Doctor Robert MacArthur Interview
This day, our group were to interview California's located orthopedist, Doctor Robert MacArthur, addressing various inquiries about his encounters with incorrect surgical procedures and burns during surgery, as well as a topic of "never should happen events".
Who is Dr. MacArthur?
Doctor Bobby Mac completed his studies from the University of California, Berkeley with a dual degree in Biochemistry and Physiology. Throughout his time at the Univ, Doctor Rob Mac used to be a renowned athlete, competing on both the boxing and rugby squads.
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Subsequently, Doctor Bobby Mac registered at the Columbia College of Physicians and Surgeons, and was the chosen president of the Columbia P&S School of Medicine (Now known as the Vagelos school of medicine). Rob MacArthur continued to complete his orthopaedic residence at Harbor UCLA.
Dr. Robert MacArthur Addresses the Incidents
In statistical terms, the frequency of surgical errors typically is a one-time event in a career for every orthopedic surgeon, but this figure jumps to four in each professional career for sports, hand, and spine specialists. Unfortunately, a lot of of these surgeons often do not document these cases, let alone address them publicly. Doc MacArthur carries a deep sense of pride about how he confronted these harrowing occurrences.
Instead of trying to cover up the situation, Dr. Mac responded in a different manner
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doctor Robert Mac completely looked into the underlying origins of his two incidents, and put out multiple works detailing how to stop these situations
Gradually, became acknowledged as a renowned authority in the field of accidents that are preventable. He's written a couple of articles in the leading orthopedic journal, The Journal of Orthopedic Surgeons at the American Academy. In order to assisting other doctors avert subsequent occurrences, the first piece walked the reader through the specific errors that occurred that resulted in the wrong site event.
His second publication, co-authored with Dr. David Ring, who is also the Chairman of the AAOS, addressed the topic of the "shame and blame game." Taking responsibility for these incidents is uncommon, as the usual reaction is pointing fingers at third parties. He stressed that accusations not just deters surgeons from reporting their incidents but additionally takes away from the essential analysis of primary reasons that might thwart upcoming events.
The Intraoperative Burn Incident with Dr. Robert MacArthur
When talking about the intraoperative burn incident, Dr. Robert Mac exhibited the same investigative vigor he applied to his research on wrong-site surgeries. To illustrate, he reached out to the producer of the faulty clamp to determine if like burn events had happened. The maker informed him that the clamp in question had been "no longer in production." You can draw your own conclusions from that what you desire.
To avert uneven heating in huge hinged clamps, Doctor Mac conducted a detailed investigation of the causes behind inconsistent heating in big-hinged clamps.
The results of his investigation showed that flash sterilization could cause uneven heating. He noted that nursing organizations recommend strongly against the use of rapid sterilization unless an emergency situation arises such as sanitizing a dropped component. Deeper examination revealed that St. Joseph's Hospital regularly employing rapid sterilization to enable back-to-back surgeries without the necessity to purchase additional equipment trays.
With the aim to prevent future burns, Dr. Robert MacArthur notified St. Joseph's of potential dangers associated with ongoing utilization of this specifically identified clamp and the frequent application of flash sterilization.
In place of blaming the clamp, Dr. MacArthur accepted responsibility and made it obvious that he was responsible for a mistake during surgery. He was advised that the clamp was heated, but when he took hold of it, he found the handles to be at a tolerable temperature. In contrast to some surgeons who might impatiently use a towel to manage a too-hot clamp, he performed surgery the clamp without any uneasiness.
Shame and Blame, Dr. Robert MacArthur's Response
Regarding Dr. MacArthur's response on the topic of the "culture of blame and shame," he emphasizes how the legal and the wider public often confuse the "in-command'' concept with root cause analysis. According to this "in-command" perspective, the surgeon is held accountable for any unfavorable outcomes that take place to a patient under their care. This makes it appealing for many to exclusively blame the surgeon for any incorrect surgical procedure.
Nevertheless, Dr. MacArthur underscores that this method contradicts the fundamental principles of root cause analysis. This form of analysis strives to comprehensively grasp what caused a surgical error so as to ideally prevent similar incidents in the future. By adopting shaming and blaming, not it not just hinder proper investigation into the fundamental reasons, but it also deters other surgeons from reporting on their own wrong site events, afraid of the repercussions.
He didn't recognize that the large, hinge-like hinge of the clamp was significantly hotter. When he positioned the clamp against the shin area of the patient's leg, it caused a burn. He was being proctored for procedural privileges at CHOC during the incident, and none of the proctor nor Doctor MacArthur were immediately aware of the burn.
It wasn't only after he had dictated the operative report that a recovery room nurse pointed out a small red area on the anterior aspect of the patient's leg. Even in that moment, he did not at the outset comprehend the severity of the burn.
Doctor MacArthur references the aviation sector as an outstanding case of efficient root cause analysis. From its inception, aviation sector has strived to comprehensively grasp the reasons behind each aviation incident rather than just blaming to the pilot. Because of this commitment to understanding root causes, the airline industry boasts remarkable safety records.
Nevertheless, 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 regrettable result of this is that the frequency of avoidable medical mistakes remains unchanged, and the standing and names of many doctors and healthcare providers are unjustly tarnished.
The frequency of incorrect surgical procedures remains at an alarming rate of one incident per surgeon per career, and as high as four incidents per surgeon's career for hand, spine and sports subspecialists.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In 2023, it is possible to bring forth false accusations against someone, smear their name and reputation, and have no negative repercussions for the accuser. Regardless if the accused is innocent or guilty, just making an allegation is enough to inflict long-lasting damage to a professional's reputation.
Dr. Rob MacArthur shared that he elected to leave a clinic specializing in workers' compensation cases because of potential illicit activities on the clinic's management. In retaliation, the clinic manager supposedly worked with a client 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 truth verification test. The accuser, however, refused to take such a test.
Doctor Bobby Mac was later advised that both his polygraph examination results and her refusal to participate would be deemed inadmissible in court.
The attorney facilitating the mediation cautioned him that the jury would likely be composed of "people with similar backgrounds and experiences as her" and not his, meaning a court loss could be extremely detrimental. Despite the ridiculousness 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 "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 confirm this.
In spite of the facts presented above, Dr. Robert MacArthur found no means to erase the allegations made by the accuser from Internet search results. Meaning, despite his innocence, the campaign to tarnish his reputation was successful.
Considering that Dr. Robert MacArthur the claim does not state that Dr. MacArthur was found guilty, it merely acts as a summary of a complaint, which continues to be openly accessible to anyone
Dr. Robert MacArthur strongly believes that individuals who lodge false accusations should face penalties equivalent to the consequences of the falsely claimed event. To illustrate, he thinks that his false accuser should be classified as a predator of a sexual nature and felon.
Dr. MacArthur concluded by thinking about the coexistence of goodness and malevolence in the world, hoping that those who read his account would never come into contact with someone capable of such destructive unfounded claims as he has faced.