WINNIPEG FREE PRESS, Tuesday, July 18, 2006.

MD disciplined after wrong baby circumcised

Tried to hide error from parents

Tue Jul 18 2006

By Jen Skerritt

A Winnipeg doctor, who didn't check a newborn's identification before a circumcision was performed on the wrong baby at St. Boniface General Hospital, later duped the baby's parents into believing the operation wasn't performed until after they gave consent, a College of Physicians and Surgeons investigation has concluded.

Dr. Matthew Howard Lazar failed to check the identification of a newborn baby boy before his trainee performed surgery to remove the child's foreskin on Nov. 8, 2005. The baby's parents had not signed a consent form, and the mother later told the College she was still "undecided" about the surgery because of the pain.

And even though the surgery had already been done, Lazar still discussed the pros and cons of circumcision with the baby's parents at a meeting at which the parents signed a consent form.

After performing a circumcision on another patient, Lazar then carried their baby, who had earlier been wrongfully circumcised, into his parents' arms, telling them the surgery was a success.

Later the same evening, after hospital administration found out about the mistake and ordered Lazar to meet with the parents and apologize, the doctor didn't tell the parents a trainee, and not he, had performed the procedure.

According to a written report by the college's investigation committee, that final omission, which the parents only learned about the next day, left them feeling "betrayed", questioning whether they had been told "the whole truth of what had occurred", and believing the doctor's apology "was insincere".

Dr. Bill Pope, the college's registrar, said Lazar's actions have left him with a permanent blemish on his record and he has been ordered to pay the $4,676.30 cost of the investigation.

"It's not a fine, but the cost of doing a censure process," Pope said yesterday.

"It is a public discipline and it goes on the public record."

Pope said the censure will have to be reported if Lazar applies to practice elsewhere.

Lazar could not be reached for comment.

Pope said the college's investigation only looked into the role of the physician in the matter and not into whether other hospital personnel brought the wrong child into the procedure room in the first place.

Shortly after the incident, St. Boniface General Hospital suspended circumcisions of newborn boys and since then it has decided not to reinstate the procedure.

A spokeswoman for the hospital said they have taken steps to make sure such a mix-up doesn't happen for any other procedures. It involves double-checking patient information and ensuring that the consent be signed and noted on the child's chart. A spokeswoman for the Winnipeg Regional Health Authority said Health Sciences Centre does not perform circumcisions.

Prof. Arthur Schafer, an ethics consultant in pediatrics at the Health Sciences Centre, said St. Boniface should be looking at whether they have proper safeguards in place to ensure any kind of medical procedure is not performed on the wrong patient and investigating why none of Lazar's colleagues checked patient ID.

Schafer also said Lazar's initial refusal to take responsibility for his mistake illustrates the culture of "concealment" in medicine. With the threat of lawsuits and losing their insurance, Schafer said most doctors would have likely tried to cover up their error just as Lazar did.

"There isn't an adequate culture of openness and disclosure and mostly it's generated by a fear of lawsuits," he said. "He did what most of his colleagues would have done and he got caught."

(File created 24 July 2006)