Can we assess risk of psychiatric sequelae from perinatal injuries?
Medical malpractice litigation involving seven to nine figure settlements has been on the rise over the past decade. Given the life-altering scope of these incidents, forensic child psychiatrists may be asked to opine on the effects of a permanent perinatal injury on normal human development. Whether forensic child psychiatrists can assess risk of future psychiatric effects from such incidents is an important question. This paper is spurred by two separate cases, each involving a male infant having a portion of their genitals accidentally amputated by an obstetrician-gynecologist (OB/GYN) during a routine circumcision. In each case, the genitals were repaired, but permanent defects remained. The question arises how such injuries would affect these children as they matured. An analysis of the literature supported that there are risks of psychiatric effects of such birth-related injuries. Such predictions are made with reference to what is already known about human development, and by an exploration of the literature on the psychiatric effects of comparable injuries to children.
Chief Fellow, Division of Child & Adolescent Psychiatry, Institute of Psychiatry, Medical University of South Carolina, Charleston, SC, United States. Electronic address: eappen@musc.edu.
Seth A
SA
Eappen
Adjunct Professor of Psychiatry at the University of Michigan, Ann Arbor, MI, United States. She is also in private practice; Clinical Assistant Professor, Division of Child & Adolescent Psychiatry, Institute of Psychiatry, Medical University of South Carolina, Charleston, SC, United States. Electronic address: epb@umich.edu.
Elissa P
EP
Benedek
Chief Fellow, Division of Child & Adolescent Psychiatry, Institute of Psychiatry, Medical University of South Carolina, Charleston, SC, United States. Electronic address: murphker@musc.edu.
Kerrie
K
Murphy
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology*; D005555:Forensic Psychiatry / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D010413:Penis / Q000293:injuries; D018743:Perinatal Care / Q000331:legislation & jurisprudence; D018570:Risk Assessment
Circumcision injury; Forensic child psychiatry; Medical malpractice; Personal injury; Urological injury