SECOND DIVISION

[G.R. No. 118141. September 5, 1997]

LEONILA GARCIA-RUEDA, petitioner, vs. IL!REDO L. "ASCASIO,
RAUL R. ARNAU, A#ELARDO L. A"OR$ADERA %R., &o'or(b)e
CONDRADO *. +AS,UE-, ()) o. t/e O..01e o. t/e Omb234m('5
%ESUS !. GUERRERO, "OR!IRIO *ACARAEG, ('3 GREGORIO
A. ARI-ALA, ()) o. t/e O..01e o. t/e C0t6 "ro4e12tor,
*('0)(, respondents.
D E C I S I O N
RO*ERO, J.7
May this Court review the findings of the Office of the Ombudsman? The genera
rue has been enunciated in Ocam!o v" Ombudsman
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which states&
In the exercise of its investigative power, this Court has consistently held that courts
will not interfere with the discretion of the fiscal or the Ombudsman to determine the
specificity and adequacy of the averments of the offense charged. He may dismiss the
complaint forthwith if he finds it to be insufficient in form and substance or if he
otherwise finds no ground to continue with the inquiry or he may proceed with the
investigation of the complaint if, in his view, it is in due and proper form.!
Does the instant case warrant a de!arture from the foregoing genera rue? 'hen a
!atient dies soon after surgery under circumstances which indicate that the attending
surgeon and anaesthesioogist may have been guity of negigence but u!on their being
charged( a series of nine !rosecutors toss the res!onsibiity of conducting a !reiminary
investigation to each other with contradictory recommendations( )!ing*!ong+ stye(
!erha!s the distraught widow is not to be bamed if she finay decides to accuse the
City ,rosecutors at the end of the ine for !artiaity under the -nti*.raft and Corru!t
,ractices -ct" Nor may she be entirey fauted for finay fiing a !etition before this
Court against the Ombudsman for grave abuse of discretion in dismissing her com!aint
against said City ,rosecutors on the ground of ac/ of evidence" Much as we
sym!athi0e with the bereaved widow( however( this Court is of the o!inion that the
genera rue sti finds a!!ication in instant case" In other words( the res!ondent
Ombudsman did not commit grave abuse of discretion in deciding against fiing the
necessary information against !ubic res!ondents of the Office of the City ,rosecutor"
The foowing facts are borne out by the records"
1orencio V" 2ueda( husband of !etitioner 3eonia .arcia*2ueda( underwent
surgica o!eration at the 4ST hos!ita for the remova of a stone boc/ing his ureter" 5e
was attended by Dr" Domingo -ntonio( 6r" who was the surgeon( whie Dr" Erinda
7aatbat*2eyes was the anaesthesioogist" Si8 hours after the surgery( however(
1orencio died of com!ications of )un/nown cause(+ according to officias of the 4ST
5os!ita"
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Not satisfied with the findings of the hos!ita( !etitioner re:uested the Nationa
7ureau of Investigation ;N7I< to conduct an auto!sy on her husband=s
body" Conse:uenty( the N7I rued that 1orencio=s death was due to ac/ of care by the
attending !hysician in administering anaesthesia" ,ursuant to its findings( the N7I
recommended that Dr" Domingo -ntonio and Dr" Erinda 7aatbat*2eyes be charged for
5omicide through 2ec/ess Im!rudence before the Office of the City ,rosecutor"
During the !reiminary investigation( what trans!ired was a confounding series of
events which we sha try to disentange" The case was initiay assigned to ,rosecutor
-ntonio M" Israe( who had to inhibit himsef because he was reated to the counse of
one of the doctors" -s a resut( the case was re*raffed to ,rosecutor Norberto ."
3eono who was( however( dis:uaified on motion of the !etitioner since he disregarded
!revaiing aws and >uris!rudence regarding !reiminary investigation" The case was
then referred to ,rosecutor 2amon O" Carisma( who issued a resoution recommending
that ony Dr" 2eyes be hed criminay iabe and that the com!aint against Dr" -ntonio
be dismissed"
The case too/ another !er!e8ing turn when -ssistant City ,rosecutor 6osefina
Santos Sioson( in the )interest of >ustice and !eace of mind of the !arties(+
recommended that the case be re*raffed on the ground that ,rosecutor Carisma was
!artia to the !etitioner" Thus( the case was transferred to ,rosecutor 3eoncia 2"
Dimagiba( where a vote face occurred again with the endorsement that the com!aint
against Dr" 2eyes be dismissed and instead( a corres!onding information be fied
against Dr" -ntonio" ,etitioner fied a motion for reconsideration( :uestioning the
findings of ,rosecutor Dimagiba"
,ending the resoution of !etitioner=s motion for reconsideration regarding
,rosecutor Dimagiba=s resoution( the investigative )!ing!ong+ continued when the case
was again assigned to another !rosecutor( Eudo8ia T" .uaberto( who recommended
that Dr" 2eyes be incuded in the crimina information of 5omicide through 2ec/ess
Im!rudence" 'hie the recommendation of ,rosecutor .uaberto was !ending( the
case was transferred to Senior State ,rosecutor .regorio -" -ri0aa( who resoved to
e8onerate Dr" 2eyes from any wrongdoing( a resoution which was a!!roved by both
City ,rosecutor ,orfirio ." Macaraeg and City ,rosecutor 6esus 1" .uerrero"
-ggrieved( !etitioner fied graft charges s!ecificay for vioation of Section ?;e< of
2e!ubic -ct No" ?@$A
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against ,rosecutors .uerrero( Macaraeg( and -ri0aa for
manifest !artiaity in favor of Dr" 2eyes before the Office of the Ombudsman" 5owever(
on 6uy $$( $AAB( the Ombudsman issued the assaied resoution dismissing the
com!aint for ac/ of evidence"
In fine( !etitioner assais the e8ercise of the discretionary !ower of the Ombudsman
to review the recommendations of the government !rosecutors and to a!!rove and
disa!!rove the same" ,etitioner fauts the Ombudsman for( aegedy in grave abuse of
discretion( refusing to find that there e8ists !robabe cause to hod !ubic res!ondent
City ,rosecutors iabe for vioation of Section ?;e< of 2"-" No" ?@$A"
,reiminariy( the !owers and functions of the Ombudsman have generay been
categori0ed into the foowing& investigatory !owers( !rosecutory !ower( !ubic
assistance function( authority to in:uire and obtain information( and function to ado!t(
institute and im!ement !reventive measures"
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-s !rotector of the !eo!e( the Office of the Ombudsman has the !ower( function
and duty )to act !rom!ty on com!aints fied in any form or manner against !ubic
officias+ and )to investigate any act or omission of any !ubic officia when such act or
omission a!!ears to be iega( un>ust( im!ro!er or inefficient"+
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'hie the Ombudsman has the fu discretion to determine whether or not a crimina
case shoud be fied( this Court is not !recuded from reviewing the Ombudsman=s
action when there is an abuse of discretion( in which case 2ue DC of the 2ues of Court
may e8ce!tionay be invo/ed !ursuant to Section I( -rtice VIII of the $AEF
Constitution"
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In this regard( )grave abuse of discretion+ has been defined as )where a !ower is
e8ercised in an arbitrary or des!otic manner by reason of !assion or !ersona hostiity
so !atent and gross as to amount to evasion of !ositive duty or virtua refusa to !erform
a duty en>oined by( or in contem!ation of aw"
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1rom a !rocedura stand!oint( it is certainy odd why the successive transfers from
one !rosecutor to another were not sufficienty e8!ained in the 2esoution of the
Ombudsman" 7eing the !ro!er investigating authority with res!ect to misfeasance(
non*feasance and mafeasance of !ubic officias( the Ombudsman shoud have been
more vigiant and assiduous in determining the reasons behind the )buc/!assing+ to
ensure that no irreguarity too/ !ace"
'hether such transfers were due to any outside !ressure or uterior motive is a
matter of evidence" One woud have e8!ected the Ombudsman( however( to in:uire
into what coud hardy :uaify as )standard o!erating !rocedure(+ given the surrounding
circumstances of the case"
'hie it is true that a !reiminary investigation is essentiay in:uisitoria( and is often
the ony means to discover who may be charged with a crime( its function is merey to
determine the e8istence of !robabe cause"
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,robabe cause has been defined as )the
e8istence of such fact and circumstances as woud e8cite the beief( in a reasonabe
mind( acting on the facts within the /nowedge of the !rosecution( that the !erson
charged was guity of the crime for which he was !rosecuted"+
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),robabe cause is a reasonabe ground of !resum!tion that a matter is( or may be(
we founded( such a state of facts in the mind of the !rosecutor as woud ead a !erson
of ordinary caution and !rudence to beieve( or entertain an honest or strong sus!icion(
that a thing is so"+ The term does not mean actua and !ositive cause nor does it im!ort
absoute certainty" It is merey based on o!inion and reasonabe beief" Thus( a finding
of !robabe cause does not re:uire an in:uiry into whether there is sufficient evidence to
!rocure a conviction" It is enough that it is beieved that the act or omission com!ained
of constitutes the offense charged" ,recisey( there is a tria for the rece!tion of
evidence of the !rosecution in su!!ort of the charge"
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In the instant case( no ess than the N7I !ronounced after conducting an auto!sy
that there was indeed negigence on the !art of the attending !hysicians in
administering the anaesthesia"
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The fact of want of com!etence or diigence is
evidentiary in nature( the veracity of which can best be !assed u!on after a fu*bown
tria for it is virtuay im!ossibe to ascertain the merits of a medica negigence case
without e8tensive investigation( research( evauation and consutations with medica
e8!erts" Ceary( the City ,rosecutors are not in a com!etent !osition to !ass >udgment
on such a technica matter( es!eciay when there are conficting evidence and
findings" The bases of a !arty=s accusation and defenses are better ventiated at the
tria !ro!er than at the !reiminary investigation"
- word on medica ma!ractice or negigence cases"
In its simplest terms, the type of lawsuit which has been called medical malpractice
or, more appropriately, medical negligence, is that type of claim which a victim has
available to him or her to redress a wrong committed by a medical professional which
has caused bodily harm.
In order to successfully pursue such a claim, a patient must prove that a health care
provider, in most cases a physician, either failed to do something which a reasonably
prudent health care provider would have done, or that he or she did something that a
reasonably prudent provider would not have done and that that failure or action
caused in"ury to the patient.!
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5ence( there are four eements invoved in medica negigence cases& duty( breach(
in>ury and !ro8imate causation"
Evidenty( when the victim em!oyed the services of Dr" -ntonio and Dr" 2eyes( a
!hysician*!atient reationshi! was created" In acce!ting the case( Dr" -ntonio and Dr"
2eyes in effect re!resented that( having the needed training and s/i !ossessed by
!hysicians and surgeons !racticing in the same fied( they wi em!oy such training(
care and s/i in the treatment of their !atients"
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They have a duty to use at east the
same eve of care that any other reasonaby com!etent doctor woud use to treat a
condition under the same circumstances" The breach of these !rofessiona duties of
s/i and care( or their im!ro!er !erformance( by a !hysician surgeon whereby the
!atient is in>ured in body or in heath( constitutes actionabe ma!ractice"
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Conse:uenty( in the event that any in>ury resuts to the !atient from want of due care
or s/i during the o!eration( the surgeons may be hed answerabe in damages for
negigence"
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Moreover( in ma!ractice or negigence cases invoving the administration of
anaesthesia( the necessity of e8!ert testimony and the avaiabiity of the charge of res
ipsa loquitur to the !aintiff( have been a!!ied in actions against anaesthesioogists to
hod the defendant iabe for the death or in>ury of a !atient under e8cessive or im!ro!er
anaesthesia"
#$D%
Essentiay( it re:uires two*!ronged evidence& evidence as to the
recogni0ed standards of the medica community in the !articuar /ind of case( and a
showing that the !hysician in :uestion negigenty de!arted from this standard in his
treatment"
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-nother eement in medica negigence cases is causation which is divided into two
in:uiries& whether the doctor=s actions in fact caused the harm to the !atient and
whether these were the !ro8imate cause of the !atient=s in>ury"
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Indeed here( a causa
connection is discernibe from the occurrence of the victim=s death after the negigent
act of the anaesthesioogist in administering the anesthesia( a fact which( if confirmed(
shoud warrant the fiing of the a!!ro!riate crimina case" To be sure( the aegation of
negigence is not entirey baseess" Moreover( the N7I deduced that the attending
surgeons did not conduct the necessary interview of the !atient !rior to the o!eration" It
a!!ears that the cause of the death of the victim coud have been averted had the
!ro!er drug been a!!ied to co!e with the sym!toms of maignant hy!erthermia" -so(
we cannot ignore the fact that an antidote was readiy avaiabe to counteract whatever
deeterious effect the anaesthesia might !roduce"
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'hy these !recautionary measures
were disregarded must be sufficienty e8!ained"
The City ,rosecutors were charged with vioating Section ?;e< of the -nti*.raft and
Corru!t ,ractices -ct which re:uires the foowing facts&
$. 'he accused is a public officer discharging administrative or official functions
or private persons charged in conspiracy with them
%. 'he public officer committed the prohibited act during the performance of his
official duty or in relation to his public position
(. 'he public officer acted with manifest partiality, evident bad faith or gross,
inexcusable negligence and
). His action caused undue in"ury to the *overnment or any private party, or gave
any party any unwarranted benefit, advantage or preference to such parties.!
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'hy did the com!ainant( !etitioner in instant case( eect to charge res!ondents
under the above aw?
'hie a !arty who fees himsef aggrieved is at iberty to choose the a!!ro!riate
)wea!on from the armory(+ it is with no itte sur!rise that this Court views the choice
made by the com!ainant widow"
To our mind( the better and more ogica remedy under the circumstances woud
have been to a!!ea the resoution of the City ,rosecutors dismissing the crimina
com!aint to the Secretary of 6ustice under the De!artment of 6ustice=s Order No"
99?(
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otherwise /nown as the )$AA? 2evised 2ues on -!!eas 1rom 2esoutions In
,reiminary InvestigationsG2einvestigations(+ as amended by De!artment Order No"
?CA( Section $ of which !rovides&
,ection $. -hat .ay /e 0ppealed. 1 Only resolutions of the Chief ,tate
2rosecutor34egional ,tate 2rosecutor32rovincial or City 2rosecutor dismissing a
criminal complaint may be the sub"ect of an appeal to the ,ecretary of 5ustice except
as otherwise provided in ,ection ) hereof.!
'hat action may the Secretary of 6ustice ta/e on the a!!ea? Section A of Order
No" 99? states& )The Secretary of 6ustice may reverse( affirm or modify the a!!eaed
resoution"+ On the other hand( )5e may motu proprio or on motion of the a!!eee(
dismiss outright the a!!ea on s!ecified grounds"+
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In e8ercising his discretion under the circumstances( the Ombudsman acted within
his !ower and authority in dismissing the com!aint against the ,rosecutors and this
Court wi not interfere with the same"
&ERE!ORE( in view of the foregoing( the instant !etition is DISMISSED, without
!re>udice to the fiing of an a!!ea by the !etitioner with the Secretary of 6ustice
assaiing the dismissa of her crimina com!aint by the res!ondent City
,rosecutors" No costs"
SO ORDERED.
Regalado, (Chairman), Puno, Mendoza, and Torres, Jr., JJ., concur.
#$%
99C SC2- F9C ;$AA?<"
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Rollo( !" $ED"
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Sec" ?;e<" Causing any undue in>ury to any !arty( incuding the .overnment( or giving any !rivate !arty
any unwarranted benefits( advantage or !reference in the discharge of his officia( administrative or
>udicia functions through manifest !artiaity( evident bad faith or gross ine8cusabe negigence" This
!rovision sha a!!y to officers and em!oyees of offices or government cor!orations charged with the
grant of icenses or !ermits or other concessions"
#B%
Concerned Officias of the Metro!oitan 'aterwor/s and Sewerage System ;M'SS< v" Vas:ue0( 9B@
SC2- C@9 ;$AAC<"
#C%
Deoso v" Domingo( $A$ SC2- CB ;$AA@<"
#D%
Habut v" Office of the Ombudsman( 9?? SC2- ?$@ ;$AAB<I Houng v" Office of the Ombudsman( 99E
SC2- F$E ;$AA?<"
#F%
Commission on Interna 2evenue v" Court of -!!eas( 9CF SC2- 9@@ ;$AAD<"
#E%
,angandaman v" Casar( $CA SC2- CAA ;$AEE<"
#A%
Cru0 v" ,eo!e( 9?? SC2- B?A ;$AAB<"
#$@%
,ia!i v" Sandiganbayan( 99$ SC2- ?BA ;$AA?<"
#$$%
Rollo( !" $EF"
#$9%
Internet * htt!&GGwww"medicama"comGnegig"htm"
#$?%
5irschberg v" State( A$ Misc 9d CA@ ;$AFF<"
#$B%
5oover v" 'iiamson( 9?D Md 9C@"
#$C%
.ore v" 7oard of Medica Juaity( $$@ Ca -!! ?d $EB ;$AE@<"
#$D%
D$ -m 6ur 9nd ;$AF9<"
#$F%
Davis v" Virginian 2" Co( ?D$ 4S ?CB"
#$E%
Internet( supraI see footnote $9"
#$A%
N7I Dis!osition 1orm( !!" 9?E*9CB"
#9@%
Vianueva v. Sandiganbayan( 99? SC2- CB? ;$AA?<"
#9$%
Order No" 99? too/ effect on -ugust $( $AA?"
#99%
SECTION A" Dis!osition of -!!ea" * The Secretary of 6ustice may reverse( affirm or modify the
a!!eaed resoution" 5e may( motu proprio or on motion of the a!!eee( dismiss outright the a!!ea on
any of the foowing grounds&
a< That the offense has !rescribedI
b< That there is no showing of any reversibe errorI
c< That the !rocedure or re:uirements herein !rescribed have not been com!ied withI
d< That the a!!eaed resoution is interocutory in nature( e8ce!t when it sus!ends the !roceedings
based on the aeged e8istence of a !re>udicia :uestionI or
e< That other ega or factua grounds e8ist to warrant a dismissa"