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(Introduction, background and conclusion)

reference: https://www.chanrobles.com/cralaw/2017marchdecisions.php?id=232

OUR LADY OF LOURDES HOSPITAL, Petitioner VS SPOUSES ROMEO AND REGINA CAPANZANA, Respondents Regina Capanzana (Regina), a 40-year-old nurse and clinical instructor pregnant with her third child, was scheduled for her third caesarean section (C-section) on 2 January 1998. However, a week earlier, on 26 December 1997, she went into active labor and was brought to petitioner hospital for an emergency C- section. She first underwent a preoperative physical examination by Dr. Miriam Ramos* (Dr. Ramos) and Dr. Milagros Joyce Santos," (Dr. Santos) the same attending physicians in her prior childbirths. She was found fit for anesthesia after she responded negatively to questions about tuberculosis, rheumatic fever, and cardiac diseases. On that same day, she gave birth to a baby boy. When her condition stabilized, she was discharged from the recovery room and transferred to a regular hospital room. At 2:30 a.m. the following day, or 13 hours after her operation, Regina who was then under watch by her niece, Katherine L. Balad (Balad), complained of a headache, a chilly sensation, restlessness, and shortness of breath. She asked for oxygen and later became cyanotic. After undergoing an x-ray, she was found to be suffering from pulmonary edema. She was eventually transferred to the Intensive Care Unit, where she was hooked to a mechanical ventilator. The impression then was that she was showing signs of amniotic fluid embolism." On 2 January 1998, when her condition still showed no improvement, Regina was transferred to the Cardinal Santos Hospital. The doctors thereat found that she was suffering from rheumatic heart disease mitral stenosis with mild pulmonary hypertension, which contributed to the onset of fluid in her lung tissue (pulmonary edema). This development resulted in cardiopulmonary arrest and, subsequently, brain damage. Regina lost the use of her speech, eyesight, hearing and limbs. She was discharged, still in a vegetative state, on 19January 1998." Respondent spouses Capanzana filed a complaint for damages" against petitioner hospital, along with co- defendants: Dr. Miriam Ramos, an obstetrician/gynecologist; Dr. Milagros Joyce Santos, an anesthesiologist; and Jane Does, the nurses on duty stationed on the second floor of petitioner hospital on 26-27 December 1997.10 Respondents imputed negligence to Drs. Ramos and Santos for the latter's failure to detect the heart disease of Regina, resulting in failure not only to refer her to a cardiologist for cardiac clearance, but also to provide the appropriate medical management before, during, and after the operation. They further stated that the nurses were negligent for not having promptly given oxygen, and that the hospital was equally negligent for not making available and accessible the oxygen unit on that same hospital floor at the time." They prayed for actual damages amounting to P514,645.80; compensatory damages, P3,4 16,278.40; moral damages, P5,000,000; exemplary damages, P2,000,000; attorney's fees, P500,000 as well as P5,000 per hearing and the costs of suit. They likewise prayed for other just and equitable reliefs. " Petitioner hospital, defendants Dr. Ramos and Dr. Santos filed their respective Answers. " On the other hand, the service of summons on the nurses was unsuccessful, as they were no longer connected with the hospital. Thus, only defendant Fiorita Ballano (Ballano), who was later proven to be a midwife and not a nurse, filed her Answer."4 Petitioner hospital and defendant Ballano claimed that there was no instruction to the hospital or the staff to place Regina in a room with a standby oxygen tank. They also claimed that the nurses on duty had promptly attended to her needs. They prayed that the complaint be dismissed and respondent3 ordered to pay unpaid medical bills. 15 Meanwhile, defendant Dr. Ramos claimed that in all of the consultations and prenatal check-ups of Regina in the latter's three pregnancies, she never complained nor informed the doctor of any symptom or sign of a heart problem. Before the last C-section of Regina, Dr. Ramos examined her and found no abnormal cardiac sound, murmur or sign of rheumatic heart ailment. The doctor further claimed that since the operation was an emergency, she had no time or chance to have Regina undergo any cardiac examination and secure a cardiac clearance. Moreover, Dr. Ramos claimed that the cardio-pulmonary arrest took place 14 hours after the operation, long after she had performed the operation. She prayed that judgment be rendered ordering spouses Capanzana to pay her moral damages amounting to P500,000; exemplary damages, P200,000; and attorney's fees, P100,000. 16 On the other hand, defendant Dr. Santos claimed that she was the anesthesiologist in Regina's first and second childbirths via C-section. The doctor further stated that prior to the third emergency C-section, she conducted a pre-operative evaluation, and Regina showed no sign or symptom of any heart problem or abnormality in the latter's cardiovascular, respiratory, or central nervous systems. She then administered the anesthesia to Regina. She also stated that Regina's condition before, during, and after the operation was stable. Dr. Santos prayed that the complaint against her be dismissed." Trial ensued. Plaintiffs presented Dr. Erwin Dizon, a cardiologist; Dr. Godfrey Robeniol, a neurologist; Mrs. Elizabeth Tayag; Dr. Eleonor Lopez, a cardiologist; Kathleen Lucero Balad; Romeo Capanzana; and Dr. Asuncion Ranezes, a physician. After the plaintiffs rested their case, an amended complaint was filed, this time identifying and impleading as defendants the nurses on duty who included Czarina Ocampo, H.R. Bolatete, Evelyn S. David, and Angelica Concepcion." After conducting a deposition of the person in charge of the nurses' schedule, spouses Capanzana further amended their complaint to implead nurses Rochelle Padolina and Fiorita Ballano, while dropping defendants Czarina Ocampo, H.R. Bolatete, and Angelica Concepcion. 20 The trial continued with the presentation of defense evidence. The defense presented Dr. Santos; Dr. Ramos; Atty. Nicolas Lutero III, director of the Bureau of Licensing and Facilities of the Department of Health; Lourdes H. Nicolas, the assistant nursing service director; Dr. Grace de los Angeles; Ma. Selerina Cuvin, the account receivable clerk; and Milagros de Vera, the administrative supervisor of the hospital.? On 11 May 2005, and pending the resolution of the case before the trial court, Regina died and was substituted by her heirs represented by Romeo Capanzana.&quot