Is Bowel Perforation Considered Surgical Malpractice?

Gregg Hollander | November 4, 2026 | Medical Malpractice

A bowel perforation discovered after surgery can leave a family with two very different explanations: the injury was an unavoidable complication, or something went wrong that should have been prevented or recognized sooner.

Bowel perforation medical malpractice depends on much more than the fact that the bowel was injured. The central questions are how the perforation occurred, whether the medical response met the standard of care, and whether a failure to meet the standard of care changed the patient’s outcome.

Hollander Law Firm brings over 30 years of experience to significant medical malpractice cases. We examine the operative record, postoperative course, diagnostic testing, and timing of treatment to determine whether a recognized complication became a preventable catastrophic injury.

Please send us a message or call (561) 347-7770 today for a free consultation.

What Is a Bowel Perforation?

A bowel perforation is a hole or tear in the small or large intestine that allows intestinal contents to escape into the abdominal cavity. This can cause peritonitis, which is inflammation or infection of the abdominal lining, as well as sepsis, internal bleeding, and other life-threatening complications.

During surgery, the bowel can be accidentally cut, punctured, or burned by a surgical instrument. Some injuries are noticed right away, while others may not become obvious until after surgery.

Legally, the issue is whether the bowel was injured because the surgeon fell below the standard of care. Even when the perforation itself was an unavoidable complication, a separate malpractice issue can arise if the injury was not promptly recognized or treated.

What Are the Signs of Bowel Injury After Surgery?

Bowel injury signs after surgery can include worsening abdominal pain, swelling, fever, nausea, vomiting, abdominal tenderness, and signs that the intestines are not functioning normally. A developing perforation may not look dramatic immediately after the original procedure, which is why the postoperative timeline matters.

Potential warning signs include:

Severe or worsening abdominal pain. Some discomfort is expected after abdominal surgery, but increasing pain, marked tenderness, or pain that does not fit the expected recovery may require further evaluation.
A swollen or rigid abdomen. Abdominal distention and increasing tenderness can accompany leakage and inflammation within the abdominal cavity.
Fever or chills. These can indicate infection, particularly when they occur with abdominal symptoms or abnormal laboratory findings.
Nausea, vomiting, or persistent bowel dysfunction. Failure of normal bowel function after surgery can have several causes, but persistent or worsening symptoms may become important when considered with the rest of the clinical picture.
Rapid heart rate, low blood pressure, confusion, or other signs of deterioration. These findings may indicate advanced infection, sepsis, or shock and require urgent assessment.

These symptoms are not proof of malpractice, and some overlap with ordinary postoperative problems. Their significance lies in how the medical team responds. A malpractice analysis may examine whether worsening symptoms prompted an examination, laboratory testing, CT imaging, surgical consultation, or another appropriate response promptly.

Anyone experiencing sudden or severe abdominal pain, a rigid or swollen abdomen, fever with worsening symptoms, or signs of shock after surgery should seek emergency medical care. Gastrointestinal perforation can become life-threatening without prompt treatment.

Is a Nicked Bowel During Surgery or Other Bowel Injury an Unavoidable Surgical Risk?

A nicked bowel or other injury during surgery can be a recognized complication without being malpractice, but calling an injury a “known risk” does not end the legal analysis. Florida law requires evidence that a healthcare provider departed from the level of care, skill, and treatment considered acceptable by reasonably prudent similar providers under the circumstances.

That distinction matters because bowel injuries are documented complications of some abdominal and laparoscopic procedures. The question is not simply, “Can this complication happen?” It is whether the particular injury and its response were consistent with appropriate surgical care.

Potential negligence may involve circumstances such as:

Injury caused by improper surgical technique. The location of the operation, anatomy, adhesions, prior surgeries, and the instruments used can all affect whether damaging the intestine was reasonably avoidable.
Failure to recognize an injury during surgery. Operative findings may indicate that the bowel should have been inspected or that an abnormality required further assessment before closing.
Failure to recognize a thermal injury. Electrosurgical equipment can damage bowel tissue without creating an immediately obvious full-thickness hole. A later perforation requires careful analysis of the operative technique and postoperative course.
Failure to respond to postoperative warning signs. Repeated complaints, abnormal vital signs, changing laboratory results, or increasing abdominal findings may support additional testing or surgical evaluation, depending on the circumstances.
Delay after the perforation was identified. Once an intestinal leak is suspected or confirmed, a delay in controlling contamination may substantially increase the risk of peritonitis, sepsis, and organ damage.

A consent form does not give a surgeon permission to practice negligently. Florida law specifically distinguishes foreseeable consequences of properly performed treatment from injuries resulting from a departure from the professional standard of care.

This is also why outcome evidence matters so much. A technical error that is immediately recognized and repaired without lasting harm may not support the same claim as a missed perforation that progresses to sepsis, bowel loss, organ failure, or death.

What Legal Options Do I Have for a Bowel Injury After Surgery?

You may have a Florida medical malpractice claim if the bowel injury resulted from care that fell below the medical standard of care and caused additional harm.

A lawyer will look at the entire course of treatment. That review may include whether the bowel was injured due to improper technique, whether the injury should have been recognized during surgery, and whether postoperative symptoms were evaluated promptly enough.

Important evidence can include:

Operative records. These may show how the procedure was performed and whether any complications were noted.
Postoperative records. Nursing notes, vital signs, laboratory results, and physician assessments can help show when the patient began to deteriorate.
Imaging and follow-up treatment. CT scans, emergency care, and later surgery may help establish when the perforation became apparent and what harm it caused.
Expert review. Florida generally requires a qualified medical expert to support a malpractice claim before suit is filed.

The central issue is causation. Even when negligence occurred, the claim must show that it was more likely than not the cause of the additional injury. In a bowel perforation case, that may mean proving that earlier recognition or treatment likely would have prevented sepsis, organ damage, additional surgery, permanent bowel problems, or death.

FAQs

What Is the Average Perforated Bowel Settlement?

There is no meaningful average settlement that can predict the value of an individual case.

Case value can depend on various factors, including:

Strength of the evidence,
Future medical needs,
Lost earning capacity,
Willingness of the defendants to negotiate,
Permanence of the injury, and
Liability distribution.

Florida does not generally cap economic damages such as medical expenses and lost wages. Although Florida law caps noneconomic damages such as pain and suffering, the Florida Supreme Court struck down the general caps on medical malpractice cases as unconstitutional. However, some caps still apply in specific situations. For example, noneconomic damages are capped when the parties agree to Florida’s voluntary binding arbitration process (and still apply if the arbitration is rejected and the case proceeds to trial) and for malpractice claims involving Medicaid recipients. Because the applicable limits depend on the circumstances of the claim, an attorney can determine which damages rules apply.

How Long Do I Have to Bring a Bowel Perforation Lawsuit?

Florida generally requires a medical malpractice action to be commenced within two years of the incident or within two years of when the incident was discovered, or reasonably should have been discovered. The statute imposes a four-year outside limit, generally barring recovery after that period.

The Insurance Company Offered Me a Settlement. Should I Accept?

Speak with a lawyer before discussing or accepting a perforated bowel settlement. An insurer may offer money early, before your condition has stabilized and before doctors can say whether you will have lasting complications or need additional treatment.

Once you sign a settlement release, you generally cannot reopen the claim. Waiting until you reach maximum medical improvement can provide a clearer picture of the injury’s long-term effects before you decide whether an offer is adequate.

Get Answers About What Happened After Your Surgery

A bowel injury can be a recognized surgical complication, but that does not explain whether the injury was avoidable, should have been discovered earlier, or became far more damaging because treatment was delayed. Those questions require careful review of the procedure and the entire course of care that followed.

At Hollander Law Firm, we investigate a bowel perforation medical malpractice claim by examining whether a departure from the standard of care actually changed the outcome.

The firm represents clients throughout Florida and has offices in Boca Raton, Fort Lauderdale, and West Palm Beach. If a perforation caused permanent injury or a loved one died after a surgical complication, contact Hollander Law Firm online or call (561) 347-7770 today to discuss whether the medical evidence supports a bowel perforation lawsuit and what Florida law allows you to pursue.

Legal References Used to Inform This Page

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