Thursday, June 11, 2015

FLORIDA: Joe DiMaggio Children's Hospital Complicit in Medical Fraud, Child Abuse?

In my last post regarding this case, I posted about the details an anonymous user leaked on Facebook, which revealed that the child in this case is scheduled to be circumcised on Thursday, June 11 (THAT'S TODAY) at Joe DiMaggio Children's Hospital by one Gary Birken, MD.
The release of this information has gone viral, and Joe DiMaggio Children's Hospital has heard an earful (or perhaps, more appropriately, "seen a screenful?") from hundreds, if not thousands, on their Facebook page, prompting the following response:
Joe DiMaggio Children's Hospital (JDCH) calls itself "[A] pillar in the South Florida Community and an advocate for many causes, always working for the benefit of its patients, while providing quality service and care." They further state that they "[C]an't and will not discuss specifics in this forum due to HIPAA guidelines."

It appears here that JDCH is expressing concern for upholding its reputation, supposedly touting a concern for the confidentiality of their patients. The problem with this confidentiality is that it could be hiding something sinister; if there is nothing wrong with the child in question, could he rightly be called a "patient?"

The comments have not stopped, prompting a second response from them:

Again we see similar lines, if not in more stronger tones, that they are concerned for preserving their reputation. They seem to be concerned that the hospital and their doctors are being "defamed," and that their work is being "minimized." Their wording is interesting, seeing as "minimizing" what is transpiring at their hospital is precisely what they intend to do.

The peculiarity to be noted here is that they reiterate that HIPAA laws prevent them from speaking about any medical case, and yet they still manage to disclose that "the child in question is not a patient at Joe DiMaggio Children's Hospital or any Memorial Helathcare System facility or of Dr. Gary Birken."

Intactivists, and others, are watching closely and taking note of the chain of events surrounding this case.

Lie after lie...
JDCH appears to be concerned with tarnishing its reputation, but I'm afraid if the facts are what they are, this does not bode well for them. As if their involvement in this case weren't enough, a relative of the child has posted a screenshot of the child's pre-surgical assessment, dated 6/4/2015 (first visit), publicly on Facebook, catching the spokespeople at JDCH in a bold-faced lie.

As if denying that this child were a patient at JDCH weren't enough, if one reads the pre-surgical assessment, one can see the deliberate fraud, lies and fabrication taking place.
The father, of course "reports" frequent urine trapping and ballooning of the child's foreskin, and supposedly notes "erythmia (redness) of distill foreskin." The review mentions "penile pain, ballooning of the foreskin and foreskin not retractable," and further down, it reiterates "Foreskin reduces approximately 30 percent. Mild foreskin inflammation. Urine noted under foreskin."

What the father and the doctor are trying to note as "problems" should raise red flags to the learned reader.

Ballooning is a normal stage of development at this child's age; it’s one of the ways the balanopreputial lamina are naturally stretched and desquamated.

There can be several causes to redness (erythema) or inflammation, from too much soap or improper rinsing, to a mild irritation, to rubbing, to balanitis; all of those causes are usually easily treatable and are not indications for surgery. The doctor notes "penile pain," and that the child's foreskin is "not retractable." Why is this doctor trying to retract this child's foreskin? Is he not aware that non-retractability is normal for a child this age? What is the cause of this child's pain? Could it be that the child's foreskin is being forcibly retracted by the doctor or the child's caretakers? (Read about forcible retraction in a previous post.)

Why does the doctor seem more concerned in finding an alibi for performing surgery on this child than genuinely interested in finding the source of the pain? For what other inflammation of the body is surgical removal the first course of action, and not attempts to treat it by conventional means?
The doctor notes “urine noted under foreskin”, as if this were some kind of pathological symptom. The fact is that the foreskin traps moisture. This is normal, as every male in the world who has a foreskin maintains a certain moisture between the foreskin and the glans; it’s how mucosal tissues work. To try to make this into a pathological condition is like saying that moisture inside the mouth is indication of improper hygiene. Do doctors note urine in the labia as a "problem" too?

The assessment says the child's penis is "Normal. Uncircumcised."

The assessment and plan concludes:
Discussed pros and cons, RCA in detail with father and aunt as relatives to elective circumcision. They have asked that we proceed.

Here we can clearly see that the doctor refers to the circumcision to be performed on this child as "elective." There is an absence of a clear medical indication, and thus a recommendation that the child should be circumcised to alleviate any medical problem. Instead, the doctor discusses "the pros and cons.. to elective circumcision."

In other words, it is clear that the procedure is not medically necessary. The child has no condition requiring the procedure. It is clear that the doctor wants to wash his hands over the procedure and pawn any responsibility on the child's guardians who "elected" it.

It’s clear from the form that the circumcision is not necessary, that the circumcision would be purely elective, that it would happen solely because the parents gave their go-ahead, and that  the doctor wants this to be evident, presumably so that he stands blame-free in any case.

Readers note; there is no other surgery that a doctor is obliged to perform on a healthy, non-consenting child because his *parents* want it done. Surgery in children usually requires a strong medical indication, or a need to correct a problem.

If surgery is not medically indicated in this child, if the procedure is purely elective and being performed to appease the whims of the father, then the doctor cannot be expected to be reimbursed by Medicaid. Should Medicaid cover this procedure, this doctor would clearly be engaging in medical fraud, and JDCH would be complicit in facilitating it.

The plot gets thicker...
It appears this assessment was sent as an attachment to another doctor:
Note where it says "Diagnoses:" "Foreskin problem, "Redundant prepuce and phimosis"

What "foreskin problems" were there? To someone who views the circumcised penis as "normal," isn't the prepuce "redundant" at any length? What assessments were performed by Dr. Birken to verify that the child actually has "phimosis" and his genitals aren't merely presenting natural stages of development?

I will leave it up to the reader to decide what s/he thinks is going on.

Doctor to File Complaint Against Joe DiMaggio Children's Hospital
On a previous post, I noted that one Dr. John Trainer MD had publicly posted the following on JDCH's Facebook Page:
"Simply an observation: the surgeon who would perform an elective surgery on a four-year-old, over the objection of his mother, and the objection of the four-year-old, has committed a gross breach of medical ethics.

If your hospital is complicent in the mutilation of Chase Hironimus, know that I will be filing an ethical complaint with the Florida Board of Medicine the next day."
Well, it appears as though a local paper has picked it up. (Read the article here.)

I must say, it is interesting to read about this man's background:
"John Trainer, M.D., is a family doctor in Jacksonville. He has circumcised children and taught other doctors how to perform circumcisions. His own son is circumcised.

But during the past few months, as he's followed the case of 4-year-old Chase Hironimus..., Trainer reexamined his own position on the surgery and has come to believe that routine infant circumcision is a violation of medical ethics and that Chase's case is particularly egregious because the mother's consent was forced under duress."
I suppose that even it is a tragedy that this happening in our nation, I should be grateful that there are some doctors who are coming around.

I will paste more excerpts from this article here:

From a physician's point of view, Trainer told New Times, "it's absolutely mind-boggling this would be considered as real consent." Of the doctor rumored to be scheduled to perform a circumcision on Chase —  Gary Birken — Trainer said, "it is incumbent on him" to be "aware that this is a dramatic case, an unusual case.
 "Where this this galls me the most," Trainer says, "is that if we are physicians and ethical and called on to police our profession," and the doctor here "either knew or should have known" — that's the phrasing commonly used in ethical standards — "that consent was tainted," and if he proceeds in this particular case, "at the very least his ethics need to be challenged."

Furthermore, he said, pediatric surgery ethics require that a doctor make the child aware of what is happening and consider the child's opinion in elective surgeries. Court documents asserted that Chase was scared of and does not want the procedure...

It's also, he says, "the only procedure an obstetrician will do on a man — and with absolutely no follow-up. They'll never see that penis again — no follow-up. This is unheard-of with any other procedure."

Asked if he faced any career risks by preemptively speaking out against a doctor or hospital, Trainer said, "I am on the Board of Directors of Baptist Primary Care, a leader in a consortium of 150 providers — the largest and most trusted health-care system in Northeast Florida. If I suffer backlash for speaking out, I am OK with that. Actually, my Facebook page is blowing up with people commending me for being courageous. I don't really feel that brave."
Doctors Opposing Circumcision Lays Down the Law
In other news, organization Doctors Opposing Circumcision has sent the following letter to JDCH.
I'll let readers read it and make of it what they want for themselves:

One thing is for sure; whoever lays hands on this child had better get ready.

 Muslim child about to be circumcised. One can be sure
nobody "convinced" him of anything, money is not
enough to comfort this child who knows what is coming

As a 4-year-old, the child may have to be restrained.
Here is a picture of a 4-year-old being forcibly circumcised
in Turkey. Boys in Muslim traditions are circumcised at later ages.

Joe DiMaggio Children's Hospital; did you seriously allow this to happen in your facilities today?

Have you failed this child?

Some "pillar" you are.

I close with my mission statement:

Mission Statement
The foreskin is not a birth defect. Neither is it a congenital deformity or genetic anomaly akin to a 6th finger or a cleft. Neither is it a medical condition like a ruptured appendix or diseased gall bladder. Neither is it a dead part of the body, like the umbilical cord, hair, or fingernails.

The foreskin is not "extra skin." The foreskin is normal, natural, healthy, functioning tissue, present in all males at birth; it is as intrinsic to male genitalia as labia are to female genitalia.

Unless there is a medical or clinical indication, the circumcision of a healthy, non-consenting individuals is a deliberate wound; it is the destruction of normal, healthy tissue, the permanent disfigurement of normal, healthy organs, and by very definition, infant genital mutilation, and a violation of the most basic of human rights.

Without medical or clinical indication, doctors have absolutely no business performing surgery in healthy, non-consenting individuals, much less be eliciting any kind of "decision" from parents, and much less expect to be reimbursed by public coffers.

Genital mutilation, whether it be wrapped in culture, religion or “research” is still genital mutilation.

It is mistaken, the belief that the right amount of “science” can be used to legitimize the deliberate violation of basic human rights.

FLORIDA: What Happened Today As Per Intact America

FLORIDA BULLETIN: Circumcision Scheduled for 4-yo - Anonymous User Discloses Details

Related Links:

Related Post:
Phony Phimosis: How American Doctors Get Away With Medical Fraud


  1. A part of me won't be at all surprised if they go through with it...but given all this now-public documentation on how UNNECESSARY the circumcision is...another part of me thinks they'd be absolute FOOLS to go through with it and not expect a huge malpractice and personal injury suit.

    It's plain as day: nothing is really wrong with this child, and Joe DiMaggio is merely a willing accomplice in custody spite surgery.

    Thanks for all the documenting you're doing for this case!

  2. If they go ahead and mutilate Chase, I wonder how many people he will be able to sue into bankruptcy when he reaches 18?