Showing posts with label glans ablation. Show all posts
Showing posts with label glans ablation. Show all posts

Tuesday, July 18, 2017

CONNECTICUT: Baby's Glans Partially Amputated - Doctor Cleared of Negligence

Particularly in the United States, suing for circumcision malpractice is an uphill battle.

About 80% of US males are circumcised from birth, and though male infant circumcision rates have fallen in the past years, to about about 56% if CDC numbers are to be believed, the practice is still quite prevalent, at about 1.3 million boys circumcised a year.

This means that male infant circumcision is viewed favorably by a considerable number of the population.

The country is exposed to a constant drizzle of news articles and "studies" saying that circumcising male infants is "beneficial," and that adverse effects of it are "negligible."

So we, as a nation, are predisposed to believe that circumcision is a benign, "harmless" procedure and that nothing could ever go wrong.

It's no surprise, then, that any adverse results that do present themselves are minimized, and those who are at fault for negligence or malpractice are often absolved, boys and men who have to live with the consequences of a circumcision gone wrong be damned.

Connecticut Mogen Clamp Case
A circumcision malpractice case is currently stirring up controversy on Facebook, where at least one user who posted the case on his timeline has been punished with a 30 day ban.




The case in question is Mahoney v. Smith, a case in Connecticut where parents sued Dr. Lori Storch Smith over malpractice for a circumcision performed at Norwalk Hospital on December 29, 2010.

During this procedure, Dr. Smith used a Mogen Clamp, and then realized that she had cut off approximately 30% of the glans of the baby's penis. The baby was subsequently transported to Yale-New Haven Hospital where he had the amputated portion reattached.

The trial began on April 15, 2015 – and the jury cleared the defendant. The verdict was appealed, and the Appellate Court ruled against the plaintiffs on July 13, 2017.

Long story short, the jury was presented with evidence, and despite the fact that the child's circumcision resulted in 30% of his glans being amputated, decided that the Bay Street Pediatrics doctor should be cleared of medical negligence.

The Devil in the Details
The parents tried appealing the court decision but were unsuccessful.

They tried to argue that  a video shown in court was unfairly allowed by the trial judge, which may have swayed or confused the jurors.

The video shows a Mogen procedure being completed successfully without any complications.

Furthermore, details that were never an issue or point of contention were addressed, namely that anesthesia and the right surgical tools to control bleeding were used. (The end result was 30% of the child's glans being severed, regardless of how much anesthesia or which tools were used.)

According to the appellate court, rather than confuse, the video likely illustrated for the jury the testimony given by the Mahoneys’ own expert witness, Dr. David Weiss, describing a circumcision using a Mogen clamp, an allegation that can't be true, given the fact that the child's circumcision was a botched surgery, not one completed successfully as shown in the video.

The problem lies in the technicality that the Mahoneys' counsel identified the video as acceptable evidence for presentation prior to the trial.

The Mahoneys are apparently at fault for not having requested to see the video before it as presented and rejected it as evidence.

According to Law360, "The plaintiffs could have asked to watch the video prior to its introduction at trial, but did not do so; nor did they file a motion in limine seeking to preclude its admission into evidence, move for a continuance after it was marked for identification or recall Dr. Weiss to serve as a rebuttal witness concerning the video," the panel wrote in a nine-page opinion.

The Mahoneys tried to argue that use of the video violated the court rules regarding disclosure of expert testimony, but the panel rejected this argument saying the plaintiffs did not specifically make those claims in their motions to set aside the verdict for a new trial.

The jury, while deliberating, wanted to see the video again. However, this request was denied because the video itself was not part of the evidence, because it was not produced as evidence and was not a recording of the actual botched surgery. (Begging the question of why it was allowed to be shown in the first place.)

The jury then requested to hear again the declaration of the expert witness, the one that presented the video. They were told they could get a  transcript but that would take about 2 days to just listen to the transcript again.

It must be asked, what was the purpose of showing a video where the procedure went how it was supposed to in the first place?

How was it significant enough to show it to the jury the first time, but suddenly not significant enough to request to see it a second?

So if your blogger read the appellation correctly, the court discouraged the jury from re-hearing this testimony. In my opinion, this is necessarily the result of judges who are already circumcised themselves, and/or have circumcised children, working with a jury whose members are likely to be circumcised/parents of circumcised children themselves, both of whom already want believe circumcision is benign and could never go wrong, and want to see this case dismissed, so that they can go back to believing circumcision is "harmless" and "good."

In the end, a child's glans was partially amputated, and the jury believed the doctor wasn't negligent and performed the circumcision "properly" because that's what they saw in a video.

And it's the parents' fault for not requesting to see the video before it was presented.

The details can be read here.

It Doesn't Matter
 A Mogen clamp; the circumcision clamp used in this case

We can go on and on quibbling about the details in this case, how the judges, jury, lawyers handled it etc., but that is beating around the bush.

The fact is a mogen clamp was used in 2010, when it was already clear that there is potential for injury even in the best case.

I have already written numerous posts on this before, but the Mogen Clamp is notorious for glans amputations.


Common Mogen Problem: The circumciser is blind to the
conditionof the child's glans. Some or all of the glans is pulled up
along with the foreskin, resulting in partial or full glans amputations.

Back in August, 2000, the FDA issued a warning regarding the potential for injury employing the use of the Mogen and Gomco clamps, after 105 reports of injuries between July 1996 and January 2000.

On July of 2010, six months before this botched procedure, an Atlanta Lawyer won a $10.8 million lawsuit for the family of a baby whose glans was amputated during a Mogen clamp circumcision.

Mogen Circumcision Instruments of New York was already $7 million in default on another lawsuit, and was thus forced out of business.

Another baby, born on March of 2010 (9 months before this botched circumcision) also had the glans of his penis removed during a Mogen clamp circumcision. His parents filed a lawsuit on April of 2015.

The FDA warning was later archived, but remained accessible on their website for some time.

(Incidentally, your blogger tried accessing that warning today, but it is nowhere to be seen. The failed search even offers to search the FDA archive, but this is also a dead end. Fortunately, a copy of the warning can be found archived on the CIRP webpage.)

AAP Silent
In 2012, the American Academy of Pediatrics issued their policy statement on circumcision, in which they make the self-contradictory statement that “the benefits outweigh the risks”, but that “the benefits are not enough to recommend circumcision.”

Dr. Andrew Freedman from the task force said that “there are modest benefits and modest risks."

In their statement, the AAP tries to minimize the risks and complications of male infant circumcision, including the most catastrophic risks, which include partial or full ablation of the penis, hemorrhage and even death. Reported incidences of adverse effects of circumcision are dismissed as "case reports" because of the lack of statistics.

The AAP admits in their 2012 statement that "the true incidence of complications after newborn circumcision is unknown."

The AAP policy statement on circumcision is turning 5 years next month.

Will they reaffirm it?

Will they present a new one?

Are they even trying to document the actual number of catastrophic injuries?

The fact is, physicians and hospitals are not required to report adverse outcomes of circumcision procedures.

It's also a fact that the AAP is first and foremost a trade union, whose primary interest is the welfare of their members, a great deal of who profit from the business of male infant circumcision.

Something tells me they're not interested in conducting investigations that could prove devastating to their members.

The bottom line is that male infant circumcision is elective, cosmetic non medical surgery whose risks and complications are no longer deniable.

Are parents being warned of these risks?

But more importantly, can doctors get away with reaping profit performing non-medical surgery on healthy, non-consenting individuals?

Were it the amputation or extraction of any other part of the body, the medical fraud would be undeniable.

Why is it that doctors who perform male infant circumcision get a free pass?

Related News Articles:
Schmidt Law - Mogen Clamp Circumcision Lawsuit Filed for Penis Amputation

AJC - Atlanta lawyer wins $11 million lawsuit for family in botched circumcision

WCPO Cincinnati - Cincinnati protesters demand end to circumcisions at Good Samaritan Hospital

Journal of Perinatology - Pain During Mogen or PlastiBell Circumcision


Related Posts:
Mogen Circumcision Clamp Manufacturers Face Civil Lawsuit

The Ghost of Mogen

CINCINNATI: Intactivists Protest Circumcision "Experiment" at Good Samaritan Hospital

AFRICA: Botwsana to Implement Controversial Infant Circumcision Devices

Thursday, April 30, 2015

Mogen Circumcision Clamp Manufacturers Face Civil Lawsuit




Three Mogen Manufacturers and Distributors Face A Civil Law Suit
Mogen Circumcision Instruments of New York, the makers of the Mogen circumcision clamp, went out of business five years ago, but a lawsuit has been filed against several companies that continue to sell and/or make the device, according to the Schmidt Law Firm.

The lawsuit has been filed on behalf of a boy whose penis was partially amputated during a circumcision procedure involving the use of a Mogen circumcision clamp. Doctors amputated the tip of the boy's penis during his circumcision, which took place one week after his birth. The boy was permanently injured, will require future corrective surgery, and will continue to experience significant complications.

The civil lawsuit was filed a week ago in the Philadelphia Court of Common Pleas, against three Pennsylvania-based companies that sell the Mogen Clamp, including Misdom-Frank Corporation, Sklar Corporation, and Medco Inc.

The lawsuit can be accessed in PDF format here.

It's All Happened Before
Five years ago, one where it was ordered to pay $7.5 million by a jury in Massachusetts. The injury behind another lawsuit at Fulton County Superior Court had already put Mogen on notice about the danger of the device.

In a separate case, a judge approved a $4.6 million settlement on a behalf of a boy who lost the head of his penis in a botched circumcision attempt, this time against Miltex Inc. and its parent company, Integra Life Sciences Holding Corp. The doctor who performed the circumcision used a Mogen clamp, though manufactured by Miltex Inc.

According to the plaintiff's court papers filed regarding the settlement:
"Because of the defective design of the circumcision clamp, there was no protection for the head of the penis, and [the doctor] was unable to visualize the glans (or head of the penis) when excising the foreskin."
In this case, the boy, age 8 at the time of the lawsuit, lost 80% of his penis, according to the suit.

Data from Attorneys for the Rights of the Child, ARCLaw, show over 80 million dollars paid on settlements over botched circumcisions since 1985. Beyond the economic value (when compared to a billion dollar a year industry), those numbers represent children whose lives will have been impacted for the rest of their lives due to a non-medical elective surgery.

Notorious for Glans Amputations
The Mogen circumcision clamp is known for glans amputations, even when used by professionals.

In August 2000, the FDA issued the following Safety Communication:
“The clamp may allow too much tissue to be drawn through the opening of the device, thus facilitating the removal of an excessive amount of foreskin and in some cases, a portion of the glans penis. … We received 105 reports of injuries involving circumcision clamps between July 1996 and January 2000. These have included laceration, hemorrhage, penile amputation, and urethral damage.”
The "Manual for early infant male circumcision under local anaesthesia,"published by the World Health organization in 2010, details that both the Mogen clamp and the Gomco clamp have a risk for penile laceration and amputation, but extends to say that "penile amputation can occur even under ideal circumstances" with the Mogen clamp.

In a 2013 study in Botswana, the Mogen clamp and the Plastibell were compared. The adverse events with the Mogen clamp were considered to be more frequent but "minor" (removal of too little skin and development of skin bridges and adhesions). Bleeding was more frequent with the Mogen clamp as well.

Unlike other circumcision devices, the Mogen Clamp has two major design flaws:
  • The head of the penis is not protected by a shield or bell
  • The doctor cannot see the head of the penis when cutting the foreskin with a scalpel.

Common Mogen Problem: The circumciser is blind to the condition of the child's glans. Some or all of the glans is pulled up along with the foreskin, resulting in partial or full glans amputations.
Despite the Mogen clamp's notoriety for glans amputations, and despite the FDA warning given 10 years prior, Mogen Circumcision Instruments insisted 'till the very end that injury was impossible with the use of their clamp. When called for interview, the secretary for the company who was served the papers of the lawsuit that would put them out of business, said that the Mogen circumcision clamp was "painless and safe when used properly."

The Mogen Legacy Continues Today
5 years after the Mogen company was put out of business, and 15 years after the FDA issued their warning, other companies continue to manufacture and sell the Mogen clamp, doctors continue to use it, and the botches continue to happen. In addition, the devices are easily accessible. As of now, Mogen clamps can be purchased on eBay for under $15, and anyone with a credit card can buy them without license.

The FDA gave their warning in 2000, but the clamps were never recalled or modified, doctors kept using them, and the injuries kept on occurring. It wasn't until last year, in December of 2014, that the FDA recalled a number of Mogen clamps from a number of manufacturers, including Boss Instruments, Millennium Surgical, Symmetry Surgical, Medline Industries, CareFusion and others. The reason given in the text for the recall, however, was that “Instrumed did not market these devices prior to September 26, 1976, and therefore, does not meet all FDA requirements to market the devices as 'Pre-Amendment' devices." Certain companies, however, such as Misdom-Frank Corporation, Sklar Corporation, and Medco Inc., continue to sell and/or make the device.

Although the Mogen clamp itself was invented in 1954, it is actually one of many successors to a much older, traditional barzel device. Even so, a number of interested doctors who use the device, try to market the Mogen clamp as "a new and innovative approach."

 The Mogen clamp's design is based on
a traditional tool used by Jewish mohels.
The word "mogen" is derived from the
Hebrew word for "shield," or "magain."

Neil Pollock, Murray Katz, Pierre Crouse and other doctors who specialize in male infant circumcision, boast their use of the Mogen clamp, and claim their "technique" to be "new and innovative," going as far as saying that the circumcisions they perform are "bloodless, painless and taking under 30 seconds."


Neil Pollock, flashing the tools of his trade

Neil Pollock in particular, has taken it upon himself to promote the use of the Mogen clamp as far away as Rwanda in Africa, and Haiti in the Carribean Rim. In fact, the WHO has approved the Mogen clamp for use in infant circumcision in Africa, under the pretext of HIV prevention. They're currently being used in Kenya, Rwanda and Botswana.

Even given the disreputable history of the Mogen clamp, somehow, "researchers" at TriHealth Good Samaritan Hospital in Cincinnati thought it was necessary to conduct a comparative "study" to see what was the "better circumcision clamp." Given what is known about the Mogen clamp, the lawsuits, the FDA warning, the WHO etc., somehow the "researchers" have the audacity to begin with the hypothesis that the Mogen clamp is the superior circumcision device.

Conclusion
Even given the numerous reports of injury, even given the FDA warnings, even given the numerous lawsuits that put Mogen Circumcision Instruments out of business, even given the lawsuits against secondary manufacturers, even given the known design flaws of the clamp, even given the known risks for penile laceration and amputation even under the most ideal circumstances, the Mogen clamp continues to be made, sold, used and promoted as "medically acceptable."

It must be asked, why?

Related News Articles:
Schmidt Law - Mogen Clamp Circumcision Lawsuit Filed for Penis Amputation




Related Posts:
The Ghost of Mogen

CINCINNATI: Intactivists Protest Circumcision "Experiment" at Good Samaritan Hospital

Letter to Editors at the Vancouver Sun

AFRICA: Botwsana to Implement Controversial Infant Circumcision Devices

CANADA: Circumcision Evangelist Sets His Sights for Haiti, Caribbean


CIRCUMCISION PHALLUSIES BLOG SERIES: Ad Novitam

Thursday, March 7, 2013

Another Mohel Botches a Bris


Whenever a botched circumcision case makes the news, and people start talking about it, either in the commentary section (when news outlets are actually brave enough to allow them), or parenting forums, or on Facebook, there is always somebody who says something along the lines of:

"This wouldn't have happened if it were performed by a mohel. Mohels are jacks of their trade who do circumcisions for a living."

Actually, mohels are often put on pedestals in more ways than one.

A Jewish bris performed by a mohel is better than a hospital circumcision performed by a doctor for a myriad of reasons. Here are some that I've heard:
  • Mohels are more experienced, so your son is sure not to suffer a botched job
  • Mohels take less time than doctors(some claim less than 10 seconds), shortening the painful procedure
  • Mohels don't use pain medication (this is supposed to be a good thing, in spite of the facts)
  • Mohels do their work outside of the hospital, in a religious setting, giving "meaning" to circumcision, making it more "holistic" ("holistic" taking on an entirely different meaning here)
There are other reasons, but these seem to be the main ones.

Now, there have been quite a few documented cases of mohels botching a bris, and being taken to court for it. (For example, here and here.)

But whenever I bring these up, strings and straws are grasped for, here and there, and Jewish circumcision advocates begin to list off alibis of why these are "special cases," and why mohels continue to be the best circumcision performers.

Among these are:
  • The child had a pre-existing condition; not the mohel's fault (when a child is found later on to be a hemophiliac, have a heart condition and other ailments)
  • The child had a particularly strange-shaped penis to work with; the case is an exception
  • The botch was a result of clamp malfunction; mohel is not at fault
  • The botch was performed by an inexperienced mohel; not a representative case
It's interesting to hear Jewish advocates of circumcision clarify that the bris has to be performed by a "trained and qualified mohel."

Thus, the reasons why Jewish circumcision performed by a mohel in a bris milah ritual are an ever moving target, and Jewish circumcision and its officiators remain sacrosanct.

Parents Usually Not Forthcoming
One of the reasons why very few botched circumcision jobs make the news is because parents, both Jewish and non-Jewish alike, are complicit in keeping the botched circumcision job and its perpetrator secret.

What parent wants to admit that their child has been permanently disfigured because they decided to agree to a medically unnecessary procedure?

In the case of Jewish parents, who wants to admit that what is perhaps the most precious of Jewish mitzvot is the cause of their child's disfigurement, and in worse cases, death?

As an example, when investigators were querying the Jewish families whose babies were infected with herpes, they would not name names. People in these communities were also unwilling to help find the perpetrator. The preservation of a cherished tradition that people have emotional attachment to is more important.

Circumcisors, Jewish and non-Jewish have reputations to protect. Gentile parents have peace of mind to preserve. Jewish parents have the added burden of protecting their own, and not giving away a holy man who performs the sacred ritual of bris milah. Thus, silence is perpetuated, and parents are complicit in keeping this silence.

That is, until now.

Circumcision Lawsuits
Recent years have seen a series of lawsuits against circumcisors, mohels and doctors, sometimes people who are both, for circumcision mishaps, which indicates that there are parents who are deciding to no longer keep silent about what has happened to their sons.

In a very recent case, a judge approved a $4.6 million settlement on a behalf of a boy who lost the head of his penis in a botched circumcision attempt. The doctor who performed the circumcision used a Mogen clamp, a device notorious for glans amputations, even when used by professionals. So notorious is the Mogen clamp for glans amputations that the company that makes this device went out of business, because it couldn't afford the $11 million dollar lawsuit filed against it, after a mohel severed the end of another baby's glans using one of their clamps

The peculiar thing about Mogen is that up until the very end, they claimed that injury was impossible with the use of their clamp, "when used properly," even after other glans amputations were reported. The injury behind a prior lawsuit at Fulton County Superior Court had already put Mogen on notice about the danger of the device. In a different case, at South Fulton Medical Center, another law suit was won in 2009. In that case, a child lost a third of his glans, and the plaintiffs were awarded 2.3 million dollars.

And, just this month, another mohel was taken to court by parents in Queens. The rabbi told the parents he did an "acceptable job" that was "performed appropriately" and "within the standard of care and skill required of Jewish mohelim and circumcisers." He also allegedly told the parents that calling a doctor wasn't necessary, even though it was obvious that something had gone wrong with the bris. The parents claim that the delay in medical treatment resulted in greater permanent damage to his son, resulting in the necessity for corrective surgery with general anesthesia; the boy may need more operations in the future.

Of course there will be those who claim that this would never happen if the circumcision were "properly performed."

To which I would retort that female circumcision does not result in complications "when properly performed" by the right shaman priestess either.

The self-serving, ad hoc special pleading is astounding.

Interesting note; Jewish groups are challenging a New York law that says mohels have to warn parents of the risks, and have them sign a consent form before proceeding. Does this mean that Jewish parents AREN'T being told of the risk of glans ablations, herpes infections and death?

Hopefully more parents, Jewish and non-Jewish, will find the courage to bring the botched circumcisions of their sons to light.

Related Posts:
Circumcision Botches and the Elephant in the Room 

The Ghost of Mogen 

Mohels Spreading Herpes: New York Looks the Other Way 

New York: Oral Mohel Tests Positive for Herpes 

Circumcision Indicted in Yet Another Death: Rabbis and Mohels are "Upset"

Herpes Circumcision Babies: Another One? Geez!

 Rabbis Delay NYC's Metzitzah B'Peh Regulations - Meanwhile, in Israel...