Gastroenterologists perform more procedures per physician than nearly any other specialty, and the volume carries risk.
Colonoscopy remains the most litigated procedure in GI, but the landscape extends to ERCP (endoscopic retrograde cholangiopancreatography), missed diagnoses and wrong-patient errors.
Here are five numbers that define where GI malpractice exposure stands:
0.34% to 2.5%: Rates of serious injury due to colonoscopies vary in research between 0.34% and 2.5%, according to a law firm Miller and Zois analysis. The risk of bowel perforation specifically is estimated at 0.2% to 1%. Perforation is the most litigated injury, but hemorrhage following polyp removal, splenic injury and sepsis also appear regularly in malpractice filings.
$10.8 million: One of the largest colonoscopy malpractice verdicts involved a woman in her 40s who died from complications after her bowel was perforated while undergoing a polyp removal. Her family alleged negligence and lack of informed consent, resulting in a $10.75 million verdict. Colonoscopy malpractice verdicts span a wide range: a perforated colon resulting in emergency surgery settled for $331,402 in one case, while a death following delayed recognition of perforation symptoms settled for $750,000.
1: The number of technique disputes that can define a case. A Virginia jury returned a unanimous verdict for the defense in January 2026 in a colonoscopy malpractice case wherein the plaintiff alleged the physician improperly used a hot snare to remove a 5mm polyp, arguing cold snaring was safer according to recent research. The defense countered that hot snaring was standard practice in 2019, when the procedure was performed.
2: Prior to a 2023 colonoscopy in which Naples, Fla.-based physician Scott Wiesen, MD, allegedly punctured a patient’s colon and mistakenly removed her ovary and fallopian tube, believing them to be polyps, state records showed he had previously settled two malpractice claims — one involving a fatal colonoscopy and another for a misdiagnosed small bowel obstruction that also resulted in death. Dr. Wiesen subsequently surrendered his medical license.
No. 1: The most frequent malpractice-related allegation against gastroenterologists is failure to diagnose or delayed diagnosis. Other common allegations include treatment complications, failure to treat or delayed treatment, poor outcome and wrongful death. The failure-to-diagnose category is significant for GI given the specialty’s central role in colorectal cancer screening.
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