MESH POOL Flashcards
Patient was aware that physician was drunk yet he allowed the doctor to inject him
Res ipsa loquitor
Dr. Cantoy operated on a patient and inadvertently left behind a clamp. Which malpractice doctrine is applicable in this case?
Res ipsa loquitor
Patient Mr. Simporios promised to pay Dr. Sacris one million pesos if he is cured of his cancer. The professional fee to be collected by Dr. Sacris refers to
Contingent fee
HIV patient takes experimental drugs despite unknown side effects
Assumption of risk
There is direct physical connection between the wrongful act of the physician and the injury suffered by the patient
Doctrine of proximate cause
Under the doctrine the hospital owner may be liable for the mistakes of the residents
Vicarious liability
Originally there were railings on the bed of the patient. Mr A, the father removed the railings so that he himself can sleep on the bed. His child fell with a broken skull. What is the doctrine applicable
Common knowledge
Patient leaves the hospital against advice
Contributory negligence
Principle applied when the medical fee is not specified
Asumpsit on quanthum merit
The responsibility of a person, who is not negligent, for the wrongful conduct or negligence of another
Vicarious liability
In cases wherein the employees are at the same time independent contractors of the hospital, the hospital must be held liable for their negligent acts (pathologist, radiologist, anesthesiologist)
Doctrine of ostensible agent
Ordinarily, resident physicians, nurses and other personnel of the hospital are employees or servants of the hospital
Borrowed servant
Liability of the surgeon not only for the wrongful acts of those who are under his physical control but also those wherein he has extension of control
CAPTAIN-OF-THE-SHIP DOCTRINE
“The thing speaks for itself”
RES IPSA LOQUITOR
Nature of the wrongful act or injury is suggestive of negligence
RES IPSA LOQUITOR
Injury to a healthy part of the body
RES IPSA LOQUITOR
Removal of a wrong part of the body when another part wad intended
RES IPSA LOQUITOR
Infection resulting from unsterilized instruments
RES IPSA LOQUITOR
Failure to take radiographs to diagnose a possible fracture
RES IPSA LOQUITOR ??? Negligence
The act or omission amounting to want of care on the part of the complaining party which, concurring with the defendant’s negligence, is the proximate cause of the injury
CONTRIBUTORY NEGLIGENCE
Doctrine of CONTRIBUTORY NEGLIGENCE is aka
Doctrine of Common Fault
The patient just follows the instructions and orders of the physician and is usually inactive and virtually places himself in the command and control of the physician
Doctrine of Superior Knowledge
After a prolonged treatment of a patient which normally produces alleviation of the condition, fails to investigate non-response; in the exercise of care and diligence he could have discovered the cause of non-response
DOCTRINE OF CONTINUING NEGLIGENCE
Anyone who voluntarily assumes the risk of injury from a known danger, if injured, is barred from recovery
DOCTRINE OF ASSUMPTION OF RISK
Implies thought, appreciation, mental direction and lapse of sufficient time to effectually act upon impulse to save the life or prevent injury to another
DOCTRINE OF LAST CLEAR CHANCE
A physician cannot be held accountable for negligence if the injury sustained by the patient is on account of unforeseen conditions
Doctrine of foreseeability
A pathologist, connected and associated with a hospital on salary contract, reported after tissue biopsy that a patient had cancer when in fact he did not. The patient underwent hysterectomy as a result of the misdiagnosis. The hospital was held liable by the court under the doctrine of
Ostensible agent
A 45 year old female had breast surgery for CA of the breast with metastasis. She consented in writing to undergo trial of a new chemotherapeutic modality. The patient continued to deteriorate and sued the physician. The physician was absolved under the doctrine of
Assumption of risk
According to RA 4226, which of the following is a place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment, and care of individuals suffering from illness or disease
Hospital (RA 4226 is aka Hopsital Act
While incising an abscess on a patient’s face, the physician accidentally cut an ear. He can be held liable under the doctrine of
RES IPSA LOQUITOR
A violent psychotic patient was ordered confined by his psychiatrist in a private room without a watcher, windows without grills. The patient dies after jumping through the window. The psychiatrist may be held liable under the doctrine of
Foreseeability
Ramos vs. Court of Appeals
Captain of the Ship Doctrine
Cruz vs. Court of Appeals
Doctors are not Guarantors
Reyes vs. Srs of Mercy Hospital
Reasonable Negligence from the Least to the Most Knowlegable
An evidence not proceeding from personal knowledge of the witness, but from mere repetition of what he had heard others say
HEARSAY EVIDENCE
The statement made by a person who is at the point of death, and is conscious of his impending death, in reference to the manner in which he receives his injuries of which he is dying
Dying declaration
Direct vs indirect contempt: Misbehavior of an officer of a court in the performance of his official duties or in his official transactions
Indirect
Direct vs indirect contempt: Disobedience of or resistance to a lawful writ, process, order, or judgment of a court
Indirect
Direct vs indirect contempt: Any abuse of or any unlawful interference with the process or proceedings of a court not constituting direct contempt
Indirect
Direct vs indirect contempt: Any improper conduct tending directly or indirectly to impede, obstruct, or degrade the administration of justice
Indirect
Direct vs indirect contempt: The rescue of a person or property in the custody of an officer by virtue of an order
Indirect
Direct vs indirect contempt: Assuming to be an attorney
Indirect
Article 365 which deals with imprudence and negligence is a provision of
Revised Penal Code
To which forum can an administrative complaint be filed against doctors?
PRC
Reprimand is a sanction imposed against a doctor when he is guilty of what liability
Administrative liability
If the license of a physician is suspended indefinitely, after how long can he apply for reinstatement
2 years
What is the degree of proof/evidence needed to convict physician of a crime?
Guilt beyond reasonable doubt
The reporting of treatment of serious physical injuries by a physician is
Mandatory
The bone which is most informative regarding the sex of the owner of the skeleton being examined is the
Pelvis
The willful deliberate and painless acceleration of death of a person
Euthanasia
The cause of death resulting from lack of skill, lack of foresight, and reckless imprudence is called
Negligence
Exhumation is also known as
Disinterment
Presidential Decree 169 mandates all doctors to report all cases involving what kind of physical injuries
Less serious and serious
When the color of the contusion changes to green, the contusion’s estimated age is
4-5 days
Fracture produced by a tangential or glancing approach of bullet
Gutter fracture
Its main function is the transformation of mechanical energy by the hit of the firing pin on the percussion cap to chemical energy
Primer
If the diameter of the gunshot wound point of entry is 1 cm x 1 cm the probable caliber of the firearm used is
0.45
The primer is usually made up of
Lead, barium, antimony
Tattooing is also known as
Stippling
The absence of smoke soiling, burning or powder tattooing is suggestive of this type of gunshot wound
Long range wound
States that the greater the number of points of similarities and dissimilarities of 2 persons compared, the greater is the probability for the conclusion to be correct
LAW OF MULTIPLICITY OF EVIDENCE IN IDENTIFICATION
When the court has once laid down a principle of law or interpretation as applied to certain state of facts, it will adhere to and apply to all future cases where the facts are substantially the same
PRINCIPLE OF STARE DECICIS
“Pugilistic” position of a boxer is associated with
Burns
The average time required for death in drowning is
2-5 minutes
This is quantitative determination of the chloride content of the blood in the right and left ventricle of the heart
Gettler’s test
Determines whether blood/semen is of human origin or not
Precipitin test
It is an expressed acknowledgement by the accused in a criminal case of the truth of his guilt as the crime charged
Confession
The presence of weapon which is highly grasped by the hand of a victim of a shooting incident is an example of
Cadaveric spasm
The most practical, useful and reliable means of preserving evidence is by
Photography
Virginity is a requirement in this crime
Qualified seduction
The body vested by law to have general supervision and regulation over the practice of medicine is
PRC
Mayen Grageda graduated from the Pulangue College of Medicine and immediately used the title MD after her name. She is
Academically entitled to use MD
T/F Collection of professional fees constitutes practice of medicine
F
Dr. Senga is scheduled to preside over a CPC in the Medical School. She is late, so that on her own volition, countered the traffic flow in the opposite lane to reach his destination. She was caught by a traffic officer. Which can she invoke?
NONE
You evaluated a 65-year old man with 3-month history of chest pains and fainting spells that you feel merit cardiac catheterization. After informing him fully of the benefits, consequences, risks, etc. and he was able to demonstrate that he understands all of these, he refuses the intervention. What should you do?
Respect his choice
While driving in EDSA, Dr. Suilian witnessed the shooting of a politician by a group of armed assailants. He was subpoenaed to appear in court because of his as heavy practice. He relented nevertheless and appeared as a
Ordinary witness
A physician must appear in response to a subpoena if his place of residence is how many kilometers from the court issuing the subpoena?
Less than 50km
In a malpractice case, Dr. Milante was ordered by the court to produce at trial the patient’s charts, laboratory and x-ray results and other documents under his possession and control. The process served on him to do this is called
Subpoena duces tecum
One of the following is not a liability resulting from the wrongful act by a physician: A. Criminal B. Moral C. Civil D. Administrative
Moral
An administrative complaint was filed with the PRC against a physician who was eventually found guilty. This may result in
Reprimand, suspension or revocation of license to practice
A gynecologist performed a total abdominal hysterectomy on a patient with myoma uteri. Before closing the abdomen, he discovered that the patient had cancer of the cecum so he referred the patient to a general surgeon to perform the resection. Three days post-op, the patient had to be reopened and a piece of gauze was found. Who may be held liable under the Captain of the ship Doctrine?
The gynecologist
The receptionist in the hospital lobby receives a fee from Dr. Libat for referring cases to the latter. This fee, which is unethical, is called
Dichotomous fee
As a result of the deformity he sustained from a facelift operation, Juana sued Dr. Hannibal for mental anguish, social humiliation and moral shock. The type of damages she can recover as a result of these is
Moral damages
The presence of an intact hymen with distinct and regular edges and where the opening barely admits tip of the smallest finger even if the thighs are separated Is seen in
True physical virginity
Carnal knowledge means
Slightest penetration of the female sexual organ by the male sexual organ
Luisa is 10 years old. She gave consent to have carnal knowledge with a male tourist provided she is paid money. Josefa is a victim of ___
Statutory rape
Luisa scratched Mark in the face in an altercation. The doctor attended to the injury that resolved in less than 10 days but a resultant keloid scar formation. The legal classification of this injury is
Serious physical injuries
A form of sexual perversion where a man has a compulsive desire to seek gratification by having sexual intercourse with a child of either sex
Pedophilia
Condition where the body becomes soft and flaccid after the disappearance of rigor mortis is called
Sugilation
Part of the body that putrefies early
Brain
No longer true of rape under RA 8353
Offended party must be female
Jake calls people up on the phone in the early hours of the morning and starts using obscene and foul language to obtain sexual gratification. This sexual deviation is known as
Coprolalia
The lead agency tasked to handle cases of child abuse is
DSWD
An idiot is exempted from criminal liability. An idiot has an IQ of
0-20
A false interpretation of external stimulus which may be manifested with the sense of sight, hearing, taste touch and smell is
Illusion
Disorientation, mental confusion, dizziness, sensory disturbances exaggerated emotional state suggest that the blood alcohol level is
150-300mg%
Locus minoris resitencia
Head injury which may be found in areas of the skull offering the least resistance
The chemical change of body fat which takes place in wet conditions and results in a grayish, greasy or brittle compound is known as
Adipocere formation
Lung findings in someone who died from drowning
Emphysema aquosum
Tardieu spots are associated with
Hanging
When blood accumulates in the most dependent portions of the dead body, it is called
Post-mortem lividity
Cadaveric rigidity is also known as
Rigor mortis
The convict is put to death by a volley of fire from a firing squad in
Musketry
An unembalmed body should be buried not later than: (if the person died as a result of a communicable disease)
12 hours
Instantaneous rigor is also known as
Cadaveric spasm
It is the prominence of the superficial veins with reddish discoloration due to the process of decomposition which develops on both flanks of the abdomen
Marbolization
The microorganisms that plays a dominant role in decomposition
Clostridium welchi
For a child to be legitimate, he must be born in lawful wedlock or within these number of days after the dissolution of marriage
300 days
BOARD OF MEDICINE: Qualifications
• Natural-born citizen
• Duly-registered physician
• In the practice of medicine for at least 10 years
• Of good moral character and of recognized standing in the medical profession as certified by PMA
* Not a member of any faculty of any medical school (including any pecuniary interest)
SCOPE OF PRELIMINARY BOARD EXAMINATION
1) Anatomy and histology 2) Physiology 3) Microbiology and Parasitology 4) Biochemistry
INHERENT RIGHTS
” To choose patients
“ To limit practice of medicine
“ To determine appropriate management procedures
“ To avail of hospital services
INCIDENTAL RIGHTS
” Right of way while responding to emergency
“ Right of exemption from execution of instruments and library
“ To hold certain public/private offices
“ To perform certain services
“ To compensation
“ Right to membership in medical societies
RIGHTS OF PATIENTS
- Right to give consent to diagnostic and treatment procedures
- Right to religious belief
- Right of privacy
- Right to disclosure of information
- Right to confidential information •Right to choose his physician
- Right of treatment
- Right to refuse necessary treatment
Instances where there is no Physician-Patient Relationship by DECISIONS OF COURTS
- Pre-employment PE for purposes of determining whether an applicant is suitable for employment;
- PE for eligibility for insurance;
- Physician appointed by court to examine the accused;
- In performing an autopsy;
- Casual consultation in an unordinary place.
GROUNDS FOR ADMINISTRATIVE LIABILITIES
Personal disqualifications
–Immoral or dishonorable conduct;
–Insanity;
–Gross negligence, ignorance or incompetence resulting in an injury to or death of the patient;
–Addiction to alcoholic beverages or to any habit-forming drug rendering him incompetent to practice medicine
The court may grant consent for the minor under what doctrine
Doctrine of parens patriae
Deficiency of action or failing to take the necessary precaution once they are foreseen
Imprudence
Is that cause, which, in natural continuous sequence, unbroken by an efficient intervening cause, produces the injury and without which the result would not have occurred
Proximate cause
A former hospital patient requested access to his clinical records but was refused by the hospital administration. He can file a court order of
Mandamus
The main basis for the physician-patient relationship
Trust
T/F Any foreign student who has resided in the Philippines for > 2 years is qualified to take the Philippine Medical Board Examinations
F
Qualifications to take the Philippine Medical Board examinations
o Filipino Citizen
o Any foreign student who has resided in the Philippines for > 2 years o Passed Internship
o Conferred the degree of MD
o Good moral character
Disputable presumption of death to one unheard from is this period of
More than 7 years
A 60 year old millionaire was autopsied and found to have died of arsenic poisoning based on examination of the following organs
Liver, kidney, skin
An 18 year old female student was enticed by her father to have sexual intercourse with him. This is called
Incestuous qualified seduction
Res ipsa loquitor means
The thing speaks for itself
The American Medical Association drafted 10 principles to serve as guidelines in the conduct of medical research. This serves as the cornerstone in the Allied cases against Nazi physicians. This is known as
Declaration of Helsinki
The body of the crime which points to the act of the criminal is
Corpus delicti
During physical examination, a physician fondled the breast of his female patient. He may be charged with
Act of lasciviousness
T/F Use of EEG is commonly used to detect lying
F
The commonly used methods of detection of lying are the following
− use of polygraph or lie detection machine
− administration of truth serum
− hypnotism
T/F Tibia is used in determining sex of a skeleton
F
T/F Mercy-killing or euthanasia is a method of judicial death
F
The different methods of judicial death
− death by musketry
− death by electrocution
− death by hanging
− death by gas chamber
Reasons for the inadmissibility to the court of the result of lie detector examination
− polygraph techniques are still in the experimental stage
− there is no way to assure that a qualified examiner administered the test
− the test cannot be relied upon because of many errors
In molecular or cellular death is death of individual cells in
3-6 hours
This is a medical evidence made known or addressed to the senses of the court not limited to the sense of vision, but is intended to the sense of hearing, taste, smell and touch
autoptic or real evidence
As a general rule, if there is no heart action within the following number of minutes, death is regarded as certain
5 minutes
A cadaver found in an ordinary tropical environment is presenting the physical findings of rigor mortis, well developed hypostasis with greenish discoloration over the cecal region. The cadaver has been dead
12 hours
The farthest distance speckling or tattooing can be visible through our naked eye is
24 inches
The most prominent sign of death is
Progressive fall of the body temperature (algor mortis)
Considered to be the most valuable method of identification and is universally
Fingerprinting
T/F Fingerprints are formed in the fetus in the 9 month of pregnancy
F, 4 months
Fingerprinting is considered to be the most valuable method of identification and is universally used because
− there are no two identical fingerprints
− fingerprints are not chageable
− fingerprints are formed in the fetus in the 4th month of pregnancy
− finger may be wounded or burned but the whole pattern will re-appear
The right to regulate the practice of medicine (like the issuance of a license) is based on what inherent power of the state
Police power
Every person who contrary to law, willfully or negligently cause damage to another shall indemnity the latter for the same. This is found
Article 20, Civil Code
Violation of any of the provisions of the code of ethics as approved by the Philippine Medical Association is a ground for
− reprimand, suspension, revocation of license (administrative)
The penalty of illegal practice of medicine is
− imprisonment of 1-5 yrs, fine of php1000-10000
A physician has every right to choose his patient except in cases of
− emergency
− when there is no other available physician
This doctrine means that no one must enrich himself at the expense of another and this is known as
− doctrine of unjust enrichment
− L’enrichissement same cause
The nature of the relationship between physician and the patient is
− consensual
− fiduciary
The doctrine of vicarious liability in the American Law is commonly known as
- doctrine of imputed negligence
- command of responsibility doctrine
- doctrine of respondent superior
A physician who deliberately refuses to obey a subpoena without justifiable reason is guilty of
Indirect contempt
Faith healing is allowed as a norm of treatment modality in the Philippines. This is allowed on the basis of Constitutional guarantee on
freedom of religion
Foreign physicians may likewise be allowed to practice in the Philippines
− endorsement
− reciprocity
Killing of a ascendant, descendant, spouse escept laterals
Parricide
Killing of a brother or sister
Homicide
Killing of a 12-18 year old
Murder
Punishment for parricide
Reclusion perpetua; 20-40 years
How long can spermatozoa survive in the vaginal canal after sexual intercourse
72 hours
Included in the application of legal medicine in civil law
a. circumstances affecting criminal liability
b. crimes against chastity
c. paternity and filiation
The child of a prostitute
Manceres
