Vident Partners provides vetted colon and rectal surgery expert witnesses for cases involving anastomotic leak, colonoscopic perforation, delayed diagnosis of colorectal cancer, ureteral and bowel injury during pelvic surgery, ostomy complications, and screening interval and surveillance failures. Request a referral today.
Find a Colorectal Surgery Expert →Overview
Colon and rectal surgery is certified by the American Board of Colon and Rectal Surgery, which requires prior general surgery certification and a dedicated colorectal fellowship 1. Litigation in the field concentrates in three places: cancer that was not found, an anastomosis that did not hold, and an injury to a neighboring structure that nobody recognized until the patient was septic.
Colorectal cancer is the third most common cancer diagnosis and cause of cancer death in the United States, with over 153,000 new cases diagnosed in 2023, and an increasing proportion of new diagnoses occurring in people younger than 55 2. That demographic shift drives a growing share of missed-diagnosis claims, because rectal bleeding and altered bowel habits in a patient in their forties are still frequently attributed to hemorrhoids or irritable bowel syndrome. The screening framework is the benchmark: the U.S. Preventive Services Task Force recommends screening beginning at age 45, with a Grade B recommendation for ages 45 to 49 and a Grade A recommendation for ages 50 to 75, using colonoscopy every 10 years, annual fecal immunochemical testing, stool DNA-FIT every one to three years, CT colonography or flexible sigmoidoscopy every five years, or flexible sigmoidoscopy every 10 years with annual FIT 3. Experts address whether screening was offered and documented, whether an abnormal stool test was followed by diagnostic colonoscopy, whether the examination reached the cecum with adequate preparation, and whether the recommended surveillance interval after polypectomy was communicated and honored 45.
The allocation matters more here than in most specialties. A colonoscopy performed by a gastroenterologist and a colonoscopy performed by a colorectal surgeon are held to the same procedural standard, and quality benchmarks such as cecal intubation, preparation adequacy, and adenoma detection are endoscopy standards rather than specialty-specific ones 45. But the surgical judgment questions — whether to divert, whether to perform a primary anastomosis in a contaminated field, whether the mesorectal specimen was adequate — belong to a practicing colorectal surgeon. Where the case involves both a missed lesion at endoscopy and a subsequent operative complication, counsel should expect to retain more than one expert, and should confirm that the surgical expert is currently performing the specific operation in dispute rather than testifying from historical practice 7.
The U.S. Preventive Services Task Force recommends colorectal cancer screening beginning at age 45 — a Grade B recommendation for ages 45 to 49 and Grade A for ages 50 to 75 — even as an increasing proportion of new colorectal cancers are diagnosed in people younger than 55.
Case Types
Delayed diagnosis of colorectal cancer in a symptomatic patient under age 50
Failure to offer screening or to follow up an abnormal stool-based test with colonoscopy
Incomplete or inadequately prepared colonoscopy without documented repeat examination
Anastomotic leak with delayed recognition and failure to return to the operating room
Colonoscopic perforation and delay to operative repair
Ureteral or bowel injury during pelvic dissection recognized postoperatively
Inadequate total mesorectal excision or positive margins in rectal cancer resection
Ostomy siting and management failures, including parastomal hernia and retraction
Qualifications
Related Specialties
FAQ
The expert should hold American Board of Colon and Rectal Surgery certification, which requires prior General Surgery certification and a colorectal fellowship, and should be currently performing the operation at issue. For cases involving endoscopy, the expert also needs a working endoscopic practice and familiarity with recognized colonoscopy quality indicators.
These experts are retained in delayed colorectal cancer diagnosis claims, colonoscopy perforation and quality cases, anastomotic leak and failure-to-rescue matters, ureteral and bowel injuries during pelvic surgery, rectal cancer specimen and margin disputes, ostomy complications, and anorectal procedure claims involving incontinence.
Along two tracks. The screening track asks whether age-appropriate screening was offered and documented, whether an abnormal stool test was followed by diagnostic colonoscopy, and whether the surveillance interval after a prior polypectomy was correct. The symptomatic track asks whether rectal bleeding, iron deficiency anemia, or a change in bowel habit was worked up rather than attributed to hemorrhoids or irritable bowel syndrome. The rising incidence in patients under 55 has made the second track increasingly common.
Not by itself. Leak is a recognized complication of every bowel anastomosis and occurs in the hands of excellent surgeons. What is litigated is the surrounding judgment and the response: whether a diverting stoma should have been created given the patient's risk factors, whether a primary anastomosis was appropriate in a contaminated or poorly perfused field, and — most often — how long the postoperative deterioration was observed before imaging or reoperation.
Sometimes, and jurisdictions vary in how strictly they apply same-specialty requirements. General surgeons perform colon resections routinely, so on a segmental colectomy the overlap is real. On rectal cancer surgery, complex pelvic reoperation, and sphincter-preserving procedures, courts increasingly expect a fellowship-trained colorectal surgeon, and a general surgeon opining outside that scope is exposed on qualification.
In general, expert fees are determined by the expert themselves, based on a variety of criteria. Among those criteria are professional experience, forensic and testimony experience, relevant certifications, case-type specialization, and publications. Vident does have some influence over expert fees by comparing experts within a specialty, but ultimately it is a personal decision by the expert.
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