Yes, when the perforation was caused by a failure to take reasonable care, when you were not properly warned of the risk, or, most often, when it was not recognised and treated in time. A hole in the bowel is a recognised risk of colonoscopy and of abdominal and pelvic surgery, including a hysterectomy, and it can happen when everything is done carefully. The Australian Commission on Safety and Quality in Health Care puts the risk at about 3.1 perforations per 10,000 screening colonoscopies, and higher when polyps are removed. So the perforation alone is usually not enough. What more often supports a claim in Victoria is what happened next: whether pain, fever or a swollen abdomen was recognised as a possible perforation and investigated, or whether you were sent home and came back with peritonitis or sepsis. Under the Wrongs Act 1958 (Vic) you also need to show that the failure made a real difference to the harm you suffered.
| Usually not negligence on its own | May support a claim | |
|---|---|---|
| The perforation itself | A perforation during a careful, appropriate procedure | A technique or decision that a reasonable practitioner would not have used in your circumstances |
| Recognition afterwards | The perforation seen or suspected quickly, investigated and treated | Pain, fever, a swollen abdomen or abnormal results charted but not acted on for hours or days |
| Going home | Discharge after you met the discharge criteria, with written advice on what symptoms to report and a number to call | Discharge despite warning signs, or with no advice about what to watch for |
| The warning before | Perforation explained to you, in terms that fit your situation, before you agreed | A risk that mattered to you never explained, where you would have chosen differently |
| What you were told after | A clear explanation of the complication and how it was managed | No explanation. Not proof of negligence, but a reason to get the records |
If you were told your perforation was a known complication, that may be true. It is also where the questions start.
How common is bowel perforation after a colonoscopy?
It is uncommon. The Colonoscopy Clinical Care Standard, published by the Australian Commission on Safety and Quality in Health Care in 2025, puts the risk of serious complications at about 3.1 perforations and 14.6 major bleeding events per 10,000 screening colonoscopies. It says the risk increases with age, with the number of colonoscopies and when polyps are removed. More than 900,000 colonoscopies are performed in Australia each year.
Bowel injury is also a recognised risk of some abdominal and pelvic operations. The Victorian Government's Better Health Channel lists damage to the bowel among the risks of a hysterectomy.
A known risk is not the same as an unavoidable one. That distinction is the subject of our guide on whether a known complication can still be medical negligence.
Is a perforated bowel during a colonoscopy negligence?
Not because it happened. The law asks whether the care was reasonable, not whether the outcome was bad.
Section 48 of the Wrongs Act 1958 (Vic) says a person is not negligent in failing to take precautions against a risk unless the risk was foreseeable, it was not insignificant, and a reasonable person in their position would have taken those precautions. Section 49 adds that the fact a risk could have been avoided by doing something differently does not, by itself, create liability.
Section 55 goes further for an inherent risk, which is a risk that cannot be avoided by the exercise of reasonable care. There is no liability in negligence when an inherent risk materialises. But the same section says it does not exclude liability for a failure to warn.
Sections 58 and 59 set the standard. A specialist is measured against what could reasonably be expected of a person with that skill at the time. A professional is not negligent if they acted in a way that was widely accepted in Australia by a significant number of respected practitioners as competent practice, unless a court finds that opinion unreasonable.
So a claim based on the perforation itself needs independent expert evidence that the way the procedure was planned or performed fell outside that range. That is possible, but it is usually the hardest part of a perforation claim to prove.
What if the perforation was missed and you were sent home?
This is where many of these claims actually sit. A perforation found during the procedure and dealt with then is a very different case from one nobody looked for.
Healthdirect, the Australian Government's health information service, says perforation can occur during or after a colonoscopy. It lists fever, more than a tablespoon of rectal bleeding, severe abdominal pain or bloating, and persistent nausea or vomiting among the symptoms that call for immediate contact with a doctor. It describes peritonitis, which can follow a hole in the bowel, as life-threatening, and notes that it can lead to sepsis.
The Colonoscopy Clinical Care Standard also expects a certain kind of discharge. Before you leave, you should be told whether any adverse event occurred, given written instructions, and told what to do if you have symptoms suggesting a complication, with contact details for advice. It says a clinician should consider admission for a patient at high risk of an adverse outcome.
None of that is a legal test by itself. It is evidence of what reasonable care looked like. When your records are reviewed, the questions are usually these:
- What pain scores, observations and blood results were recorded after the procedure or operation?
- Did anyone suspect a perforation, and when was imaging ordered?
- Were you discharged while those signs were present, and what advice were you given?
- When you came back, how long did it take to diagnose the perforation and operate?
A delay raises two separate questions. Was failing to recognise the perforation a breach of the standard of care? And if so, what difference did it make? Section 51 of the Wrongs Act 1958 (Vic) requires you to show the negligence was a necessary condition of the harm, and section 52 puts the burden of proving causation on you. In practice that means expert evidence that earlier recognition would probably have led to a better outcome, such as less extensive surgery, less infection or a shorter stay in intensive care.
What about a perforated bowel after a hysterectomy or other surgery?
The same structure applies. The bowel can be injured during a hysterectomy or other abdominal or pelvic surgery, and the injury is not always obvious at the time.
The claim more often lies in whether the injury was looked for, recognised when symptoms appeared and repaired promptly. Our guide to hysterectomy and gynaecological surgery injury claims covers the pelvic surgery questions in more detail, and surgical error claims covers surgery more broadly.
Were you properly warned about the risk of perforation?
A separate claim can arise if the risk was not properly explained, even where the procedure itself was done well.
In Rogers v Whitaker (1992) 175 CLR 479 the High Court held that a doctor has a duty to warn of a material risk. A risk is material if a reasonable person in the patient's position would be likely to attach significance to it, or if the doctor knows or should know that this particular patient would. The risk in that case was about 1 in 14,000. Rarity did not decide it.
In Victoria, section 50 of the Wrongs Act 1958 says the duty to warn is satisfied by taking reasonable care in giving the warning. Section 60 says the peer professional opinion defence in section 59 does not apply to warnings. The Colonoscopy Clinical Care Standard expects you to be told about perforation, bleeding, splenic injury and missed pathology, and about the alternatives, with enough time to ask questions.
Two things make a warning claim harder than it sounds. Section 56 puts the burden on you to prove you were not aware of the risk. And under section 51 you must show what you would have done if properly warned, which is decided on your own circumstances. If you would have gone ahead anyway, the missing warning may not have caused the harm.
A signed consent form matters, but it is not the whole answer. See whether signing a consent form stops a claim.
What has Safer Care Victoria found about colonoscopy care?
One of the three key themes in Safer Care Victoria's Sentinel Events Annual Report 2023–2024 was sentinel events related to a clinical process or procedure, with a focus on colonoscopy. Safer Care Victoria reviewed 14 colonoscopy-related sentinel events from the previous three years. The most common findings concerned procedures and guidelines, teamwork, and documentation, assessment and decision support.
The report also records that a colonoscopy notification in July 2022 led to a review, the recall of nearly 2,000 patients and a set of best practice recommendations, including on consent for colonoscopy. That recall is covered in our page on the Albury–Wodonga colonoscopy recall.
A sentinel event review is a patient safety process, not a finding that anyone was negligent. It shows where Victorian regulators think colonoscopy care can go wrong. It does not decide your case.
What records show whether the perforation was handled properly?
The procedure report is rarely the document people are given, and it matters most. Ask for:
- the colonoscopy or operation report, and any images or photographs taken;
- the signed consent form and any clinic letters or notes from before the procedure;
- recovery-room and ward observations, pain scores and nursing notes;
- blood tests and imaging after the procedure, with the times they were ordered and reported;
- the discharge summary and any written discharge instructions; and
- emergency department and admission records from when you came back.
How to get your medical records in Victoria explains which law applies and what a provider can charge.
How long do you have to make a claim in Victoria?
Section 27D of the Limitation of Actions Act 1958 (Vic) sets two periods, and the first to expire applies: three years from the date the cause of action is discoverable by you, or twelve years from the act or omission complained of. Different rules apply to a person who was under a disability at the time, which under section 3 includes a child.
Requesting records does not pause the clock. Time limits for medical negligence claims explains how discoverability works.
How does Clever Legal assess a bowel perforation claim?
Reading a perforation file hour by hour is the expensive part of finding out whether a claim exists. It is why claims like this are sometimes declined before anyone has read the observations chart closely. Clever Legal uses technology to organise the records, and a lawyer reviews the evidence and makes every legal decision.
If another firm has already said no, that may have been a judgement about the cost of investigating rather than about your treatment. A previous rejection is not a finding.
Start a free assessment. Tell us what procedure you had, what you were told beforehand, what happened in the hours and days afterwards, and what treatment followed. There is no obligation and no guaranteed outcome.
Common questions
Can you sue for a bowel perforation during a colonoscopy?
You can bring a claim if the perforation, or what happened after it, involved a failure to take reasonable care that caused you harm. The perforation alone is usually not enough. In Victoria the Wrongs Act 1958 sets the test, and most claims turn on whether the perforation was recognised and treated promptly, or whether you were properly warned of the risk before you agreed to the procedure.
What if you were sent home from hospital with a perforated bowel?
That is often the strongest part of a claim. The question is whether your symptoms, observations and results, read at the time, should have led a reasonable clinician to suspect a perforation and investigate before letting you go. You also need to show that earlier recognition would probably have reduced the harm you suffered.
Is a perforated bowel after a hysterectomy medical negligence?
Not by itself. The Better Health Channel lists damage to the bowel among the risks of a hysterectomy. A claim more often depends on whether the injury was looked for during the operation, recognised afterwards when symptoms appeared and repaired promptly, or on whether the risk was properly explained to you beforehand.
Does a signed consent form that lists perforation stop a claim?
No. A signed form is evidence that the risk was mentioned, but it does not prove the procedure was performed with reasonable care or that a later complication was managed properly. If your claim is that you were not warned, section 56 of the Wrongs Act 1958 (Vic) puts the burden on you to prove you were not aware of the risk.
Sources
- Wrongs Act 1958 (Vic), sections 48, 49, 50, 51, 52, 55, 56, 58, 59 and 60 (authorised version 130, incorporating amendments as at 25 February 2026, checked 26 September 2026)
- Limitation of Actions Act 1958 (Vic), sections 3 and 27D (authorised version 112, incorporating amendments as at 25 February 2026, checked 26 September 2026)
- Rogers v Whitaker [1992] HCA 58; (1992) 175 CLR 479
- Australian Commission on Safety and Quality in Health Care, Colonoscopy Clinical Care Standard (2025), quality statements 3 (informed decision making and consent) and 8 (discharge)
- Safer Care Victoria, Sentinel Events Annual Report 2023–2024
- Healthdirect (Australian Government), Colonoscopy
- Healthdirect (Australian Government), Peritonitis
- Better Health Channel (Victorian Government), Hysterectomy
This article provides general information and is not legal advice or medical advice. Medical negligence claims depend on their facts and are subject to strict time limits. Seek specific advice about your circumstances.