The Supreme Court has denied the Petition for Review on Certiorari filed by Dr. Vivian S. Flores and affirmed her suspension from the practice of medicine for one year after finding her guilty of gross negligence in the handling of a patient who died shortly after being transferred from a provincial hospital in Guimaras.
The Court affirmed the September 26, 2024 Decision and the April 15, 2025 Resolution of the Court of Appeals in CA-G.R. SP No. 16171, which had earlier affirmed with modification the rulings of the Professional Regulation Commission (PRC) and its Board of Medicine.
The Case
Helen Garque filed an administrative complaint for gross negligence and/or incompetence against Dr. Flores, Dr. Sheree Ann C. Caballero, and several other medical personnel of the Dr. Catalino Gallego Nava Provincial Hospital in Guimaras. Dr. Flores is the chairperson of the Department of Obstetrics and Gynecology of the Provincial Hospital.
According to the decision, Helen's mother, Welma Garque, was rushed to the Provincial Hospital at around 5:00 a.m. on November 15, 2013 because she was having labor pains. Dr. Caballero, the attending physician, examined her and advised her to walk around because her cervical opening was only two centimeters.
At around 8:00 a.m., Welma's waterbag broke while walking. She was rushed back to the emergency room after an examination showed her cervical dilation was already between 6 cm and 7 cm. She was given intravenous fluids and medicine, then brought to the labor room under the care of Dr. Flores, Dr. Caballero, and several nurses.
Welma was in the labor room from 8:00 a.m. until 3:50 p.m. Her companions were prohibited from entering and were not given updates on her condition. At around 3:30 p.m., Dr. Caballero informed Welma's companions that Welma was very weak and needed to be transferred to another hospital, and that the baby's heartbeat was not good.
The transfer was delayed by the Provincial Hospital's refusal because of a PHP 15.00 deficiency in payment. Welma was eventually transferred to the Western Visayas Medical Center (WVMC) in Iloilo City, where her blood pressure had significantly dropped. She was in a deep coma, and doctors attempted to revive her for two hours. Welma was declared dead at around 7:15 p.m. The fetus also died inside her womb.
Dr. Nicasio M. Botin, a medico-legal officer of the National Bureau of Investigation-Western Visayas Regional Office, conducted an autopsy and issued an Autopsy Report stating the cause of death.
The Issue
The question before the Court was whether there was substantial evidence that Dr. Flores was guilty of gross negligence in the performance of her duties as a doctor to her patient, Welma.
The Ruling
The Court found that there was substantial evidence that Dr. Flores was guilty of gross negligence. It held that she and Dr. Caballero were grossly negligent when they failed to diagnose the onset of hypovolemic shock which brought about the deaths of Welma and her baby, and that their failure was the proximate cause of the resulting injury.
The Court ruled: "ACCORDINGLY, the Petition for Review on Certiorari is DENIED. The September 26, 2024 Decision and the April 15, 2025 Resolution of the Court of Appeals in CA-G.R. SP No. 16171 are AFFIRMED. Petitioner Dr. Vivian S. Flores is found GUILTY of gross negligence and is meted the penalty of suspension from the practice of medicine for one year effective from the finality of this Decision."
The Court also sternly warned her to desist from the practice of the profession during the period of her suspension under pain of criminal prosecution.
By the Numbers
- November 15, 2013 — the day Welma was rushed to the Provincial Hospital for labor pains
- 5:00 a.m. / 5:15 a.m. — her arrival at the hospital, with cervical dilation of only 2 cm
- 8:00 a.m. — her waterbag broke; cervical dilation was already 6 cm to 7 cm
- 3:50 p.m. — end of her stay in the labor room
- 7:15 p.m. — the time Welma was declared dead
- PHP 15.00 — the deficiency in payment that delayed her hospital transfer
- One year — the period of suspension from the practice of medicine
The Court's Reasoning
Applying res ipsa loquitur, the Court noted the Board of Medicine's finding that it is highly improbable for a person to suddenly enter a deep comatose state with zero blood pressure, heart rate, and respiratory rate and suddenly die without warning signs, and that the only inference is negligence in the management of Welma and her baby.
On the second element, the Court found that Dr. Flores and Dr. Caballero had exclusive control in the management of Welma while she was at the Provincial Hospital. Her condition drastically deteriorated during her stay in the labor room from 8:00 a.m. to 3:50 p.m. The Court said Dr. Flores could have presented evidence of a preexisting condition or that the patient refused instructions, or could have suggested a caesarian operation given that the bag of water broke as early as 8:00 a.m.
On the third element, the Court found Welma could not be attributed contributory negligence since she followed everything instructed. Her comatose state was due to severe loss of blood or body fluids. The Court also found incredible the testimonies that Welma's vital signs were stable until her discharge, compared to the fact that she arrived at WVMC on the verge of death.
The Court defined substantial evidence as more than a mere scintilla, or such relevant evidence as a reasonable mind might accept as adequate to support a conclusion, even if other minds equally reasonable might conceivably opine.
Source: Supreme Court Decision, G.R. No. E-02164, penned by Associate Justice Jhosep Y. Lopez.
This report summarizes a public Supreme Court decision and is not legal advice.