Doctor testifies Kantak's care adequate

A policy-maker for the premier standard-setting organization on infant circumcision in America testified Monday that the care given to Anita Flatt met or even exceeded the norm.

Dr. George Kaplan, one of six doctors from across the country selected to review infant circumcision for the American Academy of Pediatrics, told jurors he came to his conclusion after reviewing medical records and from depositions from people that cared for the child.

I feel ( Dr. Sunita Kantak) did inform Mrs. Flatt on what was to be done, said Kaplan, the chief of urology and surgery at the  Children's Hospital in San Diego.

 Flatt of  Hawley, Minn., is suing Kantak and Fargo-based  MeritCare Hospital claiming she and her husband, James, weren't told complete and accurate information about the procedure for removing the foreskin from their son's penis.

She has told the jury she did not receive any information prior to her son's birth about the risks and benefits of circumcision.

She says she never received the booklet MeritCare gives to parents, and only talked to Kantak briefly about the pain involved before the procedure was performed.

Had Flatt understood the risks involved in the procedure, she wouldn't have had it done, she said.

Flatt attorney,  Zenas Baer, asked Kaplan if he made assumptions in determining adequate information was given to Flatt.

In part, yes, Kaplan said.

Baer then asked if one of those assumptions was that MeritCare employees followed procedure by giving Flatt the circumcision booklet and talking to her about the procedure.

Kaplan said yes, pointing to two references in MeritCare medical records documenting discussions with or material given to Flatt on circumcision and noted that Flatt signed the consent form.

He said most parents don't sign the consent slip if they still have questions about the procedure.

Baer showed Kaplan that one of the medical records documenting discussion on circumcision was dated a day after the surgery.

The other record documenting circumcision discussion was signed by Kantak the day before the March 7, 1997, circumcision, but not initialed by Flatt, Baer said.

Flatt said she didn't meet with Kantak until March 7.

When Baer asked Kaplan what the foreskin was for, he said that is not known.

Yet you remove it? Baer said.

The American Academy of Pediatrics concluded in 1999 there are some potential medical benefits to circumcision but not enough to recommend routine newborn circumcision.

The academy encourages parents to discuss the benefits and risks of circumcision with their pediatrician, and then make an informed decision about what is in the best interest of the child, Kaplan said.

Circumcision benefits include a lower rate of urinary infections and cases of penile cancer, Kaplan said.

The major risks in circumcision include infection, most of which are treatable with antibiotics, and bleeding, Kaplan said.

MeritCare attorneys were allowed to call Kaplan before Baer was done calling his witnesses because of a conflict in Kaplan's schedule.

Baer will resume examining one of his witnesses today.

Flatt, an attorney at Baer's law firm, is asking for an unspecified amount in damages.

The trial, in its sixth day, is expected to end this week.  East Central District  Judge Cynthia Rothe-Seeger is presiding over the case.

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