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A tragic case of medical misconduct

December 8th, 2011

Dr Petra

In 2008 Alice Dogruyol representing The Spa PR Company wrote to me requesting I plug a new genital cosmetic procedure – the g-shot. It involved injecting collagen into the vaginal wall. And was being spearheaded in the UK by a Professor Phanuel Dartey of Harley Street.

I immediately noticed there seemed to be no robust peer reviewed clinical evidence for the safety and effectiveness of the g-shot procedure. I felt the press release I was sent was so poor and the ‘treatment’ described seemed so bizarre that it was best ignored. I assumed no media outlet would pick up on it.

I was wrong.

Several newspapers including the Sun, Mirror, Telegraph and Mail clearly had been sent the same press release as me. The only difference was they joyfully publicized the g-shot and promoted Prof Dartey’s Harley Street practice. And in the case of the Sun and the Mirror the pieces were written by their Health and Science correspondents. Who really should have known better. Since then many women’s magazines and websites have also described the procedure as a sex life enhancer, promoting both the g-shot and Laser Vaginal Surgery (which Dartey also offered).

I was so concerned I wrote a blog post about the problems I foresaw with the g-shot procedure and subsequent media coverage. I also outlined core questions journalists and the public ought to be asking about it.

A journalist colleague then tried to pitch a story critiquing the g-shot , but they were unsuccessful. Over the past three years I sent my blog post questioning the g-shot to any media outlet I spotted giving it publicity. In most cases I heard nothing back. Occasionally a journalist would politely thank me and tell me they’d consider my opinions if they wrote similar pieces in the future.

In other words they ignored my concerns and questions. Probably because they weren’t as exciting as the sexy ‘science’ of collagen injections, and probably because anyone critiquing their breathy discussions of amazing orgasms through genital enhancement could be dismissed as an anti capitalist/feminist/academic killjoy.

I did not systematically continue to campaign against the g-shot because I reasoned even if the media were occasionally (albeit enthusiastically) covering it, I doubted many women would opt for either the g-shot or Laser Vaginal Surgery.

I was wrong here as well.

Last week Phanuel Dartey was struck off by the General Medical Council (GMC).

This followed complaints from five women. The British Medical Journal (16 November) reports Dartey ‘botched laser operations on four women and left another seriously ill after a termination’ . It goes on to report from the GMC hearing:
“Patient A was said to have suffered visible scarring and asymmetry of her genitals, although she had been told that the incisions would be nearly invisible. Part of her vagina had been “effectively amputated,” and she required revision surgery
Patients B and C were given laser surgery for urinary incontinence, which the GMC’s experts say would have been of “limited value”.
Patient E was in major pain after a labioplasty to reduce the size of her labia minora, which Dr Dartey is said to have “significantly over-reduced.” When she complained of the pain, the GMC alleges that he suggested an injection of absolute alcohol into the area of the labial scar to kill the nerve endings, an intervention that was “inappropriate.”
Patient D travelled from Ireland to the Marie Stopes centre for a termination at 18 weeks’ gestation. Dr Dartey is alleged to have perforated her uterus during the procedure but failed to recognise this.
The GMC alleges that he failed to check that all the products of conception had gone and failed to notice that the fetal thorax had not been removed. When D returned home, she became “extremely ill,” … “She was on the critical list and was in hospital for two months.”
Dr Dartey, who was suspended from practice pending the hearing, is also charged with having no valid medical indemnity insurance when he carried out the termination in February 2006”.

A further report of the hearing, again from the BMJ (6 December), explains why Dartey was struck off:
“Robin Knill-Jones, who chaired the GMC’s fitness to practise panel, said, “In the panel’s judgment there is a continuing risk to patients from the way Dr Dartey conducts his practice. His dishonest actions in relation to professional indemnity were a serious abuse of the trust that his patients and those with whom he worked were entitled to place in him.
“The panel considers that the extent and seriousness of Dr Dartey’s clinical misconduct, the gravity of his dishonesty, and his subsequent lack of insight evidence a harmful attitudinal problem.”
When Dr Dartey carried out the termination in 2006 on a woman who had travelled from Ireland, he perforated her uterus and failed to remove the fetal thorax. When she returned home she became extremely ill and was in hospital for two months, the panel heard.
Dr Dartey’s membership of the Medical Protection Society had lapsed in 2002, and he had no indemnity cover when he performed the abortion. The panel found that a membership certificate he sent to Marie Stopes International purporting to cover 2005-6 was a forgery.
Dr Knill-Jones said, “Each of the five patients with which this inquiry has been concerned has suffered from the events in question. In his written communications to the GMC Dr Dartey has shown little remorse or acknowledgment of, or insight into, his failures.
“He has rather adopted a derogatory attitude towards his patients, accusing one of racism, another of blackmail, a third of causing her own problems by failing to follow his advice, and another of reporting him to the GMC because she wanted free corrective surgery for an unrelated problem. The panel has found no substance in any of these complaints and regards Dr Dartey’s lack of insight as a matter of serious concern.””
The lack of insight comment seems particularly relevant given that during the time the GMC were investigating his case, and while it was being covered in the media, someone claiming to be Professor Dartey appeared to comment at Ghanaweb where he belittled those complaining against him. This comment has not been verified as from Prof Dartey but it seems uncannily similar to the report from the GMC hearing.

This is truly shocking case that raises questions about the conduct and supervision of medics in private practitice. Marie Stopes also undoubtedly need to review procedures for the selection and supervision of staff working at their clinics.

The media also has a role to play here, but this was not (as far as I know) picked up on at the GMC investigation.

The PR company who promoted Dartey and the journalists who covered his g-shot and Laser Vaginal Surgery interventions in uncritical and often glowing terms are, in my opinion, culpable.

We know from research on women seeking cosmetic genital surgery one of the main things that persuades them they need cosmetic procedures is advertising from clinics/consultants. And how better to advertise than via an enthusiastic media endorsement? Even though it is well documented there’s no evidence of effectiveness of cosmetic genital surgery but plenty of evidence of active efforts by medics to promote such practices.

Perhaps unsurprisingly the papers that fawned over the g-shot have been remarkably silent about the GMC hearing. And none have admitted they gave publicity to an untested and dangerous cosmetic intervention.

The only paper who reported in favour of Dartey and also on his striking off was The Daily Mail. They managed an incredible about face with their initial piece ‘I’ve had the G Shot and YES, YES, YES my sex life has never been better!’ promoting the g shot procedure. While Dartey’s GMC investigation was ongoing they were still publishing testimonies in his favour. Finally describing his fall from grace in less than glowing terms. The latter piece, of course, made no reference to the former. (Thanks to @MrNorthice for helping with these links).

This media distancing could be coincidence, or it may be more deliberate. In the Mail’s case it can be seen as deliberate in the way Dartey is talked about. When his g-shot procedures are being lauded he’s a Professor from Harley Street. When his striking off is detailed his qualifications from the Soviet Union and Ghanaian heritage are at the fore. As @PeteDeveson astutely commented on twitter: “on the way up it’s “Hollywood” and “Harley Street”. On the way down it’s “Ghana” and “Soviet””. This xenophobic coverage neatly airbrushes any involvement of the newspaper in promoting Dartey’s practice – and subsequent harm done to his patients.

When I first read the press release about the g-shot it raised not so much a red flag as a string of red bunting. I tried to challenge it where possible with journalists but felt powerless to really get anyone to listen.

I still feel powerless about this situation and the countless others like it. Journalists cover stories on sex and health topics that advocate untested treatments, products and procedures. Therapists and practitioners are showcased with no check on their skills, qualifications or professional ethics. Cosmetic genital surgery is increasingly presented as ‘the norm’ and if any criticism is allowed it is always a small voice of dissent in a wider promotion of surgical intervention. While this case concerns surgery performed on women, men’s media is just as problematic when it comes to promoting dodgy sex pills, potions and procedures.

Of course claims that science, medicine and surgery can transform your sex life, give you amazing orgasms, make you more desirable or a better lover are beguiling to both editors and the public.

Sadly these claims are rarely put to the test.

Which allows dangerous practices like those offered by Professor Dartey to go unchecked.

Editors and journalists lack basic skills to evaluate press releases or stories they are sent about sex-related products and procedures. Either because they are busy, seduced by science speak, or unable to critically evaluate medical claims. More importantly editors and journalists do not make enough use of willing qualified individuals and organisations who could help them assess whether claims they’re about to write about are accurate or not (for example using guides like this one created by Dr Jennifer Gunter). Where practitioners try and tell them they could be advocating something that is ineffective at best, life threatening at worst, the media (for the most part) ignores them.

We should be rightly angry with the media and with practitioners who promote untested and unnecessary cosmetic genital surgery.

This will be of little comfort to the five women involved in this case, who will be scarred psychologically and physically for the rest of their lives.

Professor Dartey should be ashamed of his actions, but GMC reports imply this is unlikely.

The journalists who didn’t bother checking a simple press release and promoted his products and services should also be ashamed of their actions. Again, I think this is unlikely.

The Spa PR Company who originally promoted the g-shot and Dartey’s clinic should also take responsibility for their role in this tragedy. I have written to them offering a right to reply which I will post here if they wish me to.

Other media outlets could now write about this case critically, and make a commitment to reporting on sex/science stories ethically and carefully. They could campaign against cosmetic genital surgery or refuse to showcase it in their features or advertising. Here too I expect this is unlikely.

It is easy to forget in stories like this how real lives can be destroyed. My sympathies are with the women affected by Dartey’s professional misconduct. While I find it easy to compile a case against media and medical incompetence, I find I lack the words to adequately express how badly I feel for them.

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