G.R. No. 142625 . December 19, 2006.
ROGELIO P. NOGALES, et al., petitioners, vs. CAPITOL MEDICAL CENTER, DR. OSCAR ESTRADA, et al., respondents.

FACTS

Petitioners are the husband and children of Corazon Nogales, who died from postpartum hemorrhage after delivering a baby at Capitol Medical Center (CMC). Corazon, under the exclusive prenatal care of Dr. Oscar Estrada, was diagnosed with preeclampsia. She was admitted to CMC upon Dr. Estrada’s advice. During delivery, Dr. Estrada applied low forceps, causing a cervical tear leading to profuse bleeding. Dr. Estrada ordered an inadequate dosage of magnesium sulfate, which his assistant, Dr. Villaflor, administered. Nurse Dumlao also administered a plasma expander incorrectly. There were delays in blood delivery from the hospital lab and in the arrival of Dr. Espinola, the department head summoned for a hysterectomy. Corazon died despite the procedure.
Petitioners sued CMC and the involved physicians and nurse for damages, alleging negligence in Corazon’s treatment and management. The trial court found only Dr. Estrada liable, absolving CMC and the other respondents. The Court of Appeals affirmed this decision, prompting this petition.

ISSUE

Whether the Court of Appeals erred in absolving Capitol Medical Center and the other respondent physicians from liability for the death of Corazon Nogales.

RULING

The Supreme Court affirmed the liability of Dr. Estrada but reversed the absolution of CMC, holding it solidarily liable with Dr. Estrada under the doctrine of apparent authority or agency by estoppel. The Court applied the “holding out” theory, where a hospital can be vicariously liable for the negligence of independent contractor-physicians if the patient reasonably believed the physician was a hospital agent. Here, CMC presented itself as a full-service hospital. Rogelio Nogales dealt directly with CMC upon admission, executing standard consent forms that made no distinction between hospital employees and independent staff, leading him to reasonably believe all treating physicians were hospital agents. CMC’s failure to inform the patient of the physicians’ independent status created an apparent agency.
Regarding the other respondents, the Court found no reversible error in their absolution. Dr. Villaflor was correctly found to be merely following Dr. Estrada’s orders. Dr. Uy, Dr. Enriquez, and Dr. Lacson performed their respective roles within standard practice, with no proven causal negligence. Dr. Espinola’s delayed arrival due to inclement weather was not gross negligence. Nurse Dumlao’s incorrect procedure, while negligent, was not shown to be the proximate cause of death, as the primary cause was the cervical tear from Dr. Estrada’s forceps application. Thus, only Dr. Estrada and CMC, by operation of apparent authority, were held solidarily liable for damages.