Life and death judgment call

A landmark case involving a doctor and a prestigious medical center serves as a reminder for physicians to prioritize the interests of their patients and exercise sound judgment in handling critical situations.

It also underscores the Hippocratic Oath, which partly states: “I will use my power to help the sick to the best of my ability and judgment. I will abstain from harming or wrongdoing any man by it. I will not give a fatal draught to anyone if I am asked, nor will I suggest any such thing.”

The Regional Trial Court of Quezon City recently ruled on a case of alleged medical malpractice and negligence against a prominent health institute and a reputable cardiologist.

The court found that the doctor acted negligently by choosing to wait for the arrival of stents — a small device used to keep arteries open — instead of transferring the patient, who faced the imminent risk of an aneurysm rupture, to another tertiary hospital capable of performing endograft repair or open-chest surgery.

Tragically, the patient passed away before the stents arrived. The patient’s children filed a case, alleging that delays in critical medical procedures and mismanagement of care caused her untimely death in 2010.

“By opting to wait for the grafts or stents and, more critically, leaving the late [patient] for four days, the defendant doctor gambled with her life,” the court stated.

The court censured the doctor, emphasizing that his decision reflected “a serious failure to act in the best interest of the patient,” who was in a critical condition.

However, while the court acknowledged the doctor’s lapse, it ruled that the complainants failed to establish a breach of the standard of care. Nonetheless, the court ordered the defendants to compensate the plaintiffs for damages arising from their failure to facilitate timely surgical intervention.

The complainants argued that their mother’s death resulted from the unperformed endograft repair of a life-threatening descending thoracic aortic aneurysm. They highlighted that delays in acquiring the necessary medical devices, compounded by the doctor’s absence for several days, denied the patient timely surgical care to prevent the aneurysm’s rupture.

The defendants countered that the patient was asymptomatic during her hospital stay and that the delayed procedure was due to the unavailability of the stents required for the less invasive endograft surgery. They also maintained that transferring the patient to another facility or opting for open-chest surgery carried significant risks.

In its decision, the court found insufficient evidence to support claims of negligence or willful misconduct. While it recognized that the aneurysm was life-threatening, it ruled that there was no definitive proof that either the doctor or the hospital violated professional standards in handling the case.

‘By opting to wait for the grafts or stents and, more critically, leaving the late (patient) for four days, the defendant doctor gambled with her life.’

Nevertheless, the court awarded damages to the patient’s heirs for the emotional distress caused by the failure to provide timely solutions: P2 million in moral damages, P500,000 in exemplary damages, attorney’s fees of P250,000, and the cost of the suit amounting to P563,970. All amounts will earn a 6-percent annual interest from the finality of the decision until fully paid.