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Counsel That You Can Trust & Depend On


Guy DiMartino
Nov. 4, 2014

Michigan City Indiana Malpractice Lawyer Discusses Perforated Colon after Colonoscopy and whether the perforation is considered malpractice.

Colon perforation (breaks open/a hole) after colonoscopy can have a drastic impact on the patient. If the colon perforates feces can travel throughout the abdomen and cause a ravenous infection. Many times these patients develop sepsis, may need a part of their colon removed or may die.

The typical treatment for a colon perforation is a colostomy, where they close off a part of the intestine allowing it to heal, and divert all feces and waste material through the abdomen wall into a bag. The colostomy is usually temporary. Once the bowel (intestine) heals, the surgeon will reattach the bowel and remove the bag.

Perforation during or shortly after colonoscopy is a recognized risk and complication of the procedure, and many times, causing the perforation is not considered malpractice. In these cases, the medical malpractice happens when the healthcare providers fail to recognize the signs and symptoms of the perforation, and because they fail the recognize the problem, the problem is not timely treated.

A recent case decided by the Indiana Court of Appeals gives a real life story to a colon perforation.

The patient goes in for a colonoscopy. When the patient wakes up in the recovery room, she complains of severe abdominal pain. The nursing staff tells the patient that it is normal bowel gas and recommends that she walk around to move the gas. The patient can barely walk because of the pain. After 25 minutes in the recovery room, the patient is discharged from the hospital in severe pain. She returns to the hospital 12 hours later and is diagnosed with a perforated colon. The patient undergoes emergency surgery, removal of a piece of her bowel, and colostomy.

The patient sues for medical malpractice, and her expert's deposition is taken. The expert's deposition testimony is similar to the testimony that a patient with a colon perforation after colonoscopy. Specifically, the expert said:

that a prudent Doctor who had just performed a colonoscopy would have recognized symptoms associated with the perforation of the colon during the test and would have considered the possibility that the pain [patient] was having was associated with, and consistent with, a complication of the procedure namely a perforated colon….

In this way, I am of the opinion to a reasonable degree of medical certainty, that [the doctor] performed below the standard of care in connection with the colonoscopy given to [patient]….

Now, a jury will decide whether the doctor or hospital committed malpractice in this matter. One of the issues that pops its head up in colon perforation cases is causation. The legal standard of causation requires the patient to show that the negligence caused or substantially contributed to the injury. Generally, the treatment for a perforated colon is colostomy. So these cases really lend themselves to the “so what” defense. If you read the above opinion carefully, you will see the “so what” defense under the surface.

The “so what” defense goes like this. We don't believe the healthcare provider committed malpractice but even if she/he did – “so what.” The patient would have needed the treatment that patient received, in this example a colostomy, whether the doctor was negligent or not.

I share this information and my opinions to explore the issues involved in colon perforation medical malpractice case. I am not making specific comment regarding the facts, legal standing, or merits of the above reported case because I have no intimate knowledge of the specifics involving that case.