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3. What advice should we give the parents who want to know if to
go ahead with this sort of surgery?
4. If we decide to operate on the child, what is the recommended
age to do so?
We forwarded these questions to Dr. A. Tomer and to Professor A.
Humnai from the Kiryah Hospital in Tel Aviv.
This was their response:
To the honorable Rav… shlit”a:
There are two possibilities regarding this sort of mistake:
The first is that the spermatic cord was cut together with the blood
vessels that accompany it to the testicle, causing a lack of sufficient
blood flow through the testicle, which will gradually wither and dis-
appear. In this case, the child will be left with one testicle able to fully
fulfill the function of fertility and reproduction.
The second possibility is that while the spermatic cord was cut, the
blood vessels that accompany it to the testicle remained fully intact.
In this case the testicle will develop normally until adulthood, but the
sperm will have no way of getting out since the cord was cut. These
sperm cells will disintegrate within the testicle. These disintegrating
materials will cause the production of autoantibodies in the blood,
which will then attack the healthy sperm cells located in the healthy
testicle opposite the damaged one. This would lead to a decrease in
sperm count and difficulties in fertility.
There are no reports in medical literature about the results of such
a surgical error. However, reports of a blocked spermatic cord due
to other causes seem to indicate that the presence of these sorts of
antibodies can lead to infertility.
There is the possibility of repairing the cut spermatic cord by sur-
gery, but because of the problematic location of the cut, the chances of
success by microsurgery depend on the surgeon’s expertise.
The danger to life with this type of surgery is small. On the other
hand, there is a chance of successful repair of the damage. Thus it is
advisable for the parents to go ahead with the surgery.
18 1 Medical-HalacHic Responsa of Rav ZilbeRstein
38 AN ANESTHESIOLOGIST OPENED THE ANESTHESIA 20818_efi-ab - 20818_efi-ab | 1 - A | 18-08-20 | 13:29:01 | SR:-- | Cyan 20818_efi-ab - 20818_efi-ab | 1 - A | 18-08-20 | 13:29:01 | SR:-- | Magenta 20818_efi-ab - 20818_efi-a
VALVE INSTEAD OF THE OXYGEN VALVE ......................133
A medical error that caused a patient’s death .........................138
Notifying parents and physicians about a negligent anesthesi-
ologist ......................................................................................... 149
Informing the family of medical negligence resulting from lack
of follow-up ................................................................................152
If one suspects a person of stealing, should one inform the
police? ..........................................................................................159
A hospital director returning to his position after being arrest-
ed for killing someone in a traffic accident .............................. 161
A volunteer killed someone unintentionally – does he have to
go into exile? ...............................................................................162
41 A PHYSICIAN DID NOT RESPOND TO A CALL FOR HELP
AND THE PATIENT DIED .......................................................165
A physician did not convince a cardiac patient to go to the 20818_efi-ab - 20818_efi-ab | 1 - A | 18-08-20 | 13:29:01 | SR:-- | Magenta
hospital by ambulance, and the patient died on the way to his #20818_efi-ab - 20818_efi-ab | 1 - A | 18-08-20 | 13:29:01 | SR:-- | Yellow 20818_efi-ab - 20818_efi-ab | 1 - A | 18-08-20 | 13:29:01 | SR:-- | Black 2081
car. ................................................................................................169
43 A PHYSICIAN SHORTENED HIS WIFE’S LIFE BY
NEGLIGENCE. CAN HE INHERIT HER ASSETS? .............176
44 DIVORCE DUE TO ERRONEOUS MEDICAL
INFORMATION ..........................................................................182
To live in a place forbidden to a person by his physician .......187
A couple divorces due to infertility and the wife later had
children ...................................................................................... 190
45 PUBLIC CRITICISM OF A MEDICAL OMISSION ..............196
One should remember the positive traits of the dedicated
midwives ....................................................................................202
46 A DIRECTOR DICTATING HIS NEGATIVE OPINIONS
ABOUT PHYSICIANS TO HIS SECRETARY ...................... 204
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