Austrian urologist case (important to all possible victims of sclerosing operations, especially in Austria

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Jan Tellerlift
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Austrian urologist case (important to all possible victims of sclerosing operations, especially in Austria

Postby Jan Tellerlift » Sat May 15, 2021 11:06 am

Since some implanted brothers may also have tried sclerotherapy before because of an alleged venous leak, I am taking the liberty of posting this story here as well, because it is really important and the "Implant" section has the largest number of readers. I ask the moderator to forgive me for this.

As a silent reader on this forum, I know that tragic cases have been reported here in some places in the past where men who previously had mild erectile dysfunction became completely impotent after an operation to close a venous leak (sclerotherapy procedure); some even killed themselves (Gollam, for example).

I am not accusing this urologist of criminal acts or infringements of law here, I am only passing to you what can be read in the Austrian press and media:

Criminal proceedings have just begun in Austria against the doctor responsible for these operations; in 5 cases he has been charged with grievous bodily harm and serious fraud; the criminal trial has just begun. In terms of civil law, he has already been sentenced to pay € 50.000 in damages in one case. In addition, proceedings are underway against him because he is alleged to have used a false professorial title, to have sold vitamin D preparations as cancer drugs and, as head of a COVID 19 laboratory, to have carried out partly false tests and to have illegally obtained public contracts withot public tender (there is a state affair on this issue).

If there are other victims of this man, now would be exactly the right time to report to asap:

Vienna Public Prosecutor's Office (Staatsanwaltschaft Wien), Fax: +43 1 40127 306950 (yes, you have to send a fax, e-mail is apparently not available from the Austrian public prosecutor's office), Adress: Vienna Public Prosecutor's Office (Staatsanwaltschaft Wien), Landesgerichtsstraße 11, A-1080 Vienna, Austria (best, if you write a letter describing your case to this adress)

Of interest to the public prosecutor's office are not only treatments that have actually led to damage, but also possible false diagnoses of the "venous leak", with which the doctor could have tried to induce his patients to undergo his operations.

If you want to know more about the whole affair, just google the name of the doctor (find his name in the translated article below) and look at the numerous articles under "News" of Google.com (the topic is currently a big headline in Austria), I'll link you to one article and translate it if you don't speak German.

https://www.profil.at/wissenschaft/der- ... /401368124

("profil" is a renowned Austrian weekly magazine; but in all Austrian newspapers there are currently many articles about the machinations of this urologist).

Translation (DeepL transcript):

The braggart: trial against Viennese urologist

His operations are said to have rendered men impotent and driven some to suicide. Most recently, the doctor made headlines in Tyrol: as the country's contractor for Covid tests.

by Alwin Schönberger (profil, Austria)

At first, it didn't quite want to work out. The mishap occurred during sex with new partners when the young man from Lower Austria used a condom: In such situations, he had erection problems. Although these always disappeared, the man, born in 1984, sought medical advice. Google recommended a urologist to him: Ralf Herwig, who likes to adorn himself with a professorial title and significant scientific achievements. Anyone searching for his name gets the impression of being confronted with a cosmopolitan personality who also promotes his work extensively on websites and in YouTube videos. One finds addresses in Vienna, in Baden, and even in Dubai he ordains as an expert in urology, andrology and male infertility.

People like to trust such an expert, and so did the Lower Austrian who visited Herwig's private practice in Wollzeile on November 30, 2016. It was the beginning of a momentous story: for the patient, who is now a 36-year-old suffering from lifelong impotence instead of occasional erectile dysfunction; and for Ralf Herwig, who will face a criminal trial in Vienna starting Friday of this week - not only because of this patient case, but because of the stories of five injured parties. Two of these people can no longer testify: they committed suicide after treatments by Herwig. The Vienna public prosecutor's office now charges Herwig with the crime of bodily injury with permanent consequences, the crime of grievous bodily harm, the crime of negligent bodily harm, and the crime of aggravated fraud.

profil has the indictment, expert opinions and verdicts from other proceedings. The documents provide insight into a case that goes far beyond the typical malpractice trial: in terms of the scope of the allegations as well as the unambiguity of the experts' assessment; in terms of years of inaction by the medical association, which has known about tragic patient cases since 2014; and in terms of Herwig's considerable scope of action, which grew over the years - parallel to and long unaffected by mounting allegations of grossly flawed surgical techniques.

Ralf Herwig, born in 1965 in Germany, married, four children, medical studies, residency in urology, andrology and surgery in Münster, worked from 2000 in Innsbruck, from 2005 at Vienna General Hospital, initially as senior physician, from 2012 as associate professor and head of the andrology outpatient clinic. Along the way, he ordained privately, and also worked at hospitals such as the Vienna Rudolfinerhaus and the Protestant Hospital. He also runs a company called HG Pharma, whose webshop sells nutritional supplements. Some of them even promise benefits for serious diseases such as cancer, ALS and autism. In the fall of the previous year, Herwig opened up yet another field of activity that amazed connoisseurs of the case: He offered mobile Covid tests with a "lab truck" from his company HG Pharma in cooperation with the state of Tyrol, appeared in the media as a pandemic expert and held joint press meetings with state governor Günther Platter - at a time when the Vienna public prosecutor's office was already typing up the indictment.

"Since the operation I suffer from complete impotence".

In essence, the accusations contained therein are almost congruent in all cases and can be exemplified by telling the story of the 36-year-old Lower Austrian. He told Herwig about his erection problems during his initial visit at the end of November 2016. The doctor quickly voiced a tentative diagnosis and brought a term into play that is now frequently found in the files: "venous leakage." Such a thing does exist: for an erection, blood must flow into the penis via arteries, but venous outflow must be throttled. If the veins are not sufficiently squeezed by the blood-filled erectile tissue, this is called a venous leak. This would result in permanent erectile dysfunction - and not just situational. Surgical repair is considered antiquated and not useful, which is why international professional societies do not list the method in their treatment repertoire. Hospitals like AKH never perform the procedure - unlike Herwig.

On December 21, 2016, he ordered the young patient to undergo a CT scan, which he performed himself. In the process, he confirmed his own diagnosis: venous leakage, unequivocal. Herwig advised surgery, saying it was risk-free and minimally invasive, taking no more than 20 minutes, and that no complaints had ever occurred in more than 200 patients. Then it happened very quickly: only a few days later, the patient received a call saying that an operation date had become available "at short notice": as early as January 4, 2017. The man came to the Protestant hospital, paid 3,500 euros in cash, had the safety of the operation confirmed several times and underwent the operation. Already in the first night the pain came. Herwig could not be reached. He was in Dubai, they said. The pain increased, and on January 6, the patient went to the emergency room of the AKH. He later stated to the court expert: "Since the operation, I suffer from complete impotence." He underwent psychotherapy to learn to accept his condition. The records state that if the man ever wanted to have sex again, he would need aids such as a penis pump. Therefore, the procedure was "bodily injury with serious permanent consequences."

What Herwig practices is called sclerotherapy. An incision is made on the penis under local anesthesia and a vein sclerosing agent is injected. The description in the indictment sounds sinister: "The principle of action of such an operation is contact denaturation (namely, destruction) of the inner wall of the vessel and thrombosis." The venous blood flow is to be throttled in this way. Apart from the fact that this is a fundamentally unrecognized method, the prosecution also insinuates that neither the diagnosis nor the intervention were performed "lege artis," i.e., professionally: The defendant had injected the sclerosing agent via a catheter "which he inserted into the freely prepared penile vein, but without contrast medium, so that the injections were made blindly."

The possible consequence is detailed in a decision last November by the Vienna Higher Regional Court, which had to rule on an action for damages brought by the Lower Austrian against Herwig: the sclerosant could have caused such substantial damage "that an erection required for penetrative sexual intercourse was no longer achievable." The court awarded the injured party "for this catastrophic permanent consequence of a medical malpractice" the sum of 70,000 euros, which is enormously high by Austrian standards.

But what was the ominous venous leak all about? The experts consulted are convinced that there was no such thing. The expert Walter Kozak states: "From a urological and radiological point of view (...) the diagnosis of venous leakage was not made correctly.

Yet the young man's case is not the worst at all.

At the end of November 2013, a 56-year-old university lecturer visited the AKH. His resident urologist had sent him for an ultrasound examination because of chronic prostatitis. Herwig, then head of andrology at the hospital, had a diagnosis ready shortly after taking a medical history: venous leakage. Here, too, everything went quickly because an appointment was "surprisingly" available: the operation took place as early as December 2, 2013, after cash payment of 3,000 euros, and in a private clinic in Vienna's 18th district. According to internal documents at MedUni Vienna, Herwig would not have been allowed to perform the operation at the AKH "due to a lack of sufficient scientific evidence.

The next morning, the patient palpated nodules in his penis. In the course of December, he found that he could no longer achieve an erection. The man, who had already been in a state of psychological emergency before the AKH (=largest hospital in Vienna) visit, slid into ever deeper despair. Diary entries document this: "Sleepless from three forty," he noted on December 22, 2013. "Fainting and anger at myself, but more at Prof. Herwig and his assistant, how they could fool me so cheaply."

A few weeks later, the man put an end to his life by killing himself.

Because accusations against Herwig were found in his notes, the police moved in at the AKH. As the only institution to date, MedUni reacted promptly and dismissed Herwig as of February 11, 2014, because he had diverted patients to private operations as part of an unauthorized secondary occupation, which, moreover, would be prohibited at AKH due to a lack of evidence. Herwig filed a lawsuit against the dismissal, and an amicable termination of the employment relationship was agreed upon. The title of professor, which was "associated" with the AKH job, thus also expired, but Herwig continues to use it: He mentions it on the answering machine text as well as in the imprint of his website, where an AKH job is also still listed.

"Currently not authorized to practice medicine".

Apart from the AKH, little happened. Several aggrieved parties wrote to the Patients' Ombudsman's Office and, over the years, repeatedly to the Medical Association, even after the suicide in 2014. Most recently, two years ago, the latter assured that the "facts of the case were already known" and were being "examined". Thus, the case and at least one suicide has been documented with the medical representatives for about seven years. What does the medical association say about this? Their comment is quite remarkable: The chamber is allowed to inform that Ralf Herwig "is currently not authorized to practice medicine due to an interim measure imposed by the Disciplinary Commission for Vienna (...)". Further information could "not be given". It is quite certain that the measure is a formalism: if criminal proceedings are pending, a physician is not allowed to practice during this time - why no intervention was made all the years before remains open.

If someone had intervened, other tragic fates might have been avoided: for example, that of a British man who traveled especially for the operation - and committed suicide in 2017; or that of another man who underwent penis surgery in May 2014 and killed himself the previous year after a long history of suffering. The indictment is now based on this case as well.

"Herwig is particularly incriminated," according to the prosecution, by the testimony of a man who visited the urologist as an "agent provocateur." He came to the practice at the request of one of the injured parties and reported erection problems. In fact, he had never suffered from them and led a carefree sex life. Herwig diagnosed: venous leakage. It is not possible to find out how often he made this finding in total. In the compensation proceedings, he himself stated that in some years he had made up to 800,000 euros from treatments in his practice.

The synopsis of the evidence shows, according to the prosecution, "that the defendant, although he knew that none of the ( ...) persons had a venous leak, deliberately deceived them about the diagnosis." And further, "Finally, he performed the operations although they were not medically indicated, to which was added that he also did not perform them lege artis." He will therefore "be punished according to his criminal energy culpable - and appropriate to the crime."

"No comment on the ongoing proceedings"

What does Ralf Herwig say to all the accusations? profil sent an extensive list of questions to four e-mail addresses. Last Thursday, he confirmed by mail the receipt of the questions and assured a response by Friday morning. On Friday, however, he decided "not to comment on the ongoing proceedings.

The criminal proceedings are not the only front for Herwig at the moment. After all the years in which accusations largely bounced off, but instead local media sang praises that he was even worthy of the Nobel Prize, trouble is now breaking in from several sides: Last Friday, he had to attend a hearing at the Vienna Administrative Court. Reason: The medicament authority had obtained against Herwig a penalty of approximately 3000 euro because of the selling of not certified medicaments, over whose adequacy the court had to judge. The case concerned preparations without scientifically proven efficacy such as ImmunoD, which HG Pharma recommends to patients suffering from cancer, among other things, for 990 euros. The Austrian Medicines Agency (AGES) had already warned against the preparations in 2016. One of its representatives, pharmaceutical expert Christoph Baumgärtel, had announced on ORF: "We will stop this." A prominent advocate for ImmunoD was German TV presenter Miriam Pielhau, who battled breast cancer for years and, like many desperate patients, also tried cures without a solid scientific basis. In 2016, Pielhau lost the battle.

In Tyrol, too, the skies are darkening right now. Last week, ORF reported on unpleasant questions from the Tyrolean List Fritz. Its chairwoman, Andrea Haselwanter-Schneider, demanded to know from Bernhard Tilg, the regional health councillor, why a contract had been concluded with Herwig without a call for tenders - and why a urologist was a suitable partner for the Covid tests. profil also asked why Tyrol was contracting with a doctor charged with aggravated assault. "The state of Tyrol was not aware of this," it said in a reply. Moreover, the contract does not exist with Herwig as a person, but "with the company HG Labtruck GmbH." The purpose is purely "the fulfillment of the duties and obligations to the citizens in the health sector". Who pays for the fulfillment of duties? Answer: "The tests are remunerated by the federal government."

Soon Ralf Herwig could at least have more time again to devote to his criminal proceedings: The contract with Tyrol expired at the end of March.

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