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Conflicting expert testimony opens day 2 of amputation trial

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Experts called by both sides debate when the penis should have been amputated immediately

By Lisa King

Jurors heard conflicting testimony Tuesday morning from two urologists called in the case of a Waddy man suing his surgeon for amputating his penis without his permission.

One of them, Dr. David Benson, who was called Kevin George, attorney for the plaintiff, Phillip Seaton of Waddy, testified that he thought that Dr. John Patterson of Frankfort was in the wrong to remove Seaton's penis without his discussing it with him first.

Dr. David Paulson, a retired urologist and former chairman of urology at Duke University, said he thought Patterson did the right thing.

Those opinions were in the second day of testimony in Shelby Circuit Court in a case that dates back to 2007, when Patterson said he found cancer in Seaton’s penis while performing at circumcision at Jewish Hospital Shelbyville and amputated the penis without awakening Seaton.

Seaton, 64, and his wife, Deborah also had sued Jewish Hospital Shelbyville and the anesthesiologist, Dr. Oliver James, but both those suits were settled out of court.

On Tuesday, George completed the presentation of his case before noon, and defense attorney Clay Robinson began the response for Patterson.

"The accepted standard of care would have been to do a dorsal slit, which he did, then biopsy it, and discuss it with the patient's family," Benson said.

He said he didn't think the situation constituted an emergency situation and that Patterson should have bandaged the penis and then discussed the situation with Seaton’s  family.

He said that even if the procedure Patterson performed had been the right thing to do from a medical standpoint, that type of surgery is extremely physiologically debilitating to the patient, and it needs to be discussed in advance.

"The patient needs to know what to expect," he said. "The patient may decide he doesn't want anything done. He may just decide to live out his life the way he is."

Benson talked about a patient he once had whose case was very similar to Seaton's. He said when he discovered cancer in that patient's penis, he took a biopsy, stitched the man up and went out to talk to his family.

The man decided to have a partial penectomy and reconstruction done at another facility. In that case, the cancer had spread to the man's lymph nodes, and he is currently undergoing chemotherapy, Benson said.

During cross examination Robinson pointed out that was able to locate his patient's urethral opening, whereas Patterson could not find Seaton's.

Paulson was the next witness, called by Robinson. He said he thought Patterson did the right thing in amputating Seaton's penis.

"I have no fault with Dr. Patterson proceeding with a partial penectomy," he said, adding that from his review of the case that Patterson, "performed it quite well."

Paulson described Seaton's penis as ugly, nasty and infected and resembling a head of cauliflower.  "It measured 4 centimeters; it was a big tumor," he said.

He added that this type of tumor grows slowly.

"Men have a tendency ignore these types of things," he said. "Physiologically, they just don't want to deal with it. I would say it was probably present from eighteen to twenty-four months before he saw a doctor about it."

Paulson said he agreed with Patterson's decision not to stop the procedure and awaken Seaton, for a number of reasons.

He said suturing the incision could cause further damage, and he said he could understand why Patterson was concerned about not being able to locate Seaton's urethral opening.

Paulson also said that Seaton could not have had a penal reconstruction at the same time as the procedure, because not only was the area too infected but reconstruction is a complicated process that takes several surgeries to complete.

During his cross-examination of Paulson, George pointed out that Paulson is retired and has not treated patients for several years.

The trial had an emotional beginning on Monday.

Eight women and six men seated in the jury box saw graphic photos of Phillip Seaton’s groin area and heard him express how he felt when he first examined himself after waking up in the hospital and being told what happened to his penis. They heard his expressions of anger and despair as he was questioned by both attorneys.

And they heard Patterson, testifying after being called by the plaintiff, that not only was Seaton’s penis cancerous, but its urethra was “obliterated.”

George and Robinson questioned several witnesses in addition to Seaton and Patterson, including Deborah Seaton and James.

Phillip Seaton testified  that he could not read yet signed consent forms giving the doctor permission to do whatever was necessary during the surgery.

He said that after the surgery he was surprised to waken and find not only his wife in the recovery room but a roomful of family members as well.

“I said, ‘What are you all are doing here?’” he recalled.

Then he said Patterson told him he had found cancer in his penis and had to remove some of it, he said.

Seaton said he went into the bathroom to see for himself what had been done.

 “I pulled the dressing down, and I didn’t see anything,” he said. “I said, ‘I’m getting the hell out of this hospital.’”

He testified that in 2009 he had what was left of his organ amputated so that he would no longer have to be catheterized to urinate, a task that his wife had been performing for him twice a day since the surgery.

In his opening statement, George, told the jury that Patterson said he only removed the end of Seaton’s penis, but George contended more than that  had been removed.

He said that in performing the operation without waking Seaton, the doctor robbed him of the opportunity to get a second opinion, or to decide whether or not to have the surgery, or to decide if Patterson was the right man for the job.

Robinson said that Patterson was faced with a terrible dilemma but did the only thing he could do: to remove a deadly, invasive cancer.

“Frankly, it was a penis no more, it was cancer – Dr. Patterson saved Phillip Seaton’s life,” Robinson said.

When asked by George why he didn’t stop the procedure and go into the waiting room to ask Deborah Seaton what to do, Patterson said that he was not certain he considered her to be a credible source of information on what Seaton would want because he had the impression they could be estranged, because she had never accompanied him to any of his appointments or gone to the hospital with him.

On the stand, Deborah Seaton said that was because her mother had recently passed away in the hospital, and the atmosphere there was too hard for her to bear.

James testified via videotape, discussing the nature of the surgery and that he could not tell how advanced the cancer was because that was not his specialty.

The day ended with Deborah Seaton’s testimony, who answered questions about what happened after the surgery, and about her relationship with her husband, both before the surgery and currently.

“We don’t have relations any more, but we still love each other,” she said.