Abstract
Aims: Colon perforation is the most serious complication of colonoscopy,
and tends to be considered as malpractice. The aim of this study was to
identify the characteristics and causes of medical accidents by
analyzing lawsuit cases on colon perforation during colonoscopy.
Methods: We collected judgment results that were ruled from 2005 to 2015
using the keyword of ‘colonoscopy’ in the ‘Korea’s Written Judgment
Public Reading System’ of the Supreme Court, and extracted the cases of
colon perforation. Characteristics of medical accidents and the
decisions of courts were analyzed from written judgments. Results:
Twenty-two lawsuits were analyzed. Most cases were ruled in favor of the
plaintiff (n=20). The allegations against defendants, filed by the
plaintiffs, were the performance error (n=22), the improper monitoring
after colonoscopy (n=7), and the lack of informed consent (n=8). The
median compensation was 9,335.47 US dollar, this is about 130 times the
cost of a single colonoscopy in Korea. The greater the intestinal
damage, the greater the amount of compensation (p=0.016). The time
interval from procedure to diagnosis of perforation was most frequently
24 hours later (n=9). Conclusions: It is important to educate patients
fully about the symptoms of colon perforation and to guide them to
contact medical institutions immediately when symptoms occur. In
addition, doctors should explain sufficiently the possibility of
perforation before colonoscopy to the patients, not caregiver, and get
an informed consent.