Midnight trip to ER results in complaint against men's sexual health clinic

A men's sexual health clinic in Bloomington has been accused of medical negligence after selling injectable medication to a patient who suffered an eight-hour erection and ultimately required emergency room care.

The patient bought a long-term supply of the treatment for erectile dysfunction from the Minneapolis Men's Clinic but found that no one was available to help him early on the morning of May 17 when he called the clinic in a panic, according to Dr. Karl Kemberling, a Twin Cities urologist.

Kemberling and his partners at Edina-based Urology Associates have filed complaints with the Minnesota Attorney General and the state Board of Medicine.

The urologists say they've seen other patients with similar reports. "We … consider their lack of care medical negligence or patient abandonment," Kemberling wrote on behalf of his practice.

Underlying the complaint is the growing number of older men who seek medical options to remain sexually active. A 2007 survey in the New England Journal said that 14 percent of men ages 57 and older had tried a medication or supplement to boost sexual performance.

"The guys … are usually so embarrassed and ashamed" about erectile dysfunction, Kemberling said. "They'll do anything."

A Men's Clinic official said this week that the injectable medications are commonly used and recommended by the American Urological Association as the best nonsurgical treatment for erectile dysfunction. Thomas Lund, a regional medical director for the Bloomington clinic, said it has an emergency hot line with medical staff on call 24 hours.

Officials at the attorney general's office and the Board of Medicine would only say that they do not disclose complaints received from the public or any investigation that may result.

The middle-aged patient described by Kemberling wound up seeking treatment at 2 a.m. at the Ridgeview Medical Center in Waconia, where the ER doctor called Kemberling for advice and used needles to drain clotted blood from the man's penis.

The condition — known as priapism — can result in long-term impotence and other complications.

Another Twin Cities patient, a 63-year-old former surgeon, had similar problems after seeking care at the Bloomington clinic. The man responded to an ad suggesting a free trial, but after a brief evaluation by the clinic doctor and a pitch from a sales representative, he said he found himself committing to a two-year supply of an injectable medication that cost $2,800. When he asked if he could buy a smaller supply, the salesman sighed.

"He rolled his eyes and he made it sound like it was going to be so difficult," said the doctor, who requested anonymity because he was embarrassed by the episode. "They had such a slick marketing technique."

"The treatment to get rid of it is excruciating," he said.

The man said he tried a lower dose and ended up in the ER again. A third time at an even lower dose ended with a visit to the Men's Clinic for help.

"The stuff worked," he said, "it just didn't unwork."

Dr. William Borkon, a Park Nicollet urologist who wasn't part of the complaint, said he, too, has recently treated patients for priapism after they took injections. He said the urology community is troubled by the clinics because they default to injectable drugs for men whose impotency might have psychological origins or require other treatments.

"People need to be careful not to be misled," he said.

"If the medication does not work in the office, we do not charge the patient for the visit, nor would we ever prescribe a treatment plan based on the medicine not working," he said.

The injectable medications include papaverine, phentolamine and alprostadil — which can be mixed in different strengths and injected with small-gauge needles into the side of the penis. They were commonly used by urologists before the advent of Viagra in 1998 and similar medications afterward, and remain available as second-line treatments for impotence, Kemberling said.

The Men's Clinic in Bloomington is part of a national practice, one of 14 clinics operated by Men's Medical Clinic LLC. It is staffed locally by Dr. Richard Beck, 80, who is trained in general and plastic surgery, but was founded in Florida by Dr. Kevin Hornsby, according to the clinic website.

Hornsby has positioned his practice as a source of alternative care for men who don't have success with Viagra or other pills. He self-published an online book on the treatment of erectile dysfunction. His group of doctors — many in their 70s and practicing in second careers outside their specialties — includes one board-certified urologist.

The Better Business Bureau has 19 complaints on file from men who used the Men's Clinics in various states. Reviews on other websites reveal men who felt duped, but also some who wrote favorable reviews.

Kemberling said patients should talk with their urologists or family doctors before going to such a clinic, and find out if their health plans cover treatment for erectile dysfunction.

A similar controversy surfaced in 2008, when Urology Associates complained about patients having complications after impotency treatments by Parnell Medical Group, which had set up an Edina clinic. Parnell has since closed, as did a similar clinic in Woodbury that was opened in 2011 by a St. Paul man who owns a Twin Cities plumbing business.