MANILA, Philippines – Dr. Benigno “Iggy” Agbayani Jr. was put behind bars on May 25, 2023 over a reckless imprudence case filed by lawyer Saul Hofileña Jr., who complained about an operation that led to infection of his knee.

Unfortunately, Agbayani passed away on October 5, 2023 due to cardiac arrest while in the Manila City Jail. His death caused a discussion among legal and medical professionals, specifically on how the case should have gone.

Hofileña, in a statement sent to Rappler, explained his experience after the operation. He said he waited for 40 days after Agbayani’s death before releasing his statement in respect for the doctor’s family.

The lawyer said the arthroscopic surgery – used for treating joint problems – was conducted on his left knee on January 5, 2006. He added that an infection occurred “exactly in the same site” where the arthroscope was inserted.

Another operation was conducted to remove the infection. Then, on June 20, 2007, Hofileña had another operation to remove the scar inside his left knee, which “resulted from the removal of the infection.” He added that he underwent physical rehabilitation for three years.

“More than a dozen doctors who graduated from the University of the Philippines (UP) helped me in my predicament. What they did was nothing short of a miracle because I thought that I will never walk again, and I was only 46 years old at that time and now I am 64 years old,” the lawyer said.

Doctor of the people

As a medical doctor, Iggy’s routine involved waking up at 5 am and preparing himself for his patients. He made sure that every day, he was fighting fit every time he faced his patients, Agbayani’s sister, Isa Buencamino, told Rappler in an interview.

Agbayani’s father is Dr. Benigno Agbayani, a professor emeritus of the UP College of Medicine and considered one of the pioneers in allergy and immunology in the country. Despite this, Iggy was the only one who took medicine among Benigno’s children.

“He absolutely loved his job,” Buencamino told Rappler, referring to her brother’s love for medicine.

As an orthopedic surgeon, Agbayani showed care for his patients by ensuring that they got the best care possible. There were times Agabayani even waived his professional fees for his patients to help them, Buencamino said. Agbayani’s patients were also not charged for follow-up questions, she added.

In their family, Agbayani was the funny and bubbly one. He was witty, generous, and the life of the party during special occasions. Agbayani was also everyone’s favorite tito (uncle), Buencamino said.

“But in the last five years of his life, the Iggy that we know was disappearing. You know, he wasn’t happy anymore. Talagang (It seems), the weight of 17 years of [the case], it’s like a Damocles sword. Like that sword constantly on his head, waiting for it to finally plunge,” Buencamino told Rappler.

Surprisingly, Buencamino said they saw the old Iggy again while he was in jail. “Despite the fact [that he was incarcerated], he was like, like bouncy and really happy. And it was because when he was in jail, ang dami niya namang natutulungan (he was able to help many people),” she said.

In the few months he was in the Manila City Jail, Agbayani was able to hold medical and feeding missions. He also planned to hold literacy missions to help his fellow persons deprived of liberty (PDL).

While behind bars, Agbayani also started collecting old five-peso coins because the two pay phones inside the jail only accept old coins. The doctor would ask his family and visitors to give him old five-peso coins so that they can give these coins to other PDLs inside the jail. At Agbayani’s funeral, someone even left a bag full of five-peso coins, Buencamino said.

During his last days, Agbayani was so happy that he apparently glossed over his worsening heart condition, Buencamino told Rappler. The week before he died, the doctor was already experiencing chest pains, but he just brushed it off. Agbayani was excited, too, because he was set to be released due to good conduct.

Hours before he died, he was talking to people inside jail, coordinating with them about their feeding program. Buencamino said his brother died in the middle of a meeting with the warden.

“He died right there and then, after nine days of big heart attack and small ones. As in, literally, his heart stopped,” the doctor’s sister said.

Case’s timeline

According to a briefer provided by the doctor’s family, Agbayani performed the operation on Hofileña’s knee in a hospital in Manila. Hofileña alleged that the arthroscope used by the doctor was not properly sterilized.

This “supposedly caused an infection on the operated knee, such that Hofileña was incapacitated to work for more than 30 days and required another operation on his right wrist as he walked with a cane for a prolonged period of time.” The lawyer filed both civil and criminal complaints against Agbayani.

On January 26, 2006, Agbayani was charged with reckless imprudence resulting in serious physical injuries before the Manila Metropolitan Trial Court (METC) Branch 26. Seven years later, on March 1, 2013, Judge Emmanuel Loredo, who handled the case, announced that it was submitted for resolution.

However, Agbayani’s lawyers asked the judge to inhibit, “because they believed he was biased and connected with Saul Hofileña Jr.” Loredo inhibited, and the case was passed to Judge Manuel Recto, who also submitted the case for resolution.

In a decision dated July 29, 2013, the METC found Agbayani guilty of reckless imprudence resulting in serious physical injuries and sentenced him to imprisonment of two years. The doctor appealed his case at the Regional Trial Court (RTC), which directed him to submit a memorandum in accordance with Section 7b, Rule 40, of the Rules of Civil Procedure.

However, according to the briefer, Agbayani’s lawyer filed a motion for an extension of 15 days, instead of the motion asked by the court. The RTC granted the extension. The counsel was again directed to file the memorandum on December 19, 2013, but instead, the lawyer filed two successive motions for extension.

But, the two last extensions were not granted by the court. On December 23, 2013, the RTC dismissed the appeal after the first extension lapsed based on Section 7b, Rule 40 of the Rules of Civil Procedure. The case then went to the Court of Appeals (CA).

However, the CA also dismissed Agbayani’s appeal. The appellate court noted that pursuant to Sections 2(d) and 3, Rule 42, of the Rules of Civil Procedure, the CA can dismiss a petition for failure to attach supporting records of the case. The CA also affirmed the RTC’s reliance on Section 7(b), Rule 40 of the Rules of Civil Procedure.

Agbayani then sought the Supreme Court (SC)’s help as the court of last resort by filing a petition for review on certiorari, which is used to ask a review of a lower court’s decision. But, in a resolution dated June 23, 2021, the SC affirmed the CA’s decision.

“The petition for review before the CA was correctly dismissed since Dr. Agbayani did not provide any satisfactory explanation for failing to attach the other portions of the records of the case, even in the motion for reconsideration,” the briefer said, quoting the SC ruling.

The SC added that the issue of non-sterilization of the arthroscope is a question of fact that should have been raised before the RTC and the CA. The SC amended the penalty against Agbayani and sentenced him to a minimum of one month and one day, to one year and one day.

On March 16, 2022, the SC denied the doctor’s motion for reconsideration and supplemental motion for reconsideration.

Massive support

Amid Agbayani’s predicament and his eventual demise, several doctors rallied behind him.

The Philippine Medical Association (PMA) came out with a statement supporting Agbayani. The letter was signed by the PMA’s national officers and governors.

“It is regrettable that he died while serving his sentence in prison and still in the course of exploring his options to help clear his name. The PMA remains supportive of such an aspiration and hopeful of its favorable reconsideration, in view of its transcendental importance to the medical profession,” the PMA said.

Other groups like the Philippine Orthopedic Association and Phi Kappa Mu Fraternity at the University of the Philippines College of Medicine also threw their support behind Agbayani.

The Phi Kappa Mu Fraternity has also started a change.org petition, which urges the Judicial Integrity Board (JIB) to revisit the doctor’s case. The petition, launched on October 31, has garnered 14,293 signatures, as of 4 pm, November 17.

However, in an interview with the Philippine Star, former Integrated Bar of the Philippines (IBP) president Domingo Cayosa said the JIB is not the proper body to raise concerns over Agbayani’s case. He added that the JIB cannot also overturn the SC, in reference to its decision on the doctor’s case.

The former IBP president said Agbayani’s family can opt to ask the SC for a new trial based on new grounds.

Buencamino said they are aware that the JIB cannot overturn the SC ruling. What they want is for the body to see if there was anything irregular that happened in Agbayani’s trial, including the relationships of the people involved in the case.

On the suggestion to go after Agbayani’s lawyers for the alleged mistakes in the case, Buencamino said they have no plans to do it.

“And should we go on a path, bent on destroying other people’s lives? Tuloy-tuloy pa namin, ‘di ba? (We should go on with it, right?) But no, enough pain and suffering has been spent. And we don’t want the legacy of our brother to be that. He’s already dead,” she added.

“But instead, we’re taking a step back from our pain and we’re asking the question. What really went wrong? How did it get this far? And to really seek justice. Not revenge, just justice.”

As for Hofileña, Buencamino has this to say:

“If Hofilena truly feels that he was justified in his actions towards Iggy these last 17 years, then he should support us – let us all put this case under the bright light of justice. He should also sign the petition to review the case.” — Rappler.com