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Medico-legal implications for the colon perforation during colonoscopy

Authors
 Hae Mi Oh  ;  Jae Myung Cha  ;  SuHwan Shin  ;  Jiyong Park  ;  Danbi Cho  ;  Sungkyoung Choi 
Citation
 JOURNAL OF FORENSIC AND LEGAL MEDICINE, Vol.80 : 102185, 2021-05 
Journal Title
JOURNAL OF FORENSIC AND LEGAL MEDICINE
ISSN
 1752-928X 
Issue Date
2021-05
MeSH
Adult ; Aged ; Aged, 80 and over ; Colon / injuries* ; Colonoscopy / adverse effects* ; Colonoscopy / legislation & jurisprudence* ; Compensation and Redress / legislation & jurisprudence* ; Female ; Humans ; Informed Consent / legislation & jurisprudence ; Intestinal Perforation / epidemiology ; Intestinal Perforation / etiology* ; Male ; Malpractice / economics ; Malpractice / statistics & numerical data* ; Middle Aged ; Republic of Korea / epidemiology ; Retrospective Studies
Keywords
Colonoscopy ; Dissent and disputes ; Intestinal perforation ; Jurisprudence ; Malpractice
Abstract
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. We collected judgment results that were ruled from 2005 to 2015 using the keyword '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. Twenty-two lawsuits were analyzed. Most cases were ruled in favor of the plaintiff (n = 20). The allegations against defendants, as filed by the plaintiffs, were performance error (n = 22), improper monitoring after colonoscopy (n = 7), and a lack of informed consent (n = 8). The median compensation was 9335.47 US dollars; 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 h later (n = 9). It is important to educate patients completely 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 patient, and not the caregiver, and get informed consent.
Full Text
https://www.sciencedirect.com/science/article/pii/S1752928X21000706
DOI
10.1016/j.jflm.2021.102185
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Medical Humanities and Social Sciences (인문사회의학교실) > 1. Journal Papers
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190915
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