WARNING: This story contains graphic descriptions
A Winnipeg doctor has been suspended for five months after he performed circumcisions on multiple young patients in an inappropriate manner, including two cases where patients were taken to the emergency room in life-threatening condition, according to a decision from the College of Physicians and Surgeons of Manitoba.
Dr. Ejaz Ahmad performed 18 circumcisions at his private clinic between June 2016 and July 2017, the Dec. 14 decision says, using an out-of-date surgical technique associated with a higher risk of complication.
At least six of the procedures resulted in the young patients being taken to the emergency room, the decision says, including one case where a portion of the head of a patient’s penis was amputated.
In that case and one other, Ahmad also asked the parents of the child to lie to doctors at the emergency room and say that it was not he who performed the procedure, the decision says. He told doctors in one instance the procedure had been performed by a “traditional man.”
The patient population was primarily recent immigrants who had been referred to Ahmad by community members, the decision says.
In its decision, the college says Ahmad’s professional misconduct caused harm, in some cases potentially serious harm, to his patients.
“Furthermore, Dr. Ahmad’s actions caused many of the patients and their families serious upset and anxiety,” the decision says.
“All of the patients involved were young and vulnerable.”
5-month suspension
According to the decision, Ahmad pleaded guilty on Oct. 15 to four charges from the college: professional misconduct, contravening two college bylaws and displaying a lack of knowledge, skill and judgment in the practice of medicine.
He faces a five-month suspension and was ordered to pay more than $24,400 for the investigation and inquiry. He’s also been ordered to complete an ethics course and has been barred from performing circumcisions until he receives formal training and approval from a pediatric urologist.
The college was alerted about Ahmad by a doctor at the Children’s Hospital emergency room, the decision says, after other physicians there raised concerns about multiple patients who came in with complications from circumcisions in a 30-day period.
Ahmad began performing circumcisions in 2016 after being approached by parents who wanted the procedure for their young children, the college says in its decision. He had not performed a circumcision for 19 years.
He agreed, despite initial hesitancy from a lack of confidence in his abilities, the document states, and without taking any steps to update his knowledge or skills.
From June 2016 to July 2017, he performed 18 procedures, the decision says. The document only provided detail on six patients.
In the first of those six cases, from May 2017, the father of the patient brought his son to a surgical clinic for a consultation after the circumcision, the document says. The attending physician said the procedure performed by Ahmad would lead to a “very abnormal appearance” of the penis and, likely a severe stricture.
Surgical technique was inappropriate: college
In the second case, on July 1, the patient was left with an arterial bleed and was taken to the Children’s Hospital emergency department, where he was taken to the operating room in life-threatening condition and required a revision of the procedure.
Three brothers were also taken to the emergency room after circumcisions performed July 15. Two of them required fentanyl to remove embedded gauze and doctors noted the skin had separated approximately a centimetre at the surgical site.
In the final of the six cases, on July 21, the patient was taken to the emergency room in life-threatening condition with significant arterial bleeding after Ahmad amputated a portion of the penis during the procedure.
The document says the surgical technique he used “did not meet the current standard of care in that it was inappropriate and associated with greater risk of complication.”
The circumcisions were performed at his private clinic, instead of a hospital, it states. He also failed to provide appropriate anesthetic at a “non-specific dose,” used only alcohol swabs to sterilize the surgical site and did not suture the wound after circumcision.
Ahmad also failed to create records at the time and then created copies after the fact to satisfy the college’s investigation.
The college wrote Ahmad has already completed training on how to properly do a circumcision from a specialist at Humber River Hospital in Toronto and understands he was using an inappropriate technique.
“The college does not have evidence that Dr. Ahmad failed to meet appropriate professional standards in any other area of his practice,” the decision says.
“Rehabilitation is therefore possible and appropriate in this case.”
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