The surgeon should have ordered a urinalysis prior to performing a circumcision on a 53-year-old man.

Dr. U, 41, was a sole urologist in a small community in the Midwest. He’d been in private practice for only two years, but he felt quite positive about his professional prospects and his future—until he was sued.

It all started routinely when a new patient, Mr. K, a 53-year-old man, came in. He was asked to fill out a medical information form as well as provide his in-surance information before entering the examination room. After skimming the medical in-formation form, Dr. U spoke to Mr. K, and examined him. He discovered a urological lesion that the patient claimed he’d “had for several months and that it just wouldn’t heal.” Dr. U recommended circumcision, and subsequently scheduled Mr. K for the procedure the following week.

The surgery was performed in Dr. U’s office under local anesthesia. The procedure was routine, and both Dr. U and the patient expected a positive outcome. However, serious problems soon developed. Over the next three months, Mr. K kept returning to Dr. U’s office with a host of issues, including pain, an unusual protrusion, urination problems, and lack of sensation. Then Mr. K abruptly stopped coming to Dr. U’s office, or calling, and sought the help of another physician.

The new physician ordered a urinalysis that indicated Mr. K had diabetes. When the new physician asked whether Mr. K was aware that he had diabetes, the patient answered that he was aware. “Do you take medication?” queried the physician. “No, I just try to eat healthy and exercise sometimes,” replied Mr. K. “Did you tell your previous doctor?” asked the new physician. “He didn’t ask,” replied the pa-tient. “Did Dr. U do a urinalysis before your circumcision?” asked the physician. “No,” replied Mr. K, “Should he have?”

Diabetes hinders recovery

Armed with information from his new physician that his un-controlled diabetes was probably responsible for his poor recovery from surgery, Mr. K hired a plaintiff’s attorney. The attorney immediately hired an expert board-certified urologist. The expert stated that Dr. U should have performed a urinalysis prior to surgery.

Had he done so, said the expert, he would have been aware of the diabetes and could have worked with the patient to get the condition under control to avoid complications. The attorney began an action on behalf of his client, suing Dr. U for negligence for failing to order a urinalysis prior to surgery, and alleging that the urologist also was negligent in failing to properly treat the postoperative complications.

At trial, the expert testified that it was his opinion that Dr. U should have checked Mr. K for diabetes before performing the surgical procedure. According to the expert, failing to check for diabetes was a departure from the standard of care, and Dr. U had breached his duty of care to Mr. K.