Medical malpractice litigation related to gastrointestinal endoscopy in Japan: A two-decade review of civil court cases

Table 1 Litigations related to gastrointestinal endoscopy in Japan, 1985-2005

	Procedure	Complication/diagnostic error	Allegation 1	Decision	Allegation 2	Decision	Allegation 3	Decision
1	ERCP	Death due to peritonitis induced by duodenal perforation	Performance error during procedure	P
2	EGD	Massive hemorrhage	Performance error during procedure	L
3	EGD	Death due to premedication shock	Premedication error	P
4	Colonoscopic polypectomy	Colonic perforation	Indication error	L	Lack of informed consent	P
5	Colonoscopy	Colonic perforation	Performance error during procedure	P
6	EST	Death due to pancreatitis	Performance error during procedure	L	Performance error after procedure	P
7	EGD	Death due to premedication shock	Premedication error	L	Lack of informed consent	L
8	EGD	Massive hemorrhage	Performance error during procedure	P
9	EGD removal of foreign body	Unexpected emergent surgery due to fixation of foreign body	Lack of informed consent	P	Performance error during procedure	P
10	EGD	Traffic accident due to the effect of sedative agent	Lack of informed consent	P
11	EGD	Death due to premedication shock	Premedication error	L	Lack of informed consent	P
12	Colonoscopy	Colonic perforation	Performance error during procedure	L	Lack of informed consent	P
13	EGD	Misdiagnosis of gastric cancer	Diagnostic error	P
14	EST	Death due to pancreatitis	Performance error during procedure	L	Performance error after procedure	L	Lack of informed consent	L
15	EST	Death due to pancreatitis	Performance error during procedure	L	Performance error after procedure	L	Lack of informed consent	L
16	ERCP	Death due to pancreatitis	Lack of informed consent	L	Performance error during procedure	P	Performance error after procedure	P
17	Colonoscopy	Colonic perforation	Performance error during procedure	P
18	EST	Death due to peritonitis induced by duodenal perforation	Performance error during procedure	P

ERCP: Endoscopic retrograde cholangiopancreatography; EGD: Esophagogastrodudenoscopy; EST: Endoscopic sphincterotomy. P: The claim prevailed; L: The claim was lost.

Table 2 Complications referred to in the litigations (n = 17)

Complication	n (%)
Death	9 (53)
Shock due to premedication of EGD	3 (18)
Severe acute pancreatitis due to ERCP	1 (6)
Panperitonitis due to duodenal perforation during ERCP	1 (6)
Severe acute pancreatitis due to EST	3 (18)
Panperitonitis due to duodenal perforation during EST	1 (6)
Perforation	4 (24)
Colonoscopy	3 (18)
Colonoscopic polypectomy	1 (6)
Massive hemorrhage after EGD	2 (12)
Traffic accident due to the effect of a sedative used for EGD	1 (6)
Unexpected emergency surgery due to lodging of a foreign body	1 (6)

EGD: Esophagogastroduodenoscopy; ERCP: Endoscopic retrograde cholangio-pancreatography; EST: Endoscopic sphincterotomy.