Medical professional concedes he would've seen tumour if he continued colonoscopy
The Manitoba Court of Appeal denied an appeal from a trial judgment finding that a doctor’s negligent performance of a colonoscopy did not cause his patient’s death from colorectal cancer.
The patient in the case of Tripp v Ross, 2025 MBCA 25, visited his family physician’s office
with complaints about abdominal cramps and rectal bleeding. His family doctor referred him to the defendant doctor for a colonoscopy.
In January 2018, the defendant performed a colonoscopy, observed five polyps, and biopsied four. After the pathologist found a risk for developing adenocarcinoma, the defendant told the patient to return for a follow‑up colonoscopy after a year.
By August 2018, the patient experienced episodes of abdominal pain and rectal bleeding. He returned to his family physician, who referred him again to the defendant. In September 2018, the defendant ordered a barium enema, which revealed a tumour in the patient’s descending colon. A CT scan confirmed the tumour and other abnormalities.
In October 2018, when the patient had stage IIIC cancer, a surgeon removed his tumour, 40 percent of his pancreas, his spleen, and all except a foot of his lower bowel. The patient suffered post‑surgery complications and underwent numerous chemotherapy cycles, CT scans, and MRIs.
In January 2020, the patient learned that he had stage IV colorectal cancer with liver metastases. He filed a medical malpractice claim alleging that the defendant’s negligence delayed his diagnosis of colorectal cancer. He passed away due to this illness in February 2022.
The defendant conceded that his negligence in conducting the colonoscopy delayed the cancer diagnosis by eight months. Upon finding the polyps, he appeared to assume he had discovered the cause of the bleeding and stopped the procedure. He did not dispute that he would have seen the tumour if he continued the colonoscopy.
The trial judge considered the evidence and determined that the defendant’s negligent performance of the colonoscopy did not cause the patient’s death. However, she awarded damages of $75,000 upon concluding that the delayed diagnosis caused the patient’s pain and suffering.
As a representative of the patient’s estate, the plaintiff appealed the trial judge’s decision. The Court of Appeal of Manitoba dismissed the appeal.
The appeal court ruled that the trial judge issued thorough reasons, made no reversible errors in her factual findings, and properly stated and applied the relevant legal principles regarding causation in negligence in the case of Benhaim v St-Germain, 2016 SCC 48.
The appeal court decided that the evidentiary record reasonably supported the trial judge’s findings that the patient had liver metastases and a 30-percent chance of survival at the time of the colonoscopy in January 2018.
The appeal court found the trial judge entitled to determine that the liver metastasis was most likely existing at the time of the negligent colonoscopy, that detecting cancer in January 2018 would not have given the patient a more than 50-percent chance of survival, and that the defendant’s negligence did not cause the patient’s death.
The appeal court said that the trial judge carefully reviewed all the evidence, reasonably found the medical experts’ evidence mostly consistent, and made no palpable and overriding errors in accepting the testimony of the oncologist called by the defendant.
The appeal court noted that the oncologist relied on widely accepted statistical survival rates for colon cancer and gave the opinion that the patient had a 30-percent chance in January 2018. The appeal court added that the oncologist based this opinion on the size of the liver metastasis found in December 2018, the kind of cancer involved, and the doubling rate of cancer cells.
