THE PEOPLE OF THE PHILIPPINES, PLAINTIFF-APPELLEE, VS. ANGELO UMAGUING, DEFENDANT WHOSE DEATH SENTENCE IS UNDER REVIEW.

There is no controversy as to the facts of this extra­ordinary case
where the accused attempted to hasten the death of a septuagenarian woman who
had suffered a stroke.

In the evening of January 8, 1977, Amparo Lazo y Villaflor, 76, a
resident of 45-B 11th Avenue, Cubao, Quezon City (a native of Sto. Domingo,
Ilocos Sur), had a severe headache and a bout of vomiting, followed by cerebral
hemorrhage.  She fell into a coma.

She was rushed by her relatives and two boarders to the Polymedic
General Hospital, located at E. de los Santos Avenue, Mandaluyong, Metro Manila
and adminis­tered by Doctor Victor Potenciano. 
She arrived in the emergency room at seven-forty-five.  She was on a stretcher.

She was unconscious due to cerebro-vascular conges­tion.  She had difficulty in breathing.  Her blood pressure was 200/100.  Her pulse rate was 100 per minute (Exh. B-1).

The nurse on duty administered oxygen inhalation to the
patient.  She was given dextrose,
penicillin, solu-cortef, serpasil, decadron and sodium bicarbonate.  A vein of the patient was cut to diminish the
blood pressure.

As the patient had apnea, Doctor Emmanuel Favila called the other
resident physicians for a consultation. 
At about eight-thirty, Doctor Estacio, an anesthesiologist, inserted
into the patient’s mouth and windpipe an endotra­cheal rubber tube, about six
inches long and half an inch in diameter with a plastic ventilator.  It was taped to the pa­tient’s mouth by means
of a plaster.  The purpose was for
“ventilation” or the excretion of the carbon dioxide (to pre­vent
“drowning”, according to Doctor Favila).

After the endotracheal tube had been inserted, Angelo Umaguing, a
janitor, for reasons known only to himself and without the least justification,
tried to remove the plaster holding the tube in place.  Doctor Estacio shooed him away.  That episode was witnessed by Doctor Favila
(81-82 tsn March 9, 1977).

Then, a few minutes later, after the doctors had left the
emergency room and while the nurse’ s back was turned, Umaguing went to the
patient’s bed and, to suit his purpose (for being a mere janitor he had nothing
to do with the patient), he removed the endotracheal tube.  His reckless and irrational act was witnessed
by Jojo Cruz and Adelaida Apostol, the patient’s grandson and niece,
respectively.

According to Adelaida, the removal of the tube caused the patient
to bleed in the mouth and to have a convulsion (nangisay).  Umaguing even closed the patient’s eyes, (6-7
tsn November 11, 1977).

The nurse called the doctors to the emergency room.  Doctor Ramon Sison, the chief resident
physician, restored the endotracheal tube. 
The patient was still breathing. 
The security guard was alerted and directed to detain Umaguing.  A relative of the patient called a
policeman.  Umaguing was arrested and
brought to the police station of Mandaluyong where the incident was
investigated.

The removal of the tube impelled the patient’s relatives to
transfer her to the Cardinal Santos Hospital. 
She was brought there in an ambulance. 
She died there the next day at four-quarter in the morning.  Death was due to cardio­respiratory arrest
brought about by cerebro-vascular hemor­rhage and hypertension (Exh. A).

The Mandaluyong police secured the statement of Jojo Cruz, Gloria
Apostol, Adelaida Apostol and the nurse who pointed to Umaguing (he was present
when the statements were taken) as the culprit who removed the endotracheal
tube.

Jose Cruz, the sixteen-year-old grandson of the patient, in his
statement taken in Umaguing’s presence, said:

“. . . ng nasa emergency room kami ay ginamot siya (the
patient) ng doktor ay nanduruon siya (Angelo Umaguing, the accused) ay
inaalis niya ang plaster ng gomang inilagay ng doktor sa bibig ng aking Lola,
ay pinalis ng doktor ang kanyang kamay at sinabi sa kanya na:  ‘Bakit mo pinakiki­alaman iyon?’ at umalis na
siya (Angelo Umaguing).

“Pumunta kami ng tiyahin kong si Gloria Apostol, sa
information para iconfine ang aking Lola. 
Ako po ay bumalik sa emergency room. 
Nakita ko ang aking tiyang si Adelaida na nakaupo at minamasahe ang
kamay ng aking Lola.

“Mga ilang sandali po ay biglang lumapit siya (Angelo
Umaguing) ulit at tinanggal ang
plaster na nakakabit sa gomang nakalagay sa bibig ng aking Lola at
hinugot iyon.

“Mabuti at may lumabas na nurse at tinanong kami:  ‘Sino ang nagalis niyan?’ Ang taong iyan
(Angelo Umaguing) ay pilit na ipinipikit ang (mga) mata ng aking Lola at
tinanong si Angelo na kung bakit siya nakikialam.

“At lumabas itong si Angelo patungo sa corridor at siya ay
hinabol ng nurse at narinig ko na huwag papaalisin ang taong iyan.” (Exh.
F, p. 62, Record).

Adelaida Apostol, a niece of the patient who was also in the
emergency room, in her statement gave the following account of what Umaguing
did:

“Ng aming pong dalahin ang aking tiyang si Amparo Lazo sa
Polymedic Hospital ay ipinasok siya sa emergency room.  Agad namang inasikaso ng mga doktor at ng
nurse ang aking tiyahin.  Kami nuon ng
aking pamangking si Jojo (Jose Cruz) at ang dalawang boarders ng aking tiya ay
nasa paligid din ng emergency room.

“Nakita ko na may nagmamasahe sa tiyan ng aking tiya.  May nagbobomba sa bibig niya at may nagsaksak
ng iniksyon sa kamay.  Ng may inilalagay
na ang isang doktor sa bibig ng aking tiya na parang tubo ay nakita ko ang
taong iyan (Angelo Umaguing) na
inalis ang plaster (adhesive tape) at pinalis pa ang kamay niya (Angelo Umaguing) ng doktor at
pinaalis.

“Ng ang aking hipag na si Gloria ay lumabas upang ipaconfine
na ang aking tiyahin at matapos na ang paglalagay ng tubo sa bibig ng aking
tiya.  Hindi nagtagal ay umalis na rin
ang doktor at ang natira ay ang orderly na isang lalaki, ay pumasok ang
lalaking iyan (pointing again to Angelo Uma­guing) at biglang inalis ang nasabing tubo sa bibig ng
aking tiya, at nakita
ko na parang hinabol ng Tiya Amparing ko ang kanyang hininga at ang orderly ay nagsalita ng:  ‘Bakit mo inalis iyan?’ at inutusan ang isang
guwardiya yata na pigilin ang taong iyan (Angelo Umaguing) ng siya ay palabas
na” (Exh. H, p. 64,
Record).

These statements are reflected in the
initial police inves­tigation report of the incident, excerpts from which are
quoted below:

“During the process when the endotracheal tube was being
installed/inserted, the suspect, Angelo Umaguing, took off the adhesive tape
that strengthened the said tube and the doctor attending to it, seeing the
hands of the sus­pect, warded them and was sent off (shooed away) by him (the
first attempt).

“After the installation of the endotracheal tube and the
doctor was out, the suspect returned and in the clear view of the witnesses,
Jose Cruz, Gloria Apostol and the other relatives of the victim, took out the
said tube from the mouth of the victim Amparo Lazo y Villaflor, causing a
disruption of her breath.” (Exh. D, p. 151, Record).

Nurse Tessie Piad gave the following account of Umaguing’s
wrongful act:

“Suddenly, Mr. Makinano (the orderly) shouted and said that
the endotracheal tube was removed by Mr. Umaguing (the janitor).  According to one of the relatives (of the
patient) (the one watching the patient) that Mr. Umaguing (the janitor)
open(ed) the curtain and suddenly took the endotracheal tube without any word.

“So, I went immediately to the patient and looked at her.  The patient was still breathing same as
before and did not look like she was in distress.  I take (took) the vital signs; then called
for the doctor.  Dr. Enrile, Dr. Sison
and Dr. Favila went down immediately. 
Dr. Sison did the reinsertion of the endotracheal tube.

“The relatives requested to transfer the patient to the
Cardinal Santos Memorial Hospital.  Our
ambulance took the patient there, accompanied by Dr. Enrile and Miss Abuan and some
relatives of the patient.  The patient
was still in the same condition when she left the hospital (Polymedic General
Hospital).” (Exh. C, p. 149, Record).

On January 12, 1977, the chief investigator of the Mandaluyong
police filed in the municipal court a complaint for murder against
Umaguing.  He waived the second stage of
the preliminary investigation.  On
January 20, 1977, the fiscal filed an information for murder against Umaguing
in the Circuit Criminal Court at Pasig, Rizal.

After trial, the court convicted Umaguing of consum­mated murder,
qualified by treachery and aggravated by abuse of superiority, nocturnity,
disregard of old age and ignominy, sentenced him to death and ordered him to
pay an in­demnity of twenty-two thousand pesos to the heirs of Amparo Lazo
(Criminal Case No. 1858).  The case was
elevated to this Court for review of the death penalty.

Umaguing, 29, who finished third year high school, testified that
in 1976 he started working as janitor in the hospital.  He became a member of the Bahala na Gang in
1967.

His defense was that at past nine o’clock he was cate­gorically
ordered by Doctor Sison to remove (“alisin na”) the endotracheal tube
and other instruments and devices because the old woman’ s case was
hopeless.  The order was allegedly given
to him and to the nurse and the orderly or attendant named Abundio Makinano (3,
9-10 tsn January 5, 1978).

In the courtroom Umaguing demonstrated the giving of the signal
by sitting on the floor, his left elbow on top of the witness stand and his
right hand making a sign that there was no more hope for the patient (9 tsn
January 5, 1978).

Immediately after Umaguing mentioned the name of Sison, Judge
Onofre A. Villaluz ordered that he be sub­poenaed to testify.  In his testimony, Sison denied that he gave a
signal to Umaguing to remove the endotracheal tube.

Umaguing denied that he was connected with any funeral
parlor.  Doctor Sison did not know
whether Umaguing was an agent of any mortician.

Umaguing admitted that after removing the endotracheal tube he
was called by the head nurse.  He was
running because he was nervous.  He was
nervous because he had pulled out the tube. 
He admitted that removing the tube was a mistake.  He was apprehended by the security guard at
the gate.  He did not tell the police
during the investigation that Doctor Sison ordered him to remove the tube
(11-12 tsn).

Umaguing’s counsel in the trial court admitted that “there
is no dispute that” Umaguing “removed the endotra­cheal tube”
(p. 164, Record).  In the police station,
when two relatives of the patient, Jose Cruz and Adelaida Apostol, fingered him
as the malefactor who removed the endotracheal tube, he did not controvert that
accusation.  He did not execute any sworn
statement to prove his innocence.

Umaguing’s counsel de oficio contends that the
trial court erred in finding that the removal of the endotracheal tube
shortened the old woman’s life or caused her death and in holding that he
committed murder.

He argues that because of the old woman’s critical condition she
was sure to die a natural death; that the tube was inserted into her windpipe
merely to lessen her suffering and that she did not die immediately after the
removal of that tube.

It is also contended that the accused accidentally re­moved the
tube while he was cleaning the emergency room and, therefore, he did not
deliberately intend to kill the old woman. 
Hence, he could not be guilty of murder.

Those contentions are devoid of merit.  As a janitor, the accused had no compelling
reason to be in the emergency room to watch the old woman’s condition while
medical assist­ance was being extended to her.

His presence in the emergency room was for some ulterior motive
and that motive became evident when he removed the tube.  The removal of the tube was not acci­dental.  Evidently, counsel de officio
did not remember the testimony of Umaguing, which counsel himself elicited on
direct examination, or counsel did not bother to read the record.

Since Umaguing testified that he removed the tube because he was
ordered to do so by Doctor Sison (3-4 tsn January 5, 1978), the removal of the
tube was not accidental.

Umaguing was not cleaning the emergency room when the old woman
was brought there.  He had stationed
himself in the emergency room to monitor or observe the medical treatment being
administered to her.  His diabolical
purpose was to wait for a good opportunity when he could attempt to hasten the
old woman’s demise.

On the other hand, the Solicitor General recommends the acquittal
of the accused on the ground that the proximate cause of the patient’s death
was not the removal of the endo­tracheal tube but cardio-respiratory arrest and
that it was not shown that the accused acted with criminal intent.

That recommendation is not well-taken.  Umaguing’s removal of the endotracheal tube
was utterly malicious and felonious.  The
victim’s relatives, who saw him committing that act, sensed immediately that he
was trying to kill the old woman.  And
so, they lost no time in calling a policeman to apprehend and investigate him.

Umaguing, as a janitor, had nothing to do with the patient.  He had no business being in the emergency
room at eight o’clock in the evening.  As
his act of removing the tube was wrongful, it is to be presumed that he did so
with an evil intent (See 5[b], Rule 131, Rules of Court; U.S. vs. Apostol, 14
Phil. 92; U.S. vs. Tria, 17 Phil. 303; U.S. vs. Ballesteros, 25 Phil. 634;
People vs. Sia Teb Ban, 54 Phil. 52; People vs. Cubelo, 106 Phil. 496).

Umaguing was not able to rebut satisfactorily that presumption.  As already noted, his testimony that he was
ordered by Doctor Sison, the chief resident physician, to remove the tube was
denied by the latter (22 tsn January 5, 1978). 
Doctor Favila testified that the removal of the tube was a serious
matter (65 tsn March 9, 1977).

The overt acts committed by the accused constitute attempted
murder.  He was not able to perform all
the acts of execution necessary to consummate the crime because the victim was
transferred to another hospital and the accused was immediately
apprehended.  Moreover, the tube was re­inserted
into the victim’s mouth.

We find the accused guilty beyond reasonable doubt of attempted
murder without any aggravating circumstances.

The trial court’s decision is modified.  The death penalty is set aside.  Umaguing is sentenced to an indeter­minate
penalty of four years of prision correctional as minimum to eight years
of prision mayor as maximum and to pay an indemnity of five thousand
pesos to the heirs of the victim, Amparo Lazo. 
Costs de oficio.

SO ORDERED.

Fernando, C.J., Teehankee, Barredo, Makasiar, Concepcion, Jr.,
Fernandez, Guerrero, De Castro, and Melencio-Herrera,
JJ., concur.

Abad Santos, J., on leave.