Infant Misidentification as actionable medical negligence under Philippine civil law

By: Nicole Billanes and Glynis Amor Caduhada

Introduction

Childbirth is universally expected to be a milestone of profound joy and absolute safety, yet systemic failures within healthcare facilities may lead to the error of neonatal misidentification. Although statistically rare, its catastrophic anomaly was brought to the forefront of Philippine public consciousness in a widely publicized 2021 episode of the news magazine program, Kapuso Mo, Jessica Soho (KMJS). The investigative report detailed a high-profile “switched at birth” case, in which DNA testing eventually confirmed that two mothers had been sent home with each other’s biological infants due to negligent identification tagging.

The public frenzy and deep maternal anguish sparked by this incident exposed a critical legal vulnerability: while the legal framework for torts and damages is firmly established under the Civil Code, the specific classification of a baby switch or infant mislabeling as a distinct form of medical malpractice remains a complex legal gray area in the Philippines.

Hospitals frequently raise the defense that identity management is a purely clerical or administrative task detached from clinical care, since this error often occurs during custodial handling rather than active surgical or diagnostic treatment. This research addresses this critical intersection of hospital administration and medical law by evaluating whether the failure to secure a newborn’s identity within a restricted medical facility constitutes an actionable breach of professional medical standards.

This study analyzes the traditional four pillars of medical negligence: duty, breach, injury, and proximate causation, by tying the harm directly to the physical risks and unauthorized medical interventions a misidentified infant undergoes. Furthermore, this study examines whether the evidentiary doctrine of res ipsa loquitur can be dynamically applied to establish standard negligence, given that a newborn is utterly helpless and the nursery or Neonatal Intensive Care Unit (NICU) is under the exclusive control of hospital staff.

The significance of this research lies in its potential to clarify institutional accountability and strengthen patient-safety standards across Philippine healthcare systems through an independent civil action for quasi-delict, bypassing the stringent intent requirements of criminal prosecution. By shifting the legal focus from individual nursing errors to systemic hospital liability, this study examines landmark Philippine Supreme Court jurisprudence, specifically the corporate duties to enforce adequate policies and maintain safe facilities established under the Doctrine of Corporate Negligence.

The scope of this research is bounded by Philippine civil law, focusing exclusively on the civil and corporate liabilities of hospitals regarding identity errors occurring within specialized, secure medical units. Ultimately, this study seeks to establish that neonatal misidentification is a severe breach of institutional medical standards that warrants strict accountability under the umbrella of medical malpractice law.

Objectives

This research aims to address the existing gap in legal jurisprudence concerning institutional accountability for neonatal misidentification or “switched at birth” incidents within Philippine healthcare facilities. With the high stakes surrounding newborn handling and specialized custody, errors in patient-identity tagging lead to devastating consequences, yet hospitals frequently evade medical malpractice claims by shielding themselves behind the defense that identity management is a purely administrative or clerical task. Consequently, many affected families remain unaware of the precise legal recourse they can seek, while healthcare providers operate without standardized, legally binding accountability protocols.

The principal objective of this study is to identify and analyze the civil liabilities of hospitals under Philippine law, with a particular focus on establishing that neonatal misidentification constitutes an actionable breach of professional medical standards under the Doctrine of Corporate Negligence and vicarious liability under Article 2180 of the Civil Code. By evaluating the traditional four pillars of medical negligence alongside the evidentiary framework of res ipsa loquitur, this research anchors the legal injury to the tangible physical risks and unauthorized medical interventions, such as incorrect medications, vaccinations, or mixed breast milk, that a misidentified infant undergoes.

In addition, this study seeks to provide a practical, independent civil framework for quasi-delict that deliberately bypasses the stringent intent requirements of criminal prosecution. By synthesizing a descriptive qualitative-quantitative analysis of the awareness and practices of frontline healthcare personnel, this research aims to propose concrete regulatory and policy reforms. Ultimately, this study intends to empower affected families to seek the justice they deserve while advocating for the Department of Health (DOH) to mandate standardized, biometric, or electronic tracking protocols across all Philippine medical institutions.

Methodology

Research Design

This study used a descriptive mixed-methods (qualitative-quantitative) research design to examine hospital liability in cases of neonatal misidentification or “switched at birth” incidents in the Philippines, particularly within the framework of medical malpractice and corporate hospital negligence. The quantitative component of the design was employed to statistically measure the awareness, clinical practices, and systemic perceptions of healthcare personnel assigned to high-risk units directly involved in newborn handling. Concurently, the qualitative design was integrated through the use of open-ended inquiry and thematic analysis to capture the nuanced understanding, lived experiences, and legal perceptions of the respondents, allowing the researchers to identify recurring institutional themes and patterns that close-ended metrics alone could not fully articulate.

Research Locale and Participants

The researchers secured administrative permission from selected medical institutions in Negros Occidental through formal letters addressed to their respective Medical Directors. Out of the hospitals contacted, five (5) institutions responded favorably and consented to participate in the study, consisting of four (4) private hospitals and one (1) public or government hospital.

The target participants were purposively selected healthcare workers assigned to the Neonatal Intensive Care Unit (NICU), Delivery Room (DR), Operating Room (OR), and Obstetrics Ward (OBW), specialized clinical environments where delivery, newborn handling, identification, and transfer procedures commonly occur. A total of twenty-four (24) participants voluntarily answered the research instrument. The respondent cohort included registered nurses and licensed midwives possessing varying lengths of clinical experience in maternity and neonatal care, ranging from two weeks to sixteen years.

Ethical Considerations

Prior to data collection, strict ethical protocols were observed. The participants’ informed consent was explicitly obtained through the signing of separate, comprehensive informed consent forms. To protect the professional and personal standings of the respondents, strict confidentiality and anonymity of all responses were guaranteed and maintained by the investigators throughout the entire course of the study.

Data Gathering Instrument and Procedure

The primary research instrument used was a structured, self-administered questionnaire carefully designed with a combination of close-ended quantitative items and open-ended qualitative prompts to evaluate seven critical areas:

1. The participants’ baseline understanding of neonatal misidentification;
2. Their familiarity with existing hospital policies and regulatory clinical guidelines;
3. Current institutional newborn identification procedures and active safeguards;
4. Personal experiences or professional encounters involving neonatal misidentification;
5. The nature of institutional training and the overall preparedness of the staff;
6. Perceived systemic and human causes of neonatal misidentification; and
7. Perceptions regarding civil, criminal, and corporate legal liability in such incidents.

The questionnaires were distributed personally by the researchers or facilitated through designated hospital coordinators, depending on the immediate availability and shift schedules of the respondents.

Data Analysis

Data gathered from the close-ended components were organized and summarized using descriptive statistics, while text-based data from the open-ended questions were evaluated using descriptive qualitative interpretation. This dual analysis served to systematically isolate recurring professional themes, institutional patterns, and common practices among frontline healthcare personnel, which were subsequently triangulated with prevailing Philippine medical malpractice jurisprudence.

Discussion

Frontline Baseline Awareness vs. Institutional System Defects

The empirical findings reveal that while the majority of surveyed healthcare workers possess a clear baseline understanding of neonatal misidentification, a critical operational disconnect exists. Most respondents admitted to being only “somewhat familiar” with existing safety policies and were entirely unable to cite specific national clinical guidelines or institutional regulations.

From a medical-malpractice standpoint, this gap between theoretical awareness and regulatory knowledge signals a profound institutional system defect. Under Article 2180 of the Civil Code, an employer hospital is held vicariously liable for the negligent omissions of its staff acting within the scope of their duties. By failing to properly disseminate clear operational rules, the hospital exposes itself to direct liability. As established in the landmark case of Professional Services, Inc. (PSI) v. Agana, hospitals owe a direct, non-delegable corporate duty to their patients to enforce adequate safety policies and maintain active, rigorous supervision over their medical staff.

Present Safeguards and Regulatory Expectations

The study notes that all participating institutions implement basic identity safeguards, such as immediate post-delivery identification bands and mandatory rooming-in practices, with one private facility utilizing advanced QR-coded wrist and foot bands. These frontline practices align broadly with the patient-safety mandates outlined in Republic Act 11223 (Universal Health Care Act) and Department of Health (DOH) Administrative Order No. 2012-0012.

However, these statutory frameworks dictate that standardized verification workflows are not merely optimal clinical goals, rather they are baseline regulatory expectations. Under RA 4226 (Hospital Licensure Act), strict compliance with DOH patient-safety directives is mandatory for maintaining a clinical license. Consequently, if these verification safeguards exist only on paper or are executed unevenly across shifts, any failure directly constitutes prima facie evidence of an institutional breach under the Agana framework.

Procedural Deficits, Informal Training, and Res Ipsa Loquitur

A striking vulnerability identified in the data is that, despite the absence of reported switching incidents, frontline staff universally lack clear knowledge of proper emergency procedures should a misidentification occur. Most respondents stated that their immediate response would simply be to deflect the matter up to a nurse supervisor. This procedural blindness is compounded by the finding that newborn identity training is overwhelmingly informal, relying heavily on peer mentorship rather than structured institutional programs, with some personnel receiving no formal training at all.

In Nogales v. Capitol Medical Center, the Supreme Court emphasized that hospitals operating high-risk perinatal settings must affirmatively ensure the specialized competency and structured training of their staff. To evaluate this breach under the standard medical malpractice framework defined in Lucas v. Tuano, the four elements of tort liability must be adapted mutatis mutandis to the hospital corporation: (1) the Hospital’s Corporate Duty; (2) Breach via Deficient System; (3) Proximate Causation; (4) Concrete Damages.

Furthermore, the lack of recorded switching incidents does not absolve the facility. Because a restricted nursery or NICU remains under the exclusive control of the hospital management, and because a newborn infant is entirely helpless, any actual instance of misidentification invokes the evidentiary doctrine of res ipsa loquitur. As affirmed in Our Lady of Lourdes Hospital v. Capanzana, when an injury occurs that ordinarily does not happen in the absence of negligence, the doctrine permits an inference of institutional guilt without requiring direct proof of the specific erratic frontline act.

Staffing Inadequacy and Misplaced Liability Focus

The study’s most legally significant finding is the unanimous belief among healthcare personnel that staffing inadequacy is the primary driver of neonatal misidentification risks, closely followed by formal training deficits. Chronic understaffing represents a classic institutional failure. Under the Agana doctrine, when corporate management creates an environment of fatigue, work overload, and chaotic handoffs due to poor staffing ratios, the hospital is directly liable for the resulting systemic breakdowns.

This directly clashes with the legal perceptions of the respondents, 100% of whom mistakenly believed that civil and criminal liability would rest solely on the individual nurse or midwife who initially received and tagged the newborn. While frontline personnel do bear personal accountability under Article 2176 (Quasi-delict) and Article 365 of the Revised Penal Code (Criminal Negligence) if physical or severe psychological harm arises, Philippine civil jurisprudence places corporate accountability at the center of the liability axis.

Transition to a Unified National Standard

The data concludes with a unanimous recommendation from the participants for the creation of national, standardized neonatal identification protocols. This clinical demand aligns directly with the contemporary trajectory of Philippine medical law. To mitigate exposure, hospitals must transition away from subjective, manual verification systems and implement a unified, DOH-endorsed neonatal identification bundle. Incorporating machine-readable QR features, rigid two-person biometric matching protocols, and formal chain-of-custody documentation satisfies the modern legal standard of due diligence, directly shifting hospital culture from defensive anxiety to structured, systemic safety.

Conclusion

This study establishes that neonatal misidentification is not merely an isolated clerical oversight, but a systemic institutional failure that amounts to actionable medical malpractice. While frontline healthcare personnel demonstrate a clear baseline awareness of the gravity of infant switching, a profound institutional system defect remains widespread. This operational vulnerability is characterized by a critical gap between policy and staff awareness, a reliance on informal peer mentorship over structured training programs, an absence of clear procedural preparedness if a switch is discovered, and a severe understaffing crisis that personnel universally identify as the primary risk factor for misidentification.  

From a legal standpoint, these findings firmly position hospital administration at the center of the liability axis in “switched at birth” cases, correcting the mistaken belief among frontline staff that personal liability rests solely with the initial receiving nurse. Under Philippine civil law, an incident of infant mislabeling triggers a dual layer of institutional exposure:  

• Vicarious Liability: Under Article 2180 of the Civil Code, hospitals face direct exposure for the negligent acts and omissions of their medical and nursery staff acting within the scope of their duties.  
• Corporate Negligence: Under the landmark doctrine established in Professional Services, Inc. v. Agana and reinforced by Our Lady of Lourdes Hospital v. Capanzana and Nogales v. Capitol Medical Center, hospitals owe patients a direct, non-delegable duty to ensure safety. Operating maternity units with chronic understaffing, unstructured training, and unformulated response protocols constitutes a direct corporate breach of these jurisprudential and regulatory expectations.  

Ultimately, by applying the traditional medical malpractice elements summarized in Lucas v. Tuano, a case of negligent neonatal misidentification successfully satisfies the requirements for a civil action for quasi-delict under Article 2176, and potentially criminal negligence under Article 365 of the Revised Penal Code if physical or psychological harm results. Because a newborn infant is entirely helpless and specialized areas like the nursery or NICU are under the exclusive control of the medical facility, the evidentiary doctrine of res ipsa loquitur serves as a powerful tool to infer negligence without requiring direct proof of the specific erratic frontline act.  

To bridge the gap between paper policies and actual clinical execution, healthcare institutions must align their operations with the regulatory expectations of the Universal Health Care Act (RA 11223), the Hospital Licensure Act (RA 4226), and DOH Administrative Order 2012-0012. Transitioning to a unified, nationally standardized neonatal identification bundle, utilizing modern safeguards like QR codes, dual-band ID systems, and electronic verification is a critical legal imperative to protect medical institutions from catastrophic liability and safeguard the sacred, irreplaceable bonds of family filiation.  

Recommendations

Based on the findings of the study, the researchers respectfully recommend the following:

1. Hospitals should establish and implement clear, written, and standardized protocols on newborn identification and neonatal misidentification response procedures. Such protocols should be properly disseminated to all healthcare personnel involved in maternity and neonatal care.
2. The Department of Health and relevant regulatory agencies should develop a uniform national newborn identification policy applicable to both private and public hospitals to ensure consistency in patient safety practices throughout the country.
3. Hospitals should strengthen newborn identification systems by utilizing modern technologies such as QR-coded identification bands, barcode systems, biometric identification, or electronic tracking devices to minimize human error.
4. Mandatory and regular training programs should be conducted for nurses, midwives, and healthcare personnel assigned in delivery rooms, operating rooms, obstetrics wards, and neonatal intensive care units. Training should include newborn identification procedures, risk management, incident reporting, and legal responsibilities related to neonatal care.
5. Healthcare institutions should ensure adequate staffing and proper supervision in maternity and neonatal units to reduce fatigue, work overload, and negligence that may contribute to neonatal misidentification.
6. Hospitals should formulate clear incident response protocols in cases of suspected neonatal misidentification, including immediate reporting procedures, documentation, verification measures, parental notification, and legal coordination.
7. Future studies may be conducted using a larger sample size and involving hospitals from different provinces or regions in the Philippines to obtain broader data regarding neonatal identification practices and hospital liability.
8. Legal and policy reforms may be considered to specifically recognize neonatal misidentification as a form of medical negligence and institutional liability under Philippine healthcare and civil laws.

Bibliography

Bhat, P. I. (2019). Idea and methods of legal research (ch. 5, pp. 117–126). Oxford University Press. https://global.oup.com/academic/product/idea-and-methods-of-legal-research-9780199493098 

Civil Code of the Philippines, Republic Act No. 386 (1950).

Department of Health (DOH). (2012). Revised rules and regulations governing the licensing and regulation of hospitals and other health facilities in the philippines (Administrative Order No. 2012-0012).

GMA News Online. (2025, January 23). The tragic baby-switching case in davao, was it finally resolved? https://www.gmanetwork.com/entertainment/showbiznews/the-tragic-baby-switching-case-in-davao-was-it-finally-resolved/119418/

GMA News Online. (2021, February 8). DOH to investigate baby-switching at hospital in Rizal  DOH to investigate baby-switching at hospital in Rizal | GMA News Online

Informed Consent on Switched at Birth: Hospital Liability on Neonatal Misidentification as Medical Malpractice in the Philippines (2026). Annex A to this paper.

Lucas v. Tuaño, G.R. No. 178763, 604 Phil. 611 (Phil. Sup. Ct. 2009).

Nogales v. Capitol Medical Center, G.R. No. 142625, 540 Phil. 225 (Phil. Sup. Ct. 2006).

Our Lady of Lourdes Hospital v. Capanzana, G.R. No. 189218, 809 Phil. 228 (Phil. Sup. Ct. 2017).

Professional Services, Inc. v. Agana, G.R. No. 126297, 513 Phil. 478 (Phil. Sup. Ct. 2007).

Republic Act No. 4226, Hospital Licensure Act (1965).

Republic Act No. 11223, Universal Health Care Act (2019).

Revised Penal Code of the Philippines, Act No. 3815 (1930).

Survey Questionnaire on Switched at Birth: Hospital Liability on Neonatal Misidentification as Medical Malpractice in the Philippines (2026). Annex B to this paper.

Varkey, B. (2019). A primer to understanding the elements of medical malpractice. Journal of Medical Principles and Practice, 27(4), 1–5. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC6531014/ 

ANNEX A

Informed Consent Form for Participation in a Survey

Title of Study:

“Switched at Birth: Hospital Liability on Neonatal Misidentification as Medical Malpractice in the Philippines”

Investigators:

Nicole A. Billanes

MLS-JD1B

USLS College of Law

Glynis Amor C. Caduhada, MD

MLS-JD1B

USLS College of Law

You are invited to participate in a research interview because you are a physician/nurse with professional experience relevant to neonatal identification, perinatal care, hospital policies, or medico-legal issues in the Philippines. Please read this form carefully and ask any questions before deciding whether to participate.

The study aims to examine hospital liability, standards of care, institutional policies, and medico-legal implications surrounding neonatal misidentification in the Philippines, and to identify legal and policy recommendations to reduce risk and improve accountability.

Procedures

– If you agree to participate, you will answer the survey/questionnaire prepared by the investigators.

– The questionnaire will cover topics such as clinical procedures for newborn identification, hospital protocols, record-keeping, incident reporting, professional responsibilities, and perceptions of legal liability.

– You may be asked to share de-identified examples from practice. Please do not disclose any patient-identifying information.

Voluntary Participation and Right to Withdraw

– Participation is entirely voluntary. You may decline to answer any question at any time without penalty or impact on your employment or professional standing.

– If you choose to withdraw, you may request that your data be destroyed; otherwise, data already included in analysis may be retained in anonymized form.

Risks and Discomforts

– There are minimal risks associated with participation. Possible risks include discomfort discussing sensitive events or medico-legal concerns.

– To minimize risk, the interview will avoid eliciting identifiers about patients. If you become uncomfortable, you may skip questions.

Benefits

– There may be no direct benefit to you. Indirect benefits include contributing to improved understanding of hospital systems and legal frameworks, which may inform policy or practice improvements.

Confidentiality and Data Handling

– Your responses will be treated as confidential. Identifying information (name, hospital, specific case details that could identify patients) will be removed or anonymized in transcripts, reports, and publications.

– Quotations used in publications will be anonymized. If specific attribution is requested or legally required, we will seek your consent before identifying you.

Use of Data and Publication

– Results may be presented at conferences and published in academic journals, policy briefs, or legal analyses. No identifiable participant information will be published without explicit consent.

– De-identified data may be used for future research on related topics.

Legal and Professional Concerns

– Participation will not affect your professional standing or employment. Responses will not be shared with employers, licensing boards, or legal authorities by the research team except where disclosure is legally mandated.

– If you have concerns about legal exposure, you are advised to consult your own legal counsel before participating.

Contact for Questions or Concerns

– For questions about the study or your rights as a participant, contact: Miss Nicole Billanes (billanesnic@gmail.com) or Dr Glynis Amor Caduhada (docglynis@yahoo.com)

Consent

I have read (or had read to me) the information above, and I have had the opportunity to ask questions. I understand the purpose, procedures, risks, and benefits of the study. I understand that participation is voluntary and that I may withdraw at any time. By signing below, I consent to participate in this interview under the terms described.

Participant:

Printed name: ___________________________

Position/Role (e.g., Nurse, Doctor): ____________________

Institution/Hospital: _______________________

Signature: _______________________________

Date: __________

Researcher obtaining consent:

Printed name: ___________________________

Signature: _______________________________

Date: __________

Thank you for considering participation. If you would like a copy of this form, please request one from the researcher.

ANNEX B

Interview Questionnaire

Research topic: “Switched at Birth: Hospital Liability for Neonatal Misidentification as Medical Malpractice in the Philippines”

Date:

Section A

1. Name (optional):

2. Current role/position:

3. Department/ward:

4. Years of experience in maternity/newborn care:

5. Type/level of hospital (public/private; tertiary/secondary/rural):

Section B

• In your own words, how would you define “neonatal misidentification” or “switched at birth”?

7. Are you aware of any laws, hospital policies, or clinical guidelines in the Philippines that address newborn identification? Please name or describe them.

8. How familiar are you with the legal concepts of medical malpractice, hospital vicarious liability, and professional negligence as they apply to newborn care? (Prompt: very familiar / somewhat / not familiar) — then: Please elaborate.

_____ Very Familiar

_____ Somewhat Familiar

_____ Not Familiar

Please elaborate:

Section C — Current identification practices and procedures

• Describe the standard identification procedures used in your unit for newborns (e.g., ID bands, rooming-in, tagging, footprints, photographs, electronic tagging).

1. Who is responsible for each step of the newborn identification process (nurse, physician, admissions staff, mother/parent)?

1. How and when is parental identification verified (at delivery, at discharge, with ID, with signatures)?

1. Are there written checklists, protocols, or forms used to document newborn identity? If yes, how consistently are they used?

1. What safeguards are in place during high-risk moments (e.g., shift changes, transfers, multiple births, busy hours, emergencies)?

Section D — Incidents, reporting, and response

1. Have you encountered or been involved in any case of suspected or confirmed neonatal misidentification in this facility? If yes, please briefly describe what happened, how it was discovered, and the immediate actions taken (maintain confidentiality).

1. If an identification error is suspected, what is the usual reporting channel and who must be notified?

1. What investigations are conducted by the hospital (administrative, clinical review, DNA testing)? How long do these typically take?

1. How are families informed and managed when an identification error is found? What support (medical, psychological, legal) is provided?

1. Have any staff faced disciplinary, civil, or criminal proceedings in relation to identification errors at your facility? (If comfortable, describe outcomes or typical consequences.)

Section E — Evidence, documentation, and forensic issues

1. What types of documentation or evidence are kept that could prove identity (birth records, nursing notes, CCTV, bracelets, photographs, DNA samples)? How accessible and reliable are these?

• In practice, what are the main obstacles to establishing what happened in an identification dispute (missing records, conflicting accounts, lack of DNA testing, destroyed evidence)?

Section F — Training, resources, and systemic factors

• What training (initial and ongoing) do staff receive about newborn identification and handling of infants?

• Do you think staffing levels, workload, or staff mix contribute to identification risks? Please explain.

• How adequate are the facility’s resources (ID bands, secure bassinets, CCTV, electronic systems) to prevent misidentification?

• Are there cultural or organizational factors (e.g., attitudes toward procedures, pressure to discharge quickly) that affect how strictly identification protocols are followed?

Section G — Legal liability, accountability, and perspectives

• In your view, who should be held responsible when a switched-at-birth incident occurs (individual staff, attending physician, hospital administration, system-level faults)? Why?

• Do you believe current Philippine legal and regulatory frameworks fairly address hospital liability and compensation in these cases? Please explain.

• What are your concerns about legal liability (e.g., fear of litigation, impact on practice, defensive medicine)?

• Would fear of legal consequences affect how you document care or interact with families? How?

Section H — Prevention and recommendations

• What specific measures (policies, technologies, workflows) would you recommend to reduce the risk of neonatal misidentification in your facility?

• Which identification technologies or practices do you consider most practical and effective in our local context (e.g., wristbands, barcodes, RFID, DNA baseline sampling, mandatory mother-infant rooming-in)?

• What policy or legislative changes, if any, would you support to improve prevention, accountability, and compensation in switched-at-birth cases?

• What role should hospitals, professional bodies, and government regulators play to prevent these incidents and protect families?

Section I — Closing

• Is there anything else you would like to add about neonatal identification, hospital responsibility, or how such cases should be handled legally and clinically?

• May we contact you for clarification or follow-up? (Yes/No) — preferred contact method:

Thank you for taking the time to complete the questionnaire.  Your participation is greatly appreciated and contributes valuable insights to this legal research. Your responses will be handled confidentially and used solely for the purposes of this study.

If you have any further questions or concerns, please do not hesitate to contact the investigators: Miss Nicole Billanes (billanesnic@gmail.com), and Dr. Glynis Amor Caduhada (docglynis@yahoo.com).

Thank you once again for your contribution.