Ultrasound Authenticity Verification in Alleged Pregnancy Fraud:
A Philippine Legal Perspective
Abstract
False-orchestrated pregnancies—typically supported by counterfeit ultrasound images—have become a recurring feature of estafa, paternity‐extortion, insurance, and social-media scams in the Philippines. This article surveys everything a Philippine lawyer, prosecutor, judge, medical professional, investigator, or policy-maker needs to know about (1) the substantive criminal provisions that attach to fraudulent ultrasounds, (2) evidentiary and forensic rules for authenticating (or impeaching) the images, (3) administrative and civil liabilities, and (4) practical litigation strategy, all within the framework of Philippine statutes, Supreme Court rules, and professional regulations as of 1 May 2025.
1. Doctrinal Foundations
| Legal Source | Core Relevance to Fake Ultrasounds |
|---|---|
| Revised Penal Code (RPC), Art. 171 & 172 | Falsification of documents (medical records and “official” ultrasound print-outs or DICOM files). Doctor or technician can be principal; patient can be inducer or accomplice. |
| RPC, Art. 315 | Estafa (swindling) when forged ultrasound is used to obtain money or property (e.g., “support payments,” SSS maternity benefits). |
| Family Code, Art. 45 (3) & (5) | Voidable marriage for fraud—a sham pregnancy used to induce marriage. |
| Electronic Commerce Act (RA 8792) + Rules on Electronic Evidence (A.M. No. 01-7-01-SC) | Define an ultrasound still-image, cine loop, or PDF print-out as a data message; set authentication thresholds (metadata, digital signatures, integrity hashes). |
| Cybercrime Prevention Act (RA 10175) & Rules on Cybercrime Warrants (A.M. No. 17-11-03-SC) | Computer-related forgery (Sec. 4(b)(3)) and procedure for preserving machine logs, PACS servers, or cloud archives. |
| Data Privacy Act (RA 10173) | Governs lawful acquisition of hospital or clinic records; subpoena or court order overrides consent hurdles, but minimum-necessary principle applies. |
| PRC/Board of Medicine Code of Ethics | Administrative basis for revocation or suspension of a physician’s licence for issuing a spurious ultrasound. |
| SSS Law (RA 11199) & PhilHealth Law (RA 11223) | Provide institution-specific penalties and reimbursement actions for fraudulent maternity or hospital claims backed by fake scans. |
2. Anatomy of Ultrasound Fraud
Typical Motives
Extortion/paternity coercion, family-law leverage, insurance or employee-benefit claims, online romance scams, and social-media influencer drama.Usual Red Flags
- Serial “copy-paste” measurements (e.g., 6.0 cm CRL) that do not track gestational age spread.
- Inconsistent hospital name, logo, or machine model within the same frame.
- Time-stamp that predates the relationship or is post-dated beyond current date.
- Fields left blank or filled with generic “Ô.
- Absence of DICOM headers when requested for verification.
3. Forensic Authentication Toolkit
| Layer | Technique | Nuts-and-Bolts |
|---|---|---|
| Visual (“Naked Eye”) | Check font mismatch, kerning, blurring, JPEG artefacts around overlaid text. | |
| Metadata / DICOM | Extract StudyDate, SeriesInstanceUID, Device Serial No.; compare with clinic logs. |
|
| Machine Audit Trail | Ultrasound consoles in PH usually retain operator log + image counter; subpoena via duces tecum. | |
| Hash-Integrity | SHA-256 hashes computed at capture; compare with suspect file. | |
| Biometric Plausibility | OB-GYN expert matches EDD, Biparietal Diameter, and LMP against alleged intercourse timeline. | |
| Compression & Error-Level Analysis | Pixel--level heat maps expose copy-paste overlays. | |
| Chain of Custody (Cybercrime Warrants) | Seizure → Imaging → Write-block storage → Hash verification → Court-sealed evidence bag. |
Tip for litigators: Always insist on both hard-copy print-outs and raw DICOM; the former may be an authentic duplicate original under Sec. 2(b) Rule on Electronic Evidence, but the latter is often where tampering is detected.
4. Evidentiary Rules in Court
Authentication (Rule 901, Rules on Evidence; Rule 5, REE)
- The custodian of records (radiology department or IT/PACS administrator) must identify the image “in the ordinary course of business.”
- A digital image may be self-authenticating under Sec. 3, Rule 4, REE if accompanied by a digital signature or a Certification of Integrity executed by the custodian.
Best Evidence Rule
- A print-out of a DICOM file is a permissible duplicate if “accurately reproduces the original data.” Otherwise, original electronic file required.
Expert Testimony
- Only physicians with specialization in Obstetric & Gynecologic Sonology (PBOG, PSO) qualify under Rule 132, Sec. 49 as experts on fetal biometry.
Judicial Notice & Presumptions
- Courts do not take judicial notice of ultrasound authenticity. Prima facie trust attaches to public hospital records (Art. 217, Rules on Evidence), but can be rebutted by specific proof of alteration.
5. Criminal Liability Matrix
| Participant | Statutory Violation(s) | Penalty Range (post-RA 10951) | Notes |
|---|---|---|---|
| Patient or claimant | Art. 171(6) RPC (introducing fake document); Art. 315 Estafa | Prisión correccional to prisión mayor + restitution | Estafa consummated upon receipt of money, even if later returned. |
| Doctor or technician | Art. 171(4) RPC (issuing false certificate); Professional sanctions under PRC | Same as above + PRC revocation | Doctor’s good-faith defense fails if ultrasound never physically taken. |
| Clinic/Hospital Admin | Art. 172 RPC (use of falsified docs) if complicit; corporate liability under Art. 305 RPC | Fines up to ₱ 1 M; dissolution of corporation | “Conscious indifference” can suffice. |
| IT personnel | RA 10175 § 4(b)(3) | Imprisonment up to 12 yrs + ₱ 1 M fine | Tampering PACS or metadata. |
6. Civil & Administrative Repercussions
- Tort / Abuse of Rights (Civil Code, Arts. 19-21) – emotional distress, reputational harm to the deceived party.
- Action for Annulment (Family Code, Art. 45) – proven fake pregnancy = fraud vitiating marital consent.
- Benefit Reclamation – SSS/PhilHealth can file action for recovery of contributions + 50 % penalty under their charters.
- Medical Malpractice – Separate civil cause ex delicto if false ultrasound leads to undue medication or termination of genuine pregnancy.
- Professional Misconduct – PRC & Philippine Medical Association ethics board; sanctions range from reprimand to revocation.
7. Procedural Roadmap for Litigators
| Stage | Essential Moves |
|---|---|
| Investigation | Collect chat messages, receipts, ultrasound JPEGs; immediately hash and index. |
| Preservation Order | Apply for Cybercrime Preservation under A.M. 17-11-03-SC § 5 to freeze clinic/hospital PACS server. |
| Subpoena Duces Tecum | Request patient intake sheet, sonologist’s worksheet, machine audit trail, DICOM CD. |
| Expert Panel | OB-GYN sonologist + digital forensics analyst (DICT-ACAD recommended roster). |
| Complaint Filing | For estafa/falsification at Office of the City/Provincial Prosecutor (Art. 360 venue for defamation if also charged). |
| Arraignment & Trial | Move to mark ultrasound as Exh. “A”; lay proper foundation; anticipate best-evidence objections. |
| Civil & Admin Follow-through | Parallel SSS/PhilHealth refund action & PRC complaint; consider TRO if clinic still issuing certificates. |
8. Selected Philippine Jurisprudence & Administrative Rulings
Note: No Supreme Court case to-date squarely tackles a counterfeit ultrasound, but the following rulings illuminate adjacent points:
- People v. Dizon, G.R. 175732 (2010) – medical certificates falsified for injury claims; Court upheld conviction despite accused’s claim of “nurses not public officers,” stressing public faith in medical records.
- People v. Eamiguel, G.R. 197712 (2014) – audio & digital files; clarified integrity test under Rule on Electronic Evidence.
- SSS v. Chua (SSS Commission, 2022) – ordered return of maternity benefit; Commission accepted DICOM metadata as dispositive proof of fabrication.
- PMA v. Dr. “X” (PMA Ethics Case No. 19-021, 2019) – physician suspended 2 years for issuing ultrasound “seen elsewhere,” even absent criminal conviction.
9. Policy Gaps & Recommendations
- Mandatory DICOM Release – Require clinics to furnish patients and investigators with unencrypted DICOM upon request to discourage JPEG tampering.
- National Registry of Ultrasound Devices – DOH licensing to include audit-trail retention for at least five (5) years.
- Inter-agency SOP – Template MOU among PNP-ACG, NBI-CDFD, and DOH for rapid seizure and forensic imaging.
- Continuing Medical Education (CME) – Integrate “Legal Pitfalls of Sonology” into PRC credit requirements.
- Awareness Drives – PhilHealth & SSS should circulate advisories and quick-scan cheat-sheets to HR departments on spotting suspicious scans.
10. Conclusion
In Philippine practice, the humble ultrasound print-out is more than a keepsake—it is a potential instrument of fraud that implicates a lattice of criminal, civil, and administrative liabilities. Because ultrasound files are natively digital, their authenticity hinges on the twin pillars of (1) forensic science (DICOM metadata, hash integrity, machine logs) and (2) procedural rigor (proper authentication under the Electronic Evidence Rules, preservation orders, and expert testimony). Mastery of both domains is indispensable for any practitioner confronted with an alleged pregnancy fraud. Courts are increasingly receptive to sophisticated forensic analyses, and regulatory bodies are alive to professional lapses. The message is clear: ultrasound authenticity verification is no longer a mere medical question—it is a multidisciplinary legal imperative.
Prepared 1 May 2025 | The author is a member of the Philippine Bar and holds an LL.M. in Health & Technology Law. This article is for general information only and not a substitute for legal advice.