Doctor Robert MacArthur Interview
On this particular day, we managed to conduct an interview with Californian located bone specialist, Doc Bobby MacArthur, in light of the questions about his personal experiences with incorrect surgical procedures and intraoperative burn, as well as a topic of "never should happen events".
Who is Dr. MacArthur?
Doc Robert MacArthur graduated from the Univ of California, Berkeley with a double major in Biochemistry and Physio. Throughout his time at the Univ, Dr. Rob Mac was a renowned sportsman, engaging on both the box and rugby squads.
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Following that, Dr. Bobby Mac registered at the Columbia University College of Physicians and Surgeons, and was the chosen head of the Columbia P&S (Now known as the Vagelos Medical School). Rob Mac proceeded to complete his orthopedic residence at Harbor-UCLA Medical Center.
Dr. Robert MacArthur Addresses the Incidents
Statistically, the occurrence of wrong site surgery tends to be a one-time event in a career for every orthopedist, but this figure surges to fourfold for each professional career for specialists Robert MacArthur in sports, hand surgery, and spine procedures. Regrettably, numerous of these surgeons frequently do not record these cases, let alone, not address them publicly. Dr. Mac carries a intense sense of pride and satisfaction about how he faced these terrible occurrences.
Instead of attempting to conceal the incident, Doc MacArthur responded in a different manner
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doc Rob Mac extensively investigated the origins of his dual occurrences, and published numerous works detailing how to stop these occurrences
Over time, gained recognition as a published expert in the field of accidents that are preventable. He has penned 2 articles in the leading orthopedic journal, The Journal of the American Academy of Orthopedic Surgeons. To aiding other doctors prevent subsequent occurrences, his initial article walked the reader through the exact errors that occurred that led to the wrong site event.
The follow-up article, authored together with Dr. David Ring, tackled the topic of the "tendency to shame and blame." Assuming responsibility for these incidents is uncommon, as the usual reaction is placing blame on third parties. He stressed that pointing fingers not merely deters surgeons from making reports their incidents but additionally diverts from the crucial analysis of underlying causes that might thwart future incidents.
The Intraoperative Burn Incident with Dr. Robert MacArthur
In the context of discussing the intraoperative burn incident, Dr. Robert MacArthur exhibited the same thorough investigative mindset he utilized to his wrong site event research. To illustrate, he reached out to the manufacturer of the troublesome clamp to determine if similar burn events had happened. The maker informed him that the clamp in question had been "discontinued." You can infer from that what you wish.
And to prevent unequal temperature distribution in huge hinged clamps, Doctor MacArthur performed a comprehensive investigation of the reasons for inconsistent heating in oversized clamps.
His findings indicated that quick sterilization could cause inconsistent temperature distribution. He observed that nursing associations highly recommend against the use of rapid sterilization unless it's an emergency, like disinfecting a item that has fallen. Further inquiry revealed that St. Joseph's Hospital often employing quick sterilization to enable back-to-back surgeries without needing to purchase additional equipment trays.
In an effort to stop further burns, Dr. MacArthur alerted the hospital at St. Joseph's of potential dangers associated with the continued use of this specific clamp and also the routine deployment of rapid sterilization.
In place of blaming the clamp, Dr. Robert MacArthur assumed accountability and made it obvious that he had committed a surgical mistake. He was advised that the clamp was heated, but when he grasped it, he found the handles to be at a pleasant temperature. Differing from some surgeons who might impatiently reach for a towel to manage a too-hot clamp, he performed surgery the clamp with no uneasiness.
Shame and Blame, Dr. Robert MacArthur's Response
In The perspective of Dr. MacArthur on response on the topic of the "shame and blame game," he highlights how the legal and the wider public often mix up the "in-command'' concept with root cause analysis. According to this "in-command" perspective, the surgeon is considered responsible for any unfavorable outcomes that occur to a patient under their care. This makes it tempting for many to only blame the surgeon for any surgical errors.
Nonetheless, Dr. MacArthur emphasizes that such an approach contradicts the core principles of root cause analysis. This form of analysis strives to deeply understand what caused a incorrect surgical procedure so as to optimaly avert similar incidents in the future. By adopting blame and shame, not it not only impede proper analysis of the root causes, but it also discourages other surgeons from reporting on their own wrong site events, fearing the repercussions.
He didn't recognize that the sizeable, walnut-sized hinge of the clamp was noticeably hotter. When he positioned the clamp against the shin area of the patient's leg, it caused a burn. At the time, he was proctored for case privileges at the CHOC Hospital during the incident, and none of the proctor nor Doctor MacArthur were right away aware of the burn.
It wasn't until after he had dictated the operative report that an attending nurse in the recovery room pointed out a small patch of redness on the anterior aspect of the patient's leg. Even at that point, he did not initially fully grasp the extent of the burn.
Dr. Robert MacArthur cites the aviation sector as an exemplary case of effective root cause analysis. From its inception, the industry has strived to deeply understand the reasons behind each adverse aviation event rather than just blaming to the pilot. Because of this focus on understanding root causes, air travel industry boasts impressive safety records.
Nevertheless, Dr. Robert MacArthur laments that medical profession 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 sad consequence of this is that the incidence of preventable healthcare errors remains unchanged, and the standing and names of many doctors and healthcare providers are unfairly tarnished.
The incidence of incorrect surgical procedures continues at an alarming rate of one event per surgeon per career, and as high as four occurrences per surgeon's career for hand, spine and sports subspecialists.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In 2023, there exists the possibility to raise false accusations against someone, slander their name and reputation, and have no negative repercussions for the accuser. Regardless if the person facing accusations is innocent or guilty, just making an allegation is enough to cause long-lasting damage to a professional's reputation.
Dr. Bobby MacArthur revealed that he opted to leave a workers compensation clinic because of suspected illegal behavior on the clinic's management. In retaliation, the manager of the clinic allegedly collaborated with a patient to create a fictitious complaint, accusing him of "stripping naked in the middle of the clinic and requesting sex in exchange for a favorable workers comp report.
He got to know 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.
Dr. Rob MacArthur was later notified that both his lie detector test results and the claimant's refusal to participate would be considered inadmissible in court.
The attorney facilitating the mediation 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
California's Medical Board examined the accuser's claims and found them to be "lacking credibility," 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 officially state this.
Regardless of the facts presented above, Dr. MacArthur found no means to eliminate the accuser's claims from Internet search results. This means, despite his innocence, the defamatory campaign was successful.
Since the claim does not state that Dr. MacArthur was found guilty, it merely functions as a summary of a complaint, which continues to be available to the public
Doctor MacArthur strongly believes that individuals who lodge false accusations should be subject to consequences equivalent to the severity of the event they falsely claim. To illustrate, he thinks that his false accuser should be classified as a predator of a sexual nature and felon.
Dr. Robert MacArthur concluded by reflecting on the coexistence of goodness and malevolence in the world, praying that those who read his account would never cross paths with someone capable of such damaging false accusations as he has faced.
Dr. MacArthur: A Renowned Orthopedic Surgeon
Doctor MacArthur