A Virginia jury ruled in favor of an ER physician in a malpractice case alleging that a missed diagnosis of priapism led to loss of sexual function.
Discussing injuries or illnesses that can lead to changes in sexual or reproductive function with patients can be challenging and can lead to confusion.
Physicians can take steps to increase patient comfort during these conversations.
A Virginia jury heard three days of testimony before ruling in favor of an ER physician in a case centered on a 2019 hospital visit. On February 11, 2019, the plaintiff, a 33-year-old man, was taken by ambulance to the ER. He presented with pain in the groin area. According to medical records, first responders noted that he was found in his living room “with testicle pain acute onset around 6 a.m.”
ER records noted that the plaintiff had scrotal and groin pain, which had begun that morning. After being examined at triage with nursing staff, the plaintiff was examined by the ER physician assistant, who noted the plaintiff’s chief complaint was “testicular pain and [d]ysuria.” The plaintiff alleges that he had a prolonged and painful erection during his ER visit; however, hospital records do not note an erection or priapism.
A physical exam was conducted, and a testicular ultrasound was ordered. The ultrasound returned no abnormal findings. The plaintiff was diagnosed with urethritis and discharged the same day with antibiotics.
On February 13, 2019, the plaintiff returned to the ER with complaints of groin pain and an erection of approximately 53 hours. During this ER evaluation, the plaintiff was diagnosed with priapism and transferred to another facility, where surgical intervention was attempted.
The attempted intervention was unsuccessful at restoring the plaintiff’s penile function. In the malpractice suit, the plaintiff claimed that he now experiences impotence, an inability to maintain an erection, an inability to perform “any meaningful conjuga[l] act,” and permanent disfigurement. The suit alleged that failure to diagnose priapism during the February 11 ER visit led to these complications.
The jury ruled in favor of the defense.
Loss of sexual function and medical malpractice
A wide range of medical errors, or alleged medical errors, can lead to malpractice cases seeking damages for loss of sexual function. For instance, spinal surgeries, urology procedures, and treatments for conditions that affect the pelvic region can all be linked to loss of sexual function. The results of malpractice cases involving loss of sexual function can vary. Notable loss of sexual function cases with high plaintiff awards include:
$4.5 million awarded to an Oregon couple, Jason and Kassandra Croff, who claimed loss of sexual function after Jason’s 2013 spinal surgery.
$3.9 million awarded to a Georgia man who developed impotence and incontinence after being treated with a microwave transurethral device.
$1,750,000 awarded to a New York man who experienced retrograde ejaculation and erectile dysfunction following the incorrect placement of a urethral stent.
$900,000 awarded to a Virginia man after his leg was placed in traction for more than 5 hours, leading to permanent nerve damage and loss of sexual function.
Talking to patients about sensitive issues
Injuries and illnesses that might affect sexual or reproductive function can lead to difficult conversations with patients. For many, these are sensitive topics. Patients might feel uncomfortable discussing the issue and might not voice all of their questions or concerns. Unfortunately, this can lead to information not being communicated and patients not fully understanding of a condition or injury.
It’s important for physicians to keep in mind that there are numerous reasons patients might experience discomfort about these issues. For instance, a patient’s cultural or religious upbringing may lead them to consider all discussions of sex and sexual function taboo and off-limits, even if those discussions are with medical professionals. Additionally, LGBTQ patients might be concerned that asking specific questions will lead to discrimination.
There are some steps you can take to help patients feel safer and more comfortable during these discussions. Many of these steps come before any discussion of injury or illness by, for example, using inclusive language and creating a safe and welcoming environment. You can read more about this here. The American Academy of Family Physicians recommends that, when coming to a specific diagnosis, you should start with an open discussion:
“[G]ive the patient permission to be curious and to ask open-ended questions such as, ‘Many people are concerned about how this condition might affect their sex life. What is your experience?’ The patient’s response determines what information the physician offers about the diagnosis and sexual function connection.’”
Sam Parkinson, MD, a family medicine practitioner, agrees, stating:
“Sometimes, it’s as simple as making a comment about it instead of asking a question. So, making a declarative, [such as], ‘We know that this can often cause people to experience changes in either their sexual function or desire, or a change in their ability. If you have any questions, I’d be happy to answer them or put you in touch with someone who can address them more fully. Something super simple like that, and you gauge from there how the patient wants to go forward. Their body language will probably tell you a lot.”