การประมาททางการแพทย์

Based on Philippine medical malpractice law and standards of care for pediatric intestinal obstruction, here are the steps you should take immediately to protect your niece's interests and prepare for potential legal action.

Immediate Documentation Steps
Start gathering evidence now, while your niece is still in the hospital:

Request complete medical records immediately - you have a legal right to copies of all charts, physician orders, nursing notes, lab results, imaging studies, and daily progress notes from November 25 onwards

Document the timeline in writing - record dates, times, specific conversations with the pediatrician and surgeon, what treatment options were discussed (or not discussed), and who was present

Send a preservation letter to the hospital administration requesting they preserve all records, including electronic records, CCTV footage, and staff schedules related to your niece's care

Take photographs of your niece's condition if medically appropriate and with parents' permission

Legal Elements Required to Prove Medical Malpractice
Under Philippine law, you must establish four elements: (1) duty - a doctor-patient relationship existed; (2) breach - the doctor failed to meet the accepted standard of care; (3) injury - the patient suffered harm; and (4) proximate causation - the breach directly caused the injury. The critical element in your case will be proving that the pediatrician's delay in surgical consultation and ICU transfer fell below the accepted standard of care for pediatric intestinal obstruction.

Expert Medical Opinion
You will need expert testimony from another pediatric surgeon or gastroenterologist to establish that the standard of care requires earlier surgical evaluation and ICU consideration for partial intestinal obstruction in children. Medical literature generally indicates that intestinal obstruction requires early surgical consultation, IV fluids, nasogastric decompression, and close monitoring - with surgery indicated if conservative management fails or complications develop.

Three Parallel Tracks for Complaints
You can pursue multiple avenues simultaneously in the Philippines:

Administrative complaint with the Professional Regulation Commission (PRC) Board of Medicine against the pediatrician for failure to meet professional standards - this can result in license suspension or revocation

Administrative complaint with the Department of Health (DOH) against the hospital for failing to ensure proper protocols and patient safety standards were followed

Civil case for damages (medical expenses, moral damages, loss of earning capacity if applicable) based on negligence or breach of contract

Criminal complaint for reckless imprudence resulting in physical injuries or worse under Article 365 of the Revised Penal Code if the outcome warrants it

Next Steps
Consult with a medical malpractice attorney in the Philippines as soon as possible - preferably one with experience in pediatric cases. The attorney can help you obtain an independent medical expert review of the records to determine if the standard of care was breached, and guide you on which legal remedies to pursue. Time is critical both for your niece's medical care and for preserving evidence for any future legal action.