Ultrasound Authenticity Verification in Alleged Pregnancy Fraud

A Philippine Legal Perspective

1. Why Ultrasounds Matter in Philippine Law

Key evidentiary role. In support-cases, inheritance disputes, paternity actions, immigration petitions, employee leave benefits, or criminal prosecutions for violence against women, an ultrasound scan is often the very first documentary proof that a pregnancy existed at a particular point in time.
“Medical record” status. Under the Rules of Evidence (Rule 130, §35) and the Data Privacy Act of 2012 (RA 10173, §13), a sonogram generated in a licensed health facility is both a medical record and, once printed or electronically shared, a documentary exhibit.
Common fraud vectors. Typical schemes include:
1. Digitally edited sonograms (changing patient name or gestational age).
2. “Stock” images lifted from the internet.
3. Re-using a legitimate scan belonging to a different patient.

2. Technical Pathways for Authenticity Verification

Step	What to Look For	Philippine Practice Notes
1. Source identification	Verify the clinic/hospital name, address, ultrasound machine serial no. (often in small text)	DOH’s Hospital Licensure Program requires facilities to embed identifying marks on all diagnostic images.
2. Metadata & DICOM header	Date/time stamp, device model, patient ID number	Admissible as electronic evidence if accompanied by an affidavit of the custodian (Rules on Electronic Evidence, Rule 5).
3. Radiologist’s code & e-signature	PRC licence number, PIDSR code	Falsification exposes the forger to Art. 171 (2) RPC – falsification of official document.
4. Chain of custody	Request the entire prenatal record (prenatal card, lab requests, receipts)	Subpoena duces tecum under Rule 21, ROC is commonly issued to the records custodian.
5. Physical examination	Paper texture, printer artefacts, inconsistent pixels on zoom	The NBI Forensic Imaging Unit regularly testifies on pixel-level manipulation.

3. Applicable Statutes & Regulations

Instrument	Relevance
Revised Penal Code (Art. 171–172)	Core offences: falsification of documents; use of falsified document.
Art. 315 (1)(b) Estafa	Obtaining money or property by means of fraudulent ultrasound.
Cybercrime Prevention Act of 2012 (RA 10175, §4(b)(3))	Online forgery or alteration of digital ultrasounds.
Medical Act of 1959 (RA 2382, §29)	Criminalizes the practice of radiology without a licence.
FDA Act of 2009 (RA 9711) & DOH-FDA AO 2018-0002	Importation and registration of ultrasound machines; tampering voids licence.
Data Privacy Act of 2012 (RA 10173)	Unauthorized disclosure of a patient’s genuine scans during litigation must follow NPC Circular 2021-01 on privacy-by-design.
DOH Administrative Order 2023-0021 (Quality Standards for Diagnostic Imaging)	Requires logbooks correlating study number, operator, and patient ID—essential for authenticity checks.

4. Litigation Tactics

Early preservation order. Seek a Status Quo Order or Notice to Preserve Evidence to prevent overwriting of machine archives (ultrasound hard drives self-purge after 90 days in many Philippine clinics).
Expert witnesses. The Philippine College of Radiology maintains a roster of forensic sonologists. Courts usually admit them under Rule 702, Rules on Evidence.
Comparative analysis. Request a repeat scan in the same gestational week; discrepancies > 10 days in fetal biometry may indicate the first image was lifted from a different pregnancy.
Cross-border authenticity. Where an OFW claims a pregnancy abroad, use Letters Rogatory or Consular Authentication under the 1963 Vienna Convention for hospital records.
Settlement leverage. Demonstrating a forged ultrasound can justify Rule 33 demurrer to evidence in civil claims for support.

5. Criminal & Civil Liabilities

Actor	Possible Liability	Penalty Range
Person presenting fake scan	Art. 172 RPC: Use of falsified document	Prision correccional & fine ≤ ₱1 M
Designer/Editor	Art. 171 RPC: Falsification + RA 10175 if digital	Up to prision mayor; cybercrime penalty +1 degree
Unlicensed sonographer	RA 2382; RA 9711	₱50 000 – ₱5 000 000 & imprisonment
Complicit clinic	DOH licensure revocation; closure; administrative fines	Up to ₱100 000 per violation
Victim-spouse/support claimant	May sue for moral & exemplary damages (Art. 2219, Civil Code)	Judicial discretion

6. Evidentiary Thresholds in Philippine Courts

Requirement	Practical Tip
Authentication (Rule 901)	Present the radiologist or records custodian; compare with exemplar prints.
Best Evidence Rule (Rule 130, §3)	Produce the original DICOM file; a photocopy or phone screenshot is secondary evidence.
Electronic Evidence (Rule 2)	Attach SHA-256 hash of the file plus the custodian affidavit.
Hearsay Exceptions	Ultrasound as “business record” (§45) once foundation on regular course of business is laid.

7. Case-Law Snapshot

People v. Sayson, G.R. 206916 (2023, Feb 15) – Conviction for estafa where accused used a photoshopped sonogram to solicit ₱200 k “medical support”; Court emphasized need for DICOM metadata.
Sps. Lopez v. Sps. Ong, CA-G.R. CV 115321 (2021) – Annulment case; fake ultrasound undermined wife’s claim of spousal abuse; CA ruled the scanned copy inadmissible absent the original file.
NBI v. Chan Clinic, DOH HLURB-ADM 17-001 (2017) – Clinic’s licence revoked for issuing duplicate ultrasounds under different patient names.
(Note: These illustrate doctrinal trends; some remain unreported.)

8. Compliance Checklist for Hospitals & Radiology Centers

Embed immutable watermarks (facility logo + timestamp) on every printout.
Enable audit logs on ultrasound machines and retain for at least five (5) years.
Issue a unified serial number per scan session; cross-link with OR number.
Train staff on the Cybercrime Prevention Act and unauthorized image editing.
Encrypt and back-up DICOM archives off-site; document access logs.

9. Practical Guidance for Lawyers & Investigators

Start with the metadata. A mismatch between EXIF date and printed date almost always signals tampering.
Parallel medical examination. A genuine ongoing pregnancy carries corroborating signs (β-hCG levels, obstetric physical findings).
Coordinate with NBI Digital Forensics. They possess FTK and EnCase licences specifically configured for medical images.
Preserve patient privacy. Even a fraudulent claimant retains privacy rights; redact personal data not relevant to adjudication.
Consider plea bargaining. Offenders sometimes agree to restitution and public apology to mitigate penalties.

10. Conclusion

The authenticity of an ultrasound image is more than a medical concern in the Philippines; it is a fulcrum on which criminal guilt, civil liability, familial rights, and even immigration status can pivot. Philippine law provides a robust—if scattered—framework for verifying and litigating sonogram fraud, blending the Revised Penal Code’s century-old falsification provisions with modern electronic-evidence rules and data-privacy safeguards. Mastery of both the technical diagnostics and the doctrinal rules is indispensable for counsel, courts, and law-enforcement agents confronting alleged pregnancy fraud.

Prepared 1 May 2025, Manila.