FIRST DIVISION

[G.R. No. 206306. April 3, 2024.]

MIGUEL KIM, petitioner, vs. SLIMMERS WORLD INTERNATIONAL,

ALBERT CUESTA, and DINAH QUINTO, respondents.

[G.R. No. 206321. April 3, 2024.]

SLIMMERS WORLD INTERNATIONAL, ALBERT CUESTA, and DINAH

QUINTO, petitioners, vs. MIGUEL KIM, respondent.

DECISION

MARQUEZ, J : p

Adelaida, then 59 years old, availed of the 12-visit personal training program
of a fitness center. Shortly after her workout on her 12th session, she complained of
a headache and vomited. The gym staff immediately brought her to the hospital.
After three days, she died. Her husband, Miguel, is now suing the fitness center for
damages. HTcADC

[1]
Before the Court are two consolidated petitions for review on certiorari
[2] [3]
under Rule 45, Rules of Court, assailing the Decision and Resolution of the
Court of Appeals (CA) which affirmed with modification the Decision [4] of the
Regional Trial Court (RTC) finding Slimmers World International (Slimmers World),
Albert Cuesta (Cuesta), and Dinah Quinto (Quinto) negligent in their operation of a
fitness center and thus liable for damages resulting from the death of their client,
Adelaida Kim (Adelaida), wife of Miguel Kim (Miguel).
Slimmers World, operated by Behavior Modification, Inc., is a Philippine
corporation engaged in the business of managing a chain of fitness centers, Cuesta
was employed as its fitness trainer while Quinto was its managing director. [5]
 On April 8, 1991, Adelaida, then 50 years old, became a lifetime member of
Slimmers World. Nine years later, in June 2000, she availed of the fitness center's
biometrics program or the 12-visit personal training program with Cuesta as her
personal trainer. In the morning of July 25, 2000, Adelaida went for her last session
with Cuesta. [6]
After her workout and while still within the premises, Adelaida complained of
headache, nausea, and discomfort. The gym staff took her blood pressure which
yielded a high result. Thus, she took her medication for hypertension. As she was
changing her clothes, she vomited. Consequently, the gym staff brought her to Our
Lady of Grace Hospital (OLGH) in a tricycle. At 9:33 a.m., the attending physician
diagnosed her to be suffering from essential hypertension. [7]
At 12:50 p.m. of the same day, Adelaida was transferred to the Chinese
General Hospital (CGH), which was equipped with more advanced facilities for
better monitoring. There, she immediately underwent a CT scan which revealed a
mass in her brain. The doctors informed Miguel that they could no longer do
anything. Three days later, or on July 28, 2000, Adelaida died due to cerebral
hemorrhage and severe hypertension. [8] CAIHTE

On October 17, 2000, Miguel sent a letter to Slimmers World, Cuesta, and
Quinto demanding the payment of damages as their negligence caused the death of
his wife. When they denied liability, Miguel filed a Complaint before the RTC on
November 28, 2000. [9] In their Answer, Slimmers World, Cuesta, and Quinto
insisted that Adelaida's concealment of her hypertension and their observance of
proper procedure in medical emergencies absolved them from liability. [10]
On October 29, 2009, the RTC granted Miguel's complaint for damages,
finding that the gross negligence of Slimmers World, Cuesta, and Quinto was the
proximate cause of Adelaida's death. The dispositive portion of the RTC's Decision
reads:
WHEREFORE, judgment is hereby rendered in favor of the plaintiff and
against the defendants ordering the latter to jointly and severally:

1. Indemnify the victim's heirs represented herein by the plaintiff the

amount of [PHP]50,000.00 for the death of the victim; and
2. Pay the plaintiff to wit:
 a) The sum of [PHP]299,418.94 as actual damages;
b) The sum of [PHP]500,000.00 as moral damages;

c) The sum of [PHP]200,000.00 as exemplary damages; and

d) The sum of [PHP]300,000.00 as attorney's fees.

SO ORDERED. [11]

In a Decision dated October 8, 2012, the CA affirmed the RTC's ruling with
modification as to the award of damages, viz.:
WHEREFORE, in view of the foregoing premises, judgment is hereby
rendered by us AFFIRMING the Decision dated October 29, 2009 rendered
by Branch 125 of the Regional Trial Court of the National Capital Judicial
Region in Caloocan City in Civil Case No. C-19450 with the MODIFICATION
that the award of moral and exemplary damages in favor of the plaintiff-
appellee is hereby reduced to [PHP]50,000.00 each. With regard to the award
of attorney's fees, the same is hereby deleted for lack of basis.

SO ORDERED. [12] (Emphasis in the original)

The appellate court ruled that Slimmers World, Cuesta, and Quinto committed
several transgressions evincing negligence. First, while Adelaida indicated "no" on
the questionnaire provided for high blood pressure and hypertension, the fitness
center still had to determine her general health before acceptance to its program.
Second, the fitness center failed to prove that the program was under medical
supervision as it represented in newspaper advertisements. Third, the gym staff still
allowed Adelaida to proceed with her workout without taking her blood pressure and
despite being informed that she was suffering from a headache. [13]
In a Resolution dated March 12, 2013, the CA denied the Motions for
Reconsideration of both parties. [14] aScITE

In his Petition filed before the Court docketed as G.R. No. 206306, Miguel
contends that the CA erred in reducing the award of moral and exemplary damages,
deleting the award of attorney's fees, and failing to order the payment of legal
interest. [15]

In their Petition [16] filed before the Court docketed as G.R. No. 206321,
Slimmers World and Quinto (collectively referred to as Slimmers World, et al.) argue
that Miguel failed to prove negligence on their part and that said negligence was the
proximate cause of Adelaida's death. Adelaida explicitly declared that she was not
hypertensive and that she was feeling fine before the workout. After she complained
of a headache, she was immediately taken to the nearest hospital. Moreover, the
fitness center had no duty to maintain a doctor at all times or to take the blood
pressure of all its clients. [17]
Hence, the issue brought before the Court is whether Slimmers World, et al.,
should be held liable for damages resulting from the death of Adelaida. We do not
think so.
Prefatorily, it must be noted that the present case constitutes an exception to
the general rule that only questions of law may be raised in petitions for review on
certiorari under Rule 45. [18] Records show the need to carefully re-examine the
factual findings to determine whether the courts below failed to notice certain
relevant facts which, if properly considered, would justify a different conclusion. [19]

It is observed that the courts a quo relied on different provisions of law in

[20]
holding Slimmers World, et al., liable for damages. The RTC cited Article 2176 of
the Civil Code which governs quasi-delicts whereas the CA cited Article 1172 [21]
which governs contractual obligations. In Orient Freight International, Inc. v. Keihin-
Everett Forwarding Company, Inc., [22] the Court elaborated on the differences
between the two in the following wise:
Negligence may either result in culpa aquiliana or culpa contractual.
Culpa aquiliana is the "the wrongful or negligent act or omission which creates
a vinculum juris and gives rise to an obligation between two persons not
formally bound by any other obligation," and is governed by Article 2176 of the
Civil Code:
Article 2176. Whoever by act or omission causes
damage to another, there being fault or negligence, is obliged to
pay for the damage done. Such fault or negligence, if there is no
pre-existing contractual relation between the parties, is called a
quasi-delict and is governed by the provisions of this Chapter.
Negligence in culpa contractual, on the other hand, is "the fault or
negligence incident in the performance of an obligation which already existed,
and which increases the liability from such already existing obligation." This is
governed by Articles 1170 to 1174 of the Civil Code:

Article 1170. Those who in the performance of their

obligations are guilty of fraud, negligence, or delay, and those
who in any manner contravene the tenor thereof, are liable for
damages. DETACa

Article 1171. Responsibility arising from fraud is

demandable in all obligations. Any waiver of an action for future
fraud is void.
Article 1172. Responsibility arising from negligence in
the performance of every kind of obligation is also demandable,
but such liability may be regulated by the courts, according to
the circumstances.
Article 1173. The fault or negligence of the obligor
consists in the omission of that diligence which is required by the
nature of the obligation and corresponds with the circumstances
of the persons, of the time and of the place When negligence
shows bad faith, the provisions of articles 1171 and 2201,
paragraph 2, shall apply.
If the law or contract does not state the diligence which is
to be observed in the performance, that which is expected of a
good father of a family shall be required.
Article 1174. Except in cases expressly specified by
the law, or when it is otherwise declared by stipulation, or when
the nature of the obligation requires the assumption of risk, no
person shall be responsible for those events which could not be
foreseen, or which, though foreseen, were inevitable.
Actions based on contractual negligence and actions based on quasi-
delicts differ in terms of conditions, defenses, and proof. They generally
cannot co-exist. Once a breach of contract is proved, the defendant is
presumed negligent and must prove not being at fault. In a quasi-delict,
however, the complaining party has the burden of proving the other party's
negligence [.] [23] (Emphasis supplied)
 [24]
In Dr. Huang v. Philippine Hoteliers, Inc., the Court expounded on the
distinctive characteristics as follows:
In that regard, this Court finds it significant to take note of the following
differences between quasi-delict (culpa aquiliana) and breach of contract
(culpa contractual). In quasi-delict, negligence is direct, substantive and
independent, while in breach of contract, negligence is merely incidental to
the performance of the contractual obligation; there is a pre-existing contract
or obligation. In quasi-delict, the defense of "good father of a family" is a
complete and proper defense insofar as parents, guardians and employers
are concerned, while in breach of contract, such is not a complete and proper
defense in the selection and supervision of employees. In quasi-delict, there is
no presumption of negligence and it is incumbent upon the injured party to
prove the negligence of the defendant, otherwise, the former's complaint will
be dismissed, while in breach of contract, negligence is presumed so long as
it can be proved that there was breach of the contract and the burden is on
the defendant to prove that there was no negligence in the carrying out of the
terms of the contract; the rule of respondeat superior is followed. [25]

After a judicious review of the case records, the Court finds that Slimmers
World, et al., can neither be held answerable for contractual negligence nor for
quasi-delict. HEITAD

Contrary to the CA's findings, Miguel's claim based on culpa contractual must
necessarily fail. The Court has consistently held that in actions involving contractual
negligence, once a breach of contract is proved, the defendant is presumed
negligent and must prove not being at fault. [26] For the presumption to apply,
however, the plaintiff must first establish the existence of the contract and the
[27]
defendant's failure to perform his or her obligation therein. In Sps. Carbonell v.
Metropolitan Bank and Trust Co., [28] the Court emphasized:
In order to maintain their action for damages, the petitioners must
establish that their injury resulted from a breach of duty that the respondent
had owed to them, that is, there must be the concurrence of injury caused to
them as the plaintiffs and legal responsibility on the part of the respondent.
Underlying the award of damages is the premise that an individual was injured
in contemplation of law. In this regard, there must first be a breach of some
duty and the imposition of liability for that breach before damages may be
 awarded; and the breach of such duty should be the proximate cause of the
injury. That was not so in this case.

It is true that the petitioners suffered embarrassment and humiliation in

Bangkok. Yet, we should distinguish between damage and injury. In The
Orchard Golf & Country Club, Inc. v. Yu, the Court has fittingly pointed out the
distinction, viz.:
x x x Injury is the illegal invasion of a legal right, damage
is the loss, hurt, or harm which results from the injury; and
damages are the recompense or compensation awarded for the
damage suffered. Thus, there can be damage without injury in
those instances in which the loss or harm was not the result of a
violation of a legal duty. These situations are often called
damnum absque injuria.
In every situation of damnum absque injuria, therefore, the injured
person alone bears the consequences because the law affords no remedy for
damages resulting from an act that does not amount to a legal injury or wrong
[.] [29] (Emphasis supplied)

Case records reveal that Miguel presented only two witnesses at the trial,
namely: (1) Ms. Jovita Rabaca, a friend of Adelaida who is also a member of
Slimmers World; and (2) himself. [30] In addition, he offered the following
documentary evidence: (1) newspaper advertisement of Slimmers World; (2)
personal data sheet of Adelaida; (3) a dietary prescription purportedly showing
Adelaida's hypertension diagnosis; (4) Adelaida's death certificate; (5) Slimmers
World's letter to Miguel; (6) official receipt of funeral expenses; and (7) Miguel's letter
to Slimmers World demanding the payment of damages. [31] aDSIHc

However, as Slimmers World, et al., contended, the two witnesses were not at
the fitness center at the time of the incident. Moreover, Miguel presented no witness
to properly authenticate the documentary evidence submitted or attest to their
contents or import. [32] Interestingly, the CA even gave credence to a receipt of
Malolos Memorial Park, Inc. that was not issued in the name of Miguel but of a
certain Natividad del Rosario, whose identity or relation to Miguel was neither
established nor explained. [33]
 Jurisprudence dictates that "[a]s a prerequisite to its admission in evidence,
the identity and authenticity of a private document must be properly laid and
reasonably established." [34] This is in line with Rule 132, Section 20, 2019
Amendments to the 1989 Revised Rules on Evidence (2019 Revised Rules on
Evidence), which states that the identification and authentication of a private
document may only be proven by either: (1) anyone who saw the document
executed or written; (2) evidence of the genuineness of the signature or handwriting
of the maker; or (3) other evidence showing its due execution and authenticity.
Indeed, an unverified and unidentified private document cannot be given probative
value. [35]

The foregoing notwithstanding, the CA ruled that Slimmers World, et al.,

breached their obligation to take Adelaida's blood pressure before her workout.
Nowhere in the records or the Member's Handout signed by Adelaida does it appear
that the fitness center was obliged to check her blood pressure prior to every
workout.
The reminders posted all over the gym state: "TO ALL HIGH-RISK
(HYPERTENSIVE, DIABETIC and with HEART AILMENTS) CLIENTS: PLEASE
HAVE YOUR BLOOD PRESSURE CHECKED BEFORE AND AFTER WORKOUT."
[36] Hence, it was incumbent upon the "high-risk" clients to proceed to the blood
pressure machine stations and have their blood pressure taken. In any case, as will
be discussed below, Adelaida declared that she was not a high-risk client.
As for the finding that Slimmers World, et al., breached its duty to provide
medical supervision as they represented in newspaper advertisements, [37] the Court
finds the same to be factually and legally unsupported. First, the newspaper clipping
presented in evidence lacks sufficient evidentiary weight. As mentioned previously,
Miguel did not present any witness to testify on the alleged import of the contents of
the newspaper advertisement. [38] Jurisprudence dictates, moreover, that newspaper
clippings are inadmissible and without any probative value if they were offered for
the purpose of proving the truth of the matter alleged. [39] ATICcS

Second, the newspaper advertisement cannot be the basis of Miguel's culpa

contractual action. It is a settled rule that "[p]ublic advertisements or solicitations and
the like are ordinarily construed as mere invitations to make offers or only as
 [40]
proposals." In the context of the law governing contracts, this stage pertains
merely to negotiation where the offer may still be withdrawn. [41] Hence, the
newspaper advertisement is a mere proposal of the contract between Slimmers
World, et al., and Adelaida.
It is the Member's Handout, and not the newspaper advertisement, that is the
perfected contract between the parties as it bears the signature of Adelaida
indicating her acceptance. As such, while the advertisement states that "all programs
are under medical supervision," [42] the Member's Handout clarifies that for medical
consultations and to service members more efficiently, appointments are scheduled
one week in advance. [43] Thus, the medical supervision offered merely consists of
free consultations subject to prior appointment.
Third, and more importantly, not only was there a doctor on duty who arrived
later that day; there were also, in fact, registered nurses and physical therapists
present at the time of the incident. Witnesses Merahflor Galang (Galang) and Judith
Sayson (Sayson), who took Adelaida's blood pressure and brought her to the
hospital, are registered nurses. Witness Alex Buenavista (Buenavista), a physical
therapist, was with Adelaida at the beginning of her workout up until she was taken
to OLGH. [44] Contrary to Miguel's claims, Adelaida was, in truth, under medical
supervision.
In view of the foregoing, Slimmers World, et al., cannot be held liable for
contractual negligence. Case law states that culpa contractual negligence is the
negligence incident to the performance of an already existing obligation and
increases the liability from the same. [45] Before damages may be awarded, the
plaintiff must establish that the injuries resulted from the defendant's breach of duty.
[46]
Otherwise, the law affords no remedy to the plaintiff who shall solely bear the
consequences of the injury. [47]
In the present case, however, Miguel failed to prove that Slimmers World, et
al., negligently violated their contract with Adelaida. The obligations to take
Adelaida's blood pressure and to have a doctor at the fitness center at all times
appear nowhere in the plain text of the Member's Handout or elsewhere in the
records. To be sure, the Court cannot hold the fitness center accountable for terms
that do not exist in the contract. ETHIDa
 Contrary to the findings of the RTC, moreover, Slimmers World, et al., cannot
be held liable for negligence based on a quasi-delict under Article 2176 [48] of the
Civil Code.Jurisprudence provides the following requisites to establish a quasi-delict:
(1) the damage suffered by the plaintiff; (2) the act or omission of the defendant
constituting fault or negligence; and (3) the causal connection between the act and
the damage sustained by the plaintiff, or the proximate cause. [49]
Settled is the rule that in actions based on quasi-delict, it is incumbent upon
the plaintiff to prove the presence of the foregoing elements by preponderance of
evidence. [50] They cannot rely on mere allegations but must present such evidence
more convincing as worthy of belief than that which is offered in opposition thereto.
[51]
The law presumes that a person takes ordinary care of their concerns and that
private transactions have been fair and regular. Hence, negligence cannot be
presumed but must be proven. [52]
In this case, however, while the death certificate shows the damage or injury
sustained by Adelaida, specifically, cerebral hemorrhage and severe hypertension,
[53] the totality of the evidence failed to establish the second and third elements of a
quasi-delict.
As previously stated, the second element requires that the act or omission
constitutes negligence. Negligence is defined as "the failure to observe for the
protection of the interests of another person, that degree of care, precaution and
vigilance which the circumstances justly demand, whereby such other person suffers
injury." [54] It is the "omission to do something which a reasonable man, guided by
those considerations which ordinarily regulate the conduct of human affairs, would
do, or the doing of something which a prudent and reasonable man would not do."
[55]

In the assailed Decision, the CA ruled that Slimmers World, et al.'s negligence
was shown by the fact that they did not do anything to address Adelaida's headache
and even proceeded with the workout. Buenavista testified that Adelaida complained
of a headache between 6:30 a.m. and 7:30 a.m. [56] At almost 9:00 a.m., she was
seated on the bench being assisted by gym staff. According to the appellate court,
this presupposes that Adelaida complained of a headache before the workout. [57]
 The Court, however, cannot fully adopt these assumptions as a more thorough
examination of the case records controverts the same. In the first place, in his own
Pre-Trial Brief, [58] Miguel expressly averred that Adelaida complained of a headache
after her exercises. [59] Second, Adelaida's friend, Ms. Rabaca, who was not at the
fitness center that day, testified that before Adelaida went to the gym, Adelaida called
her before 7:00 a.m. to ask if she was attending the session. Hence, it cannot be
concluded that Adelaida complained of a headache as early as 6:30 a.m. as she was
not at the gym yet before 7:00 a.m. [60] Third, Buenavista testified to the sequence of
events as follows:
Q: Can you tell us what area of Slimmers' World International, Caloocan
Branch were you particularly in, Mr. Witness?
A: We were in the weights area, ma'am.

Q: And how about Mr. Cuesta?

A: He was also there, ma'am.

Q: And since you were very near Mr. Cuesta and Mrs. Kim, did you see
what particular activities were done by Mrs. Kim at that time?

A: Before they started the workout they do the warm up exercises first
before they do the resistance exercises, ma'am, and after that when
Albert Cuesta asked me to assist him they were doing the shoulder
exercise using dumbbells, I think it is very light dumbbell.
Q: Do you remember what type of warm-up exercises they did?

A: First they do the bike exercises for five minutes and after that they do the
stretching exercise and body exercises, ma'am.
Q: When they were exercising, did you notice the appearance of Mrs. Kim?

A: Before they actually started Albert Cuesta asked her if she is doing okay,
if she is doing fine. Usually before we start the exercising we check the
general appearance of the client. TIADCc

Q: So before a client starts exercising, it is part of your responsibility to

assess the condition of the client?
A: We have to check the general appearance if she is feeling well, ma'am.

Q: And at that time did you notice anything unusual about Mrs. Kim?
 A: No, ma'am.

Q: What happened next?

A: After that I asked Mr. Albert Cuesta about Mrs. Kim and he told me that
they are in the reception area.
Q: And after that?

A: Mr. Albert Cuesta asked me to check on Mrs. Kim and when I arrived at
the reception area two of my colleagues/co-workers Flor and Judith were
checking on her blood pressure, ma'am.

Q: So at that time when you checked on Mrs. Kim what did she tell you or
what did you do, did you ask if she is feeling good?

A: I asked her if she is feeling well at that time and then she told me
"masakit ang ulo ko," that is what she said ma'am.

Q: And after she said that, what did you do?

A: I told Flor Galang that we should bring her to the doctor because I think
that is an emergency situation, so I asked them that she should bring her
to the hospital, ma'am. cSEDTC

Q: Were you able to bring her to the hospital?

A: That moment no, ma'am.

Q: Why?

A: Because Mrs. Kim refused to be brought to the hospital, ma'am.

Q: And do you know the reason why she refused to be brought to the
hospital?

A: She told us that she's gonna be fine after a while, ma'am. [61] (Emphasis
supplied)

Based on Buenavista's recollection above, it is clear that before Adelaida

began exercising, he did not observe anything unusual about her nor did he hear
any complaints. When Adelaida started exercising, she was in the weights section
doing shoulder exercises, bike exercises for five minutes, then stretching and body
exercises. After the exercises, Adelaida moved to the reception area where
Buenavista asked her if she was feeling well, to which she replied, "masakit ang ulo
ko." [62]
 Accordingly, Adelaida had no complaints before she began her exercises. The
moment she complained of a headache, the gym staff told her to sit on a couch, took
her blood pressure, asked her if she had any medications and if so, told her to take
them, and convinced her to be brought to a hospital. [63] Hence, regardless of the
inconsistency in Buenavista's recollection of the precise time of events, he remained
firm in his testimony that Adelaida's complaint came after she began her workout.
Against the findings of negligence, moreover, records show that Slimmers
World, et al., took necessary precautions given the circumstances.
It bears stressing that when Adelaida availed of the 12-visit program in June
2000, she expressly declared in her application that she was not: (1) suffering from
low or high blood; (2) on any medication; (3) hypertensive; (4) a smoker; (5) diabetic;
(6) asthmatic; (7) sedentary; (8) suffering from a heart condition; (9) suffering from a
lower back injury; and (10) suffering from arthritis, buritis, or rheumatism. [64]
Notably, Adelaida made these declarations despite her duty to "inform the Fitness
Trainer of any medical problem or concern before engaging in any gym activity." [65]

While Miguel presented Adelaida's personal data sheet and dietary

prescription purportedly showing that she was hypertensive, said documents were
not only unverified but were also dated sometime in 1991 or nine years prior to the
12-visit program. As such, the fitness center cannot be faulted for relying on a more
recent declaration of health made in June 2000.
Moreover, Rule 131, Section 2 (a), 2019 Revised Rules on Evidence, is clear:
"Whenever a party has, by his or her own declaration, act, or omission, intentionally
and deliberately led another to believe a particular thing true, and to act upon such
belief, he or she cannot, in any litigation arising out of such declaration, act or
omission, be permitted to falsify it." [66] Since Adelaida's declaration led the fitness
center to believe that she was not a high-risk client, the same could no longer be
changed to hold the fitness center accountable for relying on the same. AIDSTE

Notwithstanding Adelaida's concealments, records reveal that efforts were

exerted to determine her general health and ability to withstand the program. The
fitness center conducted several fitness and cardiovascular tests, as well as a body
composition training at the commencement of the program. [67] In fact, she had
already finished 11 sessions without any untoward incident or feedback.
 That Slimmers World, et al., exercised the necessary care is bolstered by the
findings of their expert witness, Dr. Peter F. Quilala, a diplomate in emergency
[68]
medicine and a training officer at St. Luke's Medical Center. Dr. Quilala prepared
a Case Evaluation Report and testified to its contents during trial. [69] The pertinent
portions provide:
In this case, the measures immediately undertaken by Slimmers World
personnel at that point in time and at their level, after the patient first
complained of dizziness with headache and vomiting, were in accordance with
the foregoing standards of care and with the generally accepted practices in
dealing with emergency cases. The said personnel made an assessment of
Mrs. Kim's condition, made sure she was comfortable, gave her the medicine
she said she had previously taken to lower her high blood pressure, and more
importantly, they insisted on bringing her, and in fact brought her, to a hospital
despite her initial desistance.
xxx xxx xxx

However, based on the medical records from the Our Lady of Grace Hospital,
the following facts are noticeable: (a) that upon initial examination, it appears
that the medical history taken of the patient lacked the usual matters such as
menstrual OB history, history of allergies, history of operation or other medical
interventions done on the patient and the presence or absence of other
medical problems; (b) while laboratory tests (ECG, CBC, Hgt) were done, it
appears that the results of the same were not even made available during the
time the patient's condition was still being assessed or during her stay at the
said hospital and is not even a part of the medical records at present, (c) no
other tests were done; (d) while initially, the working diagnosis or impression
was that of essential hypertension, the diagnosis was changed to
cerebrovascular accident or CVA, hemorrhage upon admission; and (e) the
patient was admitted to and stayed for four (4) hours even as it appears that
the hospital, one that has no intensive care unit or even a respirator, was not
equipped to handle her condition.

In which case, considering that the diagnosis upon admission was already
CVA, hemorrhage and in accordance with the generally accepted standards of
case, the patient should have been: (a) given a neurological exam and asked
to undergo a CT scan, which could provide very useful information to identify
potential cause of patient's condition and helps determine the intensity of the
 treatment needed. If these were done, the patient's condition could have been
diagnosed early and definitive treatment, which is lifesaving, could have been
instituted; (b) already placed in an intensive care setting instead of just
admitting her to a room of her choice; (c) by the time she was already
cyanotic and her level of consciousness appeared to be deteriorating,
intubation should have been done to maintain an open airway and to ensure
the lungs are ventilated [.] [70] (Emphasis supplied)

Dr. Quilala distinctly commended the gym staff as their swift actions were in
accordance with the necessary standards of care and generally accepted practices
in emergency cases. In contrast, he emphasized that OLGH failed to conduct
important tests and made Adelaida stay for four hours only to inform her that it was
incapable of handling her condition. It even admitted her to her room of choice after
the diagnosis was changed from "essential hypertension" to "T/C CVA Hge" or
cerebrovascular accident with hemorrhage. Miguel corroborated this in recalling that
OLGH informed him that it lacked the facilities to manage Adelaida's condition and
suggested that she be transferred to a "bigger hospital." [71] SDAaTC

As for the third element in quasi-delict actions, the plaintiff must prove
proximate causation or the causal connection between the act and the damage
sustained. Jurisprudential precedents define proximate cause as "that cause which, in
natural and continuous sequence, unbroken by any efficient intervening cause,
produces the injury and without which the result would not have occurred." [72] An
injury or damage is deemed proximately caused by an act or omission when it was a
direct result or a reasonably probable consequence thereof. [73] The rule, therefore,
is that imputations of negligence cannot prosper in the absence of proximate
causation.

In VDM Trading, Inc., [74] the Court denied the negligence claim of petitioners
for failure to establish the causal link between respondents' alleged negligent
plumbing works and the damage to their condominium unit. Petitioners could have
utilized technical experts to substantiate proximate causation instead of relying on
the mere "say-so" of their counsel. Moreover, they could not even point to a specific
rule that was violated nor was there proof that the act was prohibited, disallowed, or
undertaken in a negligent manner.
 Similarly, in Huang, [75] the Court found no indication that the hotel's actions
caused the head injury sustained by Huang at the swimming pool area. Huang merely
alleged that since the door from the shower room to the pool area was locked and
the lights were off, she walked around to look for a house phone. She spotted a
phone behind a counter. As she moved towards the counter, a wooden countertop
fell on her head. According to the Court, however, there was no causal relation
between her accident and the brain damage she sustained. Not only did she fail to
present the doctors who prepared the reports, the symptoms she was experiencing
might have been due to factors other than the head trauma she suffered. AaCTcI

This was reiterated in Molina v. Trans-Global Maritime Agency [76] where it

was ruled that the death certificate presented in evidence merely showed that the
deceased died of intracerebral hemorrhage. It did not prove that the injury was the
immediate cause that produced the medical condition. It was observed that "the fact
that intracerebral hemorrhage may have been caused by other factors such as
hypertension, blood disorders, and drug abuse spells doubt as to the relation
between the work-related injury and the cause of death." [77]

Again, in BJDC Construction v. Lanuzo, [78] there was no proof that the death
of a motorcycle rider was caused by the negligent construction works of BJDC
Construction. On the contrary, the company installed necessary warning signs and
lights on the highway. Moreover, the rider had control of how he operated his
motorcycle and was, in fact, very familiar with the risks in the site, having passed the
same for more than a month already. Thus, the Court found that the death of the
rider was proximately caused by his own negligence of driving at a fast speed
without a helmet.

In Dr. Dela Llana v. Biong, [79] it was held that none of the pieces of evidence
presented established the causal connection between the vehicular accident and
Dela Llana's whiplash injury. First, the pictures of the damaged car only
demonstrated the impact of the collision. Second, the medical certificate merely
attested to her injury, but not that the injury was the result of the accident.
A review of American jurisprudence leads to similar conclusions. In Pryce v.
Town Sports Int'l, LLC, [80] Pryce's negligence claim could not prosper in the
absence of proof that her shoulder injury was proximately caused by Town Sports'
breach of duty to ensure a safe exercise environment. Pryce was a diabetic female
in her mid-50s, with a previous lateral meniscus tear. She claimed that on the last
session of her 12-day personal training program, her trainer was not paying attention
when she pulled her shoulder while carrying a medicine ball.
The New York court, however, found that Pryce failed to demonstrate the
mechanism by which she was injured. Evidence is wanting to show that she did not
freely consent to the exercises or that the fitness center concealed or unreasonably
increased any associated risks. Pryce understood that she could stop an exercise if
she felt it was too difficult to complete. As a matter of fact, once she advised the
trainer of the pull she felt on her shoulder, he immediately stopped the session and
stretched her out.

In L.A. Fitness Int'l, LLC v. Mayer, [81] the Florida court concluded that L.A.
Fitness fulfilled its duty by summoning paramedics within a reasonable time. The
Court rejected the contention that the club member, who suffered a cardiac arrest
while on a stepping machine, died because the gym staff failed to conduct
cardiopulmonary resuscitation (CPR). First, the gym staff did not perform CPR as he
believed it would worsen his condition. Second, there was no statutory or case law
imposing a duty on health clubs to administer CPR or to have CPR-qualified
employees on site at all times. By signing a contract with the club, moreover, the
decedent represented that he was in good physical condition and had consulted a
physician. acEHCD

In De La Flor v. Ritz-Carlton Hotel Co., [82] the Florida court similarly

dismissed a negligence action in the absence of proof that the cardiopulmonary
arrest suffered at the defendant's fitness facility was caused by the latter's
negligence. The fact that the defendant represents itself to be a "state-of-the-art"
fitness center and maintains cardiovascular intensive equipment does not create a
duty to provide more than common first aid to its members. Under Florida law, there
is no obligation to maintain an external defibrillator machine within the premises.

Likewise, in Evans v. Fitness & Sports Clubs, LCC, [83] the Pennsylvania court
denied the negligence suit of 61-year-old Evans as she signed the membership
agreement releasing the fitness center from liability for injuries sustained during its
programs. While she alleged that her personal trainer told her to "go faster" resulting
in her fractured wrists, she was under no compulsion to participate in voluntary
sporting or recreational activities or to sign the agreement governing said activity.
In the present case, the CA simply held that the proximate cause of Adelaida's
death was the negligence of Slimmers World, et al., as they "should have reasonably
foreseen that, even if Adelaida did not declare that she was hypertensive, still a
potential risk existed, given the age of Adelaida who was then already 59 years old
and the severe headache she was complaining about at that time." [84]
The
explanation, however, leaves much to be desired.
Apart from Miguel's assertions that his wife's death was proximately caused by
the fitness center's negligence, no sufficient evidence was presented to substantiate
the same. In fact, Dr. Quilala even clarified that Adelaida's diagnosis of essential
hypertension "indicates that no specific medical cause can be found to explain a
patient's condition." [85]
As discerned in Huang and Molina, the Court cannot
preclude the probability that Adelaida's headache and eventual death might have
been due to factors other than her workout at the fitness center.
Indeed, Dela Llana pointed out that judges are no experts in the field of
medicine. [86] Without an established standard, they cannot simply take judicial
notice that a particular act directly causes an injury. That Adelaida's workout caused
her death is neither public knowledge nor capable of unquestionable demonstration
nor ought to be known to judges due to their judicial functions. [87]
In the final analysis, while the Court commiserates with Miguel for the death of
his wife, it is the solemn duty of this Court to impartially assess the merits of the
case on applicable law and evidence adduced. [88] As exhaustively discussed above,
however, Miguel failed to discharge his burden of proving that which is incumbent
upon him to prove. EcTCAD

Similar to the observations in VDM Trading, Inc., L.A. Fitness Int'l, LCC, and
De La Flor, Slimmers World, et al., were not compelled by any rule, law, or
jurisprudential pronouncement to take Adelaida's blood pressure before every
workout or to have a doctor on site at all times.
Much like the plaintiffs in BJDC Construction, Pryce, and Evans, moreover,
Adelaida may be deemed familiar with the risks involved considering the number of
sessions she had completed without any complaint. Besides, if an activity turned out
to be too challenging, or even granting that she was suffering from a headache prior
to the workout, she could have easily discontinued or cancelled the same. To be
sure, Adelaida was by no means under any compulsion to participate in the activity,
having freely consented to the same.

All told, both Philippine and American jurisprudence [89] impart that the present
matter ultimately requires a fair and proper balance of interests. While gyms and
fitness centers are not mandated to guarantee safety from all risks in the premises,
they nonetheless adhere to a duty not to engage in reckless or gross negligence. In
providing "specialized equipment and facility to their invitees who are there to
exercise, train, and to push their physical limits," gyms and fitness centers are
ultimately bound by "a standard of care congruent with the nature of their business."
[90]

In light of the foregoing, the Court is constrained to rule against Miguel's claim
for damages in the absence of preponderant evidence proving that Slimmers World,
et al., were guilty of breach of a pre-existing contract or negligence in a quasi-delict.
Miguel not only failed to establish that the fitness center violated the terms of its
contract, he also failed to prove the center's alleged negligence and the causal
connection between Adelaida's last workout and her death.
ACCORDINGLY, the Court resolves to:
1. GRANT the Petition of Slimmers World International and Dinah Quinto
in G.R. No. 206321;
2. REVERSE the Decision dated October 8, 2012 and Resolution dated
March 12, 2013 of the Court of Appeals in CA-G.R. CV No. 96344;
3. DENY the Petition of Miguel Kim in G.R. No. 206306; and
4. DISMISS the Complaint of Miguel Kim for recovery of damages for the
death of his wife, Adelaida Kim, for lack of merit. SDHTEC

SO ORDERED.

Footnotes

1. Rollo (G.R. No. 206306), pp. 9-31; rollo (G.R. No. 206321), pp. 29-133.
2. Rollo (G.R. No. 206306), pp. 33-49. The October 8, 2012 Decision in CA-G.R. CV No.
96344 was penned by Associate Justice Isaias P. Dicdican and concurred in by
Associate Justices Michael P. Elbinias and Nina G. Antonio-Valenzuela of the
Thirteenth Division, Court of Appeals, Manila.

3. Id. at 51-52. The March 12, 2013 Resolution in CA-G.R. CV No. 96344 was penned by
Associate Justice Isaias P. Dicdican and concurred in by Associate Justices Michael P.
Elbinias and Nina G. Antonio-Valenzuela of the Thirteenth Division, Court of Appeals,
Manila.

4. Id. at 53-62. The October 29, 2009 Decision in Civil Case No. C-19450 was penned by
Presiding Judge Dionisio C. Sison of Branch 125, Regional Trial Court, Caloocan City.

5. Id. at 34.

6. Id.

7. Id. at 34-35.

8. Id. at 35.

9. Id. at 35-36.

10. Id. at 36.

11. Id. at 62.

12. Id. at 48.

13. Id. at 40-41.

14. Id. at 51-52.

15. Id. at 9.

16. Rollo (G.R. No. 206321), p. 33. Counsel for petitioners in G.R. No. 206321 explained
that Albert Cuesta's whereabouts are no longer known to Slimmers World International
"since he resigned from his post sometime in 2001 and reportedly worked abroad."
Thus, they can no longer represent him in the proceedings.

17. Id. at 77.

18. Allarey v. Dela Cruz, G.R. No. 250919, November 10, 2021 [Per J. Carandang,
Third Division] at 8. This pinpoint citation refers to the copy of the Decision uploaded to
the Supreme Court website.

19. In Microsoft Corp. v. Farajallah, 742 Phil. 775, 785 (2014) [Per Acting C.J. Carpio,
Second Division], cited in Allarey v. Dela Cruz, G.R. No. 250919, November 10, 2021
[Per J. Carandang, Third Division], the Court provided the following instances when a
review of the factual findings of the CA is proper: (1) when the factual findings of the
Court of Appeals and the trial court are contradictory; (2) when the conclusion is a
finding grounded entirely on speculations, surmises, or conjectures; (3) when the
inference made by the Court of Appeals from its findings of fact is manifestly mistaken,
absurd, or impossible; (4) when there is a grave abuse of discretion in the appreciation
of facts; (5) when the appellate court, in making its findings, went beyond the issues of
the case and such findings are contrary to the admissions of both appellant and
appellee; (6) when the judgment of the Court of Appeals is premised on a
misapprehension of facts; (7) when the Court of Appeals failed to notice certain
relevant facts which, if properly considered, would justify a different conclusion; (8)
when the findings of fact are themselves conflicting; (9) when the findings of fact are
conclusions without citation of the specific evidence on which they are based; and (10)
when the findings of fact of the Court of Appeals are premised on the absence of
evidence but such findings are contradicted by the evidence on record.

20. Art. 2176. Whoever by act or omission causes damage to another, there being fault
or negligence, is obliged to pay for the damage done. Such fault or negligence, if there
is no pre-existing contractual relation between the parties, is called a quasi-delict and
is governed by the provisions of this Chapter. (1902a)

21. Art. 1172. Responsibility arising from negligence in the performance of every kind of
obligation is also demandable, but such liability may be regulated by the courts,
according to the circumstances. (1103)

22. 816 Phil. 163 (2017) [Per J. Leonen, Second Division].

23. Id. at 175-176.

24. 700 Phil. 327 (2012) [Per J. Perez, Second Division].

25. Id. at 357-358.

26. Orient Freight International, Inc. v. Keihin-Everett Forwarding Co., Inc., 816
Phil. 163, 176 (2017) [Per J. Leonen, Second Division].

27. Torres-Madrid Brokerage, Inc. v. FEB Mitsui Marine Insurance Co., Inc., 789
Phil. 413, 427 (2016) [Per J. Brion, Second Division].

28. 809 Phil. 725 (2017) [Per J. Bersamin, Third Division].

29. Id. at 734.

30. Rollo (G.R. No. 206321), p. 338.

31. Id. at 695-696.

32. Id. at 110.

33. Id. at 118.

34. VDM Trading, Inc. v. Carungcong, 846 Phil. 425, 437 (2019) [Per J. Caguioa,
Second Division].

35. St. Martin Polyclinic, Inc. v. LWV Construction Corp., 822 Phil. 1, 20 (2017) [Per
J. Perlas-Bernabe, Second Division].

36. Rollo (G.R. No. 206321), p. 979.

37. Id. at 384. The newspaper advertisement states: "FREE CONSULTATION FOR MEN
& WOMEN! All programs are under medical supervision."

38. Id. at 60.

39. Spouses Viloria v. Continental Airlines, Inc., 679 Phil. 61, 95 (2012) [Per J. Reyes,
Second Division].

40. Swedish Match, AB v. Court of Appeals, 483 Phil. 735, 751 (2004) [Per J. Tinga,
Second Division].

41. Id.

42. Rollo (G.R. No. 206321), p. 384.

43. Id. at 522.

44. Id. at 95.

45. Orient Freight International, Inc. v. Keihin-Everett Forwarding Co., Inc., 816
Phil. 163, 176 (2017) [Per J. Leonen, Second Division].

46. Oreta-Ferrer v. Right Eight Security Agency, Inc., G.R. No. 223635, June 14,
2021 [Per J. J.Y. Lopez, Third Division] at 9. This pinpoint citation refers to the copy of
the Decision uploaded to the Supreme Court website.

47. Id.

48. Article 2176. Whoever by act or omission causes damage to another, there being
fault or negligence, is obliged to pay for the damage done. Such fault or negligence, if
there is no pre-existing contractual relation between the parties, is called a quasi-delict
and is governed by the provisions of this Chapter.

49. VDM Trading, Inc. v. Carungcong, 846 Phil. 425, 436 (2019) [Per J. Caguioa,
Second Division].

50. Dr. Huang v. Philippine Hoteliers, Inc., 700 Phil. 327, 357-358 (2012) [Per J.
Perez, Second Division].

51. BJDC Construction v. Lanuzo, 730 Phil. 240, 253 (2014) [Per J. Bersamin, First
Division].

52. St. Martin Polyclinic, Inc. v. LWV Construction Corp., 822 Phil. 1, 16 (2017) [Per
J. Perlas-Bernabe, Second Division].

53. Rollo (G.R. No. 206321), p. 1070.

54. St. Martin Polyclinic, Inc. v. LWV Construction Corp., 822 Phil. 1, 15 (2017) [Per
J. Perlas-Bernabe, Second Division].

55. BJDC Construction v. Lanuzo, 730 Phil. 240, 253 (2014) [Per J. Bersamin, First
Division].

56. Rollo (G.R. No. 206306), pp. 41-42. Witness Buenavista testified as follows:

Q: Can you tell us what this unusual incident was?

 A: On July 25, 2000, Albert Cuesta asked me to assist them with his client, that is Ms.
Adelaida Kim, ma'am.

Q: Why did this Mr. Albert Cuesta ask for your assistance?

A: He asked me to assist him because his client is complaining of headache and he

asked me to assist him.

Q: Around what time did this happen?

A: Between 6:30 and 7:30 in the morning, ma'am.

57. Id. at 43.

58. Rollo (G.R. No. 206321), pp. 658-664.

59. Id. at 662. The Pre-Trial Brief states the following admission: "5. That deceased was
under her personal trainor that day of the incident, and felt discomfort after the
exercises under her trainor's supervision and while still inside the premises of
Slimmers World Caloocan City."

60. Id. at 469.Witness Rabaca testified as follows:

Q: How did you know that she was in the Slimmers' World at that time?

A: Before going there, she even called me up. That was before 7:00 o'clock in the
morning, asking me if I will attend the session, sir.

Q: Did you attend the session?

A: Unfortunately not, sir.

61. Id. at 585-588.

62. Id. at 588.

63. Id. at 69.

64. Id. at 423.

65. Id. at 978.

66. University of Mindanao, Inc. v. Bangko Sentral ng Pilipinas, 776 Phil. 401, 435
(2016) [Per J. Leonen, Second Division].

67. Rollo (G.R. No. 206321), pp. 423-424.

68. Id. at 344.

69. Id. at 97.

70. Id. at 705.

71. Id. at 47.

72. VDM Trading, Inc. v. Carungcong, 846 Phil. 425, 441 (2019) [Per J. Caguioa,
Second Division].

73. Cayao-Lasam v. Spouses Ramolete, 595 Phil. 56, 77 (2008) [Per J. Austria-
Martinez, Third Division].

74. 846 Phil. 425, 441-443 (2019) [Per J. Caguioa, Second Division].

75. 700 Phil. 327 (2012) [Per J. Perez, Second Division].

76. G.R. No. 226951, December 10, 2019 [Unsigned Resolution, First Division].

77. Id.

78. 730 Phil. 240, 245-246, 255-256 (2014) [Per J. Bersamin, First Division].

79. 722 Phil. 743 (2013) [Per J. Brion, Second Division].

80. 18 Civ. 5863, 2021 U.S. Dist. LEXIS 62977 (2021).

81. 980 So. 2d 550, 2008 Fla. App. LEXIS 5893 (2008).

82. 930 F. Supp. 2d 1325, 2013 U.S. Dist. LEXIS 58797 (2013).

83. 2016 U.S. Dist. LEXIS 133490 (2016).

84. Rollo (G.R. No. 206321), p. 20.

85. Id. at 705.

86. 722 Phil. 743, 762 (2013) [Per J. Brion, Second Division].
87. Id.

88. Id.

89. Stelluti v. Casapenn Enters, LLC, 203 N.J. 286, 1 A.3d 678, 2010 N.J. LEXIS 750
(2010).

90. Id.