Supreme Court Clears Surgeon in Stenting Malpractice Case

By Gerome Dalipe IV

The Supreme Court has cleared a top cardiovascular surgeon of liability in a medical malpractice case involving a failed stenting procedure that led to a patient’s death.

In a decision penned by retired Associate Justice Mario V. Lopez, the SC’s Second Division upheld the dismissal of a civil complaint against Dr. Avelino P. Aventura, head of the Surgery Department at the Philippine Heart Center, over the death of patient Quintin Que.

The Court ruled that when a physician provides proper medical advice, explains the risks, and secures informed consent, they cannot be held liable for malpractice.

The case stemmed from a damages suit filed by Elpidio Que, the patient’s son, who accused Dr. Aventura of negligence following his father’s death after a stenting procedure.

According to court records, Quintin Que first consulted Dr. Aventura after developing hoarseness caused by an aortic arch aneurysm compressing his vocal cords.

A CT scan confirmed that the aneurysm posed a serious risk.

Dr. Aventura advised a heart bypass operation first, with the aneurysm to be addressed later.

The bypass surgery was successful.

Months later, the aneurysm worsened.

Dr. Aventura then presented two treatment options: traditional open-chest surgery or a less invasive stenting procedure.

After thorough discussions and assurances that stenting carried fewer complications, the Que family consented to the latter.

Dr. Aventura informed the family that he would not perform the stenting himself, as it fell outside his expertise.

Instead, he introduced them to Dr. Verhoeven, a visiting Belgian endovascular specialist.

He reiterated that both procedures carried significant risks, including the risk of death.

On the day of the operation, Dr. Verhoeven attempted three times to deploy the custom-made stent but was unsuccessful due to a sharp bend in Que’s artery.

He later informed the family that the stent was “faulty.”

Shortly afterward, Que suffered a stroke and never regained consciousness.

The Supreme Court upheld the earlier rulings of the Regional Trial Court and Court of Appeals, both of which found no negligence on Dr. Aventura’s part.

The Court reiterated that medical malpractice arises only when a physician fails to meet the standard of care expected of other practitioners in similar circumstances, resulting in harm.

It also noted that the lack of informed consent is a key element in establishing liability in malpractice claims.

In this case, the SC said Dr. Aventura had adequately explained the risks and obtained the proper consent.

The patient and his family were aware that another doctor would perform the procedure and signed consent forms accordingly.

Expert witnesses in cardiovascular and endovascular surgery testified that stenting was a medically sound and reasonable option for Que, despite its risks.

They confirmed it was a viable alternative to open-heart surgery.

In a separate concurring opinion, Senior Associate Justice Marvic M.V.F. Leonen emphasized that a referring doctor’s responsibility does not end when the patient is turned over to a foreign specialist.

The referring physician must still demonstrate they fulfilled their duty of care by verifying the qualifications of the specialist and taking reasonable precautions, not merely relying on informed consent.