Nevertheless, there is merit in the argument proffered by Villacorta that in the event he is found to have indeed stabbed Cruz, he should only be held liable for slight physical injuries for the stab wound he inflicted upon Cruz. The proximate cause of Cruz’s death is the tetanus infection, and not the stab wound.
Proximate cause has been defined 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.”[21]
In this case, immediately after he was stabbed by Villacorta in the early morning of January 23, 2002, Cruz was rushed to and treated as an out-patient at the Tondo Medical Center. On
In Urbano v. Intermediate Appellate Court,[22] the Court was confronted with a case of very similar factual background as the one at bar. During an altercation on
We quote extensively from the ratiocination of the Court in Urbano:
The issue, therefore, hinges on whether or not there was an efficient intervening cause from the time Javier was wounded until his death which would exculpate Urbano from any liability for Javier's death.
We look into the nature of tetanus-
“The incubation period of tetanus, i.e., the time between injury and the appearance of unmistakable symptoms, ranges from
“Non-specific premonitory symptoms such as restlessness, irritability, and headache are encountered occasionally, but the commonest presenting complaints are pain and stiffness in the jaw, abdomen, or back and difficulty swallowing. As the disease progresses, stiffness gives way to rigidity, and patients often complain of difficulty opening their mouths. In fact, trismus is the commonest manifestation of tetanus and is responsible for the familiar descriptive name of lockjaw. As more muscles are involved, rigidity becomes generalized, and sustained contractions called risus sardonicus. The intensity and sequence of muscle involvement is quite variable. In a small proportion of patients, only local signs and symptoms develop in the region of the injury. In the vast majority, however, most muscles are involved to some degree, and the signs and symptoms encountered depend upon the major muscle groups affected.
“Reflex spasm usually occur within 24 to 72 hours of the first symptoms, an interval referred to as the onset time. As in the case of the incubation period, a short onset time is associated with a poor prognosis. Spasms are caused by sudden intensification of afferent stimuli arising in the periphery, which increases rigidity and causes simultaneous and excessive contraction of muscles and their antagonists. Spasms may be both painful and dangerous. As the disease progresses, minimal or inapparent stimuli produce more intense and longer lasting spasms with increasing frequency. Respiration may be impaired by laryngospasm or tonic contraction of respiratory muscles which prevent adequate ventilation. Hypoxia may then lead to irreversible central nervous system damage and death.
“Mild tetanus is characterized by an incubation period of at least 14 days and an onset time of more than 6 days.Trismus is usually present, but dysphagia is absent and generalized spasms are brief and mild. Moderately severe tetanus has a somewhat shorter incubation period and onset time; trismus is marked, dysphagia and generalized rigidity are present, but ventilation remains adequate even during spasms. The criteria for severe tetanus include a short incubation time, and an onset time of 72 hrs., or less, severe trismus, dysphagia and rigidity and frequent prolonged, generalized convulsive spasms. (Harrison's Principle of Internal Medicine, 1983 Edition, pp. 1004-1005; Emphasis supplied)
Therefore, medically speaking, the reaction to tetanus found inside a man's body depends on the incubation period of the disease.
In the case at bar, Javier suffered a 2-inch incised wound on his right palm when he parried the bolo which Urbano used in hacking him. This incident took place on
If, therefore, the wound of Javier inflicted by the appellant was already infected by tetanus germs at the time, it is more medically probable that Javier should have been infected with only a mild case of tetanus because the symptoms of tetanus appeared on the 22nd day after the hacking incident or more than 14 days after the infliction of the wound. Therefore, the onset time should have been more than six days. Javier, however, died on the second day from the onset time. The more credible conclusion is that at the time Javier's wound was inflicted by the appellant, the severe form of tetanus that killed him was not yet present. Consequently, Javier's wound could have been infected with tetanus after the hacking incident. Considering the circumstance surrounding Javier's death, his wound could have been infected by tetanus 2 or 3 or a few but not 20 to 22 days before he died.[23]
The incubation period for tetanus infection and the length of time between the hacking incident and the manifestation of severe tetanus infection created doubts in the mind of the Court that Javier acquired the severe tetanus infection from the hacking incident. We explained in Urbano that:
The rule is that the death of the victim must be the direct, natural, and logical consequence of the wounds inflicted upon him by the accused. (People v. Cardenas, supra) And since we are dealing with a criminal conviction, the proof that the accused caused the victim's death must convince a rational mind beyond reasonable doubt. The medical findings, however, lead us to a distinct possibility that the infection of the wound by tetanus was an efficient intervening cause later or between the time Javier was wounded to the time of his death. The infection was, therefore, distinct and foreign to the crime. (People v. Rellin, 77 Phil. 1038).
Doubts are present. There is a likelihood that the wound was but the remote cause and its subsequent infection, for failure to take necessary precautions, with tetanus may have been the proximate cause of Javier's death with which the petitioner had nothing to do. As we ruled in Manila Electric Co. v. Remoquillo, et al. (99 Phil. 118).
"A prior and remote cause cannot be made the basis of an action if such remote cause did nothing more than furnish the condition or give rise to the occasion by which the injury was made possible, if there intervened between such prior or remote cause and the injury a distinct, successive, unrelated, and efficient cause of the injury, even though such injury would not have happened but for such condition or occasion. If no danger existed in the condition except because of the independent cause, such condition was not the proximate cause. And if an independent negligent act or defective condition sets into operation the instances, which result in injury because of the prior defective condition, such subsequent act or condition is the proximate cause." (45 C.J. pp. 931-932). (at p. 125)[24]
We face the very same doubts in the instant case that compel us to set aside the conviction of Villacorta for murder. There had been an interval of 22 days between the date of the stabbing and the date when Cruz was rushed to San Lazaro Hospital, exhibiting symptoms of severe tetanus infection. If Cruz acquired severe tetanus infection from the stabbing, then the symptoms would have appeared a lot sooner than 22 days later. As the Court noted in Urbano, severe tetanus infection has a short incubation period, less than 14 days; and those that exhibit symptoms with two to three days from the injury, have one hundred percent (100%) mortality. Ultimately, we can only deduce that Cruz’s stab wound was merely the remote cause, and its subsequent infection with tetanus might have been the proximate cause of Cruz's death. The infection of Cruz’s stab wound by tetanus was an efficient intervening cause later or between the time Cruz was stabbed to the time of his death.
However, Villacorta is not totally without criminal liability. Villacorta is guilty of slight physical injuries under Article 266(1) of the Revised Penal Code for the stab wound he inflicted upon Cruz. Although the charge in the instant case is for murder, a finding of guilt for the lesser offense of slight physical injuries may be made considering that the latter offense is necessarily included in the former since the essential ingredients of slight physical injuries constitute and form part of those constituting the offense of murder.[25]
We cannot hold Villacorta criminally liable for attempted or frustrated murder because the prosecution was not able to establish Villacorta’s intent to kill. In fact, the Court of Appeals expressly observed the lack of evidence to prove such an intent beyond reasonable doubt, to wit:
Appellant stabbed the victim only once using a sharpened bamboo stick, hitting him on the left side of the body and then immediately fled. The instrument used is not as lethal as those made of metallic material. The part of the body hit is not delicate in the sense that instant death can ensue by reason of a single stab wound. The assault was done only once. Thus, there is doubt as to whether appellant had an intent to kill the victim, which should be resolved in favor of the appellant. x x x.[26]
The intent must be proved in a clear and evident manner to exclude every possible doubt as to the homicidal (or murderous) intent of the aggressor. The onus probandi lies not on accused-appellant but on the prosecution. The inference that the intent to kill existed should not be drawn in the absence of circumstances sufficient to prove this fact beyond reasonable doubt. When such intent is lacking but wounds were inflicted, the crime is not frustrated murder but physical injuries only.[27]
Evidence on record shows that Cruz was brought to Tondo Medical Center for medical treatment immediately after the stabbing incident. Right after receiving medical treatment, Cruz was then released by the Tondo Medical Center as an out-patient. There was no other evidence to establish that Cruz was incapacitated for labor and/or required medical attendance for more than nine days. Without such evidence, the offense is only slight physical injuries.[28]
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