Colonoscopy Lawsuit: Injuries, Settlements, and Proof

If a colonoscopy left you or a family member seriously injured, a colonoscopy lawsuit is a medical malpractice claim built around one of a handful of recurring errors: a perforated bowel, a missed cancer, a sedation failure, an infection from a contaminated scope, or a doctor who ignored warning signs after you went home. Colonoscopy-related claims make up roughly half of all procedure-based malpractice suits in gastroenterology, more than any other single procedure in the specialty.¹ Whether a given case is worth pursuing turns on what went wrong, what it cost you, and whether you can prove a competent doctor would have done something different.

The Injuries That Drive These Cases

Most colonoscopy claims fall into five categories.

A colon perforation is a puncture of the bowel wall during the procedure and is the single most common basis for a suit alleging a procedural error. In one review of 305 colonoscopy malpractice cases spanning nearly four decades, perforation accounted for 67% of claims alleging procedural negligence.² A perforation can leak intestinal contents into the abdomen and lead to emergency surgery, sepsis, and death.

A missed or delayed cancer diagnosis covers a physician who failed to identify a cancerous or precancerous lesion, failed to biopsy suspicious tissue, or failed to send a symptomatic patient for a colonoscopy at all. Among cases in the same study alleging a failure to order appropriate tests, 97% involved a claim that a cancerous lesion was missed.²

Anesthesia and sedation errors include the wrong dose of a sedative, failure to monitor the airway, and proceeding with deep sedation in a high-risk patient without proper safeguards. These errors can cause brain damage, cardiac arrest, and death.

Infection from contaminated equipment is a separate track discussed below: patients have contracted antibiotic-resistant bacteria and other serious infections from endoscopes that were not properly cleaned between uses.

Post-procedure negligence covers the doctor or facility that fails to recognize or promptly treat complications — internal bleeding, worsening pain, signs of perforation — after the patient has been discharged.

What You Have to Prove

A colonoscopy malpractice claim is a negligence case. You (or the family, in a wrongful death action) must establish four things: that a doctor-patient relationship existed, that the physician or facility failed to meet the accepted standard of care, that the failure directly caused the injury, and that you suffered real harm as a result.³ Expert testimony from a physician in the same specialty is almost always required to explain what a competent gastroenterologist or anesthesiologist would have done in the same circumstances and how the defendant fell short.⁴

One distinction shapes the strength of a case. Gastroenterologist Dr. Lawrence Kosinski has drawn a line between “acts of commission” and “acts of omission.” A perforation is an act of commission: something went wrong during the physical performance of the procedure. A missed cancer is an act of omission: the physician failed to act on what was, or should have been, apparent. Kosinski’s analysis found that acts of omission are more likely to produce successful claims for the patient.² A perforation can occur even during a well-performed colonoscopy, which makes negligence harder to prove; a physician who ignores rectal bleeding for two years is on much shakier ground.

How Informed Consent Cuts Both Ways

Informed consent shows up in most colonoscopy cases, and not always in the way patients expect. Under New York law, for example, a patient claiming lack of informed consent must show that the physician failed to disclose reasonably foreseeable risks, that a prudent person in the patient’s position would not have agreed to the procedure if properly informed, and that the missing information was a proximate cause of the injury.⁵

Raising a lack-of-informed-consent theory can actually hurt a plaintiff. In the 305-case study, cases that included an informed consent allegation were four times more likely to end in a defense verdict.² If the patient was warned about perforation and signed a consent form, and a perforation later occurred, the defense argues the patient accepted a known risk. That said, a signed general consent form is often not enough on its own to defeat a claim. Legal commentators recommend that consent forms require the patient to initial each individual risk and that physicians tailor the conversation for higher-risk patients, such as the elderly or those with conditions like Crohn’s disease.⁵ And in missed-lesion cases, one endoscopy specialist has noted that the consent form almost invariably says nothing about the possibility of missing something important.³

What Colonoscopy Cases Have Been Worth

Awards vary enormously with the severity of the injury, the quality of the evidence, and the jurisdiction. A few reference points from the public record:

$24.6 million wrongful death verdict, Oregon (2024). A Multnomah County jury awarded roughly $24.6 million to the family of Erric Gilbert, a 43-year-old man who went into respiratory arrest during a routine colonoscopy at The Portland Clinic. Gilbert had obesity, sleep apnea, and high blood pressure. Plaintiffs argued the outpatient clinic was the wrong setting for the procedure and that the facility lacked basic emergency resuscitation training; defense experts conceded at trial that there was “absolutely no training at the Portland Clinic on how to deal with emergency response.” The jury assigned 60% of liability to the anesthesiologist, who had previously settled out of the case and surrendered his medical license, and 40% to the clinic. Oregon has a $500,000 cap on wrongful death damages; the trial judge ruled the cap unconstitutional under Oregon’s Remedy Clause, and the case is on appeal.⁶⁷⁸
$10.75 million verdict, New York (2020). A woman in her 40s died following a bowel perforation during polyp removal, in a case alleging negligence and lack of informed consent.⁹
$4.5 million settlement, Massachusetts. A primary care physician failed to refer a 42-year-old patient for a colonoscopy after reports of rectal bleeding, leading to a delayed Stage IV colorectal cancer diagnosis. Experts argued the cancer would have been curable with earlier screening.¹⁰
$1.5 million settlement, Massachusetts. A screening colonoscopy lacerated the patient’s spleen, causing internal bleeding. An emergency room physician allegedly failed to order a timely CT scan or call a surgeon, and the patient died roughly three hours after arriving at the ER.¹¹
$1 million verdict affirmed on appeal, New York (2017). In Gaspard v. Aronoff, a jury awarded $600,000 for past and $400,000 for future pain and suffering after a physician failed to provide written post-colonoscopy instructions or warn of perforation symptoms. The patient underwent a Hartmann procedure, a colostomy, a colostomy reversal, and a hernia repair.¹²
$1.01 million verdict, Illinois (2017). In Flores v. Alva, a jury found that physicians performed an unnecessary colonoscopy on a 90-year-old man without adequate informed consent. The procedure resulted in a perforation, septic shock, and a six-week recovery.¹³

Those are outliers on the high end. Across gastroenterology as a whole between 2009 and 2018, the average paid claim was roughly $330,876, with average defense costs of about $97,000.¹

When the Scope Itself Is the Defendant

Not every colonoscopy injury is a mistake by an individual doctor. A distinct line of litigation involves reusable endoscopes that were not adequately cleaned between patients, causing outbreaks of antibiotic-resistant infections. These cases can be brought against hospitals, cleaning-protocol vendors, or the device manufacturers themselves.

Olympus Medical Systems Corporation, the largest manufacturer, pleaded guilty in December 2018 to three federal criminal misdemeanors for failing to file required safety reports about infections tied to its TJF-Q180V duodenoscope and for distributing misbranded devices. The company paid approximately $85 million in fines and forfeitures.¹⁴ Pentax Medical Company entered a three-year deferred prosecution agreement in April 2020 and paid $43 million to resolve criminal charges that it shipped endoscopes with outdated cleaning instructions for 18 months in 2014 and 2015, and failed to timely report infection clusters at Advocate Lutheran General Hospital in Chicago and Massachusetts General Hospital in Boston, where a total of eight patients were infected with drug-resistant bacteria.¹⁵

The problems are ongoing. In June 2025, the FDA issued import alerts covering more than 50 types of Olympus devices manufactured in Japan.¹⁶ In October 2025, Olympus issued an urgent field safety notice acknowledging that existing reprocessing protocols for its duodenoscopes were insufficient, reporting two deaths and five serious injuries linked to its TJF duodenoscopes since 2024. New cases are being filed, but as of mid-2026 no multidistrict litigation has been consolidated and no global settlement has been reached in this second wave.¹⁷

The scale of the harm is significant. The U.S. Senate Health, Education, Labor, and Pensions Committee has reported that more than 250 patients have developed carbapenem-resistant Enterobacteriaceae from contaminated endoscopes.¹⁸ Hospital-level outbreaks include 11 patient deaths at a Seattle hospital and two at UCLA, both attributed to Olympus scopes.¹⁹ Separately, more than 11,000 veterans received colonoscopies with improperly cleaned equipment at VA hospitals in Miami; Murfreesboro, Tennessee; and Augusta, Georgia, between 2004 and 2009. In a 2013 bench trial arising from those infections, a federal judge awarded $1.25 million to a 69-year-old Air Force veteran who contracted Hepatitis C from the contaminated equipment.²⁰

How Often Plaintiffs Actually Win

Defendants win these cases more often than they lose. In the 305-case analysis covering 1980 through 2017, about 52% were decided for the defendant, 25% for the plaintiff, and 17% settled. Sedation and medication-error claims were the exception, with a noticeably lower rate of defense success.² The practical read: strong cases exist, and some are worth millions, but this is not easy litigation, and a lawyer who takes it on contingency will screen carefully.

Filing Deadlines and Pre-Suit Steps

Every state sets a deadline to file a medical malpractice lawsuit, and it is usually shorter than for other personal injury claims. The window varies by state and is often shaped by the discovery rule, which pauses the clock until you knew, or reasonably should have known, that a medical error caused the injury.²¹ Many states also impose an outer statute of repose that cuts off claims after a fixed number of years regardless of when the injury was discovered.

Florida, for example, requires filing within two years of when the patient became aware of the injury, with a four-year outer limit from the date of the procedure. Florida also requires a pre-suit investigation and a formal notice of intent to each defendant before the case can be filed.²² Many other states require an affidavit or certificate of merit — a sworn statement from a qualified medical expert confirming that the claim has a reasonable basis — before the case can move forward.²¹ Missing any of these deadlines or procedural steps can end an otherwise valid case before it starts, which is the practical reason to talk to a malpractice attorney in your state as soon as you suspect something went wrong.

1
PMC. Medical Professional Liability in Gastroenterology
2
MDEdge. How to Predict Successful Colonoscopy Malpractice
3
PMC. Informed Consent and the Possibility of a Missed Lesion at Colonoscopy
4
Justia. Expert Witnesses in Medical Malpractice Cases
5
MCB Law. Informed Consent in Colonoscopy Cases
6
Courtroom View Network. $25M Verdict Over Colonoscopy Death Beats $500K Settlement Offer
7
MDLinx. Outpatient Flub Leads to $25M Wrongful Death Verdict
8
Johnson Law. Oregon Personal Injury Law Comprehensive Guide
9
Becker’s ASC Review. 5 Colonoscopy Malpractice Cases to Know
10
Lubin & Meyer. Colorectal Cancer Diagnose
11
Lubin & Meyer. Colonoscopy Injury Lawsuit
12
Medical Malpractice Lawyers. New York Appellate Court Affirms $1M Medical Malpractice Verdict
13
GWC Law. Colonoscopy Injury Award Informed Consent
14
Olympus America. Olympus Issues Statement Regarding US Department of Justice Settlement
15
U.S. Department of Justice. Pentax Medical Company Agrees to Pay $43 Million
16
U.S. Food and Drug Administration. Import Alerts for Certain Olympus Medical Devices Manufactured in Japan
17
Drugwatch. Olympus Scope Lawsuit
18
Sokolove Law. Endoscopy Infection Lawsuits
19
Drugwatch. Colonoscopy Scope Infection Lawsuits
20
Fierce Healthcare. Federal Judge Awards $1.25 Million in First Malpractice Trial Against VA Hospital
21
Justia. Statutes of Limitations and the Discovery Rule
22
The Florida Bar. Florida Medical Malpractice and the Statute of Limitations