; and (3) the accident must not have been due to any voluntary action or contribution on the part of the person injured. The doctrine applies when the circumstances attendant upon the harm are themselves sufficient to justify an inference of negligence as the cause of the harm. Examples include leaving a foreign object inside the body during an operation, injuries sustained on a healthy part of the body, or removing the wrong part of the body. The application of res ipsa loquitur in medical negligence cases presents a question of law, and it provides prima facie evidence of negligence, shifting the burden to the defendant to explain.

Resulting Crimes and Penalties

Crimes arising from medical negligence under Article 365 of the RPC include reckless imprudence resulting in homicide or reckless imprudence resulting in serious or less serious physical injuries. Conspiracy is not applicable in crimes of reckless imprudence. The penalty for the offender guilty of reckless imprudence is based on the gravity of the resulting injuries. Article 365 stipulates varying penalties depending on whether the act would have constituted a grave, less grave, or light felony if intentional. A less grave felony results in arresto mayor in its minimum and medium periods, while a light felony results in arresto menor in its maximum period.