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Men who paid $1,500 for erectile dysfunction drugs that left them permanently disfigured sue clinic

Botched erectile dysfunction injections allegedly left men permanently disfigured – and they are now suing the Alabama clinic that charged them $1,500 for the treatment.  

One patient, Robert Snell, filed a lawsuit claiming the second injection caused his penis ‘to be permanently bent at a 90-degree angle.’

Another, 51-year-old Michael Forkner, claims in a lawsuit that he was left with a painful curve caused by scar tissue that other urologists warn may never heal because it wasn’t dealt with soon enough. 

They are just a couple of the men profiled in a new report by, who both claim their lives were ruined by The Alabama Men’s Clinic, which had run a series of glitzy ads on a local sports station promising instant results. 

A Mayo Clinic urologist told penile injections should cost $100 per bottle – which works out at $15 for three injections. Forkner paid $1,500 for three shots.  

Side effects (of long-lasting erections) should be treated instantly with an adrenaline shot to prevent further, permanent damage. 

But Forker and Snell allege that their hours-long erections and painful deformities were dismissed – and Forker told he was told to ‘put a cold rag on it.’ 

Now, Forkner says his girlfriend left him, and he fears he will never be intimate again. 

51-year-old Michael Forkner was left with a painful curve in his penis caused by scar tissue that other urologists warn may never heal because it wasn’t dealt with soon enough


The stories of Snell (who won a case in court but was then overruled in an appeal) and Forkner (still waiting his day in court a year after he sued) raise questions about the multitude of unofficial urology clinics popping up across the US. 

According to, several of these clinics, like Alabama Men’s Clinic, do not accept insurance, charging patients eye-watering fees. And though the doctors at the helm may made a medical degree, they often do not have the experience required to treat erectile dysfunction. 

Alabama Men’s Clinic has long been run by Dr John Justin Caulfield, a man who was reprimanded in 2011 by the North Carolina Medical Board about lying on his applications for a medical license in both North Carolina and Alabama. He hid the fact that he had been charged with receiving stolen goods. He was also reprimanded in 1997 by the South Carolina medical board over allegedly stealing Valium. 

None of that appeared on the website of his clinic, which is run with former Bachelorette contestant Evan Bass, who brands himself an ‘erectile dysfunction expert’.

Dr John Justin Caulfield

Evan Bass

The center is run by Dr John Justin Caulfield (left) who has been reprimanded for lying on his medical license applications, and former Bachelorette contestant Evan Bass (right) 

Bass, who wed Carly Waddell from the show in 2017, dubs himself an erectile dysfunction expert

Bass, who wed Carly Waddell from the show in 2017, dubs himself an erectile dysfunction expert

The pair, along with another doctor Larry Mitchell, run two other centers: one in Baton Rouge, Louisiana (where Dr Caulfield is now based), and one in Nashville, Tennessee. 

Now, following the lawsuits, a spokesman for Alabama Men’s Clinic says Dr Caulfield is not the supervising physician. It is Dr Robert Carter. But according to, there is no license-holding urologist called Robert Carter. 


The drugs themselves are not the problem. 

‘That’s like blaming the car for the driver smashing into the tree,’ Tobias Kohler, MD, a urologist at the Mayo Clinic, explained to

TriMix is a standard treatment administered by urologists for severe cases of erectile dysfunction, after pills like Cialis and Viagra don’t work or cease to work. 

If a man struggles with erectile dysfunction, pills are the first course of action, Dr Kohler said.

They can be used for five years. 

Only if the patient’s case is particularly severe – so much that the pills’ effects fail – or they finish their five years on the pills, do they explore the other, riskier options. 

Those options are: injections or surgery (i.e. a penile implant).  

TriMix is a commonly-used type of penile injection. It is a blend of alprostadil, papaverine, and phentolamine, which dilate vessels and smooth muscles, easing blood flow to the penis.

‘This is a routinely written-for medication,’ Dr Kohler said.

It is not FDA-regulated, largely because there is no company producing it for medical use, but Dr Kohler says he and other urologists administer it ‘all the time.’

The problem is that many of these clinics, popping up across the country, are not spearheaded by urologists who have been trained in what dose to give, nor how to counsel the patient (who has to self-administer the injections).

Crucially, most don’t know how to handle the situation when it goes wrong. 

Anything can cause side effects if it’s administered wrong, Dr Kohler says. But if you’re trained, you know how to do it and how to handle it when issues do arise. 

The Alabama Men's Clinic had run a series of glitzy ads on a local sports station promising instant results

The Alabama Men’s Clinic had run a series of glitzy ads on a local sports station promising instant results


Normally, when a patient is a possible candidate for TriMix or any other penile injection, they will do a test sample. If it’s too powerful or there’s an adverse reaction, the urologist reverses it with an adrenaline shot.

If it’s decided that they are a good candidate for the injections, patients are taught to use the drug in a controlled fashion. It’s carefully dosed and a physician can fix the problem if there’s a problem. 

Priapism (a persistent erection that lingers for hours) is a common side effect – especially if you inject a relatively healthy man who dose not need something as strong as an injection. 

‘Take a guy who has normal physiology and give him TriMix. They’re going to get priapism,’ Dr Kohler said. 

It can also happen for people who are good candidates for TriMix. 

While many may not think it’s a terribly bad thing, it can be very painful. And, importantly, it can have long-lasting damage. 

Forker told his hours-long erections left him with painful curvature that is still there years later. 

If a man does develop priapism, they should go straight to the ER. If their erection still hasn’t gone down by the time they get there, they need to get an adrenaline shot. 

If that doesn’t work, they can go to a urologist for a surgical shunting procedure.  

‘Caught early, it’s very treatable,’ Dr Kohler said.  


According to Dr Kohler, cases like Forkner’s arise all the time. 

‘[Penile injections] are used just fine by urologists but the problem comes from those clinics selling them to the patient for a high cost.

‘These places pop up out of nowhere and they prey on patients’ embarrassment, desire for some kind of magical treatment that somehow is better than you would get from a normal physician or urologist.’ 

There are no clear legislative pathways to curb misuse, though.

It usually comes from ‘momentum created by the physicians’ who are treating the victims of these clinics. 


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