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Circumcision of young boy at local medical centre (09HDC00810)
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(09HDC00810, 10 November 2009)
General practitioner ~ Medical clinic ~ Unregistered doctor
~ Circumcision ~ Local anaesthetic ~ Contravention of generally
accepted practice ~ Standard of care ~ Information ~ Rights 4(1),
4(2), 4(3), 6(1), 6(2), 7(1)
The parents of a four-year-old boy complained about the care
provided by a general practitioner at a medical clinic when they
took their son to be circumcised. The boy was given a local
anaesthetic but he was distressed throughout the procedure and
would not lie still. Attempts were made to hold the boy still, but
he continued to move erratically and the general practitioner was
unable to insert stitches to stem bleeding from the frenular
artery. The boy was transferred to hospital by ambulance where he
underwent haemostasis and a revision of the circumcision under
general anaesthetic.
The parents noted the presence of another man in the general
practitioner's surgery during the circumcision procedure. They had
no knowledge of his identity at the time, but it later transpired
that he was an overseas registered doctor who is not registered in
New Zealand. It was alleged by the parents that the unregistered
doctor performed the circumcision on their son, not the general
practitioner.
It was held that the general practitioner failed to provide
services of an appropriate standard by choosing to carry out the
procedure, and by his subsequent management of the boy during the
procedure. It was also held that the general practitioner failed to
provide the parents with adequate information. Accordingly, he
breached Rights 4(1), 4(2), 4(3), 6(1), 6(2) and 7(1) of the Code.
The unregistered doctor was also found to have played an active
role in the procedure, and this issue was referred to the Medical
Council and the Ministry of Health.
This case illustrates what can happen when a doctor is
unfamiliar with, or chooses not to follow, recommended guidelines
for a surgical procedure. It also highlights why patients (or their
parents) need to be provided with adequate information so they can
make an informed choice and give their informed consent.
The general practitioner was referred to the Director of
Proceedings, who decided not to issue proceedings.