Parents watch boy writhe in pain as doctor botches circumcision

BY REBECCA TODD

A father saw his son being held down like a "wild animal" while a doctor performed a circumcision with inadequate anaesthetic, a Health and Disability Commission (HDC) report says.

In findings released yesterday, commissioner Ron Paterson found an unnamed GP's breaches of the HDC code, including using unreasonable force on a patient, were so serious that he referred him to the commission's director of proceedings to consider further disciplinary action.

An unregistered doctor who assisted with the circumcision was also censured and those findings sent to the Medical Council and the Ministry of Health for review.

The GP, who trained overseas, performed about 60 circumcisions every year but has voluntarily stopped after the investigation.

The HDC report, which reveals no names, said the GP circumcised a four-year-old Muslim boy in January.

The boy was given a local anaesthetic but was distressed and would not lie still.

He eventually had to be taken to hospital as he was bleeding profusely, and the GP could not insert stitches to stem the flow. The boy underwent a revision of the circumcision under general anaesthetic and was discharged the following day.

Paterson's report said common practice was for young children to be circumcised under general anaesthetic. The boy's parents said they were advised a local anaesthetic would be fine and that their son would not feel any pain.

They said that when they arrived early at the medical centre on the day of the procedure they could hear the screams of another young patient from the waiting room.

The clinic manager, the GP's wife, told them that the 14-year-old being operated on had been given the maximum dose of morphine but was "too sensitive and could not handle the pain".

The mother of the four-year-old said the doctor started cutting immediately after giving her son the anaesthetic.

"I started crying, seeing my son in so much pain. I was chased out of the room by the doctor saying that I am passing my anxiety on to my son," she said.

Her husband was also sent out. They could hear their son crying out for them and begged to be allowed back in.

When the father eventually re-entered the room, he saw his son bleeding profusely.

"The doctor, his wife and unlicensed man were holding my son as if they were holding a wild animal," he said.

Nearly two hours after the procedure began, an ambulance was called and the boy was rushed to hospital.

Auckland doctor Gerald Young prepared a report for the inquiry, saying he had concerns about the GP's surgical skills.

The only evidence of the GP's training and expertise in circumcisions was a letter saying he was a junior resident in paediatric surgery for seven months in 1983, he said.

"With an increasing Muslim population in New Zealand, there is increasing demand to perform circumcisions for religious and cultural reasons, particularly the desire to have circumcision performed under local anaesthetic for reasons of cost," Young said.

"What may be acceptable overseas with respect to the standard of information disclosure and the circumcision procedure itself, especially the amount of physical force used to restrain the child, may not be acceptable in New Zealand."

HDC director of proceedings Aaron Martin said he hoped to decide before Christmas whether to take the GP to the Health Practitioners Disciplinary Tribunal. If he successfully prosecuted the case, the man could be struck off the medical register or fined. Martin could also take the case to the Human Rights Review Tribunal to get compensation for the family.

The GP was subject to a competency review by the Medical Council that found his performance was acceptable. The council would not comment.

CIRCUMCISION FACTS

Between 15 and 20 per cent of boys are circumcised in New Zealand and Australia.

Muslims are the largest single religious group to circumcise boys. Male circumcision is among the rites of Islam.

Nearly 100 per cent of Pacific Island boys are circumcised for cultural reasons in late childhood or early puberty.

Circumcisions are ususally performed for hygiene reasons, religious or cultural reasons or because of recurrent infections.

Risks include infection, persistent bleeding or narrowing of the urethra, making it hard to pass urine.

- © Fairfax NZ News