Doctor who did improper testicular exam on boy agrees to never practise again

A Manitoba pediatrician who put his ungloved hands inside the pants of a 12-year-old male patient to conduct a testicular exam without the boy’s consent has been censured and ordered to pay $4,020 in investigation costs. Dr. Emmett Joseph Elves, who practices in Brandon, has also decided to retire on June 30 and agreed to an undertaking to never again practise medicine in Manitoba or in any other jurisdiction. “Dr. Elves failed to meet the standard of the profession and displayed a lack of judgment when he failed to maintain appropriate professional boundaries and failed to respect his patient’s dignity and privacy in his approach to a testicular examination,” the investigation committee of the College of Physicians and Surgeons of Manitoba wrote in its censure of Dr. Elves. “In the case of an adolescent, the patient’s age and circumstances enhance the importance of sensitive and clear communication to ensure that the patient knows what to expect and consents to the examination.” Following a syncopal episode in the summer of 2022, the boy was brought by his mother to see Dr. Elves, who took down the patient’s history and conducted a physical exam while the boy was sitting on the examination table. His mother was in in the exam room for the entire appointment. Read: Misdiagnosed emergency: Doctor's appeal is denied in the case of teen patient who lost his only testicle Dr. Elves instructed the boy to lie down on the table and asked him if he knew how to check for testicular cancer. When the patient said he did not, Dr. Elves said he would show him. According to the written censure, Dr. Elves failed to explain clearly the purpose of the testicular examination and did not expressly ask permission from the patient or his mother. Dr. Elves also failed to ensure there was appropriate draping during the examination. Instead, he lifted the waistbands of the boy’s sweatpants and underwear with his right hand and said “We’re going to say hello” before proceeding to examine the patient’s testicle, according to the censure. During the procedure, he gave verbal instructions on how to do a self examination. He also told the patient he knew of patients who had died of testicular cancer. Read: Physicians and patients share stories of disastrous breakdowns in healthcare communication Dr. Elves did not wear gloves during the examination nor did he document the testicular exam in the patient’s medical records In his statement to the college, the patient recalled being “so shocked” by what was happening that he couldn’t process what Dr. Elves was saying. His mother also testified that she was shocked by Dr. Elves’s actions and that both she and her son were confused by the approach he had taken for the examination. Dr. Elves acknowledged to the investigation committee that he did not wear gloves but stated that he had washed his hands shortly before the examination. He also said he had explained to the boy he was now at a stage in his life when he should be doing regular self-examinations for testicular cancer. Dr. Elves told the committee that when the patient responded with “uh-huh,” he took it to mean that he knew the testicular exam would be proceeding and that he understood the reasons for it. Until his retirement on June 30, Dr. Elves will be under practice conditions that include chaperone and signage requirements. Read: University of Calgary new study on testicular cancer 'a paradigm shift'

Doctor who did improper testicular exam on boy agrees to never practise again

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