| [ Summary ] |
According to nationwide studies on adverse effects related to digestive endoscopy, the frequency of adverse effects related to colonoscopy have decreased, probably reflecting progress in devices and clinical techniques. Therefore, the medical standard, for the quality of medicine which is legally required by practitioners in court judgments, is considered have improved year by year. On the other hand, as colonoscopic treatments, such as polypectomy and endoscopic mucosal resection (EMR), are inevitably at a higher risk for adverse events in comparison with simple colonoscopic observation, high medical standards for colonoscopy must be formulated from the characteristics of individual cases.Iatrogenic perforation during colonoscopy is one of the most typical causes of medical disputes in the field of gastrointestinal medicine. Settlements of this kind of dispute could be summarized as follows: (1) Cases involving perforation during simple colonoscopic observation are usually settled out of court with a certain amount of compensation. (2) In difficult cases, those with severe adhesion for example, and cases treated with hot biopsy, the points at issue would be endoscopic skills and informed consent. (3) In cases treated with polypectomy or EMR, the points at issue would be informed consent, advice for postoperative life, and follow-up to find adverse effects. Furthermore, other points at issue in court cases concerning colonoscopy would involve indications, diagnoses, pretreatment, anesthesia, and treatment for adverse effects. |