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Introduction Health systems often emphasize technical skills to reduce iatrogenic injuries. Nontechnical skills such as clinical and communication skills are mostly overlooked or not readily retrievable from medical records. Our aim was to estimate the association of technical and nontechnical skills of endoscopists with indemnity payments to patients after endoscopic perforations. Methods This is an observational registry-based study of closed claims against gastroenterologists involved in endoscopic perforations. Results We analyzed 17