Perforating the colon can happen when the scope used for colonoscopy accidentally punches through the wall of the colon. This can be a devastating injury if not caught quickly, as bacteria-laden bowel contents are spread through the abdomen and a life-threatening infection called peritonitis or sepsis can result.
The hole itself is not usually considered a provable cause of medical malpractice. The malpractice issue usually focuses on whether the doctor noticed the injury and reacted quickly and appropriately.
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