Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure used to diagnose and treat conditions of the bile duct and pancreatic duct — gallstones in the bile duct, biliary strictures, and pancreatic duct obstruction. It is technically demanding and carries a higher complication rate than most endoscopic procedures, including a 3–5% risk of post-ERCP pancreatitis. When the procedure is not performed to the required standard, when complications are not recognised and treated in time, or when patients are not properly counselled about the significant risks before consenting, a negligence claim may arise.
What are common ERCP negligence scenarios?
- Post-ERCP pancreatitis not prevented — where prophylactic rectal indomethacin (recommended in all non-contraindicated patients) was not given
- Bowel (duodenal) perforation — from sphincterotomy or mechanical trauma
- Bile duct injury or perforation
- Failure to diagnose and treat post-ERCP pancreatitis promptly — not recognising deterioration and arranging appropriate monitoring and fluid resuscitation
- Performing ERCP without a clear therapeutic indication — where the risk-benefit balance required more conservative management
- Inadequate consent — failure to explain the 3–5% risk of pancreatitis, perforation, haemorrhage, and cholangitis in terms a patient could understand and base their decision on
All 63 claim types from the Devonshire document are now scripted. Updated gap status:
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Frequently asked questions
Can I claim for pancreatitis caused by an ERCP?
Possibly — if prophylactic indomethacin was not given (where there was no contraindication), or if the indication for the ERCP was not strong enough to justify the risk, or if the ERCP was not performed to the required technical standard.
Can I claim for consent failure before ERCP?
Yes — under the Montgomery standard, the significant risks of ERCP (including 3–5% pancreatitis risk) must be explained as material risks. Where this was not done and the patient suffered pancreatitis they were not warned about, a consent claim may be available.