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Journal Article

Citation

Li KD, Hakam N, Low P, Lui J, Sadighian MJ, Nabavizadeh B, Shaw NM, Breyer BN. Urology 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.urology.2021.09.036

PMID

34788667

Abstract

OBJECTIVE: To characterize circumcision-related litigation in the United States (US) and factors predictive of lawsuit outcome. Circumcision is a common urologic procedure with medical and ethical nuances.

METHODS: We reviewed the Nexis Uni legal database for state and federal cases using the term "circumcision" in combination with "medical malpractice" or "negligence" or "medical error" or "complication" or "malpractice" or "tort". Litigation primarily related to circumcision from 1939 to 2021 were reviewed for medical and legal details.

RESULTS: We identified 77 unique cases. Most cases were processed in state (87%) or appellate (59%) court systems with negligent surgical performance as the most common lawsuit reason (49%). Of reported specialties, urology was the highest proportion represented among named physicians (29%) and most patients were minors at time of circumcision (64%) and lawsuit (59%). Common complications included aesthetic dissatisfaction (20%), pain (19%), impaired sexual function (17%) and surgical trauma/injury (16%). Most verdicts favored physicians (59%), but when against physicians, the median indemnity was $175,000. Lawsuits due to negligent informed consent was significantly more likely to result in verdict favoring the physician compared to those due to negligent surgical performance.

CONCLUSIONS: Circumcision-related litigation in the US is rare and trial verdicts favor physicians, particularly in federal court cases or when parties allege negligent informed consent. Cases that favored plaintiffs successfully alleged negligent surgical technique. We recommend physicians performing circumcisions receive proper training, clearly communicate potential complications, and ensure appropriate indications for adult patients to reduce malpractice risk.


Language: en

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