Profile of complainant patients (review of 60 cases ) . . . . Mindanao Visayas 5% 10%Luzon 17% Metro manila 68% Place of Incident
Profile of complainant patients (review of 250 cases ) . . . . Elementary 13%College High School 55% 27% 5% Vocational Level of E ducation
Profile of complainant patients (review of 250 cases ) . . . . others 10% Gov’t /relative Doctor 34% Relative 20% 36%Relatives Lawyer / relative (within 6th degree)
HOSPITAL ADMINISTRATOR = = = HOSPITAL MANAGEMENT = = = MEDICAL DIRECTOR
NASTY HEADACHE FOR THE MEDICAL DIRECTOR… Fractures or burns resulting during rehab/PT session Necrotiv IV site Baby falls during delivery Wrong sex was assigned to the baby Incomplete OS/instrument count Wrong medicine/dosage/route was given Wrong type of blood was transfused Expired meds/drugs Erroneous laboratory/radiologic results
What should I do?Who shall be held responsible? Lost specimens (eaten by cats, rats, etc.) False Positive Results (Hep B) Wrong Entry/Proforma Results Contrasting Readings (Discrepancies) Wrong results (Errors) Non-availability of blood Negligent reading/Negligent staff Fake training/documents/licenses Unethical practices
OR You are being charged with lascivious conduct, sexual harassment and immorality?
Violation of Mandatory & Prohibitive Laws . . . P.D. 169 R.A. 8344 PD 603 RA 7610 Pharmacy Act GENERIC ACT R.A. 6615 Sexual Harassment Law
Certain laws requiring mandatory reporting . . . PD 169 - Physical Injuries “The attending physician of any hospital, medical clinic, sanitarium, or other medical establishment, or any medical practitioner, or who has treated . . . any person for serious or less serious physical injuries . . . shall report the fact of such treatment personally or by fastest means of communication to the nearest Philippine Constabulary [now Philippine National Police] unit without delay . . .”
Failure to comply . . . “. . . any violation of this decree and/or the rules and regulations which shall be promulgated by competent authorities in accordance herewith, with malicious intent or gross negligence shall suffer the penalty of imprisonment for not less than one (1) nor more than three (3) years and/or fine of not more than 1,000 pesos nor more than 3,000 pesos”
Article 166 of Presidential Decree No. 603, asfollows- “. . . All hospitals, clinics or other institutions as well as private physicians providing treatment shall, within forty- eight  hours from knowledge of the case, report in writing to the . . . nearest unit of the DSWD, any case of maltreated or abused child, or exploitation . . .”
violation subjects the physician to . . .Article 166, Presidential Decree No. 603, to wit- “. . . violation of this provision shall subject the hospital, clinic, institution or physician who fail to make such report to fine of not more than 2 thousand pesos . . .”
One important aspect . . .Article 166, Presidential Decree No. 603 provides as follows- “. . . in case of sexual abuse, the records pertaining to the case shall be kept strictly confidential and no information relating thereto shall be disclosed except in connection with any court or official proceeding based on such report . . .”
CHILDABUSE Still confidentiality . . . “ . . . At the instance of the offended party, his/her name may be withheld from the public until the court acquires jurisdiction over the case. It shall be unlawful for any editor, publisher, and reporter or columnist in case of printed materials, announcer or producer in case of television and radio broadcasting, producer or director of the film in case of the movie industry to cause undue and sensationalized publicity of any case in violation of this Act resulting in the moral degradation and suffering of the offended party.” [Section 29. Art. XI, RA 7610]
non-compliance . . . Article 166, Presidential Decree No. 603 “. . . any person disclosing confidential information in violation of this provision shall be punished for a fine of not less than two thousand [2,000] pesos or by imprisonment of not more than one  year or both such fine and imprisonment at the discretion of the court . . .”
R.A. 5921 PHARMACY ACT. . . on Sale of Drug Samples “. . . Section 26. No sample of any drug, biologic product, device or proprietary medicine, given or intended to be given for free to the physician and other qualified persons by any manufacturer or distributor or his representative or detailman, as part of its program, may be sold . . .”
if a doctor sells and found guilty . . . “. . . Section 40. Any person who shall violate any of this provision . . . a fine of not less than 1,000 pesos or imprisonment of not less than six (6) months and one (1) day but not more than four (4) years . . .”
REPUBLIC ACT NO. 7877 AN ACT DECLARING SEXUAL HARASSMENT UNLAWFUL IN THE EMPLOYMENT, EDUCATION OR TRAINING ENVIRONMENT, AND FOR OTHER PURPOSES.
SECTION 3. Work, Education or Training -Related, Sexual Harassment Defined. – Work, education or training-related sexual harassment is committed by an employer, employee, manager, supervisor, agent of the employer, teacher, instructor, professor, coach, trainor, or any other person who, having authority, influence or moral ascendancy over another in a work or training or education environment, demands, requests or otherwise requires any sexual favor from the other, regardless of whether the demand, request or requirement for submission is accepted by the object of said Act.
The employer or head of office, educational or training institution shall disseminate or post a copy of this Act for the information of all concerned.
SECTION 5. Liability of the Employer, Head of Office, Educational or Training Institution. - The employer or head of office, educational or training institution shall be solidarily liable for damages arising from the acts of sexual harassment committed in the employment, education or training environment if the employer or head of office, educational or training institution is informed of such acts by the offended party and no immediate action is taken.
SECTION 7. Penalties. - Any person who violates the provisions of this Act shall, upon conviction, be penalized by imprisonment of not less than one (1) month nor more than six (6) months, or a fine of not less than Ten thousand pesos (P10,000) nor more than Twenty thousand pesos (P20,000), or both such fine and imprisonment at the discretion of the court.
Emergency Cases Republic Act 6615MEDICAL ASSISTANCE IN EMERGENCY CASES -and- Republic Act 8344 “AN ACT PENALIZING THE REFUSAL OFHOSPITALS AND MEDICAL CLINICS TO ADMINISTERAPPROPRIATE INITIAL MEDICAL TREATMENT ANDSUPPORT IN EMERGENCY OR SERIOUS CASES,AMENDING FOR THE PURPOSE BATAS PAMBANSABILANG 702, OTHERWISE KNOWN AS AN ACTPROHIBITING THE DEMAND OF DEPOSITS ORADVANCE PAYMENTS FOR THE CONFINEMENT ORTREATMENT OF PATIENTS IN HOSPITALS ANDMEDICAL CLINICS IN CERTAIN CASES”
Violation gives rise to . . . “Any official, medical practitioner or employee of the hospital or medical clinic who violates the provisions of RA 8344 shall, upon conviction by final judgment, be punished by imprisonment of not less than six ( 6) months and one ( 1 ) day but not more than two ( 2 ) years and four (4) months, or a fine of not less than Twenty thousand pesos (P20,000.00 ), but not more than One hundred thousand pesos (P100,000.00 ) or both at the discretion of the court: Provided, however, That if such violation was committed pursuant to an established policy of the hospital or clinic or upon instruction of its management, the director or officer of such hospital or clinic responsible for the formulation and implementation of such policy shall, upon conviction by final judgment, suffer imprisonment of four ( 4 ) to six (6 ) years, or a fine of not less than One hundred thousand pesos (100,000.00), but not more than Five hundred thousand pesos ( P500,000.00 ) or both, at the discretion of the court”
RA 9439 - Prohibiting the Detention of Patients I promise to pay in Hospitals and Medical Clinics on Grounds of Non- Payment of Hospital Bills or Medical BILLS Expenses
Section 3. Any officer or employee of the hospital or medical clinic responsible for releasing patients, who violates the provisions of this Act shall be punished by a fine of not less than P 20,000.00, but not more than P 50,000.00, or imprisonment of not less than one month but not more than six months or both fine and imprisonment at the discretion of the proper court
LIABILITIES IN Corporation COLLEGE/ UNIVERSITY MEDICAL/HOSPITALPRACTICE . . . VICARIOUS LIABILITY HOSPITAL Interns/ Ostensible Students Agent CONSULTANT Independent Employer-Employee Contractor Relationship MedTechs/Nurses/Paramedical Employees Non paramedical employees
Supreme Court Decisions . . .December 29, 1999 RAMOS VS. COURT OF APPEALS G.R. No. 124354 SC: “Captain of the Ship Doctrine applies . . . The attending physician is responsible for the negligent acts of the staff under his control and supervision . . .”
Supreme Court Decisions . . .December, 2006: January 31, 2007 Rogelio Nogales, Professional Services, et al, vs Capitol Inc. vs. Agana, (G.R. No. Medical Center, et 126297), and Agana vs. al, G.R. No. Juan Fuentes (G.R. No. 142625 126467), O s t e n s ib l e Ag e nt
THIRD DIVISIONð ð G.R. No. 168512G. R. No. 16851G. R. NG. R. No. 16851G. R. N and BU CASTRO, Petitioners, Present: Ynares-Santiago, J. (Chairperson), - versus - Austria-Martinez, Callejo, Sr., Chico-Nazario, and Nachura, JJ.. Jchur a, ar i o, and. Jchur a, ar i o, , Promulgated: Respondents. March 20, 2007x ---------------------------------------------------------------------------------------- xDECISIONYNARES-SANTIAGO, J.:  Did not appeal from the Decision of the Court of Appeals.
“x x x From the foregoing laws andrules, it is clear that a clinical laboratory mustbe administered, directed and supervised by alicensed physician authorized by the Secretaryof Health, like a pathologist who is speciallytrained in methods of laboratory medicine; thatthe medical technologist must be under thesupervision of the pathologist or a licensedphysician; and that the results of anyexamination may be released only to therequesting physician or his authorizedrepresentative upon the direction of thelaboratory pathologist x x x”
“ x x x …… WHEREFORE, the Decision of the Court of Appeals in CA-G.R. CV No. 58668 dated February 27, 2004 finding petitioner +++++++++++ guilty of gross negligence and liable to pay to respondents P50,000.00 as moral damages, P50,000.00 as exemplary damages, and P25,000.00 as attorney’s fees, is AFFIRMED. SO ORDERED. …x x x”
“x x x Castro’s infrequent visit to the clinical laboratory barely qualifies as an effective administrative supervision and control over the activities in the laboratory. “Supervision and control” means the authority to act directly whenever a specific function is entrusted by law or regulation to a subordinate; direct the performance of duty; restrain the commission of acts; review, approve, revise or modify acts and decisions of subordinate officials or units. x x x”  Jalandoni v. Drilon, 383 Phil. 855, 868 (2000).
First, is not administered, directed and supervised by a licensed physician as required by law, but by b , a licensed Medical Technologist.  Records, p. 193. Second, , cond conducted the HBsAG test of respondent r espon without the supervision of defendant-appellee Castro Last, the disputed HBsAG test result was released to respondent r el eas without the authorization of defendant-appellee Castro
When accidents occur due to negligence, mismanagement and or fortuitous events… HOW DO YOU SAVE YOURSELF FROM A LAWSUIT?
Perhaps , the ONLY way is to… say SORRY and PRAY or ……… PAY!!!
OBJECTIVE/GOAL Mitigate, minimize violent litigious reaction from the next of kin
USEFUL TIPS Have a conference ASAP Get your acts together. Talk to the hospital lawyer right away Have an agreed upon a common stand
CONFERENCE WITH THEPATIENT’S NEXT OF KIN When? Where? With whom? Who will talk to them? How?
THE QUIT CLAIMContents of quit claim shall contain among others… waiver to file criminal, civil and administrative case against hospital and medical staff (and of course, that the doctor is not negligent and the monetary consideration is for humanitarian purposes!)
MALPRACTICE INSURANCE Is it ADVISABLE? Is it DESIRABLE?
the fact is……………. CRIMINAL and ADMINISTRATIVELIABILITIES CANNOT be INSURED On l y CIVIL LIABILITY
GOLDEN RULES- Documentalt s/r r l a t w w e l est eferas nd o hom/ her- E a t paientpur xpl in o t pose a impora ofr r l nd t nce eferas- Documentt s/efera r t est r r l esuls- Communicae w h paienta t r t a documenteffors t t it t bout est esuls nd t o communicae especial non- ia paient t ly compl nt t s.
- Chatnot shoul be ea t r d r es d sy o ea- NE E at r ds V R ler ecor- NE E int ional misdae not orent signaur a init l orr t V R ent ly t es er t es nd ias epors l t t n t dae r iew unl t corectdae is aso ent ed. aer ha he t ev ed ess he r t l er- Secur a documentCONSE aw ys. e nd NT l a
HOW TO AVOID BEING SUED FOR MALPRACTICE? STOP YOUR PRACTICE!!!Do not accept the position-Medical Director Shift to other professions or business OR……
Hi! I am the Medical Director!EAST AVENUE MEDICAL CENTER, March 27, 2008
Dear Lord, Please assign another Medical Director!