SC upholds junking of complaint vs surgeon in malpractice case

MANILA – The Supreme Court (SC) has upheld a decision dismissing a complaint against a surgeon tagged in a malpractice case, saying doctors should not be liable if they offered “proper medical advice” and explained the risks of a procedure to patients.

The High Court Second Division affirmed the dismissal of a complaint against Dr. Avelino Aventura, head of the Philippine Heart Center’s Surgery Department.

It upheld the decisions of the Regional Trial Court and Court of Appeals, saying Dr. Aventura “was not negligent and did not commit medical malpractice.”

In a release, the SC said Aventura’s patient died during a stenting procedure done by a Belgian specialist. The patient’s son then filed a lawsuit for damages against Aventura, accusing him of medical malpractice.

The patient first went to Aventura after he developed hoarseness because of an aneurysm in the aortic arch. The condition supposedly affected his vocal cords.

“A CT scan confirmed that the condition was life-threatening. After several tests, Dr. Aventura advised [patient] to first undergo a heart bypass operation and then address the aneurysm later on. The bypass operation was successful,” the release read.

Despite this, however, months later, the patient’s aneurysm worsened and Dr. Aventura offered him either an open-chest surgery or a stenting procedure.

The SC said the patient’s family opted for the latter after they were “assured it was safer and had fewer complications.”

“For his part, Dr. Aventura told the [patient’s] family that neither procedure guaranteed success and the stenting still risked death. He clarified he wouldn't perform the stenting himself, as it was outside his expertise. After introducing [him] to visiting Belgian specialist… who would do the procedure [the patient] consented,” the High Court said.

The Belgian specialist tried to insert the custom stent three times but this “failed” due to the bend in the patient’s artery.

“He informed the family that the stent was ‘faulty.’ As a result, [the patient] suffered a stroke and never woke up,” the release read.

According to the Supreme Court, medical malpractice will only happen if a doctor “fails to deliver the standard of care expected from other doctors in similar circumstances, resulting in harm to the patient.”

“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,” the SC said.

The High Court said it found that Dr. Aventura clearly informed [patient] and his family about the risks of the stenting procedure, which includes death.

“He also clarified that another doctor would perform the procedure, and [the patient] signed the consent forms,” the release read.

“Expert witnesses in cardiovascular and endovascular surgery also testified that stenting was a medically appropriate and reasonable treatment for [the patient], given his conditions. They confirmed that despite the risks, it was a sound medical choice compared to open-chest surgery,” it added.  

Senior Associate Justice Marvic Leonen, meanwhile, in his concurring opinion said the doctor’s legal duty in providing care would not stop when he refers a patient to a specialist for procedure.

“If the specialist makes a mistake, the attending doctor—who diagnosed the condition, recommended the treatment, and referred the patient—must show that they still met the expected standard of care and took all reasonable steps to minimize risks, rather than merely explaining the procedure,” the statement read.

SC looking into conviction of surgeon over medical malpractice case