Colon Cancer Misdiagnosis Lawsuits in New York

How Colon Cancer Is Diagnosed

Colon cancer diagnosis involves screening, diagnostic testing, and tissue biopsy:

• Screening colonoscopy: The gold standard for colon cancer screening. A gastroenterologist examines the entire colon with a flexible camera, looking for polyps (precancerous growths) and tumors. Polyps can be removed during the procedure, preventing cancer from developing. Screening is recommended starting at age 45 (or earlier for high-risk patients).
• Fecal occult blood test (FOBT) or fecal immunochemical test (FIT): Non-invasive tests that detect blood in the stool, a potential sign of colon cancer. Positive results require follow-up colonoscopy.
• CT colonography (virtual colonoscopy): A CT scan that creates images of the colon. Less invasive than traditional colonoscopy but less sensitive for small polyps, and any abnormal finding requires traditional colonoscopy for biopsy.
• Diagnostic colonoscopy: Performed when a patient has symptoms (rectal bleeding, change in bowel habits, abdominal pain) or an abnormal screening test. The gastroenterologist identifies suspicious areas and takes biopsies.
• Biopsy and pathology: Tissue samples taken during colonoscopy are examined by a pathologist under a microscope. The pathologist determines whether cancer is present, the type (adenocarcinoma is most common), the grade (how aggressive it appears), and the depth of invasion.
• Imaging for staging: CT scan of the chest, abdomen, and pelvis to determine whether the cancer has spread to lymph nodes or distant organs. MRI may be used for rectal cancer.
• CEA (carcinoembryonic antigen) blood test: A tumor marker used to monitor treatment response and detect recurrence.

Common Ways Colon Cancer Is Misdiagnosed

Colon cancer misdiagnosis can occur at any point in the diagnostic process:

• Attributing symptoms to a less serious condition: Rectal bleeding, change in bowel habits, and abdominal pain are often attributed to hemorrhoids, irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD) without appropriate evaluation. Hemorrhoids are the most common misdiagnosis — a patient with rectal bleeding is told it is just hemorrhoids, without a colonoscopy to rule out cancer.
• Failure to perform colonoscopy: When a patient presents with symptoms concerning for colon cancer (rectal bleeding, change in bowel habits, unexplained weight loss, abdominal pain), the standard of care requires colonoscopy. Failure to perform colonoscopy may constitute negligence.
• Incomplete colonoscopy: The gastroenterologist does not reach the cecum (the end of the colon), missing tumors in the right colon. Inadequate bowel preparation can also obscure tumors.
• Failure to identify or remove polyps: During colonoscopy, the gastroenterologist should identify and remove all visible polyps. Failure to identify polyps — particularly large or suspicious ones — allows them to grow and potentially become cancerous.
• Failure to biopsy suspicious lesions: When a suspicious area is seen during colonoscopy, the standard of care requires biopsy. Failure to biopsy may constitute negligence.
• Pathology errors: The pathologist misinterprets the biopsy tissue — diagnosing cancer when it is not present (false positive) or missing cancer that is present (false negative). Pathology errors can also involve misclassifying the type or grade of cancer, leading to inappropriate treatment.
• Failure to communicate or follow up: Abnormal results are not communicated to the patient or referring physician, or follow-up appointments are not arranged. The cancer goes untreated.
• Failure to screen: A primary care physician fails to recommend screening colonoscopy at the appropriate age (45 for average-risk patients, earlier for high-risk patients), allowing a preventable cancer to develop undetected.

Screening and the Standard of Care

The standard of care for colon cancer screening in New York includes:

- Screening starting at age 45 for average-risk patients (updated from age 50 in response to rising rates of colon cancer in younger adults). High-risk patients (family history, inflammatory bowel disease, genetic syndromes) should begin screening earlier and more frequently. - Colonoscopy every 10 years for average-risk patients with normal results. - FIT or FOBT annually as an alternative to colonoscopy, with colonoscopy required for any positive result. - Symptomatic patients: Any patient with symptoms concerning for colon cancer (rectal bleeding, change in bowel habits, unexplained weight loss, abdominal pain, anemia) should undergo diagnostic colonoscopy — regardless of age or screening status. - Surveillance colonoscopy: Patients with a history of polyps or colon cancer require more frequent surveillance colonoscopy.

Failure to recommend screening at the appropriate age, or failure to perform colonoscopy in a symptomatic patient, may constitute negligence.

Colonoscopy Errors

Colonoscopy is the primary tool for colon cancer diagnosis and prevention, but errors can occur:

- Incomplete examination: The gastroenterologist does not reach the cecum, missing tumors — particularly in the right colon, where cancers are harder to detect. The cecal intubation rate (percentage of procedures reaching the cecum) should be at least 90% in screening colonoscopies. - Inadequate bowel preparation: If the patient's bowel is not adequately cleaned, polyps and tumors may be obscured. The gastroenterologist should reschedule the procedure if preparation is inadequate, rather than proceeding with a suboptimal examination. - Low adenoma detection rate (ADR): The ADR is the percentage of screening colonoscopies in which at least one adenomatous polyp is found. A low ADR suggests that the gastroenterologist is missing polyps. The standard ADR should be at least 25-30% for men and 15-20% for women. - Failure to remove polyps: All visible polyps should be removed during colonoscopy. Failure to remove polyps allows them to grow and potentially become cancerous. - Complications: Perforation of the colon and bleeding are known risks of colonoscopy. Failure to recognize and treat these complications promptly may constitute negligence. [Link to: /surgical-errors/laparoscopic-bowel-perforation] - Failure to recommend appropriate surveillance: Patients with high-risk polyps (large, villous, or with high-grade dysplasia) require more frequent surveillance colonoscopy.

Pathology Errors in Colon Cancer

Pathology errors are a less common but devastating cause of colon cancer misdiagnosis:

- False negative: The pathologist misses cancer that is present in the biopsy tissue. The patient is told the polyp is benign, and the cancer goes untreated. - False positive: The pathologist diagnoses cancer when it is not present, leading to unnecessary surgery and treatment. - Misclassification: The pathologist misclassifies the type or grade of cancer, leading to inappropriate treatment. For example, misclassifying a high-grade (aggressive) cancer as low-grade may result in undertreatment. - Failure to assess depth of invasion: The depth of tumor invasion into the bowel wall determines the stage and treatment. Failure to accurately assess invasion may lead to inappropriate treatment. - Failure to test for molecular markers: Certain genetic markers (KRAS, NRAS, BRAF, MSI status) guide treatment decisions, particularly for metastatic colon cancer. Failure to test for these markers may result in inappropriate treatment.

An independent pathologist should review the slides in any case of suspected pathology error.

When Colon Cancer Misdiagnosis Constitutes Malpractice

Colon cancer misdiagnosis constitutes medical malpractice when a healthcare provider deviated from the standard of care and that deviation caused harm. This includes:

• Failure to screen: A primary care physician failed to recommend screening colonoscopy at the appropriate age.
• Failure to perform colonoscopy in a symptomatic patient: A patient with rectal bleeding or change in bowel habits was not referred for colonoscopy.
• Misdiagnosis of symptoms: Rectal bleeding was attributed to hemorrhoids without colonoscopy to rule out cancer.
• Colonoscopy errors: Incomplete examination, failure to identify polyps, failure to biopsy suspicious lesions, or inadequate bowel preparation obscuring tumors.
• Pathology errors: The pathologist missed cancer, misclassified the type or grade, or failed to test for molecular markers.
• Failure to communicate or follow up: Abnormal results were not communicated, or follow-up was not arranged.
• Failure to recommend appropriate surveillance: Patients with high-risk polyps or a history of colon cancer require more frequent surveillance.

The Impact of Delayed Colon Cancer Diagnosis

The impact of a delayed colon cancer diagnosis can be devastating:

- Stage progression: A cancer that could have been diagnosed at stage 1 (5-year survival: 91%) may progress to stage 3 or 4 (5-year survival: 14%) due to delayed diagnosis. - More aggressive treatment: Later-stage cancer requires more aggressive treatment — surgery with chemotherapy, radiation (for rectal cancer), and targeted therapies. - Spread to lymph nodes and distant organs: Cancer that has spread to lymph nodes or distant organs (liver, lungs) is much harder to treat and significantly reduces survival. - Need for permanent colostomy: Advanced rectal cancer may require a permanent colostomy.", - Reduced survival: The most devastating consequence. A patient who could have been cured may face a terminal diagnosis.", - Physical and emotional toll: More aggressive treatment causes more side effects — nausea, fatigue, neuropathy, diarrhea, and emotional trauma.

Lavern's Law and Your Deadline to File

Colon cancer misdiagnosis cases in New York are subject to Lavern's Law, which provides a discovery rule for cancer cases. Under Lavern's Law:

- You have 2.5 years from the date you discovered (or should have discovered) the misdiagnosis to file a lawsuit. - There is an absolute outer limit of 7 years from the date of the negligent act.

This means that even if years have passed since the misdiagnosis, you may still have a valid claim if you discovered the error recently. For example, if you were diagnosed with advanced colon cancer in 2024 and discovered in 2025 that a gastroenterologist missed a tumor on a 2021 colonoscopy, you would have 2.5 years from the date of discovery to file.

Lavern's Law applies only to cancer cases. [Link to: /misdiagnosis/laverns-law]

Frequently Asked Questions

The value of a medical malpractice case in New York depends on several factors, including the severity of the injury, the strength of liability evidence, and the economic and non-economic damages involved. New York is one of the few states with no caps on medical malpractice damages, meaning there is no artificial limit on what you can recover. Below are typical settlement ranges based on injury severity.