This case involves a female patient who had been treating with a family physician regularly for more than a decade, and had also consulted with a colo-rectal surgeon multiple times for what she was told were hemorrhoids. On one occasion, the colorectal surgeon performed banding procedures in the area of what was discovered soon after to be a large, necrotic tumor. He banded the area several times, but never identified the tumor as such. Some time after this, a colonoscopy was performed by another colorectal surgeon who discovered the presence of a large necrotic mass. A CT scan of the abdomen revealed irregular wall thickening involving proximal rectum with posterior rectal wall mass, as well as other signs that represented regional metastasis. At this time, rectal carcinoma was diagnosed and subsequently treated with chemo-radiotherapy to reduce the size of the tumor before surgery could be undertaken. It was alleged that earlier colonoscopies should have been performed to detect the tumor, and that the patient suffered a worse outcome as a result of this failure to diagnose.