Skillman, et al. v. Belin, 02-CI-2650

Summary: Pediatric surgeon held liable for performing circumcision on child with genital anomaly known as buried penis and for improperly carrying out the circumcision - the verdict is believed to be the first Plaintiff's verdict against a doctor in Fayette County, Kentucky, in nearly four years.

Plaintiffs: Evan Cole Skillman, infant, and James and Leslie Cole Skillman, Getty & Mayo, PLLC, Richard A. Getty and Mason L. Miller, Lexington Defense: Jenkins, Pisacano, Robinson & Bailey, Margaret M. Pisacano for Robert P. Belin, M.D.

Verdict: Plaintiff verdict for liability and damages, $260,000 ($40,000 future medicals and $220,000 pain and suffering)

Circuit: Fayette, S. Isaac, 10/01/04

In May 1998, Evan Cole Skillman was born prematurely with a genital anomaly known as buried penis or concealed penis. This condition was noted by pediatricians, an endocrinologist, and a neonatologist who saw the child. The parents were referred by their pediatrician to Dr. Robert P. Belin, a pediatric surgeon, for consultation as to whether a circumcision was appropriate. Twice in the months that followed, Dr. Belin examined Evan and told the parents that a circumcision could be performed. Dr. Belin did not ask for or receive medical records from the other physicians who had seen the child, and he admitted that he did not do any research or consult other medical specialists, such as a pediatric urologist, as to whether a circumcision would be contraindicated in the case of a buried penis.

The circumcision took place in February 1999. Based on subsequent consultations with other physicians who examined Evan, the parents alleged two areas of malpractice: first, that the standard circumcision procedure is contraindicated in the case of a buried penis, and secondly, that when the circumcision was carried out, too much skin was removed, thereby making later reconstruction more difficult.

At trial, Dr. Stanley J. Kogan, a pediatric urologist at Cornell Medical School, testified on behalf of the plaintiffs that the Defendant malpracticed both by not recognizing that a buried penis was a contraindication to routine circumcision and by removing too much foreskin in the course of the procedure. His testimony was supported by an article in a medical journal entitled "Buried Penis as a Contraindication to Circumcision." It was also supported by a defense expert's admission that in approximately 100 instances when he was confronted with a child with a buried penis, he had always performed reconstructive surgery rather than a routine circumcision. Dr. Kogan testified that the expense of performing the reconstructive surgery now necessary to release the buried penis and the painful skin grafts or other procedures necessary to replace the foreskin wrongfully removed would be approximately $17,000.

Dr. Harold J. Bursztajn, a forensic psychiatrist at Harvard Medical School, testified for the plaintiffs as to the pain and suffering that Evan would likely experience as a result of surgery and, as he grew to adulthood, as a result of damage to his body image, his self-esteem, and his relations with peers (as in gym locker rooms) and intimates. Dr. Bursztajn, an expert on the doctor-patient relationship who consults to physicians in primary-care and other medical specialties on patient-care issues, outlined both how a failure to obtain a specialized consultation deviated from the generally accepted standards of good primary care across the spectrum of medical and surgical specialties, and the damaging consequences of Dr. Belin's failure to obtain such a consultation or to encourage the Skillmans to get a second opinion. Even now, Evan may unknowingly be affected by his parents' anxiety, grief, and guilt over what happened to him. As he grows up, his suffering may be compounded by the realization that what happened to him might have been prevented if he had had reconstructive surgery in his first year, when it could have done the most good. Dr. Belin neither prepared the parents adequately for the complications that occurred nor acted to mitigate the family's suffering by admitting his mistake and apologizing. Instead, they were left feeling that their trust had been betrayed. Finally, Dr. Bursztajn testified as to the costs of the psychotherapy or counseling that Evan would likely need.

On the second day of deliberation, the jury returned a verdict in favor of the Plaintiff, determining that the Defendant had malpracticed. The award included $220,000 for pain and suffering and $40,000 for future medical expenses. This Plaintiff's verdict in a medical malpractice case is believed to be the first in Fayette County in nearly four years.