REPUBLIC OF THE PHILIPPINES

NATIONAL CAPITAL JUDICIAL REGION

REGIONAL TRIAL COURT
MANILA CITY, BRANCH____
FERDINAND M. JOSE
Plaintiff,
-versus-

CIVIL CASE NO._____

FOR: DAMAGES

HAYDEN C. MANUEL
Defendant.
x---------------------------------x
COMPLAINT
Plaintiff, by counsel, respectfully states:
1. Plaintiff is a Filipino citizen, of legal age, married, and a resident of
345 G. Tuazon St., Sampaloc, Manila City.
2. Defendant is a Filipino citizen, of legal age, married, and a resident
of 251 Dapitan St., Brgy. 47, Manila City.
3. Defendant is a practicing general surgeon at UST Hospital, Espaa,
Manila City.
4. On April 10, 2015, plaintiff approached defendant to inquire about
the possibility of undergoing a laparoscopic surgery in order to
remove tumors inside his body.
5. Defendant told plaintiff that the surgery would be performed on
April 15, 2015. For ready reference, a copy of the informed consent
form for the surgical procedure is attached as Annex A and made
integral part hereof.
6. During the procedure, holes were punctured in the abdomen of the
plaintiff where the instruments and camera were inserted to perform
the surgery. A plastic container was inserted inside the plaintiffs
body to extract out the tumors. Four tumors were taken out of the
body of the plaintiff. A copy of the operative technique form is
attached as Annex B and made an integral part hereof.

7. On April 18, 2015, plaintiff was discharged from UST Hospital.

Copies of the discharge form and the receipt of the medical bills in
the amount of P100,000 are attached as Annexes C and D and
made integral parts hereof.
8. On April 25, 2015, plaintiff, while at his workplace, started
vomiting and was consequently sent home. A certification by the
attending nurse is attached as Annex E and made an integral part
hereof.
9. On May 14, 2015, plaintiff went back to UST Hospital for a followup procedure as he had been vomiting for several days and already
incurred fever.
10.Defendant ordered for an X-ray to be done. The result showed no
manifestation of any abnormality or irregularity. Hence, the
defendant prescribed antibiotics to resolve the plaintiffs
discomfort. Copies of the x-ray result, prescription and the receipt
of the medical bills for P5,000 are attached as Annexes F, G,
H respectively and made an integral part hereof.
11.On May 28, 2015, plaintiff went back to UST Hospital as his
condition remained the same.
12.Plaintiff, as advised by defendant, was admitted back in UST
Hospital for observation.
13.On June 10, 2015, as the condition of the plaintiff had not
improved, defendant finally decided to open the surgical area.
14.It was discovered that a piece of the plastic used to extract the
tumors was left during the laparoscopic surgery. This caused an
internal infection to the plaintiffs body. A copy of the operative
technique form is attached as Annex H and made an integral part
hereof.
15.On June 24, 2015, plaintiff was discharged from UST Hospital. A
copy of the receipt of the medical bill amounting to P400,000 is
attached as Annex I and made an integral part hereof.
16.Defendant should be liable for the reimbursement of the medical
expenses worth P405,000 and damages incurred by the plaintiff.

17.Plaintiff was not able to report for work for sixty (60) days due to
the complications of the surgery and the treatment of the internal
infections. Plaintiff is therefore entitled to P150,000 unrealized
income equivalent to his salary for two months.
18.To serve as an example for the public good, and to prevent
defendant from repeating the same act, it should be held liable to
the plaintiff for exemplary damages in the sum of P150,000.
19.Plaintiff was constrained to engage the services of counsel in order
to protect his legal rights for a professional fee of P150,000, for
which defendant should be held liable.
20.Defendant should also be held liable for all costs and expenses of
litigation.
PRAYER
WHEREFORE, premises considered, plaintiff respectfully prays that after
trial, judgment be rendered in favor of plaintiff and against defendant for
the following:
1.
2.
3.
4.
5.
6.

Medical expenses in the amount of P405,000;

Unrealized income in the amount of P150,000;
Moral Damages in the amount of P200,000;
Exemplary Damages in the amount of P150,000;
Attorneys fees of P150,000; and
All costs and expenses of litigation.

Other just and equitable reliefs are also prayed for.

Makati for Manila. June 30, 2015.
DMTRY LAW FIRM
Counsel for Plaintiff
Unit 2808, Palm Towers,
San Antonio Village, Makati City
Tel. 333-9999
By:
JOSE MARIA MARQUEZ
Attorneys Roll No. 98564
IBP No. 123456/ 01.06.2015

PTR No. 2345678/ 01.05.2015

MCLE III Comp. No. 2223331/ 5.1.2
Republic of the Philippines)
Makati City, Metro Manila) S.S
VERIFICATION/ CERTIFICATION
I, FERDINAND M. JOSE, of legal age, Filipino, married, and a
resident of 345 G. Tuazon St., Sampaloc, Manila City, after having been
sworn to in accordance with law, hereby depose and state that:
1. I have caused the preparation of the foregoing COMPLAINT and
the allegations contained therein are true and correct based on my
own personal knowledge and on authentic records;
2. I have not heretofore commenced any action or filed any claim
involving the same issues in any court, tribunal or quasijudicial agency and,
to the best of my knowledge, no other action or claim is pending in such
other court, tribunal or quasijudicial agency; and
3. If I should learn that the same or similar action or claim has been
filed or is pending, I shall report this fact within five (5) days
therefrom to this Honorable Court.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
4th day of July 2015 at Makati City.
FERDINAND M. JOSE
Affiant
SUBSCRIBED AND SWORN to before me this 4th day of July 2015,
at Manila, affiant showing to me his PRC License No. 453712
valid until August 17, 2017.
Notary Public
Jurisdiction of Makati City
Until __________
Doc. No. _____
Page No. _____
Book No. _____
Series of 2015.