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Dec 30, 2013

Rabbi Sued After Baby Injured During Circumcision

A strange but sad story in Pittsburgh.. a mohel botched a bris pretty badly.. he cut the whole penis off. I cannot even imagine how this can happen..

From CBS Pittsburgh:

A local rabbi is being sued after allegedly botching a bris, the traditional Jewish circumcision ritual, and severing a newborn boy’s penis.
The incident detailed in the lawsuit happened at the Tree of Life Synagogue in Squirrel Hill within the last year.
The Jewish circumcision ceremony was performed by Pittsburgh Rabbi Mordechai Rosenberg – who is also a mohel.
Sometime during the bris, according to the lawsuit, Rosenberg severed the baby boy’s penis.
The baby was rushed to Children’s Hospital, where doctors performed emergency microsurgery.
“If your finger, your thumb was cut off and was put back on, that is pretty exciting,” said renowned UPMC plastic surgeon Dr. Joe Losee.
Dr. Losee was not involved in the boy’s treatment and he can’t talk specifics.
But our sources say it took eight hours. The baby needed six blood transfusions and was hospitalized for nearly two months. Sources describe the reattachment procedure as successful.
Dr. Losee says microsurgery advances every day, but it’s risky.
“Sometimes, it doesn’t always work,” he says. “When you’re reattaching a portion where you include nerves, sometimes the nerves don’t heal well beyond where you reattached it. So there are limitations for sure.”
On his website, Rabbi Rosenberg says he is recognized as a “certified mohel by the American Board of Ritual Circumcision.” His site also says “a doctor’s medical circumcision, usually performed in the hospital, is not considered valid according to Jewish law.”
“That is extraordinarily serious and is extraordinarily rare,” said attorney David Llewellyn.
Llewellyn handles cases involving injury during circumcision – injury brought on by both doctors in the hospital and mohels in religious ceremonies.
“Your average pediatric urologist probably spends about 20 percent of his or her time repairing children who have been circumcised,” Llewellyn says.
According to the American Academy of Pediatrics, one in every 500 newborn boys experience significant acute complications as a result of circumcision.
“This is pretty much unregulated,” Llewellyn said.
He says there is no regulated standard for training or certification of mohels, or any place for reporting injuries from circumcision.
“There’s virtually no regulation of this any place in the United States that I know of,” Llewellyn said. “I think the government probably should require some sort of training if this is going to be done.”
Rabbi Rosenberg told KDKA “I am trained in this.” He also called the case a “tragic accident” and a “horrible situation.” But also said he continues to perform circumcisions.
Sources close to the case say, while the baby is recovering, there’s no way to know if he’ll make a complete recovery. The incident happened about eight months ago.

I do not see why it would be a problem to regulate mohels, with certification, exams, training, etc. As far as I know, in Israel there is regulation and mohels must take a test, take an exam, become certified, in order to practice. I don't know how strictly it is regulated, but it is regulated. But even with the tightest regulation, the best training, accidents can and will still happen, mistakes can and will be made, and some tragedies will occur. The regulation and training would hopefully minimize all that, but there is no perfect solution.

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  1. Let's face it. Regulation here means medical (or at least nursing) school. Frankly, it's a miracle (most) Western societies haven't already prevented people with no qualifications from performing what is a surgical procedure.

  2. The solution to preventing botched circumcisions is to stop performing medically unnecessary circumcisions. This case is just one in a long and growing list of tragedies resulting from circumcisions that are unnecessary in the first place. Respect the bodily integrity of children, and God's design of the human body.

    See: http://wisewomanwayofbirth.com/circumcision-dirty-little-secrets-exposed/

    1. And let's not grind wheat into flour since that's the way it naturally grows...

    2. I dont know about people who do circumcisions for medical reasons, but most Jews who do circumcision, and especially religious Jews, do not do it for medical reasons. the reasons are purely religious.

    3. Same for Muslims, Rafi. Maybe certain Christian sects, as well.

    4. Herb, have you tasted bread made with unground wheat? Pretty much inedible, I'd guess. Yet 2,000,000,000 men and their partners find their "unground" parts to be perfectly "delicious" and "nutritious".

    5. Hugh, my point (which was just echoing the famous discussion between Rabbi Akiva and the Turnus Rufus quoted in Midrash Tanchuma (Tazria 5)) was rebutting the assertion by Anonymous to leave the human body as designed. The fact that people without mila feel fine is irrelevant. As Rabbi Akiva claimed, it isn't possible to say that the world was created in a perfect state as can be seen from the example of wheat. R' Akiva never claimed that *everything* created needs man to perfect it, just that it is impossible to use the state of something created as proof of that being the better state.

    6. I think Anonymous meant, "stop doing infant circumcisions, except medically necessary ones". Adults of course should be free to have themselves circumcised for whatever reasons they please, such as religion.
      Actually, Rafi, I think you are mistaken about "purely religious". Any online discussion of religious circumcision very soon raises all the old refuted medical excuses as well, along with more ritualistic than realistic notions of "uncleanness". Underlying - and sometimes explicit - reasons are conformity, power and control.

    7. I agree that "Nature knows best" is not a good argument, so I ignored that part of Anonymous's post. But the benefits of grinding wheat into flour are manifest. Those of cutting a normal, healthy, functional, non-renewing part off the body of a non-consenting person, not so much.

  3. Circumcision has historically been done well, and successfully, for many centuries with a very low attendant rate of complications.

    Now, to the article: I don't even know how to begin processing this. It is almost difficult to mistakenly sever the entire (or most of the) penis. The more common risk is placing the shield too low, and then cutting off too much at the top. Still doesn't happen very often. (No statistics at hand, but I have looked into this since we live in a very anti-cicumcision town. And yes, I am a medical professional and educated at reading and interpreting research papers and policy statements from medical bodies.) This mohel, it seems, would have to 1) have been working without a shield. In my personal opinion, that would be unnecessarily risky and irresponsible. I also think it unlikely. In my 56 years I have only known of one mohel who ever worked without a shield. Even the best of the best use a simple slide-on shield. Or, 2) he placed the shield and then allowed himself to be distracted and cut below the shield, rather than being solely focussed on the task of the moment. I suppose, too, for instance that if the sandek had bumped his knees up at just wrong moment, with knife already in motion, that might cause such an accident. Dunno. Just hard to envision.

    The AAP says that 1 in 500 circumcisions have a significant complication. Let's be clear. Assuming that is a clear piece of data (a reasonable assumption), it obviously is mostly non-Jewish circumcisions. There just aren't enough Jewish circumcisions in America as a percentage of the whole, to account for that datum. So, that would imply that many physicians are also having complications. Medical circumcisions in American are typically done by a method that is really unwieldy and unnecessarily complex. It is best done with three hands. I have witnessed some, and discussed it with several physicians who do them. The observant Jewish physicians I've discussed it with all remarked how it is unnecessarily complex when done by standard urological technique. In my head, that increases likelihood of error and accounts for the AAP datum; which again must reflect circumcisions that were mostly not 'Jewish ritual circumcision'. It's a little confusing including that datum in the article.

    I'm in favor of regulation that does not interfere with religious standards. Of course, the Jewish community would have to be honest and humble about what is really, absolutely "required" and what can be adapted. No further comment on that. ;-(

    I also think the gentleman who did this milah should cease immediately. This is a great, grievous, gross error. It requires some time to learn from mistakes, to do t'shuvah, before considering doing more circumcisions. This kind of tragedy is really a yifashfesh b'maasav moment for all who even witness such a thing. What happened to our sensibilities? A sefer torah falls to ground and the whole shul fasts (typically, historically); but a baby is accidentally mutilated and the mohel and/or community should respond with less? Oy lanu.

  4. How many complications are too many? This was a ritual circumcision performed by a mohel who says he is trained. The operation to restore the baby's penis to a semblance of normality may or may not succeed, and the full extent of its success or failure won't be known till he his an adult.

    Where is the justice or mercy in subjecting a newborn baby to such a devastating risk for the sake of beliefs that he may grow up to reject? Religious freedom is a relatively modern concept and individual religious freedom even more so. Clearly many people do not have their heads around it yet. The child is not the parents' property, nor the slave of them or their beliefs. He (or she) is entitled to an open future, including the fate of all his (or her) own (normal, healthy, functional, non-renewing) body parts.

    1. Parents make countless, irrevocable decisions which permanently affect their children's bodies, minds, and future for the rest of their lives. This is just one more and well within a parents prerogative.

  5. Every circumcision alters sex dramatically. Only the patient has the ethical standing to authorize cosmetic surgery.

    1. I can't imagine anyone doing a circumcision for cosmetic reasons. The religious do it as a Divine commandment, and many non-religious for health concerns. In either case, the child's consent isn't required as this is within the prerogative of a parent's decision making role.


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