Tag Archives: Botched Circumcision

Another mogen clamp lawsuit – botched circumcision

The Schmidt firm reported in April 23 that the parents of a boy who had his glans partially amputated during a neonatal circumcision in 2010, have filed a lawsuit against several companies that make or sell the Mogen clamp.

Mogen clamp

Mogen clamp

Now, the Mogen clamp has a known reputation for an increased risk of partial or total amputation of the glans and/or the penis. This is because unlike other devices, the mogen clamp does not protect the glans and forces the operator to cut without visualizing.

Is this really new information? No, and many of the following facts are also mentioned in the lawsuit:

In 2000, the FDA warned about the potential for injury from the Mogen and Gomco clamps for circumcision, after 105 reports of such injuries between 1996 and 2000. The devices however were not recalled nor modified. Injuries continued occurring, however the warning was later on archived.

In 2010, a single lawsuit resulted in a 11 million dollars settlement, after a complete amputation of the glans with a Mogen clamp. However, Mogen Circumcision Instruments was already in default after another 7.5 million dollars lawsuit (over a similar injury) in 2007, and was already going out of business.

In May of 2013, CircWatch / CircLeaks called the intactivist community to action after learning of a medical trial at the Good Samaritan hospital, comparing the Gomco and Mogen clamps to see which one caused less (or more) complications and pain. Five months later, Intact America and a group of intactivists protested outside the Good Samaritan hospital. The Good Samaritan responded that “the circumcision study compares two medically accepted circumcision processes” – but they failed to mention the FDA warning, or the millionaire lawsuits over penile amputations with Mogen clamps, or that a manufacturer had gone out of business due to those lawsuits.

Intactivists protest at the Good Samaritan

Intactivists protest at the Good Samaritan

Well, now we are finding about this new lawsuit. The case is not new, the injury occurred in 2010. But, could it have been prevented if the medical community had been more proactive over the FDA warning? More attentive of the lawsuits over penile injuries?

Perhaps this new lawsuit, filed 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., may bring some recalls, but will this really change anything?

BTW, in December of 2014 the FDA recalled a number of Mogen clamps from some manufacturers, including Boss Instruments, Millennium Surgical, Symmetry Surgical, Medline Industries, CareFusion and others. According to the text, “The reason these devices are being withdrawn from the market by Instrumed is 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.”

And yet Mogen clamps can be purchased on ebay under $15, without license. What hope is there for our boys to ever be protected?

Mogen clamps on eBay

Mogen clamps on eBay – 5/8/2015

 

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Circumcision Goes Wrong: 1-yr-Old Loses Manhood to Cutting

Posted: http://frontpageafricaonline.com/index.php/news/963-circumcision-goes-wrong-1-yr-old-loses-manhood-to-cutting

1 year old boy loses his penis in a circumcision performed on January 5th by a doctor in Liberia. Phillip Zinnah, Sr. 25, father of the boy explained that he took his son to the TB Annex to one Dr. Nimley for circumcision, but it all went wrong when the doctor completely cut off the boy’s penis, leaving him in severe pain. The doctor is not responding for the damages, and the institution, TB Annex, says they don’t perform circumcisions and this would have been done in secret by the doctor.

Meanwhile, a child’s life has been irreversibly damaged in a way to seems to echo the baby hurt by a rabbi from Pittsburgh and a Memphis baby hurt at Christ Community Health Centers last year. A Saudi baby also had his penis partially cut off last November.

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What Brian Morris, in conjunction with Richard Wamai (research on HIV), Aaron Tobian (Johns Hopkins University), Ronald Gray (Johns Hopkins University and director of one of the 3 African trials on HIV and circumcision), Robert Bailey (responsible for another one of the 3 African trials), Daniel Halperin (author of several papers on HIV and circumcision),  Thomas Wiswell (author of the often cited study on circumcision and UTIs) and others, wrote on their propaganda paper from 2012, “A ‘snip’ in time“:

Infant circumcision is safe, simple, convenient and cost-effective. The available evidence strongly supports infancy as the optimal time for circumcision.“ 

Of course, for those illustrious individuals, this child’s horrible experience is simply an “adverse event“. According to a 2012 paper by Robert Bailey cited by the World Health Organization:

“In developed countries, adverse events following neonatal circumcision are well documented and their incidence is very low, from 0.2 to 0.6%.5 Before the RCTs, outcomes in Africa for male circumcision among adults were poorly documented. In a review,6 adverse event rates following African male circumcisions ranged from 0 to 24%. The RCTs, which provided services in a clinical trial setting, reported the following adverse event rates: 3.8% in Orange Farm, South Africa; 1.5% in Kisumu, Kenya; and 3.6% in Rakai, Uganda.1,7,8 Most recently, at the former Orange Farm RCT site, 1.8% of medical male circumcisions offered in one high-volume facility resulted in an adverse event”

Let’s stop treating children as statistics. Let’s respect children. Children of all genders deserve to grow with intact genitals.

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Pa. Rabbi facing lawsuit for botched circumcision

A couple filed a lawsuit against Pittsburgh rabbi Mordechai Rosenberg, alleging that he caused a “catastrophic and life-changing injury” to an 8-day-old infant during a circumcision ceremony on April 28 of this year (2013).

Mordechai Rosenberg

The baby had to be taken to a nearby hospital for emergency reconstructive surgery and leech therapy.

Leeches help a body accept reattached parts by promoting blood flow and tissue regeneration, so it is somewhat fair to assume that there was a partial or total amputation of the glans, an injury common to the Mogen clamp, the one commonly used by religious practitioners.

In 2000, the FDA warned about the potential for injuries from Mogen clamps. In 2010 the manufacturer went out of business due to millionaire lawsuits based on catastrophic injuries caused by the clamp. Yet the clamp is still commonly used (currently being part of a trial at the Good Samaritan Hospital in Ohio!).

Glans amputation with a mogen clamp

Rosenberg’s webpage says he’s a certified mohel, or ritual circumciser, who’s done the operations since 1990.

Mohels are not certified by a government agency because circumcision is considered a religious ceremony and not a medical procedure.

If circumcision is a medical procedure, then religious practitioners are performing unlicensed medicine and should be charged with a crime. If this is not a medical procedure, then how can we explain the use of scalpels on the body of a baby and the loss of tissue. And if this is not a medical procedure but just a religious ritual, then we need to consider this ritual abuse of a minor.

Laws against ritual abuse of minors often leave provisions for “activities, practices, and procedures otherwise allowed by law” (http://leg.mt.gov/bills/mca/45/5/45-5-627.htm) – a loophole no doubt enacted to allow cutting male babies’ genitals, while cutting female babies’ genitals is specifically prohibited and “In applying subsection (b)(1), no account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that person, or any other person, that the operation is required as a matter of custom or ritual.” (http://mgmbill.org/usfgmlaw.htm)

Read more: http://triblive.com/news/adminpage/5277845-74/child-mohel-circumcision#axzz2neRB9Skf

And  http://www.kansascity.com/2013/12/18/4700791/pa-rabbi-facing-circumcision-lawsuit.html

In November we found out about a similar injury suffered by a Memphis baby in the context of a medical circumcision, and days later we heard about an 18 day old baby in UAE who had his penis partially severed.

Memphis baby who suffered amputation of his penis during a circumcision in August, reported in November 2013
Saudi baby who had his penis partially cut off during circumcision, November 2013

Circumcision promoters such as Brian Morris boast how safe the procedure is. Yet here, in a matter of 2 months we learn of 3 babies who suffered this life changing injury – and all without medical necessity.

Regarding this risk, the AAP says in the technical report on circumcision:

The majority of severe or even catastrophic
injuries are so infrequent as
to be reported as case reports (and
were therefore excluded from this
literature review). These rare complications
include glans or penile amputation
[...]

Isn’t it time somebody started collecting these case reports? Or do we not care about these babies, Dr. Diekema?

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Memphis report of a botched circumcision

WMCTV5 and Fox 13 reported on a mother’s anguish over a botched circumcision of her three month old son, in August. The mom, Maggie Rhodes described the surgery as taking 3 hours where the baby was crying all the time, and going back home with the baby still crying where her sister removed the bandage to find her “son’s penis was not there”.

While there are not enough details in the report to know whether this was really an accidental amputation (which I don’t consider likely, as it would have been beyond irresponsible and criminal to give back a child with an amputated penis without warning), or if there is lack of clarity and this is a case of buried penis, a known complication of circumcision. Buried penis is sometimes overcome as the baby grows, but it also needs surgical repair some times.

The report says: “All that was left was a partial penis and his tiny testicles. Rhodes said Ashton urinates through a hole in his penis.”

This, however, is consistent with the appearance of a buried penis. I’m speculating here though, because I don’t want to believe that health professionals can be so stupid, criminal and unethical as to amputate the penis and not say a word to the mother.

Concealed penis encompasses both congenital and acquired conditions whereby the phallus is retracted inward beneath the suprapubic fat pad and partially obscured by preputial skin.14  The congenital etiology of concealed penis is thought to result from (1) poor elasticity of dartos fascia, restricting its ability to move freely through deep layers of tissue, and (2) the lack of anchoring of the penile skin to deep fascia, which in turn limits extension.15  In older or obese children, anatomical factors such as a pronounced suprapubic fat pad or a large pannus may contribute to the aforementioned congenital anomalies to effectively obscure the phallus.  Moreover, an unsuccessful circumcision may also serve to exacerbate this condition by causing penile entrapment or by allowing the concealed penis to recede further beneath surrounding tissue.

Buried / Concealed penis

The AAP Technical Report on Circumcision states:

There is good evidence that circumcision of a premature infant is associated with an increased risk of later-occurring complications (ie, poor cosmesis, increased risk of trapped penis, adhesions). There is also good evidence that circumcision of a newborn who has a prominent suprapubic fat pad or penoscrotal webbing has a higher risk for the same long-term complications.

While the AAP states that the “benefits outweigh the risks“, the report also states that:

Financial costs of care, emotional tolls, or the need for future corrective surgery (with the attendant anesthetic risks, family stress, and expense) are unknown.

And the most damning statement: “The true incidence of complications after newborn circumcision is unknown.

“Like, ‘Momma like, how could this happen to me? How could this happen to me?How could you explain that to your child that you don’t have a penis that they have to reconstruct one or you probably have might not never be able to have kids? That don’t sit well with me at all.” – Maggie Rhodes

Read more: http://www.myfoxmemphis.com/story/23912521/mother-upset-over-botched-circumcision#ixzz2k44fAtcl

Also: http://www.wmctv.com/story/23899878/a-look-ahead-mother-claims-doctor-disfigured-son-after-botched-circumcision

FOX13 News contacted Christ Community Health Centers for a comment. They were told the CEO is aware of their request, but so far has not returned their repeated calls.

Maggie, our heart is with you, with your son and with your family.

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South Africa: 4 year olds child dies after hospital circumcision

Johannesburg – “They killed my child.” These were the pained words of a Germiston father whose son had to be taken off life support on Wednesday evening after he was declared brain dead by two surgeons following a medical circumcision operation a week ago.

Reggie Mokalapa, 39, took his four-year-old son, Gugulethu, to Medicross Germiston for what doctors had assured him would be a “less than two-hour” procedure last Tuesday.

On Sunday, monitors showed that Gugulethu’s brain was not responding, and on Monday he was declared brain dead.

On Wednesday, a second doctor confirmed that Gugulethu was brain dead and the family elected for doctors to take him off life support.

“We are always advised to circumcise our children young, and we did this so that he’d be okay in future. Unfortunately, we took him to a slaughterhouse,” said Mokalapa.
 
 
 
 
Rest in Peace, Gugulethu.
 
Please, let’s stop cutting minors.
 
WHO, PEFPAR, Bill and Melinda Gates Foundation, UNAIDS, please stop cutting minors.

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Safe Male Medical Circumcision in Uganda results in penile amputation

Circumcision, like every other surgery, carries some risks. The problem is when promoters argue for a surgery without medical indication and minimizing every risk in order to entice the patients to undergo the procedure.

As we know, the West is currently promoting VMMC (voluntary male medical circumcision, safe male medical circumcision) in some countries of Africa as part of the package for HIV prevention. A lot of emphasis has been set on reducing the costs of the procedure by looking for new methods (such as the PREPEX, the TaraKlamp, the Shang Ring) and trying to perform the procedure without the need for a surgeon, with minimally trained personnel.

Of course this is going to lead to complications, such as what happened to Patrick Izimba in Uganda, reported on July 16th of 2013. Patrick Izimba was enticed by one of the signs offering safe male medical circumcision, and what followed is every man’s nightmare. His penis suffered gangrene and was transferred to a specialist. Plastic surgery will be used to reconstruct his penis, but he won’t be able to have sex.

When you promote mass circumcision, these events are bound to happen. Yet, this the the message that circumcision promoters are sending to Africa:

Check out the explicit manifesto on their page: “Importance of establishing circumcision as a social norm is stressed“. It’s not about health, it’s not about preventing a disease, it’s about creating a social norm.

Let’s quickly visit the WHO’s manual for male circumcision with anesthesia, and on page 16 let’s check the listed risks:

Risks
As for any surgical procedure, there are risks associated with
circumcision. While the benefits of circumcision may be wide-ranging
and long-term, any problems generally occur during or soon after the
procedure. They include:

•pain;
•bleeding;
•haematoma (formation of a blood clot under the skin);
•infection at the site of the circumcision;
•increased sensitivity of the glans penis for the first few months
after the procedure;
•irritation of the glans;
•meatitis (inflammation of the opening of the urethra);
•injury to the penis; 
•adverse reaction to the anaesthetic used during the circumcision.

These complications are rare when circumcision is performed by well
trained, adequately equipped, experienced health care personnel, and
are usually easily and rapidly resolved. Data from controlled trials
show that fewer than 1 in 50 procedures result in complications.

Did I miss loss of the penis? Or is the loss of the penis darkly lumped into “injury to the penis”? When considering the reality of a man who just lost his sexual organ, does it make sense that these complications are rare and easily and rapidly resolved?

The news article about Patrick Izimba mentions anesthesia as possible cause of the gangrene. The WHO’s manual on male circumcision with anesthesia indicates:

“Lidocaine with epinephrine must not be used because there is a risk of constriction of the blood vessels to the whole penis, which can cause gangrene and loss of the penis”. 

Is this what happened? Was he told that gangrene and loss of the penis were possible risks of the procedure? If not, his consent was not informed consent.

Page 148 of the manual also states indicates:

Worsening wound infection with signs of gangrene. A rare risk
of genital surgery is infection with multiple bacteria, causing
progressive skin loss. In this situation, the blood supply is cut off,
and the skin becomes necrotic and turns completely black. This
condition is known as Fournier’s gangrene (synergistic gangrene
or necrotizing fasciitis) and is more common in men who have
diabetes. Any man with signs of spreading infection or black
gangrenous skin should be urgently transferred to a referral
centre. At the referral centre, it is usually necessary to give a
general anaesthetic and remove all the dead skin

And while we are in page 148 of the manual, let us wonder if men are advised about the possible late sexual complications, or are they reassured that their sexual function won’t be impacted? Page 148-149 describes late complications such as:

In the long term, the client may complain of:

• decreased sensitivity of the glans;

• oversensitivity of the glans;

• unsightly circumcision wounds, ragged scars or other cosmetic
concerns;

• persistent adhesions at the corona and inclusion cysts. These
problems can be avoided if the foreskin is fully retracted during the
operation and all adhesions carefully divided;

• discomfort during erection from the scrotal being skin pulled up the
shaft of the penis and a tight scrotal sac. This can result from
removal of too much skin during the circumcision. These problems
can be avoided by careful preoperative marking of the incision
lines.

• torsion (misalignment) of the skin of the penile shaft. This can be
avoided by taking care during the operation to align the midline
raphe with the frenulum.

Is this the new social norm? Males with unsensitive glans, unsightly scars and uncomfortable erections when the scrotum is pulled up by the penis because it doesn’t have enough skin to accommodate a normal erection? Is this the American gift to Africa? Are we transferring the American wound?

Appendix 6.2 of the WHO’s Manual shows a sample consent form for a minor. The consent form does not list the risks and complications of circumcision. It merely states that the parents were counseled on the existing risks. Without a written record, how are they to ensure that providers won’t be lying about the complications and exaggerating the benefits, when their expressed intention is to establish circumcision as a social norm?

Background

Gangrene and loss of penis is a frequent complication of traditional African circumcisions, due to the risk of infections and terrible conditions in which the procedure is usually carried. However, loss of the penis also occurs in sterile conditions. It happened in 2012 to a man in China, 2 weeks before his wedding.  In 2008 a man in Kentucky had his penis removed without consent during a circumcision because the doctor found a cancerous tumor; the man sued on grounds that he should have been waken up and given information prior to the amputation, and yet the court sided with the doctor as the consent form enables the doctor to perform any other procedure deemed necessary. And of course there is the well known case of David Reimer, who lost his penis while being circumcised as a baby, was raised as a girl until his teenage years, was reverted (breast reduction, penile reconstruction…), and committed suicide at 39 years.

Circumcision for HIV prevention remains nothing but speculation about a protective effect, with no proven causal reason. The African studies have been challenged by scientists and general public, but for some reason the UNAIDS and the WHO continue to promote circumcision as part of the HIV prevention package without stopping to think critically, sponsored by PEPFAR and the Bill & Melinda Gates Foundation.

Boy (3 years old?) suffers partial amputation of the glans during circumcision in Morocco

A boy loses 20% of his glans during a circumcision. The boy cries in horrible pain.

This video may have been posted by the parents, who wrote:

l’assassin est docteur BOUHDI FOUAD Bd Fida à casablanca et le complice Docteur FAYSSAL LAZRAK de clinique ATFAL Oasis à casa: le premier a causé la coupure pendant la circonciosion et a mis des sutures en fermant carrément le canal d’urtine et le 2ème a refusé de délivrer le compte rendu avant et après opération qu’il a effectué sur mon enfant pour sauver le fonctionnement d’urine

(the murderer is Dr. Fouad BOUHDI Bd Fida in Casablanca and the accomplice Doctor FAYSSAL LAZRAK clinical Atfal Oasis casa: the first caused the break for the circumcision and put sutures closing outright the urinary channel and a second refused to issue a report before and after the operation he performed on my child to allow urination)

The video was posted May 18th, 2013.

From the description, the procedure was performed at Clinique Atfal, in Casablanca, Morocco. http://www.blanee.com/etablissements/clinique-atfal-Casablanca

Partial and total amputation of the glans is one of the “low incidence high severity” complications of circumcision, one which leaves life long complications. EVERY CIRCUMCISION exposes the child to this risk, even if with a low incidence.

Not only is the boy traumatized, but he may have problems with urination and sex for the rest of his life.

My heart breaks for this boy.

More information (Arabic): http://hespress.com/societe/79020.html

More documented severe complications of circumcision: http://circleaks.org/index.php?title=Documented_Severe_Complications_of_Circumcision