Medical negligence: From a legal standpoint

By Atty. Eduardo T. Reyes III

Law and medicine being two noble professions, as all are when sincere and honest service is delivered to the people, one is never above the other.

Many count lawyers and doctors among their family members. (This columnist’s sibling is a doctor.)

Yet the two professions are definitely not immune to errors. As the famous Filmmaker Spike Lee was quoted as saying, “I think it would be very boring to have a film where everybody was a lawyer or doctor and had no faults. To me, the most important thing is to be truthful.”

Recently, comments pitting lawyers against doctors swirled in social media after news came out of the conviction of Dr. Benigno (Iggy) Agbayani, Jr. for reckless imprudence resulting in serious physical injuries. This stemmed from a 2006 case that was filed by a patient resulting from a post-operation infection.

Chat groups in the medical profession have been reportedly teeming with comments ranging from doctors now being wary of taking in lawyers and their families as patients to downright not accepting them altogether.

Empathy for Dr. Benigno (Iggy) Agbayani, Jr. turned into sympathy, and then outrage, when he was reported to have died after personally writing a letter to the Supreme Court telling of his sad plight while in jail after his conviction.

The reckless imprudence case filed and for which Dr. Benigno (Iggy) Agbayani, Jr. was convicted is defined and punished under Article 365 of the Revised Penal Code.

In Vibar v. People (G.R. No. 235573, November 9, 2020) and more recently in Robles v. People (G.R. No. 223810, August 2, 2023), reckless imprudence was explained as follows:

[It] “consists in voluntarily, but without malice, doing or failing to do an act from which material damage results by reason of inexcusable lack of precaution on the part of the person performing or failing to perform such act, taking into consideration his [their] employment or occupation, degree of intelligence, physical condition and other circumstances regarding persons, time and place. 

Furthermore, it has the following elements:

(1) that the offender does or fails to do an act;

(2) that the doing or the failure to do that act is voluntary;

(3) that it be without malice;

(4) that material damage results from the reckless imprudence; and

(5) that there is inexcusable lack of precaution on the part of the offender, taking into consideration his [their] employment or occupation, degree of intelligence, physical condition, and other circumstances regarding persons, time and place.” 

Yet reckless imprudence is not the same as civil negligence. In Vibar, it was underlined that for the act or omission to constitute as reckless imprudence, there must be “inexcusable lack of precaution or conscious indifference to the consequences of the conduct which supplies the criminal intent and brings an act of mere negligence and imprudence under the operation of the penal law[.]”

So, there is a point to the assertion that not every injury suffered by a patient could hold the doctor liable for criminal reckless imprudence.

Jurisprudence however recognizes the principle known as “res ipsa loquitur.” “Res ipsa loquitur is literally translated as “the thing or the transaction speaks for itself.” The doctrine means that “where the thing which causes injury is shown to be under the management of the defendant, and the accident is such as in the ordinary course of things does not happen if those who have the management use proper care, it affords reasonable evidence, in the absence of an explanation by the defendant, that the accident arose from want of care.” It is simply “a recognition of the postulate that, as a matter of common knowledge and experience, the very nature of certain types of occurrences may justify an inference of negligence on the part of the person who controls the instrumentality causing the injury in the absence of some explanation by the defendant who is charged with negligence. It is grounded in the superior logic of ordinary human experience and on the basis of such experience or common knowledge, negligence may be deduced from the mere occurrence of the accident itself.” (Dr. Fernando P. Solidum v. People of the Philippines, G.R. No. 192123, March 10, 2014 citing Jarcia, Jr. v. People, G.R. No. 187926, February 15, 2012.)

Simply, res ipsa loquitur is being applied as a presumption of negligence on the part of the doctor when the operation goes awry, ie., the patient suffers injury which is avoidable if only the generally-accepted practice or procedure was followed.  

To temper the doctrine of res ipsa loquitur, in Nilo Rosit v. Davao Doctors Hospital, G.R. No. 210445, December 15, 2015, it was concluded that for a plaintiff  to establish medical negligence, expert testimony is generally required to define the standard of behavior by which the court may determine whether the physician has properly performed the requisite duty toward the patient. This is so considering that the requisite degree of skill and care in the treatment of a patient is usually a matter of expert opinion.

Indeed, given that a certain discipline in the medical profession could only be objectively explained by an expert in the same field, courts must be sure to follow case law that dictates that an expert (another doctor) must testify to “define the standard of behavior required” before a finding of negligence let alone a conviction for reckless imprudence can be handed down.

Another safeguard is that in a criminal case for reckless imprudence, the degree of proof required is “proof beyond reasonable doubt” which is the highest quantum of proof in evidential law. After trial, should there be reasonable doubt on the guilt of the accused, acquittal must follow as a matter of law.

Litigants, including doctors, will only have faith in the justice system if the teachings of jurisprudence are adhered to.

However, it would not be fair for doctors not to accept lawyers and their families as patients. The case of Dr. Benigno (Iggy) Agbayani, Jr. may be perceived by many as a failure of the justice system. But no justice system in the world is perfect. In the sketchy details about the case, the conviction was not reviewed by the Supreme Court “on a technicality.” If this was the case, then the lesson taught by this case is for a doctor-client to get a good lawyer who will ensure that the case will be properly reviewed by the Supreme Court. In the meantime, bail must be secured to allow for the doctor-client to be free from jail.

The bottom line is that doctors need lawyers in the same way that lawyers need doctors. There are other potential law suits while living in this convoluted society of ours. Lawyers would never be justified in declining to accept doctors as clients simply because they are doctors.

Society will not benefit from a vindictive or retaliatory approach. It is not the civil, professional and honorable way that the legal and medical professions have held themselves to the public since the olden times.

            (The author is the senior partner of ET Reyes III & Associates– a law firm based in Iloilo City. He is a litigation attorney, a law professor, Bar reviewer, MCLE lecturer and a law book author. His website is


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