In 2013, Steven Hanes visited his urologist, complaining of persistent pain in his right testicle.
An ultrasound revealed that the testicle had atrophied, with scarring and damage from a previous injury, according to court documents. And so the doctor scheduled an orchiectomy - or surgical removal of the testicle - to help alleviate Hanes' pain.
The good news? The orchiectomy was successful.
The bad news? The doctor removed the wrong testicle during the surgery.
"At this point it appeared that the left testicle and cord may actually have been removed instead of the right one," the surgeon, Valley Spencer Long, wrote in a postoperative report, according to court records.
The mistake prompted Hanes in 2014 to file a medical malpractice lawsuit against Long and J.C. Blair Memorial Hospital in central Pennsylvania, citing negligence on the part of both.
Four years after the surgical mistake, a Pennsylvania jury reached a verdict last week, awarding Hanes US$870,000 (NZ$1.2m), including US$250,000 (NZ$344,000) in punitive damages, according to Hanes' attorney, Braden Lepisto.
"This case, I understand why it kind of went viral just because of what is involved, but the reality is, it's a condition that has affected my client significantly," Lepisto told The Washington Post. "Although some people may see it as kind of laughing matter initially, the award was completely justified based on the evidence and the toll that it's taken on Steve."
To this day, he added, "it's still not totally clear" how the mistake occurred in the operating room.
"The doctor gave an explanation that really made no anatomical or medical sense," Lepisto said. "He claimed that he removed the testicle that was on the right side of the scrotum and the testicle had a spermatic cord that led to the left side of the body.
"Essentially, the doctor claimed that the testicles had switched sides at some point."
Lepisto said the jury - which comprised 11 women and one man - deliberated for about 1 hour 20 minutes before siding with the plaintiff.
Reached by email Saturday, a spokeswoman for J.C. Blair Memorial Hospital did not offer further comment on the case but confirmed Long was no longer working for the hospital.
Although horrifying, cases in which doctors operate on the wrong body part are extremely rare. A 2006 study supported by the public Agency for Healthcare Research and Quality analysed nearly three million operations over nearly two decades, and found that wrong-site surgery occurred in only about 1 in 112,994 cases.
Still, it does happen. A 2011 Post roundup of such cases included doctors in Minneapolis removing a healthy kidney from a man with kidney cancer and an ophthalmologist in Portland, Oregon, operating on the wrong eye of a four-year-old boy.
"Few medical errors are as vivid and terrifying as those that involve patients who have undergone surgery on the wrong body part, undergone the incorrect procedure, or had a procedure intended for another patient," the US Department of Health and Human Services says.
In the medical community, "wrong-site, wrong-procedure, wrong-patient errors" are known as WSPEs, and they are so egregious and usually preventable that the federal health department deems them "never events" - "errors that should never occur and indicate serious underlying safety problems".
In a 2011 report, the non-profit Joint Commission Center for Transforming Healthcare recommended a number of ways to prevent wrong site surgery, from marking the incision sites with something consistent (like the surgeon's initials) before the operation to reducing noise and other possible distractions in the operating room.
In Hanes' case, Lepisto said the surgeon could have taken steps to confirm he was operating on the correct testicle.
"If he had just tracked that spermatic cord up into the body, that would have told him which side he was on," he said. "It's just extremely unlikely because there are structures in the body that prevent the testicles from moving freely from one side to the other. There was just no evidence that those structures had been compromised."
Lepisto said Hanes continues to suffer pain in his right testicle - the one that was supposed to have been removed - but has avoided seeking further medical treatment.
Even if Hanes does have the remaining testicle removed, he would then need lifelong testosterone replacement therapy, he added.
"He really is just extremely fearful of trying to get any sort of treatment for it at this point because of what happened," Lepisto said.