Bowel Perforation During Colonoscopy

67 y/o female goes in for routine colonoscopy. GI perforates her bowel and does not recognize it and sends her home. She develops severe pain and returns to the hospital the following evening. She undergoes a bowel resection and is hospitalized for 2 weeks and in rehab for several months. I know that the act of perforating is not negligence, but it is usually the failure to recognize the perforation that are meritorious cases. Was there a departure here?

medQuest Expert Responses:

Depends. Some perforations are subtle, others are more obvious read this. Some perforations are delayed (the actual perf, not the symptoms), especially if electrical current was used for polyp removal or cautery.Perforation is a known complication of the procedure, even in the best of hands. The issue is if it was promptly and appropriately recognized and treated.  Would the Rx have been different if recognized during the procedure (if that’s when it occurred) and was recognizable by endoscopic appearance, and/or symptoms/ physical exam? May be a case, or more likely not. 
Dr AH – GI

It is not ways readily identifiable and if the patient had no significant complaints then there is no deviation. The colon is extremely twisty and collapses on itself. To assume that every perforation is readily obvious is unreasonable and impossible.
Dr SL – GI