This case takes place in New Mexico and involves a male patient who underwent surgery to repair a penile deformity. The patient was discharged the day after the surgery with no instructions on wound care. A follow-up appointment was scheduled, however the appointment was postponed by the surgeon to a date several weeks in the future. During this time, the patient developed severe pain and an inability to pass urine normally. The patient was eventually seen by the urologist who preformed the procedure, who noted the presence of necrotic tissue upon physical examination of the patient’s penis. The patient went to another hospital immediately and underwent emergency corrective surgery. He endured multiple procedures to remove the necrotic skin, which required extensive grafts taken from other locations on his body to repair. The patient also had to see a psychiatrist and was prescribed Zoloft after being left with severe PTSD from the multiple surgical procedures and the injuries he had endured. It is alleged that the urologist did not explain the side effects or potential complications of the original procedure before the patient consented to surgery.
Question(s) For Expert Witness
- 1. Do you have experience treating patients with psychological symptoms following penile disfigurement? If so, how often do you come across these patients?
- 2. Could you opine on the long-term psychological consequences of such a disfigurement?
Expert Witness Response E-007082
I worked extensively with one young male who was a victim of a circumcision accident that resulted in disfigurement and who developed medical PTSD and social anxiety from the numerous surgeries and examinations required to minimize the disfigurement. I both treated him and provided a forensic evaluation of long term treatment needs and his pain and suffering. I have also been peripherally involved in the care of a few other male patients with penile disfigurement, erectile malfunction and associated chronic pain. In addition, I have extensive experience with diagnosing and treating medical PTSD in children from ongoing medical treatment related to cancer and other chronic and acute illnesses as the child psychiatrist at a large specialty children’s hospital. I also work extensively with children that are disfigured from injury and illnesses. As for the long term consequences, it can be devastating psychologically. I am aware of patients that are virtual hermits, have severe substance abuse problems and one even attempted suicide. I am also aware of patients that have had intense pain with every erection and others who were unable to have erections even with medication (surgical intervention was the only option). Most patients are afraid to date once they hit puberty for fear of how a female might react. They are terrified that she will laugh or reject them or worse, feel pity for them. Some also have such severe medical PTSD that they avoid vital medical care and put their long term health at risk.