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I Don't Mess with Testicles! (Part 2)


Undescended Testicles in Children



Undescended testicles (cryptorchidism) affect about 3–5% of newborn boys, with higher rates in premature infants. Generally, this is benign and treatable, but a delayed diagnosis or a failure to treat can result in long-term consequences such as infertility, hormonal issues, or increased cancer risk.



As a PNP, I owe it to my patient to follow the standard of care for undescended testes; and as a CLNC, I have a lot to think about when reviewing medical records:


  • Medical malpractice — Was the condition missed during routine pediatric exams?


  • Standard of care — Did healthcare providers follow guidelines recommending evaluation and surgical correction (orchiopexy) by 18 months of age?


  • Informed consent — Were parents properly counseled on the risks of non-treatment?


  • Child welfare — In some cases, failure to address this condition may intersect with issues of medical neglect.



Understanding the intersection of pediatric care and legal liability is essential. This is significant whether you’re advocating for a child, evaluating a malpractice claim, or advising healthcare institutions on risk management. 





Key Case: Jonas v. Willman (Nebraska Court of Appeals, 2019)



  • The plaintiff, Jonas, alleged his pediatrician was negligent in failing to diagnose and treat congenital bilateral undescended testicles and not referring for specialist care in a timely manner. 



  • The pediatricians involved in performing Jonas' testicular exams argued that his testicles were descended at birth and then later ascended. 



 Key issues: 


  • Was the standard of care was breached? 


  • Causation: did the delayed diagnosis lead to the alleged harm (infertility, cancer risk, etc.)? 


  • Damages: given what was proven, could the damages be apparent? 



 Result: The court ruled in favor of the defendants, finding the plaintiff failed to prove that his testicles were undescended from birth , rather than "ascending," and that the alleged harm was caused by this delay. 

 
 
 

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