This case involves a newborn male infant who was the result of a healthy pregnancy and an uncomplicated vaginal delivery. The patient was born full-term and weighed 8 pounds 2 ounces. Physical examination and testing in the neonatal period did not reveal any health problems. At six weeks-old the patient was brought to a pediatrician’s office for to undergo an elective circumcision for religious reasons. The surgery was conducted using a plastibell device. The treating pediatrician forcefully removed the ring during the procedure causing trauma to the penis. This resulted in an extreme bending of the penile shaft, a highly pigmented scar and significant loss of tissue at the glans and shaft at the tip of the penis. The patient required additional surgery, including a degloving procedure to attempt to correct the damage now suffers significant loss of tissue and long-term loss of function as a result of the initial surgery.
Question(s) For Expert Witness
Can you discuss from a psychiatric perspective, the amount of projected social damage and distress this individual is expected to sustain due to a lack of a normal appearing and normal functioning penis?
Expert Witness Response E-007082
This case is very similar to a case that I gave expert witness testimony on in the past. That case also involved a circumcision accident. I evaluated the child every six months for about three years and submitted a report of estimates of psychiatric care to the plaintiff's attorney. In that case, there was still a chance for normal appearance of the penis and function and the child was mostly suffering from medical post-traumatic stress disorder (PTSD) due to repeated corrective surgeries and examinations. It was a difficult estimation to make as the final outcome of the injury was not known at that time. As for social damage and distress in this case, it could be very profound. This type of injury would be comparable to a young female having her face severely disfigured. In my experience, many young men would prefer severe injuries to other part of their bodies, even amputations over loss of penile function. This may have a significant impact on his self-esteem, his sense of masculinity and his future relationships. This child may also suffer medical PTSD should he requires further corrective procedures in the future.
About the author
Dr. Faiza Jibril
Dr. Faiza Jibril has extensive clinical experience ranging from primary care in the United Kingdom, to pediatrics and child abuse prevention at Mount Sinai Hospital, to obstetrics in Cape Town, South Africa. Her post-graduate education centered on clinical research and medical ethics. Dr. Jibril is currently Head of Sales in the US and Canada for Chambers and Partners - a world leading legal ranking and insights intelligence company.
