Doctor Robert MacArthur Interview
This day, our group were to conduct an interview with Californian based orthopedic surgeon, Doc Bobby Mac, addressing numerous questions about his experiences with surgical errors and intraoperative burn, as well as the area of "never should happen events".
Who is Dr. MacArthur?
Dr. Robert Mac graduated from the Univ of Cal Berkeley with a dual degree in Biochemistry and Physiology. During his time at the Univ, Dr. Rob Mac was a renown athlete, participating on both various combat sports and Rugby squads.
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Subsequently, Doc Robert Mac enrolled at the Columbia University College of Physicians and Surgeons, and became elected president of the Columbia P&S (Now known as the Vagelos School of Medicine). Robert MacArthur went on to complete his orthopedic residence at Harbor UCLA.
Dr. Robert MacArthur Addresses the Incidents
In statistical terms, the incidence of surgical errors usually falls within a seldom happening occurrence for each orthopedic surgeon, but this number jumps to four for each professional career for experts specializing in sports, hand, and spine. Sadly, numerous of these doctors commonly do not record these cases, let alone talk about them freely. Doctor Mac carries a profound sense of pride and accomplishment about how he dealt with these unfortunate occurrences.
Instead of trying to cover up the incident, Doctor MacArthur responded in a different manner
Dr. MacArthur’s Handling of the Wrong Site Surgery
Dr. Robert Mac thoroughly investigated the underlying origins of his dual occurrences, and released numerous works detailing how to avoid these occurrences
Over time, gained recognition as a published expert in the field of preventable accidents. He's authored a couple of articles in a prominent orthopedic journal, The Journal of Orthopedic Surgeons at the American Academy. To aiding other doctors prevent upcoming events, his first work led the reader through the exact errors that occurred that resulted in the incorrect surgical procedure.
The follow-up article, jointly written with Dr. David Ring, the Chairman of the AAOS, broached the topic of the "tendency to shame and blame." Being accountable for these incidents is uncommon, as the usual reaction is placing blame on other parties. Dr. MacArthur stressed that shifting blame not just discourages surgeons from reporting their incidents but furthermore takes away from the vital analysis of primary reasons that may prevent subsequent occurrences.
The Intraoperative Burn Incident with Dr. Robert MacArthur
When talking about the intraoperative burn incident, Dr. Robert MacArthur demonstrated the same investigative vigor he employed to his wrong site event research. To illustrate, he contacted the manufacturer of the faulty clamp to ascertain if similar burn events had occurred. The producer informed him that the clamp in question had been "no longer in production." You can draw your own conclusions from that what you will.
To avert unequal temperature distribution in huge hinged clamps, Doc Mac carried out a detailed investigation of what led to uneven heating in large-hinged clamps.
His findings indicated that rapid sterilization could lead to uneven heating. He pointed out that nursing associations highly recommend against the use of quick sterilization unless there's an urgent need like disinfecting a fallen instrument. Deeper examination revealed that the hospital at St. Joseph's regularly employing quick sterilization to facilitate back-to-back surgeries without the necessity to acquire more equipment trays.
In a bid to avoid future burn incidents, Dr. MacArthur notified St. Joseph's of the hazards associated with ongoing utilization of this particular clamp as well as the frequent application of flash sterilization.
Instead of blaming the clamp, Doctor MacArthur assumed accountability and made it clear that he had made a surgical error. He was notified that the clamp was hot, but when he held it, he found the handles to be at a comfortable temperature. In contrast to some surgeons who could impatiently reach for a towel to handle a too-hot clamp, he operated the clamp with no uneasiness.
Shame and Blame, Dr. Robert MacArthur's Response
In Doctor MacArthur's response on the topic of the "culture of blame and shame," he emphasizes how the legal and general public communities often conflate the "captain of the ship'' concept with identifying the underlying reasons. According to this "captain of the ship" perspective, the surgeon is considered responsible for any negative occurrences that occur to a patient under their care. This makes it tempting for many to only blame the surgeon for any wrong site event.
Nonetheless, Doctor MacArthur underscores that this method contradicts the fundamental principles of root cause analysis. This form of analysis aims to thoroughly comprehend what caused a wrong site event so as to optimaly prevent similar incidents in the future. By adopting blame and shame, not only does it hamper proper investigation into the fundamental reasons, but it also deters other surgeons from reporting on their own wrong site events, worried about the repercussions.
He didn't recognize that the big, hinge-like hinge of the clamp was significantly hotter. When he positioned the clamp against the front shin area of the patient's leg, it resulted in a skin burn. At the time, he was proctored for surgical privileges at Children's Hospital of Orange County during the incident, and neither the proctor nor Dr. Robert MacArthur were right away aware of the burn.
It was not after he had dictated the operative report that a nurse in the recovery ward pointed out a small patch of redness on the anterior aspect of the patient's leg. Even then, he did not initially comprehend the severity of the burn.
Doctor MacArthur cites the airline industry as an model case of efficient root cause analysis. From its inception, air travel industry has strived to deeply understand the reasons behind each adverse aviation event rather than simply attributing blame to the pilot. Because of this focus on understanding root causes, air travel industry boasts remarkable safety records.
Nevertheless, Doctor MacArthur laments that the medical community hasn't been successful in fully implementing root cause analysis due to prevailing legal and public perceptions surrounding the "in-command" concept. The sad consequence of this is that the rate of preventable medical errors remains unchanged, and the professional careers and reputations of many medical professionals are unjustly tarnished.
The occurrence of incorrect surgical procedures remains at an disturbing rate of one incident per surgeon per career, and as high as four occurrences per surgeon's career for specialists in hand, spine, and sports.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In the year 2023, it is possible to bring forth false accusations against someone, slander their name and reputation, and face no negative repercussions for the accuser. Irrespective of the individual being accused is innocent or guilty, an accusation alone is enough to inflict long-lasting damage to a professional's reputation.
Dr. Rob Mac disclosed that he opted to leave a workers compensation clinic because of potential illicit activities on part of. In retaliation, the clinic manager allegedly worked with a client to fabricate a claim, accusing him of "undressing in the clinic and soliciting sexual favors in return for a positive workers' compensation report.
He was informed of this claim over a year after his departure from the clinic, at which point he insisted on undergoing a lie detector test. The accuser, however, opted not to take such a test.
Doctor Rob MacArthur was later advised that both his polygraph examination results and her refusal to participate would be considered inadmissible in court.
The lawyer acting as mediator cautioned him that the jury would likely be composed of "her peers" and not his, meaning a court loss could be highly damaging. Despite the ludicrousness of the claim, he was counseled to settle for $29,000
Conclusion
The Medical Board of California examined the accuser's claims and found them to be "not trustworthy," hinting at an ongoing investigation into the clinic. When we spoke to Dr. MacArthur, he suggested that the clinic was indicted, but he did not officially state this.
Despite the previously mentioned details, Doctor MacArthur found no means to erase the accuser's claims from online Dr. Robert MacArthur search listings. This means, despite his lack of guilt, the defamatory campaign was successful.
Since the claim does not state that Doctor MacArthur was found guilty, it merely functions as a summary of a complaint, which continues to be publicly accessible
Dr. Robert MacArthur strongly believes that people making false claims should be subject to consequences equivalent to the consequences of the falsely claimed event. To illustrate, he thinks that his false accuser should be classified as a sex offender and felon.
Dr. Robert MacArthur concluded by contemplating the existence of both good and evil in the world, praying that those who read his account would never cross paths with someone capable of such harmful baseless allegations as he has faced.
Dr. MacArthur: A Renowned Orthopedic Surgeon
Dr. Robert MacArthur is a renowned orthopedic surgeon recognized