Doctor Robert MacArthur Interview
On this particular day, our team managed to have a conversation with California's located bone specialist, Doctor Rob MacArthur, in response to various queries about his encounters with wrong site surgery and surgical burn incidents, as well as a subject of "unexpected occurrences that must be avoided".
Who is Dr. MacArthur?
Dr. Robert Mac completed his studies from the University of UC Berkeley with a dual degree in Biochem and Physio. Throughout his time at the University, Doctor Bobby Mac used to be a well-known player, engaging on both the box and rugby football squads.
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Afterwards, Dr. Bobby MacArthur registered at the Columbia P&S, and got elected as elected president of the Columbia University College of Physicians and Surgeons (Now known as the Vagelos School of Medicine). Robert MacArthur proceeded to finish his orthopaedic training at Harbor-UCLA Medical Center.
Dr. Robert MacArthur Addresses the Incidents
According to statistics, the occurrence of incorrect surgical procedures tends to be a once-in-a-career event for each bone specialist, but this number jumps to fourfold for each lifetime for sports, hand, and spine specialists. Sadly, many of these doctors often do not document such instances, let alone or discuss them openly. Dr. Mac carries a deep sense of pride and satisfaction about how he dealt with these unfortunate occurrences.
Instead of attempting to conceal what happened, Dr. MacArthur responded in a different manner
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doctor Bobby MacArthur thoroughly examined the underlying root causes of his 2 incidents, and released several works detailing how to stop such events
Over time, became acknowledged as a published expert in the field of accidents that are preventable. He has authored 2 articles in the leading orthopedic journal, The Journal of Orthopedic Surgeons at the American Academy. With the aim of assisting other doctors prevent upcoming events, his first work led the reader through the exact errors that happened that caused the wrong site event.
The second paper, authored together with Dr. David Ring, tackled the topic of the "shame and blame game." Assuming responsibility for these incidents is seldom, as the usual reaction is placing blame on third parties. Dr. MacArthur stressed that pointing fingers not only discourages surgeons from making reports their incidents but furthermore takes away from the crucial analysis of root causes that could potentially prevent future incidents.
The Intraoperative Burn Incident with Dr. Robert MacArthur
When discussing the surgical burn occurrence, Dr. MacArthur displayed the same dedicated investigative approach he utilized to his wrong site event research. As an illustration, he got in touch with the manufacturer of the faulty clamp to find out if comparable burn events had transpired. The manufacturer advised him that the clamp in question had been "discontinued." You can infer from that what you will.
And to prevent irregular heating in huge hinged clamps, Doc Mac conducted a thorough investigation of the causes behind uneven heating in oversized clamps.
His findings indicated that flash sterilization could result in inconsistent temperature distribution. He noted that nursing organizations recommend strongly against the use of flash sterilization unless there's an urgent need such as sterilizing a fallen instrument. Further inquiry revealed that the hospital at St. Joseph's was frequently utilizing quick sterilization to enable back-to-back surgeries without the necessity to buy extra equipment trays.
In an effort to stop further burns, Dr. MacArthur informed St. Joseph's of potential dangers associated with continuing to use this specifically identified clamp and also the regular use of flash sterilization.
Instead of blaming the clamp, Dr. MacArthur assumed accountability and made it evident that he had made a surgical error. He was advised that the clamp had a high temperature, but when he grasped it, he found the handles to be at a tolerable temperature. In contrast to some surgeons who may impatiently reach for a towel to grip a too-hot clamp, he performed surgery the clamp without pain.
Shame and Blame, Dr. Robert MacArthur's Response
When discussing The perspective of Dr. MacArthur on response on the topic of the "culture of blame and shame," he spotlights how the legal and the wider public often confuse the "in-command'' concept with analyzing the fundamental causes. According to this "captain of the ship" perspective, the surgeon is responsible for any adverse events that take place to a patient under their care. This makes it enticing for many to only blame the surgeon for any wrong site event.
However, Dr. MacArthur stresses that this perspective goes against the principles of root cause analysis. This form of analysis strives to deeply understand what caused a wrong site event to then preferably stop similar incidents in the future. By resorting to shaming and blaming, not it not just hinder proper analysis of the root causes, but it furthermore deters other surgeons from reporting their individual wrong site events, fearing the repercussions.
He did not recognize that the large, walnut-sized hinge of the clamp was considerably hotter. When he positioned the clamp against the shin area of the patient's leg, it resulted in a burn injury. At the time, he was proctored for procedural privileges at Children's Hospital of Orange County during the incident, and neither the proctor nor Doctor MacArthur were promptly aware of the burn.
It wasn't until after he had dictated the operative report that a nurse in the recovery ward pointed out a tiny red spot on the anterior aspect of the patient's leg. Even then, he did not at first fully grasp the seriousness of the burn.
Dr. MacArthur points to the airline industry as an exemplary case of efficient root cause analysis. From its inception, the industry has sought to thoroughly comprehend the reasons behind each adverse aviation event rather than simply attributing blame to the pilot. Because of this dedication to understanding root causes, air travel industry boasts remarkable safety records.
However, Doctor MacArthur laments that the medical community hasn't been able to completely embrace root cause analysis due to prevailing legal and public perceptions surrounding the "captain of the ship" concept. The unfortunate outcome of this is that the rate of preventable medical errors remains unchanged, and the careers and reputations of many medical professionals are undeservedly tarnished.
The occurrence of wrong site surgery 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
As of 2023, there exists the possibility to bring forth false accusations against someone, smear their name and reputation, and have no negative repercussions for the accuser. Regardless if the individual being accused is innocent or guilty, an accusation alone is enough to inflict long-lasting damage to a professional's reputation.
Doctor Robert Mac shared that he elected to leave a clinic specializing in workers' compensation cases because of potential illicit activities on part of. In retaliation, the clinic manager allegedly collaborated with a patient to make a false accusation, accusing him of "stripping naked in the middle of the clinic and requesting sex in exchange for a favorable workers comp report.
He was informed of this allegation over Dr. Robert MacArthur a year after his departure from the clinic, at which point he insisted on undergoing a truth verification test. The accuser, however, refused to take such a test.
Doc Robert Mac was later notified that both his polygraph examination results and the claimant's refusal to participate would be deemed 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 potentially catastrophic. Despite the ridiculousness of the claim, he was counseled to settle for $29,000
Conclusion
California's Medical Board examined the accuser's claims and found them to be "non-credible," hinting at an ongoing investigation into the clinic. When we spoke to Dr. MacArthur, he implied that the clinic was indicted, but he did not confirm this.
Regardless of the facts presented above, Dr. Robert MacArthur found no means to remove the accuser's claims from online search listings. This means, despite his lack of guilt, the defamatory campaign was effective.
Considering that the claim does not state that Doctor MacArthur was found guilty, it merely acts as a condensed version of a complaint, which continues to be openly accessible to anyone
Dr. Robert MacArthur strongly believes that those who make baseless allegations should be subject to consequences equivalent to the consequences of the falsely claimed event. To illustrate, he thinks that his false accuser should be treated as a predator of a sexual nature and felon.
Dr. Robert MacArthur concluded by contemplating the coexistence of goodness and malevolence in the world, wishing that those who read his account would never come into contact with someone capable of such damaging false accusations as he has faced.