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Complications in colonoscopy: analysis of 7-year physician-reported adverse events

Niv, Yarona; Gershtansky, Yaelb; Kenett, Ron S.c; Tal, Yossib; Birkenfeld, Shlomod

European Journal of Gastroenterology & Hepatology: June 2011 - Volume 23 - Issue 6 - p 492–498
doi: 10.1097/MEG.0b013e32834702ab
Original Articles: Colonoscopy

Introduction The number of malpractice claims against physicians and health institutes in Israel is increasing continuously, as in the rest of the Western world. This trend became a serious financial burden.

Aim In this study we analyzed reports of gastroenterologists on colonoscopy adverse events to the medical malpractice insurer, as well as complaint/demand for compensation from patients represented by lawyers, between 1 January 2000 and 31 December 2006.

Methods All the reports of physicians associated with colonoscopy adverse events from health institutes covered by Madanes Insurance Group were analyzed and summarized using a specially designed questionnaire. Clinical and epidemiological details about the patients, procedures, and adverse events were coded into an excel sheet, discussed, and evaluated.

Results One hundred and two cases of colonoscopy adverse events were reported. There were 48 cases of men (47.1%) and the average age was 69.9±12.90 years. In this period of time 252 064 colonoscopies were performed by the institutes in the sampling frame, and the number of adverse events was on average 4.0 (between 2.8 and 6.2) for 10 000 colonoscopies. The difference between the years was not statistically significant. Perforation occurred in one of 2864 procedures, bleeding in one of 29 007 procedures, and respiratory complications in one of 50 412 procedures.

Conclusion This is the first study in Israel based on physicians' reports of colonoscopic adverse events. The picture is optimistic, as the rate of complications is low, and the data encourage early detection and reporting.

aDepartment of Gastroenterology, Rabin Medical Center, Tel Aviv University

bMedical Risk Management, The Madanes Group

cThe KPA Group, University of Torino, Italy

dClalit Health Services, Tel Aviv District, Israel

Correspondence to Professor Yaron Niv, MD, FACG, AGAF, Department of Gastroenterology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski Street, Petach Tikva 49100, Israel Tel: +972 3 9377237; fax: +972 3 9210313; e-mail:

Received February 7, 2011

Accepted March 22, 2011

© 2011 Lippincott Williams & Wilkins, Inc.