Letter to an Attorney

Dear Attorney,

I am reaching out to seek legal advice regarding a concerning medical incident that occurred during my wife’s childbirth experience. Our son was born on the 12th of September, and on the 18th of the same month, a vaginal pack that had been used during the delivery unexpectedly came out of my wife. It emitted a rotting stench, which alarmed us greatly. Fortunately, after medical examination, we were informed that the retained pack did not cause any infection. However, the experience has caused significant emotional distress and mental trauma for my wife, and we are deeply disturbed by the medical negligence that led to this oversight.

I would like to inquire about the possibility of pursuing a medical malpractice claim against the hospital and the healthcare professionals involved. Specifically, we are interested in understanding the potential compensation for the pain and suffering, as well as the mental and emotional distress that my wife has endured. What are the likely outcomes of such a case in terms of compensation, and how should we proceed with filing a lawsuit?

Your guidance on this matter would be greatly appreciated.

Sincerely,
A Concerned Husband

Medical Malpractice and Compensation for Pain and Suffering in the Philippines: A Comprehensive Legal Perspective on Retained Vaginal Packs

In the Philippines, medical malpractice is a significant legal issue that involves negligence or substandard care by healthcare professionals that causes injury or harm to the patient. In the case described, a retained vaginal pack is clearly a medical error that could give rise to a malpractice claim. This article will explore the legal foundation for medical malpractice in the country, focusing on compensation for pain, suffering, and mental trauma, particularly in cases where no physical injury, such as an infection, occurred.

1. Understanding Medical Malpractice

Medical malpractice in the Philippines is governed by principles under civil law, and can also be pursued under criminal law in cases of gross negligence. The basis of a medical malpractice claim is grounded in Article 2176 of the Civil Code, which covers quasi-delicts. This provision establishes that anyone who, through an act or omission, causes damage to another person by fault or negligence, is liable for compensation.

For a malpractice claim to be successful, four essential elements must be established:

Existence of a Duty of Care: Healthcare professionals owe a duty of care to their patients, which involves providing competent and standard medical care during diagnosis and treatment. In this scenario, the hospital and its staff were responsible for ensuring that the vaginal pack used during childbirth was properly accounted for and removed after the procedure.
Breach of Duty: A breach occurs when healthcare professionals fail to provide the standard of care expected of them. Retaining a vaginal pack for several days post-delivery constitutes a breach of this duty, as the failure to remove it in a timely manner falls below the accepted standard of medical care.
Causation: The breach of duty must be directly connected to the harm caused to the patient. In this instance, the vaginal pack retained within the body, along with the physical and psychological effects of its prolonged presence, establishes causation.
Damages: The patient must have suffered actual damages as a result of the breach of duty. In the present case, even though an infection was avoided, the emotional distress and mental trauma suffered by the patient are valid forms of damage under Philippine law.

2. Potential Causes of Action and Remedies

The concerned party may pursue several causes of action against the healthcare professionals involved, depending on the severity of the malpractice and the resulting harm. These include:

a) Civil Action for Damages

The primary legal remedy available for the patient and her family is a civil action for damages. Under the Civil Code of the Philippines, the family can file a suit seeking compensation for various categories of damages:

Actual Damages: These refer to tangible losses such as medical expenses incurred due to the malpractice. In this case, if there were additional consultations, diagnostic tests, or treatments conducted as a result of the retained pack, they could be claimed as actual damages.
Moral Damages: Moral damages are awarded for pain and suffering, mental anguish, and emotional distress. Given the traumatic nature of discovering a rotting vaginal pack days after childbirth, the patient is likely entitled to moral damages. The courts consider the gravity of the distress caused and the impact on the individual’s mental well-being when determining the amount to award.
Nominal and Temperate Damages: In some cases, the court may award nominal or temperate damages even if the actual damages are not substantial. This is particularly relevant when the wrong committed is clear, but the precise monetary loss is difficult to quantify.
Exemplary Damages: Exemplary or punitive damages are awarded to deter gross negligence or reckless disregard for the safety of patients. If it can be shown that the healthcare professionals involved were grossly negligent, such damages may be awarded as a form of deterrence.

b) Criminal Liability

While civil liability is the most common route for medical malpractice claims, in cases where gross negligence is evident, criminal charges may also be pursued. Under the Revised Penal Code, reckless imprudence resulting in physical harm may constitute a criminal offense. In cases where the negligence does not result in death but causes severe emotional or mental harm, criminal action could still be pursued under the general principles of reckless imprudence.

3. Determining the Compensation for Pain and Suffering

The amount of compensation for pain and suffering, as well as mental trauma, is not subject to fixed formulas in the Philippines. Instead, it is determined by the discretion of the court based on the circumstances of the case. Courts generally consider the following factors when awarding damages:

Severity of the Malpractice: The gravity of the medical error is a significant factor in determining compensation. In this case, the prolonged retention of the vaginal pack and the distress it caused are likely to be regarded as serious breaches of duty.
Duration of Suffering: The length of time during which the patient suffered plays a role in calculating damages. Since the vaginal pack remained undiscovered for several days, resulting in anxiety and discomfort for the patient, the duration of the suffering will likely be considered in assessing compensation.
Impact on the Patient’s Well-being: The mental and emotional toll that the incident took on the patient is another key factor. In cases where a patient's mental health is adversely affected, courts may award higher compensation. Expert testimony from psychologists or psychiatrists can bolster claims for severe emotional or mental harm.
Precedent and Jurisprudence: Previous cases of medical malpractice in the Philippines serve as a guide for determining compensation. While every case is unique, courts often refer to precedents when awarding damages for pain and suffering. Notable decisions in past cases, such as Professional Services, Inc. v. Agana, provide insights into the amounts that may be awarded.

4. Challenges and Defenses in Medical Malpractice Cases

Although the law provides remedies for victims of medical negligence, pursuing a medical malpractice claim can be complex. Healthcare providers often mount strong defenses to avoid liability. Some common defenses include:

Absence of Negligence: The medical professionals may argue that the retained vaginal pack was a reasonable outcome of the procedure and that their actions were in line with accepted medical practices.
Informed Consent: In some cases, healthcare providers argue that the patient was informed of the risks involved in the procedure, including the possibility of complications.
Contributory Negligence: A defense based on contributory negligence may arise if the healthcare professionals assert that the patient contributed to the harm, perhaps by failing to follow post-operative instructions or report symptoms promptly.

5. Procedural Aspects: Filing a Malpractice Claim

To pursue a claim for medical malpractice, the patient or their family must file a formal complaint in the appropriate court. A medical expert witness is typically required to establish that the healthcare provider’s conduct deviated from the accepted standard of care. This expert testimony is crucial in proving the breach of duty.

Furthermore, cases of medical malpractice must be filed within a specific period. Under the Civil Code of the Philippines, the prescriptive period for quasi-delict cases is four years from the time the injury or harm is discovered. This provides the patient ample time to file the necessary claim.

6. Conclusion

The retained vaginal pack in the childbirth case described is a clear instance of medical negligence that could support a malpractice claim under Philippine law. While no infection resulted, the emotional distress and mental trauma experienced by the patient are compensable under the law. Compensation for such damages is determined by the courts based on various factors, including the severity of the error, the duration of suffering, and the impact on the patient's well-being.

Pursuing a medical malpractice claim requires thorough documentation, expert testimony, and legal representation to navigate the complexities of the legal process. However, given the facts of this case, it is highly likely that a court would award substantial compensation for the pain and suffering endured by the patient, especially considering the avoidable nature of the error and the emotional toll it took.

In the Philippine legal system, justice for victims of medical malpractice remains accessible, provided that the appropriate legal steps are taken, and the case is presented convincingly before the court.