title: Complications in colonoscopy: analysis of 7-year physician-reported adverse events.
abstract: BACKGROUND
  The number of malpractice claims against physicians and health institutes in Israel is increasing continuously, as in the rest of the Western world. This trend became a serious financial burden.
  
  
  OBJECTIVE
  In this study we analyzed reports of gastroenterologists on colonoscopy adverse events to the medical malpractice insurer, as well as complaint/demand for compensation from patients represented by lawyers, between 1 January 2000 and 31 December 2006.
  
  
  METHODS
  All the reports of physicians associated with colonoscopy adverse events from health institutes covered by Madanes Insurance Group were analyzed and summarized using a specially designed questionnaire. Clinical and epidemiological details about the patients, procedures, and adverse events were coded into an excel sheet, discussed, and evaluated.
  
  
  RESULTS
  One hundred and two cases of colonoscopy adverse events were reported. There were 48 cases of men (47.1%) and the average age was 69.9±12.90 years. In this period of time 252 064 colonoscopies were performed by the institutes in the sampling frame, and the number of adverse events was on average 4.0 (between 2.8 and 6.2) for 10 000 colonoscopies. The difference between the years was not statistically significant. Perforation occurred in one of 2864 procedures, bleeding in one of 29 007 procedures, and respiratory complications in one of 50 412 procedures.
  
  
  CONCLUSIONS
  This is the first study in Israel based on physicians' reports of colonoscopic adverse events. The picture is optimistic, as the rate of complications is low, and the data encourage early detection and reporting.
authors.affiliation: Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, Israel. yniv@clalit.org.il
authors.forename: Yaron
authors.initials: Y
authors.lastname: Niv
authors.forename: Yael
authors.initials: Y
authors.lastname: Gershtansky
authors.forename: Ron S
authors.initials: RS
authors.lastname: Kenett
authors.forename: Yossi
authors.initials: Y
authors.lastname: Tal
authors.forename: Shlomo
authors.initials: S
authors.lastname: Birkenfeld
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000009:adverse effects* / Q000331:legislation & jurisprudence / Q000401:mortality; D035881:Compensation and Redress; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007351:Insurance, Liability; D007416:Intestinal Perforation / Q000209:etiology; D007557:Israel; D053208:Kaplan-Meier Estimate; D016365:Liability, Legal; D008297:Male; D008318:Malpractice; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome