Kentuky man goes to the doctor for circumcision- the whole penis is removed

BU Medical Sciences
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
"Phillip Seaton says when he awoke from the surgery, he discovered that the doctor had removed his entire penis."

😱<--My exact expression when I read that
 
Off with his head!
 
I wonder if malpractice covers something that mindbogglingly stupid.
 
What an insensitive physician. Even though he had penile cancer he should have still been informed first instead of this impulsive removal. It's not like it was a mole or something... it was his penis! :slap:
 
You all are exactly the problem.

Old folks don't get "routine circumcisions" unless there is a lesion that is causing them to need a part cut off. Then they do a frozen section and cut off more if needed depending on the histology.

Cancers in the penis are a death-sentence if they reach a lymph node. Look it up, if you even know how. You obviously don't know enough about medicine to know what you don't know. Just like the terrible reporters who tried to ruin this guy's career.

Oh, and it wasn't even a full circumcision. But I guess that wouldn't make as good a headline.

The guy probably got histology back showing invasion or any type of anaplastic growth and made the right decision and probably saved the guys life.

What you think the board-certified urologist just cut the guy up for fun or because he was stupid?

The reporters are and you all are too ignorant to realize that medical decisions aren't always fuzzy and cute and somethings are more complicated than they appear in a 30 second soundbite.

This is why people can sue doctors for anything, even the most basic and simple decisions. You, the jury of the public that visits the man's practice, failed the medical profession again.
 
Waking up without a penis. Can't imagine how horrible that feels.
 
On a lighter note, if he tried to use it, he'd probably have a MI and die. Sex can kill you now-a-days.
 
Forthegood said:
You all are exactly the problem.
Click to expand...


I disagree.

Though I don't claim any medical knowledge, and I'm sure this was potentially deadly, the man should have been informed first.
 
Forthegood said:
You all are exactly the problem.

Old folks don't get "routine circumcisions" unless there is a lesion that is causing them to need a part cut off. Then they do a frozen section and cut off more if needed depending on the histology.

Cancers in the penis are a death-sentence if they reach a lymph node. Look it up, if you even know how. You obviously don't know enough about medicine to know what you don't know. Just like the terrible reporters who tried to ruin this guy's career.

Oh, and it wasn't even a full circumcision. But I guess that wouldn't make as good a headline.

The guy probably got histology back showing invasion or any type of anaplastic growth and made the right decision and probably saved the guys life.

What you think the board-certified urologist just cut the guy up for fun or because he was stupid?

The reporters are and you all are too ignorant to realize that medical decisions aren't always fuzzy and cute and somethings are more complicated than they appear in a 30 second soundbite.

This is why people can sue doctors for anything, even the most basic and simple decisions. You, the jury of the public that visits the man's practice, failed the medical profession again.
Click to expand...

While I agree with you that too much stuff happens to docs and they tend to be guilty until proven otherwise, which sucks...did you read the article?

The original article explained somewhat but a little digging provides more articles: http://www.foxnews.com/story/0,2933,427788,00.html

He was having inflammation so went in for the partial circumcision. The doctor thought he saw a cancerous growth (no apparent histo done at the time) and removed his entire penis. Later pathology showed stage I penis cancer which is treatable.

Informed consent is VERY clear. Which is why the documents are usually so long. If you think there may be something worse you have to do during the procedure its in the informed consent. (eg. the patient agrees to C-section vs. total hysterectomy if something goes wrong). So unless the patient actually signed a document saying "if you find cancer, removal of the penis may occur at the surgeons discretion" then the doctor is in the wrong. Period.

The patient had a right to wait for the pathology, weigh his options, get a second opinion and decide what he wanted to do about it.

This would be like a breast oncologist going for a biopsy and determining its cancer so he takes a woman's whole breast without consent, before she even knew she had cancer. Unnecessary. A few days won't change the prognosis and she has a right to find out how advanced it is, and decide between a lumpectomy and a mastectomy. The doctor does not get to make that decision for her.

Sure we may be missing information, but unless the info in the articles is outright wrong (it states consent was not obtained) the doctor is in the wrong here and should have known better.
 
Last edited:
You can't fight with premeds.

So you don't think the patient, who was going in for the circumcision to get the lesion biopsied and the involved area removed, was warned a part of his penis might have to be removed?

And how do I know? Because as a medical student it is my job to know these things. Because I have studied male reproductive pathology. Because I have had a rotation in urology. Because I have worked in surgery and know why people in that age group get circumcisions. Because I know how prosecuting attorneys work malpractice cases and because I know how defense attorneys work these cases. Because the news saying such a case is routine is an OBVIOUSLY inadequate representation of the case. Because I know the physician personally.

I can keep going...
 
Forthegood said:
You can't fight with premeds.

So you don't think the patient, who was going in for the circumcision to get the lesion biopsied and the involved area removed, was warned a part of his penis might have to be removed?

And how do I know? Because as a medical student it is my job to know these things. Because I have studied male reproductive pathology. Because I have had a rotation in urology. Because I have worked in surgery and know why people in that age group get circumcisions. Because I know how prosecuting attorneys work malpractice cases and because I know how defense attorneys work these cases. Because the news saying such a case is routine is an OBVIOUSLY inadequate representation of the case. Because I know the physician personally.

I can keep going...
Click to expand...

Not a premed and I still disagree with you. If the informed consent document was clear that part or the entirety of the penis (PENIS not foreskin) may be removed in THIS surgical procedure then yes the doctor was right and this will go away fairly quickly. That would shock me as the patient was apparently having the circumcision to relieve inflammation, even if they planned to check the pathology - you don't amputate body parts even for cancer without discussing options with the patient (and as a medical student...it should be your job to know that 😉 )

If the informed consent was not clear on that aspect, then the doctor is rightfully going to lose his case and probably be sanctioned by the local boards.
 
Forthegood said:
You all are exactly the problem.

Old folks don't get "routine circumcisions" unless there is a lesion that is causing them to need a part cut off. Then they do a frozen section and cut off more if needed depending on the histology.

Cancers in the penis are a death-sentence if they reach a lymph node. Look it up, if you even know how. You obviously don't know enough about medicine to know what you don't know. Just like the terrible reporters who tried to ruin this guy's career.

Oh, and it wasn't even a full circumcision. But I guess that wouldn't make as good a headline.

The guy probably got histology back showing invasion or any type of anaplastic growth and made the right decision and probably saved the guys life.

What you think the board-certified urologist just cut the guy up for fun or because he was stupid?

The reporters are and you all are too ignorant to realize that medical decisions aren't always fuzzy and cute and somethings are more complicated than they appear in a 30 second soundbite.

This is why people can sue doctors for anything, even the most basic and simple decisions. You, the jury of the public that visits the man's practice, failed the medical profession again.
Click to expand...

get-off-your-high-horse.jpg
 
alwaysaangel said:
Not a premed and I still disagree with you. If the informed consent document was clear that part or the entirety of the penis may be removed in THIS surgical procedure then yes the doctor was right and this will go away fairly quickly. That would shock me as it is rarely the case when basically a biopsy was being performed.

If the informed consent was not clear on that aspect, then the doctor is rightfully going to lose his case and probably be sanctioned by the local boards.
Click to expand...

How quickly do you think it would go away if the media was involved?
 
Forthegood said:
How quickly do you think it would go away if the media was involved?
Click to expand...

Well apparently it happened 3.5 years ago...and the lawsuit was filed at least 2.5 years ago. So a long time?

If there was documentation that clearly proved the doctor was justified in his treatment and that the patient was INFORMED the case would have gone away a long time ago. And wouldn't keep popping up in the media repeatedly.

And this is why physicians have to document each informed consent very carefully and closely. Although I'm not even sure its a medicalegal issue, I question his decision to immediately amputate the penis even if there was cancer. (see breast biopsy and mastectomy example above)
 
I wonder what the surgeon said when the man woke up. He probably said, "Surprise!".
 
Forthegood said:
You all are exactly the problem.

Old folks don't get "routine circumcisions" unless there is a lesion that is causing them to need a part cut off. Then they do a frozen section and cut off more if needed depending on the histology.

Cancers in the penis are a death-sentence if they reach a lymph node. Look it up, if you even know how. You obviously don't know enough about medicine to know what you don't know. Just like the terrible reporters who tried to ruin this guy's career.

Oh, and it wasn't even a full circumcision. But I guess that wouldn't make as good a headline.

The guy probably got histology back showing invasion or any type of anaplastic growth and made the right decision and probably saved the guys life.

What you think the board-certified urologist just cut the guy up for fun or because he was stupid?

The reporters are and you all are too ignorant to realize that medical decisions aren't always fuzzy and cute and somethings are more complicated than they appear in a 30 second soundbite.

This is why people can sue doctors for anything, even the most basic and simple decisions. You, the jury of the public that visits the man's practice, failed the medical profession again.
Click to expand...

Whoa.

First thing, calm down.

Second thing, my friend's grandma went for an amputation and the board-certified surgeon cut the wrong leg off. What's your point? That if someone is board-certified, they never make a mistake? Wrong.
 
Flashy credentials come from years of practice. Practice that you can't get without seeing thousands and thousands of patients. Which, by the way, if you frequently practice poorly, you lose your credentials.

It kills me that with so little information, some of which being obviously misleading ("routine" circumcision on 61yom), people are so quick to blame the doctor.

Yeah, the guy must have just really wanted to cut that guys dick off (which he did not do, and has been grossly misrepresented by the media).

What would be his incentive? He has more to gain personally by waking the guy up then re-operating.

And to think for a second that when cutting off a cancerous lesion, the patient wasn't informed about the OBVIOUS risk of cutting off a part of where the lesion was is just ridiculous. How often have you seen that happen? Really.

This whole case is just an easy way to sue and get settled out of court. Fortunately, I have it on good authority that the doc is not going to settle. This is a case where he is pretty damn sure he is going to win. Good for him. The attorney should lose their license.
 
Forthegood said:
How quickly do you think it would go away if the media was involved?
Click to expand...

A surgeon sees something bad while he's doing a surgery that wasn't in his origional consent, he needs to wake up the patient to get a consent to cut it out. Malpractice 101. You don't do that and the patient has an open and shut case even when there's no concievable reason he wouldn't have wanted it cut out (like an abdominal cancer discovered on ex-lap). I've seen many ex-laps, where suspected cancer was the primary reason for exploration, and I have never seen a consent for the surgeon to operate on a potentially cancerous lesion during the exploration without waking the patient up to ask if it's ok to start cutting. Cutting a guys junk off without asking him first? Media or not, no one with any sense would even bother going to trial. Any competnent lawyer would tell the insurance company to keep offering settlements until one got accepted. The surgeon will be lucky to keep a job and license.

It doesn't help that it sounds like it was a legitimate mistake. If the path read show that amputation wasn't necessary then the surgeon was not just wrong for not obtaining a consent, the amputation was also a problem in and of itself.

From your posts it sounds like you might know this guy personally. Is that the case? If so you might want to stop defending him on public internet forums, you're more likely to do harm than good. Lawyers have access to Google, and your posts (and testimony) are discoverable.
 
Last edited:
This is akin to the old "go in for a breast biopsy wake up with a mastectomy" practice that is discussed in most History of Women's Healthcare courses. It is always followed by the "now they wake the woman up and perform further informed consent" resolution.

Whether this was wrong or not depends on the informed consent form signed by the patient (as has been stated earlier). Since we all don't know what was explained to the patient pre-op and what the patient signed, I think we can all end there.
 
A few additional articles:
http://www.theandersonnews.com/content/victim’s-penis-amputation-trial-delayed
-the hospital and anesthesiologist opted to settle

This one (which is in support of the physician): http://www.msnbc.msn.com/id/26903756/ns/health-health_care/
-says that the doctor was authorized to perform "any medical procedures deemed necessary." That is just an idiotic way to do an informed consent and will always get you in trouble. Unfortunately, we do live in a litigious society, but even if we didn't - you need to full explain all of the possibilities to a patient not just a broad sweeping "anything necessary." If thats really what the informed consent says then the doc is SCREWED (and not too bright).

It was not an immediately life threatening problem. And unless he had already discussed all the possibilities of diagnosis and IF cancer was present all the stages of cancer and all the treatment options for cancer then the doctor DID NOT do his due diligence to the patient and is in the wrong.
 
Oh, and it is not at all like breast cancer.

In breast cancer, going from T1,N0,M0 to T1,N1,M0 takes you from 100% 5-year survival to 92%.

In penile cancer, N0 to N1 may take 40-50% (depending on the study) off of your 5-year survival.

And what I meant by that is I know the guy outside of his practice (although other urologists I have talked to also said he was not in the wrong). He is a very methodical, diligent, hard-working guy. He's not arrogant or any of that jazz that one might expect after hearing the story. He's also not the type of doc to get sued because he doesn't connect with people or he rushes around. It is a bit of a hot topic around here, because of proximity and referrals.

Anyway, I apologize for getting up in a tuss over it. Everybody in this area really likes the guy, and he has certainly given a lot back to the community (charity and so forth).

I'm not opposed to doctors being sued if they mess up. But this guy has been publicly humiliated again and again because of this ******* attorney trying to make a case out of falsehoods to get him to settle.
 
Last edited:
Forthegood said:
Oh, and it is not at all like breast cancer.

In breast cancer, going from T1,N0,M0 to T1,N1,M0 takes you from 100% 5-year survival to 92%.

In penile cancer, N0 to N1 may take 40-50% (depending on the study) off of your 5-year survival.
Click to expand...

And some men may choose to die rather than have their penis removed. That is their choice. Not the doctor's.

Not only that but waking him up and reoperating the next day wasn't going to be the difference between N0 and N1.

It is exactly like breast cancer in the context of this discussion.
 
Forthegood said:
You all are exactly the problem.
Click to expand...

Your poor understanding of how surgical consent works isn't exactly contributing to the solution, either.

Forthegood said:
Old folks don't get "routine circumcisions" unless there is a lesion that is causing them to need a part cut off.
Click to expand...

Well, I do disagree with whoever called this a "routine circumcision," because I don't think you can label a circumcision as "routine" in anyone over the age of 2 days.

But, lots of "old folks" get circumcised for non-cancerous reasons. Cancerous lesions are NOT the only indication for an adult circumcision - in fact, the MOST common indications are phimosis and paraphimosis, neither of which are cancerous. Balanitis is another common reason.

How much, exactly, did you learn on that urology rotation that you were boasting about?

Forthegood said:
Cancers in the penis are a death-sentence if they reach a lymph node. Look it up, if you even know how. You obviously don't know enough about medicine to know what you don't know.
Click to expand...

Well, most cancers of ANYTHING (penis, breast, colon, pancreas) become significantly harder to treat if they reach a lymph node.

But, as alwaysangel pointed out, there's no rush. It took months, maybe years, for that lesion to grow to that size; another week or so to take it all off isn't going to change much.

If you DID do your surgery rotation, as you had boasted about, you would have learned that there are really no such things as STAT mastectomies or Whipples. Surgical resection of cancerous lesions are rarely, if ever, emergencies.

Just as other people have said, the safest thing to do (medico-legally) is, if you decide that the patient may need a different procedure than what he originally consented for, you have to wake the patient up and reschedule the new procedure once the patient has consented again. I saw this done on my GYN and surgery rotations.

Forthegood said:
He is a very methodical, diligent, hard-working guy. He's not arrogant or any of that jazz that one might expect after hearing the story. He's also not the type of doc to get sued because he doesn't connect with people or he rushes around.
Click to expand...

I'm sure he's a nice guy. And I'm sure that he IS very hard working. That doesn't mean that he didn't make a mistake in this case, or have an error in judgement. Being nice doesn't make you immune from making mistakes.
 
smq123 said:
But, lots of "old folks" get circumcised for non-cancerous reasons. Cancerous lesions are NOT the only indication for an adult circumcision - in fact, the MOST common indications are phimosis and paraphimosis, neither of which are cancerous. Balanitis is another common reason.
Click to expand...
Which matters, except for in this case that was for a lesion and suspected squamous cell carcinoma.

If you DID do your surgery rotation, as you had boasted about, you would have learned that there are really no such things as STAT mastectomies or Whipples. Surgical resection of cancerous lesions are rarely, if ever, emergencies.
Click to expand...
Didn't do a surgical rotation, moonlighted there. And I didn't know experience was now boasting? My point there was that I have seen many cases for circumcision, some routine and some not.

I also didn't say it was an emergency. I didn't say it was a rush or anything like that. What I said or meant to say was that delay is bad, and that for the suspected issue, possible findings from the frozen section would warrant discussion on treatment options. Didn't think that was very controversial. In fact, everyone here seems to think that is why the guy is getting sued, that it was because he didn't talk to his pt about that.

Just as other people have said, the safest thing to do (medico-legally) is, if you decide that the patient may need a different procedure than what he originally consented for, you have to wake the patient up and reschedule the new procedure once the patient has consented again. I saw this done on my GYN and surgery rotations.
Click to expand...

As have I. What I am saying is going in, they thought the matter had been discussed adequately with the family.

From what I have seen and heard, I don't think he made a mistake.

My point on posting at all on this was to say that I think the story was terribly misrepresented in the media and that you shouldn't be so quick to judge without all of the details.
 
I would be SOOOO pissed.
 
Forthegood said:
And I didn't know experience was now boasting? My point there was that I have seen many cases for circumcision, some routine and some not.
Click to expand...

When you use your "experience" to insult pre-meds and tell them how ignorant they are, then yes, it is boasting.

Forthegood said:
I also didn't say it was an emergency. I didn't say it was a rush or anything like that. What I said or meant to say was that delay is bad, and that for the suspected issue, possible findings from the frozen section would warrant discussion on treatment options.
Click to expand...

Sure, a "delay" is bad....if the delay means, say, 3 months.

A 3 day delay? Meh. Unless this was the world's fastest growing tumor, it's not that big of a deal.

Forthegood said:
From what I have seen and heard, I don't think he made a mistake.

My point on posting at all on this was to say that I think the story was terribly misrepresented in the media and that you shouldn't be so quick to judge without all of the details.
Click to expand...

I'm not judging him. Maybe he made a mistake, maybe he did not. Maybe it was all an honest misunderstanding. Whatever.

But my point to you is - don't be so quick to defend him, either. While it's wrong to rush in and blindly judge him, it's equally wrong to rush in and defend him, too. It's not your place, and, as others have said, you're not doing him any favors.

And while you are going off of "what you have seen and heard," unless you were in pre-op, the OR, and PACU with this guy, you're going off of hearsay, too. You're not in a much better position to evaluate the situation than any of us are.

If I've learned anything from being a resident for this short while, it's that it's counter-productive to try and pass judgement on any bad outcome. Almost all situations are too complicated to pass a quick-and-dirty judgement, and it's just a fruitless exercise.

[And, if you WERE in pre-op, the OR, or PACU with this guy that day....well, you should know better than to run your mouth off on a relatively public internet forum and should stop talking before you say something that could trip you (or this urologist) up later.]
 
I'm not gonna lie, I LOLed after reading the title of this thread.
 
smq123 said:
When you use your "experience" to insult pre-meds and tell them how ignorant they are, then yes, it is boasting.

Sure, a "delay" is bad....if the delay means, say, 3 months.

A 3 day delay? Meh. Unless this was the world's fastest growing tumor, it's not that big of a deal.
Click to expand...

If you have not studied cancer then you would not be able to understand the weight of the case. The news did not explain it (or really even mention it in most reports).

Reread my posts. I didn't say anything about waiting a few hours was going to kill him. Delay is bad, everyone knows it, and that changes the way the preop risk evaluation is done and what consent you get from the patient. The consent on this case, and plans of action, were more than likely discussed because of the type of lesion and reason for the surgery.

If I've learned anything from being a resident for this short while, it's that it's counter-productive to try and pass judgement on any bad outcome. Almost all situations are too complicated to pass a quick-and-dirty judgement, and it's just a fruitless exercise.
Click to expand...

THIS.... is what I should have said from the start and avoided all of this.
 
Could have all been avoided if instead of circumcision he practiced proper penis hygiene.
 
Forthegood said:
You all are exactly the problem.

Old folks don't get "routine circumcisions" unless there is a lesion that is causing them to need a part cut off. Then they do a frozen section and cut off more if needed depending on the histology.

Cancers in the penis are a death-sentence if they reach a lymph node. Look it up, if you even know how. You obviously don't know enough about medicine to know what you don't know. Just like the terrible reporters who tried to ruin this guy's career.

Oh, and it wasn't even a full circumcision. But I guess that wouldn't make as good a headline.

The guy probably got histology back showing invasion or any type of anaplastic growth and made the right decision and probably saved the guys life.

What you think the board-certified urologist just cut the guy up for fun or because he was stupid?

The reporters are and you all are too ignorant to realize that medical decisions aren't always fuzzy and cute and somethings are more complicated than they appear in a 30 second soundbite.

This is why people can sue doctors for anything, even the most basic and simple decisions. You, the jury of the public that visits the man's practice, failed the medical profession again.
Click to expand...

This attitude doesn't really jive with what I'm learning in all the hours of required ethics classes. But I agree we really can't read too much into a 100 word news article.
 
You must log in or register to reply here.

Similar threads

S
How rigorous is the curriculum at NYU Grossman compared to 4-year programs
Replies
4
Views
473
squidlike
S
wysdoc
The Republic of Texas XLIV: The True Test Of A Man’s Character Is What He Does When No One Is Watching
2 3 4
Replies
171
Views
39K
chicandtoughness
chicandtoughness
M
TMDSAS: Is it ok for me to write the same experience in multiple sections for me? How to do hours?
Replies
10
Views
1K
MedAndBio3983
M
E
SDN Article: Dr. Varnel Antoine: Navigating the Challenges on the Path to Medicine
Replies
0
Views
334
Emil Chuck, PhD
E
H
SDN Article: Practical Perspectives for Navigating the Admissions Process
Replies
0
Views
108
Heidi Fuchs
H
Top Bottom