Man's penis is amputated by surgeon in Kentucky leading to a medical malpractice lawsuit
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There is a story in the State Journal of Frankford, Kentucky between a surgeon and his patient that will invite comments from about half the men of Kentucky. Here’s the story.
- FACTS, FICTION, TRIAL THEMES AND THE PLOT
A penectomy is removal of the penis by surgical means for medical reasons.
Penectomy is the practice of surgical removal of the penis for medical reasons.
Circumcision of course is the removal of foreskin of the penis.
Amputating a penis without the patient knowing you’re going to do so is what we call a lawsuit waiting to happen. And what many men would describe as a man’s worst nightmare.
So what happened in the curious case of Dr. John Patterson, a Frankfort, Kentucky urologist and his patient? How did we go from a scheduled circumcision to an amputation?
“Phillip Seaton complained to Patterson in October 2007 about foreskin soreness and drainage from his penis, a press release issued Wednesday said.
Patterson recommended circumcision but during the course of surgery he discovered a portion of Seaton's penis had become cancerous, it said.”
The doctor claims to have had consent to do so and that the operation was “medically necessary.” He alleges the patient had developed squamous cell carcinoma, a claim that is reported to have been bore out by the pathology report.
But if there is squamous cell carcinoma is that sufficient to justify amputating the patient’s penis? To answer that question we have to know more about the condition and its progress or lack thereof. To do that we look to medical experts and the pathology of squamous cell carcinoma.
- What is squamous cell carcinoma?
According to the Skin Cancer Foundation it’s a pretty common form of skin cancer that isn’t very serious. Because it’s a skin cancer one has to wonder why it was necessary to amputate the entire penis. Perhaps the trial will expose the answer to that question.
“Squamous cell carcinoma (SCC) is the second most common form of skin cancer, with over 250,000 new cases per year estimated in the United States. It arises in the squamous cells that compose most of the upper layer of the skin.
Most SCCs are not serious. When identified early and treated promptly, the future is bright. However, if overlooked, they are harder to treat and can cause disfigurement. While 96 to 97 percent of SCCs are localized, the small percentage of remaining cases can spread to distant organs and become life-threatening.”
- How common is squamous cell carcinoma?
According to the above it’s the second most common form of skin cancer.
- How is squamous cell carcinoma treated?
They cut the cancerous lesion from the skin. A good slide of this form of cancer can be seen at the American Academy of Dermatology. We would reprint these slides except for copyrighting.
- Is it a serious condition?
It can be but then again in the early stages it appears not to be so long as it is treated and surgically removed.
Another issue will answer the question, was the doctor justified in his judgment to not stop the surgery, wake the patient and allow the patient to decide if he consented. Stopping this serious of a surgery without exigent circumstances and additional pathology tests will not sit well with many jurors. Was someone in the waiting room for the patient that could have been consulted? How old is this patient?
The seriousness of the consequences of cutting a male’s penis without the patient making the decision has to be weighed against waiting a few days for further pathology tests and whether skin cancer can hasten a man’s death while waiting 72 hours.
- PATIENT CONSENT FORMS - The consent form isn't likely to help the doctor.
The doctor issued a press release that stated the patient signed a consent form. Of course we all do and even though the release language the hospital lawyers used is broad and vague that won’t help the doctor in this instance. The patient was probably not cut open with dire consequences if an immediate action wasn’t taken by the surgeon. That will be something the doctor will need to explain to a jury.
"Mr. Seaton signed a patient consent form, recognizing that "unforeseen conditions may necessitate additional or different procedures'," the press release said.
- IS THIS A CASE OF USING A SLEDGE HAMMER TO KILL A SINGLE FLY?
The Mayo Clinic website indicates pretty conservative style treatment that doesn’t seem to recommend cutting off an entire arm if there was this type of cancer on the forearm. So one has to wonder why the entire penis was amputated. There will be some explaining to do in that courtroom.
Treatments and drugs
Most squamous cell carcinomas can be completely removed with relatively minor surgery or occasionally with a topical medication. The type of squamous cell carcinoma treatment usually depends on the size, location and aggressiveness of the tumor and may include one or more of the following:
§ Freezing. This involves removing cancerous cells by freezing them with liquid nitrogen (cryosurgery). It's effective for small squamous cell carcinomas, but isn't recommended for larger tumors or those on your nose, ears or eyelids.
§ Simple excision. In this procedure, your doctor cuts out the cancerous tissue and a surrounding margin of healthy skin. Your doctor may recommend a wide excision — removing additional normal skin around the tumor — in some cases. To minimize scarring, especially on your face, consult a doctor skilled in skin reconstruction.
§ Laser therapy. An intense beam of light vaporizes growths, usually with little damage to surrounding tissue and with a reduced risk of bleeding, swelling and scarring. Lasers are often used to treat superficial carcinomas on the lips.
§ Mohs' surgery. This is often considered the most effective treatment for squamous cell carcinomas, especially those that are larger than 2 centimeters, have recurred, or are located on the face, mucous membranes or genital area. During the procedure, your doctor removes the tumor layer by layer, examining each layer under the microscope until no abnormal cells remain. This allows the entire growth to be removed without taking an excessive amount of surrounding healthy skin. Because it requires particular expertise, Mohs' surgery should only be performed by doctors specifically trained in the procedure.
§ Radiation therapy. This may be an option for treating large cancers on the eyelids, lips and ears — areas that are difficult to treat surgically — or for tumors too deep to cut out. The recurrence rate is high, however — as much as 50 percent for large tumors.
§ Chemotherapy. For very superficial cancers, creams or lotions containing anti-cancer agents may be applied directly to your skin. Some of these medications can cause severe inflammation and scarring, so be sure to discuss potential complications with your doctor.
--- Mayo Clinic ---
- DEFENSE BRAVADO - Save it for the courtroom.
The defense attorney issued a press release and is looking forward to a “fair hearing”. I think the patient is as well. Best of luck to every one; including the jurors.
“Clay Robinson, Patterson's attorney, did not return a call seeking comment. Robinson said in the press release that Patterson would not conduct an interview.
Seaton filed the malpractice suit in Shelby County where he lives.
"I do not believe in trying cases in the news media and will not be drawn into the media circus surrounding this case," Robinson was quoted in the press release.
"Dr. Patterson and I look forward to a full and fair hearing of this matter in a court of law."”
I've heard it stated that any publicity is good publicity. In this instance I'm not so sure. I can't think of a worse publicity campaign for a urology practice. Onward we march....