Dear PAO,

Does the absence of an employer-employee relationship between a hospital and the latter’s doctors/medical professionals would, as a matter of course, absolve the former from the negligence or liabilities of the latter?

Olivia

Dear Olivia,

The answer to your question is no. This is especially true in cases where the Doctrine of Apparent Authority or Agency by Estoppel finds application. Under the Doctrine of Apparent Authority, a hospital can be held vicariously liable for the negligent acts of a physician providing care at the hospital, and regardless of whether the physician is an independent contractor — unless the patient knows, or should have known — that the physician is an independent contractor. As reiterated in jurisprudence, the elements for its applicability are as follows:

“For a hospital to be liable under the doctrine of apparent authority, a plaintiff must show that: (1) the hospital, or its agent, acted in a manner that would lead a reasonable person to conclude that the individual who was alleged to be negligent was an employee or agent of the hospital; (2) where the acts of the agent create the appearance of authority, the plaintiff must also prove that the hospital had knowledge of and acquiesced in them; and (3) the plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent with ordinary care and prudence.” (See Casumpang v. Cortejo, GR 171127, March 11, 2015, penned by Associate Justice Arturo Brion).

Succinctly, a hospital, as a rule is not liable for the negligence of an independent contractor-physician. There is, however, an exception to this principle, i.e., if the physician is the “ostensible” agent of the hospital. As recently discussed, this exception is known as the “Doctrine of Apparent Authority.” (See Nogales v. Capitol Medical Center, GR 142625, Dec. 19, 2006, penned by Associate Justice Antonio Carpio).

In relation to the foregoing, the case of Nogales v. Capitol Medical Center (Ibid.), is pertinent. In this case, the Supreme Court discussed the two-fold factors in determining hospital liability, to wit:

“THE fiRST FACTOR focuses on the hospital’s manifestations and is sometimes described as an inquiry whether the hospital acted in a manner which would lead a reasonable person to conclude that the individual who was alleged to be negligent was an employee or agent of the hospital. In this regard, the hospital need not make express representations to the patient that the treating physician is an employee of the hospital; rather a representation may be general and implied. x x x

“The second factor focuses on the patient’s reliance. It is sometimes characterized as an inquiry on whether the plaintiff acted in reliance upon the conduct of the hospital or its agent, consistent with ordinary care and prudence.” (Emphasis and underscoring supplied).

Applying the foregoing, it would be erroneous for a hospital to deny any claim of liability or responsibility from their doctors’ actions. To repeat, a hospital can be held vicariously liable for the negligent acts of a physician (or an independent contractor) providing care at the hospital if it can prove the following factors: first, the hospital’s manifestations; and second, the patient’s reliance. (Ibid).

We hope that we were able to answer your queries. This advice is based solely on the facts you have narrated and our appreciation of the same. Our opinion may vary when other facts are changed or elaborated.

Editor’s note: Dear PAO is a daily column of the Public Attorney’s Office. Questions for Chief Acosta may be sent to dearpao@ manilatimes.net