1 of 33

HEALTHY SCHOOLS BY LAW: WHAT EVERY SCHOOL HEALTH PRACTITIONER MUST KNOW

​

Prosecutor Javier Benjamin M. Tongol, RN

May 22, 2026

2 of 33

Outline of Topics

OVERVIEW OF LAWS

JURISPRUDENCE

MITIGATING LEGAL RISKS

3 of 33

Law

A rule of conduct pronounced by the controlling authority and which may be enforced.

​

Sources of Law: 1. The Constitution

2. Statutes or Legislations

3. Regulations

4. Decisions of the Supreme Court (jurisprudence)

4 of 33

Effect and Application of Laws

Civil Code of the Philippines Article 3. Ignorance of the law excuses no one from compliance therewith.

Civil Code of the Philippines Article 6. Rights may be waived, unless the waiver is contrary to law, public order, public policy, morals, or good customs, or prejudicial to a third person with a right recognized by law. 

5 of 33

Effect and Application of Laws

Civil Code of the Philippines Article 19. Every person must, in the exercise of his rights and in the performance of his duties, act with justice, give everyone his due, and observe honesty and good faith.

Civil Code of the Philippines Article 20. Every person who, contrary to law, wilfully or negligently causes damage to another, shall indemnify the latter for the same.

​

6 of 33

Effect and Application of Laws

Civil Code of the Philippines Article 21. Any person who willfully causes loss or injury to another in a manner that is contrary to morals or good customs, or public policy shall compensate the latter for the damage.

7 of 33

Negligence

  • Negligence is the absence of reasonable care and caution that an ordinarily prudent person would have used in a given situation. (Picart v. Smith, 37 Phil. 809(1918))

​

  • A good father of a family means a person of ordinary or average diligence. To determine the prudence and diligence that must be required of all persons, we must use as basis the abstract average standard corresponding to a normal orderly person. Anyone who uses diligence below this standard is guilty of negligence (Tolentino, Arturo M., Commentaries and Jurisprudence on the Civil Code of the Philippines, Volume IV)

8 of 33

LIABILITY OF HEALTH PROFESSIONALS

9 of 33

LIABILITY OF HEALTH PROFESSIONALS

Administrative

Civil

Criminal

10 of 33

LIABILITY OF HEALTH PROFESSIONALS

Administrative

Substantial Evidence

Suspension or Revocation of License

Civil

Preponderance of Evidence

Payment of Damages

Criminal

Proof Beyond Reasonable Doubt

Imprisonment

11 of 33

LIABILITY OF HEALTH PROFESSIONALS

  • The settled rule is bad faith should be established by clear and convincing evidence since the law always presumes good faith. Bad faith, like fraud, is never presumed since it is a serious accusation that can be so conveniently and casually invoked. Hence, for anyone who claims that someone is in bad faith, the former has the duty to convincingly prove the existence of the same. (Sps. Cabasal v. BPI Family Savings Bank, GR No. 233846, November 18, 2020)

12 of 33

SUPREME COURT DECISIONS

13 of 33

Supreme Court Decisions

  • Our Lady of Lourdes Hospital vs. Sps. Capanzana (GR No. 189218, March 22, 2007)
  • Nilo B. Rosit vs. Davao Doctors Hospital (GR No. 210445, December 7, 2015)
  • Dr. Milagros L. Cantre vs. Sps. Go (GR No. 160889, April 27, 2007)
  • Reyno and De Vera v. Baltazar (GR No. 227775, October 10, 2022)

14 of 33

OUR LADY OF LOURDES HOSPITAL VS. SPS. CAPANZANA (GR NO. 189218, MARCH 22, 2007, SERENO, CJ )��

  • Facts:
    • Regina Capanzana (Regina), a 40-year-old nurse and clinical instructor pregnant with her third child, was scheduled for her third caesarean section (C-section) on 2 January 1998. However, a week earlier, on 26 December 1997, she went into active labor and was brought to petitioner hospital for an emergency C-section.
    • At 2:30 a.m. the following day, or 13 hours after her operation, Regina who was then under watch by her niece, Katherine L. Balad (Balad), complained of a headache, a chilly sensation, restlessness, and shortness of breath. She asked for oxygen and later became cyanotic. After undergoing an x-ray, she was found to be suffering from pulmonary edema. She was eventually transferred to the Intensive Care Unit, where she was hooked to a mechanical ventilator. The impression then was that she was showing signs of amniotic fluid embolism

15 of 33

OUR LADY OF LOURDES HOSPITAL VS. SPS. CAPANZANA (GR NO. 189218, MARCH 22, 2007, SERENO, CJ )��

  • Facts:
    • On 2 January 1998, when her condition still showed no improvement, Regina was transferred to the Cardinal Santos Hospital. The doctors thereat found that she was suffering from rheumatic heart disease mitral stenosis with mild pulmonary hypertension, which contributed to the onset of fluid in her lung tissue (pulmonary edema). This development resulted in cardiopulmonary arrest and, subsequently, brain damage. Regina lost the use of her speech, eyesight, hearing and limbs. She was discharged, still in a vegetative state, on 19 January 1998

16 of 33

OUR LADY OF LOURDES HOSPITAL VS. SPS. CAPANZANA (GR NO. 189218, MARCH 22, 2007, SERENO, CJ )��

  • Ruling

To recall, the records, including petitioner's Nurses' Notes, indisputably show that Regina complained of difficulty in breathing before eventually showing signs of cyanosis. We agree with the courts below in their finding that when she was gasping for breath and turning cyanotic, it was the duty of the nurses to intervene immediately by informing the resident doctor. Had they done so, proper oxygenation could have been restored and other interventions performed without wasting valuable time. That such high degree of care and responsiveness was needed cannot be overemphasized - considering that according to expert medical evidence in the records, it takes only five minutes of oxygen deprivation for irreversible brain damage to set in. 

17 of 33

OUR LADY OF LOURDES HOSPITAL VS. SPS. CAPANZANA (GR NO. 189218, MARCH 22, 2007, SERENO, CJ )��

  • Ruling

Indeed, the Court has emphasized that a higher degree of caution and an exacting standard of diligence in patient management and health care are required of a hospital's staff, as they deal with the lives of patients who seek urgent medical assistance. It is incumbent upon nurses to take precautions or undertake steps to safeguard patients under their care from any possible injury that may arise in the course of the latter's treatment and care.

18 of 33

OUR LADY OF LOURDES HOSPITAL VS. SPS. CAPANZANA (GR NO. 189218, MARCH 22, 2007, SERENO, CJ )��

  • Ruling

The Court further notes that the immediate response of the nurses was especially imperative, since Regina herself had asked for oxygen. They should have been prompted to respond immediately when Regina herself expressed her needs, especially in that emergency situation when it was not easy to determine with certainty the cause of her breathing difficulty. Indeed, even if the patient had not asked for oxygen, the mere fact that her breathing was labored to an abnormal degree should have impelled the nurses to immediately call the doctor and to administer oxygen.

​

19 of 33

NILO B. ROSIT VS. DAVAO DOCTORS HOSPITAL (GR NO. 210445, DECEMBER 7, 2015, VELASCO, J.)

  • Facts
    • On January 15, 1999, Rosit figured in a motorcycle accident. The X-ray soon taken the next day at the Davao Doctors Hospital (DDH) showed that he fractured his jaw. Rosit was then referred to Dr. Gestuvo, a specialist in mandibular injuries, who, on January 19, 1999, operated on Rosit.

​

    • During the operation, Dr. Gestuvo used a metal plate fastened to the jaw with metal screws to immobilize the mandible. As the operation required the smallest screws available, Dr. Gestuvo cut the screws on hand to make them smaller. Dr. Gestuvo knew that there were smaller titanium screws available in Manila, but did not so inform Rosit supposing that the latter would not be able to afford the same

​

20 of 33

NILO B. ROSIT VS. DAVAO DOCTORS HOSPITAL (GR NO. 210445, DECEMBER 7, 2015, VELASCO, J.)

  • Facts
    • Following the procedure, Rosit could not properly open and close his mouth and was in pain. X-rays done on Rosit two (2) days after the operation showed that the fracture in his jaw was aligned but the screws used on him touched his molar. Given the X-ray results, Dr. Gestuvo referred Rosit to a dentist. The dentist who checked Rosit, Dr. Pangan, opined that another operation is necessary and that it is to be performed in Cebu

21 of 33

NILO B. ROSIT VS. DAVAO DOCTORS HOSPITAL (GR NO. 210445, DECEMBER 7, 2015, VELASCO, J.)

  • Ruling
    • A medical negligence case is a type of claim to redress a wrong committed by a medical professional, that has caused bodily harm to or the death of a patient. There are four elements involved in a medical negligence case, namely: duty, breach, injury, and proximate causation.
    • Duty refers to the standard of behavior which imposes restrictions on one's conduct. The standard in turn refers to the amount of competence associated with the proper discharge of the profession. 

​

22 of 33

NILO B. ROSIT VS. DAVAO DOCTORS HOSPITAL (GR NO. 210445, DECEMBER 7, 2015, VELASCO, J.)

  • Ruling
    • Although generally, expert medical testimony is relied upon in malpractice suits to prove that a physician has done a negligent act or that he has deviated from the standard medical procedure, when the doctrine of res ipsa loquitur is availed by the plaintiff, the need for expert medical testimony is dispensed with because the injury itself provides the proof of negligence. 
        • Res ipsa loquitur is a Latin phrase that literally means "the thing or the transaction speaks for itself." It is a maxim for the rule that the fact of the occurrence of an injury, taken with the surrounding circumstances, may permit an inference or raise a presumption of negligence, or make out a plaintiff's prima facie case, and present a question of fact for defendant to meet with an explanation. (Tan vs. JAM Transit Inc., GR No. 183198, November 25, 2009)

23 of 33

DR. MILAGROS CANTRE VS. SPS. GO (GR NO. 160889, APRIL 27, 2007, QUISUMBING, J.)

  • Facts:
    • Petitioner Dr. Milagros L. Cantre is a specialist in Obstetrics and Gynecology at the Dr. Jesus Delgado Memorial Hospital. She was the attending physician of respondent Nora S. Go, who was admitted at the said hospital on April 19, 1992. 
    • At 1:30 a.m. of April 20, 1992, Nora gave birth to her fourth child, a baby boy. However, at around 3:30 a.m., Nora suffered profuse bleeding inside her womb due to some parts of the placenta which were not completely expelled from her womb after delivery. Consequently, Nora suffered hypovolemic shock, resulting in a drop in her blood pressure to "40" over "0." Petitioner and the assisting resident physician performed various medical procedures to stop the bleeding and to restore Nora’s blood pressure. Her blood pressure was frequently monitored with the use of a sphygmomanometer. While petitioner was massaging Nora’s uterus for it to contract and stop bleeding, she ordered a droplight to warm Nora and her baby. Nora remained unconscious until she recovered.

​

24 of 33

DR. MILAGROS CANTRE VS. SPS. GO (GR NO. 160889, APRIL 27, 2007, QUISUMBING, J.)

  • Facts:
    • While in the recovery room, her husband, respondent John David Z. Go noticed a fresh gaping wound two and a half (2 ½) by three and a half (3 ½) inches in the inner portion of her left arm, close to the armpit. He asked the nurses what caused the injury. He was informed it was a burn. Forthwith, on April 22, 1992, John David filed a request for investigation. In response, Dr. Rainerio S. Abad, the medical director of the hospital, called petitioner and the assisting resident physician to explain what happened. Petitioner said the blood pressure cuff caused the injury. 

�

25 of 33

DR. MILAGROS CANTRE VS. SPS. GO (GR NO. 160889, APRIL 27, 2007, QUISUMBING, J.)

  • Ruling:
    • Whether the injury was caused by the droplight or by the blood pressure cuff is of no moment. Both instruments are deemed within the exclusive control of the physician in charge under the "captain of the ship" doctrine. This doctrine holds the surgeon in charge of an operation liable for the negligence of his assistants during the time when those assistants are under the surgeon’s control. In this particular case, it can be logically inferred that petitioner, the senior consultant in charge during the delivery of Nora’s baby, exercised control over the assistants assigned to both the use of the droplight and the taking of Nora’s blood pressure. Hence, the use of the droplight and the blood pressure cuff is also within petitioner’s exclusive control.

��

26 of 33

REYNO AND DE VERA VS. BALTAZAR (GR NO. 227775, OCTOBER 10, 2022)

  • George Baltazar (George) and Joel Baltazar (Joel) are the husband and son, respectively, of Teresita Laurena Baltazar (Teresita). Teresita was a diabetic patient of Dr. Jade P. Malvar (Dr. Malvar), a physician holding clinic hours at Callang's General Hospital (CGH). Teresita was referred to Dr. Malvar for a wound on her left foot. Upon examination, Dr. Malvar advised that she undergo debridement, a minor and superficial procedure to thoroughly clean the wound. Due to financial constraints, Dr. Malvar suggested that Teresita transfer to a government hospital, Echague District Hospital (EDH). Following Dr. Malvar's advice and upon his written orders, Teresita was transferred to the EDH on June 9, 2009, between 8:00 p.m. and 9:00 p.m., in time for her scheduled surgery the following day. As part of Teresita's treatment being a diabetic patient, Dr. Malvar consulted a specialist, Dr. Cabucana De Guzman (Dr. De Guzman), who instructed, among others, that Teresita be administered insulin during certain times of the day, particularly at 6:00 a.m., 12:00 n.n., 6:00 p.m., and 12:00 m.n., to manage her diabetes during the course of the procedure. Further, Dr. De Guzman required that a Random Blood Sugar (RBS) test be done prior to each insulin injections.

27 of 33

REYNO AND DE VERA VS. BALTAZAR (GR NO. 227775, OCTOBER 10, 2022)

  • The aforesaid instructions were specifically left to the nurses on ward duty, namely, Gigi Tomas (Tomas), designated as the ward nurse on duty from 12 m.n. to 8:90 a.m.; De Vera, on duty from 8:00 a.m. to 4:00 p.m.; and Reyno, on duty from 4:00 p.m. to 12:00 m.n.
  • On June 10, 2009, at 10:30 a.m., George and Joel visited Teresita, who seemed to be in high spirits. At 11:15 a.m., Tomas endorsed Teresita to De Vera, who administered insulin to Teresita at 11:30 a.m. Thereafter, Dr. Malvar, along with anesthesiologist Dr. Baby Delfin L. Cabansag (Dr. Cabansag), performed the debridement, which ended at 12:20 n.n. without any complications. After the operation, Teresita was assigned to recover in the ward while De Vera was still on duty. When De Vera's shift ended at 4:00 p.m., she endorsed Teresita to the care of the incoming nurse, Reyno.
  • At 5:00 p.m., Joel visited his mother. At 5:20 p.m., Reyno, as the ward nurse on duty, administered insulin to Teresita. After about an hour, Reyno came by the room and proceeded to remove the oxygen mask attached to Teresita. Despite Joel's protestations, Reyno informed him that the hospital was short of oxygen masks and that another patient also needed it. Considering Teresita's stable condition, she sought permission from Dr. Cabansag to remove her oxygen mask.

28 of 33

REYNO AND DE VERA VS. BALTAZAR (GR NO. 227775, OCTOBER 10, 2022)

  • Moments later, Teresita's health took a turn for the worse, as Joel noticed that she was having difficulty breathing. He rushed to find Reyno to inform her of Teresita's condition, and to inquire as to the removal of his mother's oxygen mask. Reyno retorted in a defensive manner, saying "wala akong kinakatakutan ... kahit magsumbong ka sa mga taga hospital." Despite her reaction, Reyno immediately returned the oxygen mask and attached it to Teresita.

29 of 33

REYNO AND DE VERA VS. BALTAZAR (GR NO. 227775, OCTOBER 10, 2022)

  • After a while, Reyno observed that Teresita's difficulty in breathing persisted, and worse, she was beginning to salivate. Alarmed, she immediately called Dr. Malvar regarding the status of his patient. Dr. Malvar instructed that she administer a "fifty-fifty intravenous" to Teresita. When Teresita's blood pressure began to fluctuate, Reyno called Dr. Malvar a second time and sought the help of the resident physician on duty, Dr. Honorio I. Caramancion (Dr. Caramancion), to attend to Teresita in the interim. As an emergency measure, Dr. Caramancion administered epinephrine to stimulate cardiac activity. Upon checking Teresita's heartbeat and pulse rate, Dr. Caramancion noticed that she was already unresponsive, causing him to declare her dead. Shortly thereafter, Dr. Malvar arrived and attempted to resuscitate her, but to no avail. Teresita was pronounced dead at 7:00 p.m.

30 of 33

REYNO AND DE VERA VS. BALTAZAR (GR NO. 227775, OCTOBER 10, 2022)

  •  Teresita submitted herself for debridement, expecting a routine operation on her left foot. While she was transferred to the EDH due to financial constraints, she had obtained prior clearance from her main physician, Dr. Malvar. On that fateful day, respondents were with her prior to the operation, even reporting that she was in high spirits. The procedure, which lasted for a little over an hour, was a success and was without any complications. Discernibly, there was nothing amiss with the performance of the duties of Drs. Malvar and Cabansag as Teresita's physicians. As testified by De Vera herself, Teresita was healthy and exhibited good vital signs after her operation. Indubitably, the death of a patient is one that does not occur under normal circumstances following the process of a debridement. Elsewise stated, the success of the operation, which involved a mere superficial cleaning of a foot wound, and her supposed recovery, thereafter, could not have led to the death of Teresita, unless negligence had set in somewhere.
  • Similarly apparent in this case was the stark deterioration of Teresita's health during the time that she was turned over to the exclusive care and control of petitioners as a patient in their ward. As ward nurses, De Vera attested that they were charged, among others, with carrying out doctor's orders, administering all prescribed medicines and treatments, and answering to all the needs and complaints of the patients specifically assigned to their ward. Indeed, records bear out that prior to her operation, up until the circumstances leading to her death, Teresita's pre- and post-operation treatments, including, among others, the administration of her medicine and tests, were under the immediate and exclusive management of petitioners. Significantly, after the operation and until her untimely demise, Teresita was left to the care of petitioners, and not her physicians, who were not even in the hospital at such time.

31 of 33

MITIGATING LEGAL RISKS

32 of 33

HOW TO MITIGATE LEGAL RISKS

Exercise proper diligence

Think before you act

Know the law

Seek advice of a legal counsel

If in doubt, ask / clarify

33 of 33

Thank you