Malpractice Trends in Colon Cancer

Malpractice Trends in Colon Cancer

Douglas K. Rex, MD, FASGE, reviewing Panuganti PL, et al. Am J Gastroenterol 2020 May 25.

This study identified 240 malpractice cases related to colorectal cancer (CRC) between 1988 and 2018 by using a legal database called VerdictSearch. This database is skewed toward lawsuits from New York, New Jersey, Pennsylvania, Florida, Texas, and California. The reviewed lawsuits had defense verdicts in 42.1% of cases, plaintiff verdicts in 15.4%, and settlements in 40%. 

The most common defendants were primary care physicians (25.4%) and gastroenterologists (22.9%). The most common allegations were failure to perform colonoscopy for symptoms (27.9%), failure to utilize screening colonoscopy according to guidelines (19.2%), and failure to detect CRC at colonoscopy (19%). 

The most common injuries were cancer metastasis (56%), new cancer (22%), and the need for surgery (7.5%). For all injuries with plaintiff verdict cases, mean payments were around $2 million, with a wide variation in amounts.

Douglas K. Rex, MD, FASGE


Previous studies indicated that failure to diagnose CRC at colonoscopy and perforation were the two major colonoscopy-related causes of malpractice lawsuits against gastroenterologists. Anecdotal experience suggests that these factors plus splenic injury and wrong-site surgical resections remain among the most common colonoscopy-related malpractice risks.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Panuganti PL, Hartnett DA, Eltorai AE, Eltorai MI, Daniels AH. Colorectal cancer litigation: 1988-2018. Am J Gastroenterol 2020 May 25. (Epub ahead of print) (

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