A physician who gave proper medical advice, explained the risks of the medical procedure to be done on the patient, and secured proper consent is not liable for malpractice if the patient dies, the Supreme Court (SC) said.

The ruling was contained in a decision that denied the petition of Elpidio Que, who challenged the ruling of the Court of Appeals (CA) which denied his case for payment of damages for the death of his father Quintin Que in 2000 after a stenting procedure.

The decision was written by the now retired Associate Justice Mario V. Lopez.

With the decision made public on Wednesday, July 9, under GR No. 268308, the SC upheld the dismissal of the complaint against Dr. Avelino P. Aventura, head of the Philippine Heart Center (PHC) Surgery Department, for the death of his patient Quintin.

Elpidio filed a complaint against Aventura for medical malpractice and sought damages for the death of the former’s father after a failed stenting procedure.

Google says stenting “is a medical procedure where a tiny, mesh-like tube called a stent is inserted into a narrowed or blocked passageway in the body, most commonly blood vessels, to keep it open and restore proper fluid flow.”

A press briefer issued by the SC’s Office of the Spokesperson stated that Quintin was first brought to Aventura after developing hoarseness due to an aneurysm in the aortic arch.

A computed tomography (CT) scan confirmed that the condition was life-threatening. Thus, Aventura advised Quintin to first undergo a heart bypass operation and then address the aneurysm later on.

After a successful bypass operation, Quintin’s aneurysm worsened. Aventura offered two options – an open-chest surgery or a newer, less invasive stenting procedure.

Aventura explained to the Que family that neither of the two medical procedures can guarantee success and even stenting still risks death.

He also told the family that he was not the one who will perform the stenting procure but a visiting Belgian specialist Dr. Eric Verhoeven. After introducing Quintin to Dr. Verhoeven, the former consented, including members of his family.

During the medical procedure, Dr. Verhoeven attempted to insert the custom stent three times but failed due to a bend in Quintin’s artery. Verhoeven informed the family members that the stent was faulty.

Quintin suffered a stroke and died. Elpidio filed a case for damages against the PHC, Aventura, and Verhoeven.  The regional trial court (RTC) dismissed the case and the dismissal was upheld by the CA. Elpidio elevated the issue before the SC.

In resolving the petition, the SC said that medical malpractice occurs when a doctor fails to deliver the standard of care expected from other doctors in similar circumstances, resulting in harm to the patient.

It pointed out that a basis for malpractice is the lack of informed consent, which occurs when a patient agrees to a procedure without being fully informed about its risks and potential outcomes.

In the case of Quintin, the SC said that Aventura clearly informed Quintin and his family about the risks associated with the stenting procedure, including the risk of death.

Aventura also told Quintin and his family that another doctor would perform the stenting procedure, and Quintin signed the consent forms, it also said.

At the same time, the SC said that witnesses in cardiovascular and endovascular surgery also testified that stenting was a medically appropriate and reasonable treatment for Quintin, given his conditions.

The witnesses confirmed that despite the risks, it was a sound medical choice compared to open-chest surgery, it also said.

The SC ruled: “Ultimately, the CA did not commit an error in affirming the dismissal of the Complaint for Damages for lack of merit. Accordingly, the Petition for Review on Certiorari is denied. The Decision dated July 3, 2023 of the Court of Appeals in CA-G.R. CV No.115245 that affirmed the dismissal of Elpidio Que's Complaint stands.”