G.R. No.

165279

June 7, 2011

DR. RUBI LI, Petitioner,

vs.
SPOUSES REYNALDO and LINA SOLIMAN, as parents/heirs of deceased Angelica Soliman, Respondents.
FACTS:
On July 7, 1993, respondents' 11-year old daughter, Angelica Soliman, underwent a biopsy of the mass located in
her lower extremity at the St. Luke's Medical Center (SLMC). Results showed that Angelica was suffering
from osteosarcoma, osteoblastic type, a high-grade cancer of the bone which usually afflicts teenage children. Following
this diagnosis and as primary intervention, Angelica's right leg was amputated by Dr. Jaime Tamayo in order to remove
the tumor. As adjuvant treatment to eliminate any remaining cancer cells, and hence minimize the chances of recurrence
and prevent the disease from spreading to other parts of the patient's body (metastasis), chemotherapy was suggested by
Dr. Tamayo. Dr. Tamayo referred Angelica to another doctor at SLMC, herein petitioner Dr. Rubi Li, a medical oncologist.
On August 18, 1993, Angelica was admitted to SLMC. However, she died on September 1, 1993, just eleven (11)
days after the administration of the first cycle of the chemotherapy regimen.
On February 21, 1994, respondents filed a damage suit against petitioner, Dr. Leo Marbella, Mr. Jose Ledesma, a
certain Dr. Arriete and SLMC. Respondents charged them with negligence and disregard of Angelica's safety, health and
welfare by their careless administration of the chemotherapy drugs, their failure to observe the essential precautions in
detecting early the symptoms of fatal blood platelet decrease and stopping early on the chemotherapy, which bleeding led
to hypovolemic shock that caused Angelica's untimely demise. Further, it was specifically averred that petitioner assured
the respondents that Angelica would recover in view of 95% chance of healing with and when asked regarding the side
effects, petitioner mentioned only slight vomiting, hair loss and weakness. Respondents thus claimed that they would not
have given their consent to chemotherapy had petitioner not falsely assured them of its side effects.
In dismissing
the complaint, the trial court held that petitioner was not liable for damages as she observed the best known procedures
and employed her highest skill and knowledge in the administration of chemotherapy drugs on Angelica but despite all
efforts said patient died.
ISSUE:
Whether or not Dr. Rubi Li is negligent and is liable for damages.
HELD:
NO. There are four essential elements a plaintiff must prove in a malpractice action based upon the doctrine of
informed consent: "(1) the physician had a duty to disclose material risks; (2) he failed to disclose or inadequately
disclosed those risks; (3) as a direct and proximate result of the failure to disclose, the patient consented to treatment she
otherwise would not have consented to; and (4) plaintiff was injured by the proposed treatment." The gravamen in an
informed consent case requires the plaintiff to "point to significant undisclosed information relating to the treatment which
would have altered her decision to undergo it.
Examining the evidence on record, the Court held that there was adequate disclosure of material risks inherent in
the chemotherapy procedure performed with the consent of Angelica's parents. Respondents could not have been unaware
in the course of initial treatment and amputation of Angelica's lower extremity, that her immune system was already weak
on account of the malignant tumor in her knee.On the other hand, it is difficult to give credence to respondents' claim that
petitioner told them of 95% chance of recovery for their daughter, as it was unlikely for doctors like petitioner who were
dealing with grave conditions such as cancer to have falsely assured patients of chemotherapy's success rate. Besides,
informed consent laws in other countries generally require only a reasonable explanation of potential harms, so specific
disclosures such as statistical data, may not be legally necessary.