Russell-Cooke secures £75,000 settlement following failure to obtain informed parental consent for childhood circumcision

The claimant was born in 2004. In 2008 he started to experience severe testicular pain and attended the GP practice on several occasions, being referred for testing in December 2008.

In January 2009, he was examined by a Consultant Surgeon employed by the Defendant Trust. It was considered that he required bilateral orchidopexy surgery to secure the testes within the scrotum. During the consultation, the surgeon also noted that the claimant’s foreskin appeared slightly tight and told his parents that a circumcision might be undertaken at the same time.

The claimant had not presented with any symptoms relating to his foreskin or penis and his symptoms related solely to his testes and insofar as his prepuce and/or penis was concerned, he was asymptomatic. Further, the claimant’s older brother had previously undergone circumcision surgery which resulted in infection and scarring. As a consequence, the claimant’s parents were keen to avoid circumcision unless it was absolutely necessary.

On 26 February 2009, the claimant underwent bilateral orchidopexy surgery. A circumcision was also performed during the same procedure.

Following surgery, the claimant experienced significant post-operative pain and subsequently developed a wound infection in his penis. He had to return to hospital on 1 and 2 March 2009 for treatment of the infection.

The claimant had a circumcision procedure, the wound then became infected, leaving the claimant with permanent penile scarring and a cosmetically poor outcome.

As the claimant entered adolescence and adulthood, he became increasingly concerned about the appearance of his penis. He developed difficulties with intimate relationships and sexual function and suffered significant psychiatric issues.

He suffered from erectile dysfunction, which was, on the balance of probabilities, attributed to the psychological consequences of the circumcision and poor outcome.

The claimant’s case was that his parents were not consented regarding the circumcision procedure. They were not advised of reasonable alternative treatment options, including conservative management, nor were they advised of the material risks associated with circumcision surgery, including infection and scarring.

The defendant made a number of admissions in the pre-action stage in their Letter of Response. They admitted that there had been a failure to discuss reasonable alternative treatment options and a failure to discuss the material risks associated with circumcision surgery, including scarring. They raised issues regarding causation of injuries.

A Consultant Urological Surgeon was instructed on breach of duty, causation, condition and prognosis. In summary, he concluded that there had been a failure to obtain informed consent for the circumcision procedure, however, he did not consider that the surgery had been performed negligently. He concluded that the claimant had been left with permanent penile scarring and a cosmetically poor outcome.

He noted that the claimant was suffering from erectile dysfunction, but that this was not organic in origin and was, on the balance of probabilities, attributable to the psychological consequences of the circumcision. He advised that revision surgery could improve the appearance of the claimant’s penis and also reported that the claimant should engage in a course of psychosexual therapy and take medication in respect of his erectile dysfunction.

A Consultant Psychiatrist was instructed and concluded that the claimant had developed a chronic Adjustment Disorder as a consequence of the unnecessary circumcision and its sequelae. Future psychiatric and psychological treatment was recommended and it was considered that after treatment, the claimant’s condition would improve.