Doctor Robert MacArthur Interview
On this particular day, our group were able to conduct an interview with Californian based orthopedist, Doc Bobby Mac, addressing numerous questions about his own experiences with wrong site surgery and intraoperative burn, as well as the broader subject of "events that should never occur".
Who is Dr. MacArthur?
Doctor Bobby MacArthur graduated from the University of Cal Berkeley with a dual degree in Biochemistry and Physiology. During his time at the Univ, Dr. Rob Mac had been a renown athlete, engaging on both the boxing and rugby football groups.
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Afterwards, Dr. Bobby Mac registered at the Columbia College of Physicians and Surgeons, and became the president of the Columbia University College of Physicians and Surgeons (Now known as the Vagelos school of medicine). Robert Mac continued to conclude his orthopedic residency at Harbor UCLA.
Dr. Robert MacArthur Addresses the Incidents
In statistical terms, the frequency of wrong site surgery usually falls within a seldom happening occurrence for every single bone specialist, but this number surges to four per career for experts specializing in sports, hand, and spine. Regrettably, a lot of of these frequently do not document these occurrences, let alone, not discuss them publicly. Doctor MacArthur carries a intense sense of pride about how he confronted these terrible occurrences.
In lieu of attempting to cover up what happened, Doc MacArthur responded in a different manner
Dr. MacArthur’s Handling of the Wrong Site Surgery
Dr. Bobby Mac completely examined the causal factors of his two occurrences, and put out several works describing how to prevent these situations
Gradually, became acknowledged as a renowned authority in the field of accidents that can be avoided. He's authored a couple of articles in the leading orthopedic journal, The Journal of the American Academy of Orthopedic Surgeons. With the aim of aiding other doctors stop future incidents, his initial article guided the reader through the specific errors that occurred that led to the incorrect surgical procedure.
The follow-up article, co-authored with Dr. David Ring, who is also the Chairman of the AAOS, broached the topic of the "tendency to shame and blame." Being accountable for these incidents is uncommon, as the common response is pointing fingers at third parties. Dr. MacArthur stressed that shifting blame not only discourages surgeons from making reports their incidents but furthermore detracts from the vital analysis of root causes that could potentially thwart subsequent occurrences.
The Intraoperative Burn Incident with Dr. Robert MacArthur
When discussing the surgical burn occurrence, Dr. MacArthur exhibited the same investigative vigor he applied to his wrong site event research. To illustrate, he got in touch with the maker of the troublesome clamp to determine if comparable burn events had happened. The manufacturer informed him that the clamp in question had been "no longer in production." You can make your own inferences based on that what you desire.
And to prevent irregular heating in large hinged clamps, Doctor MacArthur carried out a comprehensive investigation of what led to irregular temperature distribution in large-hinged clamps.
His research findings suggested that quick sterilization could lead to inconsistent temperature distribution. He noted that nursing associations highly recommend against the use of Dr. Robert MacArthur rapid sterilization unless an emergency situation arises like sanitizing a fallen instrument. Deeper examination revealed that the hospital at St. Joseph's regularly employing flash sterilization to enable back-to-back surgeries without needing to acquire more equipment trays.
In a bid to avoid future burn incidents, Dr. Robert MacArthur alerted St Joseph's of the risks associated with ongoing utilization of this particular clamp and the routine deployment of rapid sterilization.
Rather than blaming the clamp, Doctor MacArthur accepted responsibility and made it clear that he was responsible for a mistake during surgery. He was notified that the clamp had a high temperature, but when he grasped it, he found the handles to be at a pleasant temperature. Differing from some surgeons who might impatiently use a towel to manage a too-hot clamp, he carried out the procedure the clamp with no discomfort.
Shame and Blame, Dr. Robert MacArthur's Response
When discussing Dr. MacArthur's response on the topic of the "shame and blame game," he highlights how the legal and public communities often confuse the "captain of the ship'' concept with root cause analysis. According to this "in-command" perspective, the surgeon is held accountable for any unfavorable outcomes that occur to a patient under their care. This makes it enticing for many to exclusively blame the surgeon for any wrong site event.
Nonetheless, Dr. MacArthur stresses that this method contradicts the core principles of root cause analysis. This form of analysis strives to comprehensively grasp what caused a wrong site event so as to ideally prevent similar incidents in the future. By resorting to shaming and blaming, not it not just impede proper analysis of the root causes, but it additionally deters other surgeons from reporting their individual wrong site events, worried about the repercussions.
He didn't recognize that the large, hinge-like hinge of the clamp was noticeably hotter. When he positioned the clamp against the pretibial area of the patient's leg, it resulted in a burn. He was being proctored for procedural privileges at the CHOC Hospital during the incident, and not the proctor nor Dr. MacArthur were immediately aware of the burn.
It was not until after he had dictated the operative report that an attending nurse in the recovery room noticed a small patch of redness on the anterior aspect of the patient's leg. Even at that point, he did not at first fully grasp the seriousness of the burn.
Doctor MacArthur points to the air travel industry as an outstanding case of effective root cause analysis. From its inception, air travel industry has strived to comprehensively grasp the reasons behind each aviation incident rather than simply attributing blame to the pilot. Because of this dedication to understanding root causes, air travel industry boasts notable safety records.
Nevertheless, Dr. Robert MacArthur laments that the medical community hasn't been able to fully adopt root cause analysis due to prevailing legal and public perceptions surrounding the "captain of the ship" concept. The regrettable result of this is that the incidence of preventable healthcare errors remains unchanged, and the careers and reputations of many healthcare practitioners are unfairly tarnished.
The occurrence of incorrect surgical procedures continues at an disturbing rate of one incident per surgeon per career, and up to four occurrences per surgeon's career for hand, spine and sports subspecialists.
Dr. Robert MacArthur “Sexual Harassment” Allegations
As of 2023, there exists the possibility to bring forth false accusations against someone, defame their name and reputation, and face no negative repercussions for the accuser. Regardless of whether the individual being accused is innocent or guilty, an accusation alone is enough to cause long-lasting damage to a professional's reputation.
Doc Robert MacArthur shared that he chose to leave a clinic specializing in workers' compensation cases because of possible unlawful practices on the clinic's management. In retaliation, the manager of the clinic reportedly worked with a individual under treatment to fabricate a claim, 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 accusation over a year after his departure from the clinic, at which point he asserted on undergoing a polygraph examination. The accuser, however, declined to take such a test.
Doctor Bobby Mac was later advised that both his polygraph examination results and the claimant's refusal to participate would be deemed 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 potentially catastrophic. Despite the absurdity of the claim, he was counseled to settle for $29,000
Conclusion
The California 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 hinted that the clinic was indicted, but he did not confirm this.
In spite of the facts presented above, Dr. MacArthur found no means to eliminate the accuser's claims from online search listings. Meaning, despite his innocence, the campaign to tarnish his reputation was achieving its goal.
Since 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 available to the public
Dr. MacArthur strongly believes that those who make baseless allegations should receive punishments equivalent to the severity of the event they falsely claim. To illustrate, he thinks that his false accuser should be treated as a sex offender and felon.
Dr. MacArthur concluded by reflecting on the coexistence of goodness and malevolence in the world, wishing that those