Tuesday, July 20, 2010

Botched Circumcision

Yes, that's right two words that no guy likes to hear in immediate juxtaposition to one another. 

Reporter,Ty Tagami at the Atlanta Jounal Constitution alerts us to the $11 million dollar verdict for the infant who sustained an injury arising out of device used in this common procedure.  This is from the AJC story:

The maker [Mogen] of an instrument used in circumcisions claimed that injury was impossible with its use, but after an infant lost a portion of his penis during an operation with the Mogen clamp (pic), a judge awarded $10.8 million in damages against the company.
The judgment handed down Friday in New York involves an Atlanta lawyer who has been crusading against circumcision as a dangerous and unnecessary practice.  Attorney David Llewellyn won a similar case in Atlanta last year and the injury behind that prior lawsuit in Fulton County Superior Court put the New York clamp manufacturer on notice about the danger of the device, his current lawsuit said.

The baby in the current case, identified in court documents only as L.G., lost the entire glans, or head, of his penis after it was pulled into the jaws of the clamp, according to a federal magistrate's order. On Friday, U.S. District Judge Jack B. Weinstein ordered Mogen Circumcision Instruments of New York to pay $10.8 million in compensatory and punitive damages to the Florida boy, now 3, and his parents.

The company is going out of business, according to a woman who answered the phone at its Brooklyn headquarters Monday. The woman, who said she was a secretary and would identify herself only as D. Rotter, the person whom Llewellyn said was served papers in the lawsuit. She said increased competition has undermined their business.

'It's just kind of dwindling down to nothing,' she said, adding that the phones at the Mogen office were scheduled to be disconnected Tuesday. Mogen didn't defend itself in court, and Rotter said it was because the company couldn't afford it. She said the Mogen clamp is 'painless and safe' when used properly. The case involving the Florida boy was 'unfortunate,' she said, adding that 'any medical mishap is unfortunate.'

In this case, a New York mohel, or Jewish ritual circumcisor, performed the operation in the baby's home, Llewellyn said. The mohel negotiated a separate settlement, the terms of which Llewellyn would not disclose. Llewellyn won another circumcision case in 2009 over an operation at South Fulton Medical Center. In that case, which involved a baby identified only as D.P. Jr., the mother contended that the doctor who circumcised him removed too much tissue and that his pediatrician failed to respond when a nurse complained of excessive bleeding. The tip of the penis was placed in a biohazard bag and might have been reattached if he'd gotten attention in time, Llewellyn said in 2009. His lawsuit in New York says D.P. Jr. lost a third of his glans. The jury found that both the pediatrician and the physician who performed the circumcision were negligent, and awarded $2.3 million to the plaintiffs. South Fulton Medical Center was absolved of liability.

In Friday's decision, the court determined that Mogen had to pay for medical expenses and for the years of psychotherapy that will be needed. The boy suffers pain when he urinates, the court order says. He will eventually be able to have sex, but he is likely to be embarrassed and will likely have trouble forming 'meaningful' relationships with girls, it adds. 'At 3 years old, L.G. is aware that he looks different from other boys based on both his own observations and comments from other children which make him feel inferior .'
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Wow, talk about an unusual "specialty" Mr. Llewellyn developed. 

I'd be interested in whether tort law provides a remedy for female victims of genital mutilation. It's not something I've looked at or considered, but I invite your views on the subject. 

This is an extraordinarily difficult subject because of the profound religious and cultural significance of these practices.  While I have an opinion on nearly everything, this is one area where I know so little and can add very little insight.  Maybe you can help me sort out some ways of thinking about the subject?

29 comments:

  1. No! You need a good rabbi-mohel, then no problem.

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  2. It's always amazing the extent to which people defend infant genital mutilation.

    "It's always better if done this way, by this guy. Then there's no problem"

    Yeah, except when it doesn't go right, right? I've got a few links of cut jobs that went wrong, both by mohels and medical doctors.

    So who to go to?

    Is this risk defensible in an elective, non-medical procedure?

    The mogen clamp has been around for ages, and despite the claims of a "risk-free procedure," it has a really bad history. This is why they won the law-suit.

    Neil Pollock in Vancouver offers his services as a child circumcisor using a "new and innovative technique." Actually, no he just re-hashes the mogen clamp. Nothing new, under the sun. I wonder how many close calls THAT guy's had?

    The story kind of frames Lewellyn as a "bad lawyer." Maybe "racist" even, for going after circumcision, this "holy tradition" for some people. (Namely Jews and Muslims.) But would we paint a lawyer that went after people who performed FGM under the same light?

    Why do we only vilify the lawyer that goes after MALE circumcision?

    If there is something wrong with our society, shouldn't it be somebody's job to fix it, however dirty a job it may be?

    It's time people took a serious look at what happens 3,000 times a day in our country. How many boys are living with botched procedures, but whose parents didn't want to deal with a litigation? The sad truth is, circumcision is irrevocable. There's no taking it back. Parents have no choice but to live with the consequences of it, good or bad. And a lot of the time, they won't say a peep, even when they know it's bad. The child grows up with a deformed penis for the rest of his life, and the myth that "there are no risks" continues to be perpetuated.

    Not too long ago, there was a couple... I think it was Canadian... their son died just after a circumcision. The parents, when asked about it said they'd "do it all over again if they had a second chance." Yes. That bad. People simply don't want to face the truth. They'd rather the lie continue for their own sake.

    Despite the fact that Mogen is being charged 11 million, Rotter has the nerve to insist "the Mogen clamp is 'painless and safe' when used properly." Denial up to the bitter end.

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  3. Advocates of circumcision will NEVER admit the truth. Circumcision is a baseless blood ritual. People try and try, but they can never quite reconcile it with the fact that is medically unnecessary procedure. A double-standard exists; when you cut a boy's genitals, it's "sacred tradition." When you cut a girl's genitals, it's "genital mutilation."

    One must ask, what's the reason people write so many studies on male circumcision? Some people defend male circumcision by saying "well it has all these benefits. You know, studies say..." Yeah. There are so many "studies."

    "Female circumcision is genital mutilation because it doesn't have benefits."

    Female circumcision is not shown to have any benefits because nobody has written tons of studies on it like they have on male circumcision. WHY this double-standard? With male circumcision, it's "study it 'till it's ethical." It hasn't proven "un-ethical" (in other words, that it DOESN'T have claimed benefits), but you don't need a single study to condemn female circumcision. Is anyone familiar with the Stallings 2009 study? Google it. According to Stallings et al., female circ can reduce HIV transmission as much as 50%. Still other studies show that "FGM kills a woman's sex drive" is a myth. Women that have undergone infibulation, which is the WORST kind of FGM, can still orgasm. So, if FGM doesn't have all that bad of an effect, and it decreases HIV by 50%, what's keeping the WHO from endorsing it? I say it's because they know that if they do, they'll get their asses handed to them just like the AAP. (The AAP tried to endorse a "ritual nick" this past May. They sure learned their lesson...)

    So yeah. There are all kinds of double-standards surrounding male circumcision and female circumcision. I'm so glad these suits are happening. They are bringing attention to the fact that, HELLO, yes circumcision DOES have risks. It's not "risk free" as mogen promised. As much as 200 babies die a year.

    EXCELLENT Blog post.

    For further reading, please visit:

    http://www.circumstitions.com

    http://www.cirp.org

    http://norm-uk.org/

    http://www.doctorsopposingcircumcision.org

    http://www.nocirc.org

    http://www.circumcisionandhiv.org

    For more info on circumcision litigation, go to:

    http://www.arclaw.org

    http://www.mgmbill.org

    Some people feel so devastated by their circumcisions they actually go through the trouble of stretching out a new foreskin from the remnants of what they had. Not exactly the same, but the next best thing...

    http://www.tlctugger.com

    And, just so you can see that people against circumcision aren't necessarily against Judaism, check out these Sites. There are Jews against circumcision, believe it or not! :-)

    http://www.jewishcircumcision.org/

    http://www.jewsagainstcircumcision.com/

    Only 5% of all circumcisions in the US are Jewish. The rest of the 95% are secular circumcisions that happen at hospitals. I'm against ALL of it. :-)

    Good look in searching for what you seek!

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  4. Though circumcision is infused with religious significance, it is an abuse of human rights to perform it on an unconsenting minor and thus should not be legal. Why not include a circumcision as part of a bat/bar mitzfah when the boy can decide on his own whether or not he wants to join the Jewish community? Such tragic complications resulting from a medically unnecessary surgery astound me.

    In addition to the links Jospeh provided, check out intactamerica.org!

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  5. Joseph
    Thank you so much for the information, when I get a chance I promise to look closedly at the information you supplied.
    BL

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  6. Anon @11:02
    Thank you for the link, I'm very grateful for the information.
    BL

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  7. No matter how you look at it, circumcision is removing part of a male's penis and takes away a child's autonomy and right to choose. It also takes away from their adult sex life. I think it's disgusting and this story is just one of many reasons it should be illegal to mutilate any humans genitals.

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  8. Joseph, I couldn't have said it better myself.

    Male Genital Mutilation is wrong in every way, NO ONE should chop off a part of another person's genitals with out the owner of the genitals consent.

    As for "religious" reasons....YOUR religion ENDS where another person's GENITALS BEGIN!

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  9. How did this barbaric ritual make it past the dark ages? Any parent who thinks they have the right to mutilate their sons genitals should not be allowed to have children.

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  10. Thank you all for the passionate comments, I'd love to hear a little more from the other side of this argument.
    BL

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  11. As usual, Christopher Hitchens is dead-on ("as usual" referring to his views on religion, not necessarily anything else):

    http://www.youtube.com/watch?v=Xx_ov2NiNo4

    His bit starts at 3:25, though the rabbi and minister who speak first are useful exemplars of the other side's mentality. CH's retort to the rabbi's asinine rebuttal is very worth watching - starts at 4:48.

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  12. Other side of the argument BL? Do you ask for this thing when debating female genital cutting? No? Why not when the American Academy of Paediatrics - no less - has recently admitted that many forms of FGC are less severe than male circumcision? One of the commonest forms (type IV) just makes a little slit in HER foreskin. If forced genital cutting is a moral outrage, then it's a moral outrage whether the target is male, female or intersex, black or white, one day old or 100 years old.

    There is no 'other side of the argument'.

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  13. Lippy--
    You are right, I would not ask for the other side of the argument if it involved femal genital cutting. Thank you for making that point.

    I do believe that there is a "health" basis for male circumsicion and I was looking for someone to raise this as a point of discussion.

    But all of the comments, have enlightened me, particulalry as to the passions.

    Disclosure: I was a victim of a "botched circumcision" that thankfully (?) is only a faint scar.
    BL

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  14. The World Health Organization (WHO; 2007), the Joint United Nations Programme on HIV/AIDS (UNAIDS; 2007), and the Centers for Disease Control and Prevention (CDC; 2008) state that evidence indicates male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, but also state that circumcision only provides partial protection and should not replace other interventions to prevent transmission of HIV.

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  15. Please do not compare male circumcision to female genital mutilation. For it to be an accurate comparison, male circumcision would have to routinely constitute exactly what this boy was able to sue for -- the removal of the entire glans.

    If there is an argument against male circumcision, it should stand on its own right. You shouldn't have to rely on faulty and inaccurate comparisons.

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  16. Even if there is a "health" basis to male genital cutting, it is the individual owner who alone has a stake in the outcome, therefore it is his choice alone whether or not to have the surgery.

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  17. Female circumcision: removal of the clitoral hood (foreskin).
    Male Circumcision: removal of the glans hood (foreskin).

    I can't believe the Double standards in America. It's time to protect our baby boys!

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  18. Thanks for the well written summary of male circumcision Jospeh. However, many myths of male circumcision still remain unaddressed.

    As for any health benefits, there are simply none that justify the procedure. If you cut any part of the human body off, you eliminate any potential health problems with that part. This is also true of female circumcision. The problem with either is that both affect the performance and functionality of both sexes as would be expected.

    In The US where we actually know very little about female circumcision, myths are rampant. Myths about male circumcision are also rampant simply because it is something that is practiced in our culture and must be defended at all cost. I suspect this is because at some level we realize that it smacks of gender bias and sexual motivations. In fact, if male and female circumcision are evaluated on a functionality basis, only type IV, "Pharonic" female circumcision is more invasive and debilitating than the typically performed male circumcision. The myth that female circumcision is always destroys the female's ability to participate or enjoy sex defies all reason and logic as evidenced by the reproduction statistics of the regions where it is practiced. This is simply cultural racism.

    Yes, there have been many studies on male circumcision. If you study the history of most of the study authors, you will find a distinct agenda whether it be that the study authors have a religious motive or some sort of fetish. The vast majority of the recent studies absolutely conflict with known scientific fact.

    For instance, recent studies have purported to show that male circumcision prevents transmission of the HIV virus. If these studies were true, HIV would be conspiciously absent from cultures that practice male circumcision. Instead, there is no evidence in actual populations that male circumcision provides any protection at all. The US has the highest circumcision rate among the industrialized nations and also the highest HIV infection rate.

    The much publicized African studies purported to find a similar prophylactic effect to the polio vaccine. However, the results have been much different and the expected results are not observed anywhere in the world. This is prima facie evidence The African studies are fraudlent. Research of the history of the researchers show both an agenda and a religious bias.

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  19. No girl wants to go near a guy with an anteater.
    Gross!!!

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  20. Wow - the anti-circ propaganda machine has descended upon this post with a vengeance!

    Here's the other side of the argument BadLawyer:

    Male circ can be viewed as a "surgical vaccine" against a wide variety of infections, adverse medical conditions and potentially fatal diseases over their lifetime, and also can protect circ recipients' sexual partners.

    The public health benefits are enormous, and include protection from urinary tract infections, that are common over the lifetime, inferior genital hygiene, smegma, sexually transmitted HIV, oncogenic types of human papillomavirus, genital herpes, syphilis and chancroid, penile cancer, and possibly prostate cancer, phimosis, paraphimosis, thrush, and inflammatory skin conditions such as balanitis and balanoposthitis. In women circumcision of the male partner provides substantial protection from cervical cancer, genital herpes, bacterial vaginosis (formerly termed "gardnerella"), possibly Chlamydia (that can cause pelvic inflammatory disease, infertility, and ectopic pregnancy), and other infections.

    Circumcision has socio-sexual benefits and reduces sexual problems with age and diabetes. It has no adverse effect on penile sensitivity, erectile function, or sensation during sexual arousal and is reported to enhance the sexual experience for men. Most women prefer the circumcised penis for appearance, hygiene, lower infection risk and sexual activity. At least half of all uncircumcised males will develop one or more problems over their lifetime caused by their foreskin. Given the convincing epidemiological evidence and biological support, routine circumcision should be highly recommended by all health professionals.

    Find more info at:

    http://www.circinfo.net/

    I am not a medical doctor and I have no affiliation with this site and, frankly, I am not fully pro or anti male circumcision.

    In my opinion, it's every parent's job to make important decisions for their children before and even after the child's age of majority. Many of these choices are long-lasting and at times, irreversible - that is simply a part of the enormous responsibility of being a good parent. Whether or not to circ your son is a very personal choice that father's today are faced with. It is a decision that should be made with a balanced view of the most current information available - which as both sides of the debate should admit, changes over time with advances in science. When reviewing the current literature, please look for how (and by who) studies are funded and whether or not there is a pro or anti circumcision group that may be skewing or spinning the results. Each parent should be free to make this important choice without fear of condemnation from the other side of this debate. I see compelling arguments both for and against male circ and my sincere hope is that people do not get carried away with zealous, irrational rhetoric that winds up turning people away from the facts.

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  21. If a movie theater doesn't sell popcorn and soda, or a fast food place doesn't sell anything with a higher margin in addition to the dollar menu by upselling to supper size or one of the premium product the establishment will go broke.

    In the same sense, Hospitals will earn so much more incremental revenue by doing the procedure by default because it is easy/fast money. Why operate for hours when you can get the pure fat margins in 20min?

    Everyone in the supply chain will make money, the more procedure the more supplies need to be ordered, the higher the volume discounts for anything and everything.

    Basically, a symbiotic relationship...why has a healh insurance comnpany not stopped the procedure....hmmmm...but I have my thoughts...which is obvious.

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  22. Actually, circumcision does reduce the chance of contracting penile cancer, which has a high mortality rate and AIDS. Penile cancer is almost non-existent in cirucumcised males.

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  23. Circumcision is a MONEY MAKER, for the medical equipment sales, doctors, and Insurance companies. And many states, including my own(Texas) Have a cap on med mal that makes it IMPOSSIBLE to find an attorney to find justice for their sons' botched circs. Like everything, just money.

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  24. Only the lower instrument in your picture is a Mogen clamp. The top one is a Gomco, which has caused its own share of botches. Botched circumcision is so common in the US there are several attorneys with the same specialtiy.

    Penile cancer is so vanishingly rare it's hard to find good statistics. It's rarer than MALE breast cancer, so should we give every boy baby a mammectomy? It's rarer in non-circumcising Denmark than the US. And there are plenty of documented cases in circumcised males, in fact it commonly appears on the circumcision scar.

    Many of the diseases Anonymous mentions are equally rare or easily treated or prevented. The only truth in what he says is that to keep any body part risks maybe having a problem with it at some time in your life. We could accessorise the baby in many other ways by the same reasoning.

    Circinfo.net is the site of an Australian professor of molecular biology (not a doctor) who never saw a reason for circumcising he didn't like (including "to avoid bathroom splatter" and "to prevent zipper injuries", and who spins the statistics like a dentist's drill to make it look good.

    Male circumcision is the only surgical removal of a healthy, normal, functional, non-renewable body part that is even legal, and it is only proffered in the US. The rest of the English-speaking world tried it, found it did no good, and has virtually given it up. In most of Britain and the Commonwealth it's hard to find a doctor willing to do it.

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  25. Actually BL, you should consider the "other side of the argument" concerning female circumcision. The list of "public health benefits" copied from the circlist website, concerning male circumcision, and posted by an anonymous commenter above is virtually identical to those listed for the circumcision of girls in societies where this is common, ethically and medically accepted practice.

    For example, check this entry in a Malay woman’s blog: http://aandes.blogspot.com/201.....ision.html.

    The woman refers to her own circumcised status and that of her mother and presumably the generations of female relatives who came before her. Her daughter had the procedure carried out in a medical centre by a doctor using sterile instruments. This custom continues out of cultural habit. There is no malice behind it. Circumcised Malay women have sex and give birth as easily as intact women in most of the world.

    I am not saying I approve, but I have no doubt this woman would be very offended if anyone were to tell her that she had no right to do this to her daughter, that it is harmful and unethical, even criminal. She would calmly and politely tell them that what she decides is in her daughter’s best interest is none of their concern. If you stop to think about it, this is no different than the rationalizations put forth to justify the cutting of newborn boys, which is equally harmful and unethical.

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  26. Here is the link for my previous post: http://aandes.blogspot.com/2010/04/circumcision.html

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  27. thank you
    http://healhinsurance.blogspot.com/

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  28. Anonymous wrote: "Actually, circumcision does reduce the chance of contracting penile cancer, which has a high mortality rate and AIDS. Penile cancer is almost non-existent in cirucumcised [sic] males."

    The statistics are: 1 in 100,000 intact men develop penile cancer. Approx 4 circumcisions in 100 require further surgery.
    4000 times more babies will have to go through the pain of botched circs than 1 man being 'saved' from penile cancer.
    www.nocirc.org
    1 in 8 women WILL develop breast cancer. Shall we just cut off females breasts when they have weaned there last child 'in case' she may get cancer?

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  29. http://www.ama-assn.org/resources/doc/ethics/decofprofessional.pdf It is unethical to remove a healthy body part from a non-consenting patient.

    http://findarticles.com/p/articles/mi_6869/is_10_98/ai_n32398713/?tag=content;col1

    http://findarticles.com/p/articles/mi_6869/is_10_98/ai_n32398719/

    ReplyDelete