By SUE REINERT
The Patriot Ledger
Quincy Medical Center and an obstetrician have agreed to pay more than $80,000 to a boy who was circumcised and whose parents say the procedure was carried out against their wishes.
The parents told the hospital in August 1997 that they did not want their son circumcised, according to a malpractice suit filed by the parents. Nevertheless, Dr. Sandra Chenkin performed the procedure the day after he was born, court papers said.
Medical insurance experts said the case was unusual because it was based on lack of consent rather than negligence, the usual grounds for a malpractice claim.
There were no complications from the surgery, in which a doctor removes a sheath of skin covering the tip of the penis.
Quincy Medical Center spokeswoman Karen Schwartzman said the incident occurred because a hospital policy requiring written consent for circumcisions “was not adhered to.”
Parents were supposed to be asked to sign a consent form after childbirth for the circumcision procedure, “along with a number of other forms that get filled out at the same time,” Schwartzman said.
In this case, “regrettably the consent form was not filled out,” she said.
Schwartzman said she had no information about conversations between the parents and the medical center before the birth.
“Medical errors happen, and all too frequently,” she said. “Quincy Medical Center is not immune, but it is a problem at all hospitals.”
Schwartzman added patients should judge a hospital by its “whole picture” rather than “one incident two and a half years ago.”
The hospital closed its maternity unit in November 1998 because of financial reasons.
Chenkin practices in Brockton. Her lawyer did not return telephone calls.
Papers filed at Norfolk Superior Court contain the names of the parents and child. The Patriot Ledger is not publishing the names to protect the family's privacy.
The case was settled Aug. 30, a little more than one month after the parents sued. The parents and their lawyer agreed to keep the terms of the settlement secret, not disclosing where the case had been filed and who had been sued. The Patriot Ledger obtained the court papers independently. The lawyer for the parents and child said he could not comment because of the settlement agreement.
Under terms of the settlement, the parents received $14,418 in August and their lawyer was paid $20,000. The child will collect four annual payments of $20,588 starting on his 18th birthday, for a total of $82,352, the agreement said.
The payments to parents, child and attorney total $116,770. However, Chenkin's insurer, which paid the settlement, laid out only $60,000 in cash: the immediate payments to the parents and their lawyer, plus a $25,352 annuity to cover the future payments, the court papers said.
Until about 10 years ago, circumcision was considered a routine procedure for newborn boys and few parents or doctors questioned it.
Muslims and Jews practice circumcision as part of their religions. The practice has gone beyond religious boundaries to become almost universal in the United States. The parents who sued Quincy Medical Center claimed circumcision was against their religious beliefs.
In recent years, evidence has mounted that circumcision is unnecessary and can present risks, like any surgery.
In March 1999, the American Academy of Pediatrics withdrew its longtime support for the procedure, saying the benefits were not sufficient enough to justify a recommendation.
The new guidelines said parents should decide, and laid out the benefits and risks.
Malpractice lawyers and insurers said they didn't know of a case similar to the Quincy Medical Center suit.
The suit was unusual because it hinged on lack of consent, not negligence by the doctor or hospital, said Boston malpractice lawyer David White-Lief.
Under malpractice theory, surgery without consent is considered the same as an assault on the patient, White-Lief said.
“Any surgical procedure requires informed consent,” he said.
At least five area hospitals – Brockton Hospital, South Shore Hospital in Weymouth, Caritas Good Samaritan Medical Center in Brockton, Jordan Hospital in Plymouth and Brigham and Women's Hospital in Boston – require written consent before performing a circumcision, officials said.
Dr. Robert Nelson, a pediatrician at Children's Hospital in Philadelphia and head of the bioethics committee of the American Academy of Pediatrics, said hospital policies may vary but some form of consent is necessary before performing circumcision.
Even if hospitals don't use a form, doctors should get consent verbally and document it, Nelson said.
A spokeswoman for the American College of Obstetricians and Gynecologists said the organization's guidelines call for doctors to obtain consent but don't specify that it be written.
Copyright 2001 The Patriot Ledger
Transmitted January 5, 2001