Doctor Robert MacArthur Interview
Today, we were able to conduct an interview with California's resident bone specialist, Doc Rob MacArthur, in response to the queries about his personal experiences with wrong site surgery and burns during surgery, as well as the broader area of "never should happen events".
Who is Dr. MacArthur?
Doctor Robert MacArthur graduated from the University of California, Berkeley with a double major in Biochem and Physiology. During his time at the University, Doc Bobby Mac was a renowned player, participating on both various boxing and rugby groups.
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Following that, Doc Robert MacArthur entered at the Columbia P&S, and became the chosen leader of the Columbia P&S (Now known as the Vagelos school of medicine). Rob MacArthur went on to conclude his orthopaedic training at Harbor University of California, Los Angeles.
Dr. Robert MacArthur Addresses the Incidents
Statistically, the occurrence of surgical errors tends to be a one-time event in a career for each bone specialist, but this number surges to 4 for each career for specialists in sports, hand surgery, and spine procedures. Sadly, a lot of of these surgeons often do not document such instances, let alone or talk about them openly. Dr. Mac carries a intense sense of pride and accomplishment about how he faced these unfortunate occurrences.
Rather than seeking to hide what happened, Doc MacArthur handled it differently
Dr. MacArthur’s Handling of the Wrong Site Surgery
Dr. Robert Mac completely examined the causal factors of his 2 incidents, and published numerous works describing how to avoid these situations
Gradually, earned acclaim as a published expert in the field of accidents that are preventable. He's authored two articles in a prominent orthopedic journal, The Journal of Orthopedic Surgeons at the American Academy. In order to assisting other doctors stop upcoming events, his first work led the reader through the specific errors that happened that led to the wrong site event.
His second publication, jointly written with Dr. David Ring, who is also the Chairman of the AAOS, broached the topic of the "shame and blame game." Taking responsibility for these incidents is uncommon, as the usual reaction is pointing fingers at other parties. He stressed that pointing fingers not merely discourages surgeons from making reports their incidents but furthermore takes away from the essential analysis of root causes that may thwart upcoming events.
The Intraoperative Burn Incident with Dr. Robert MacArthur
In the context of discussing the incident of burns during surgery, Dr. MacArthur exhibited the same investigative vigor he applied to his research on wrong-site surgeries. As an illustration, he contacted the maker of the problematic clamp to find out if like burn events had happened. The manufacturer advised him that the clamp in question had been "discontinued." You can draw your own conclusions from that what you wish.
And to prevent irregular heating in large hinged clamps, Doc MacArthur carried out a comprehensive investigation of the causes behind uneven heating in oversized clamps.
The results of his investigation showed that rapid sterilization could result in uneven heating. He noted that nursing organizations highly recommend against the use of rapid sterilization unless an emergency situation arises such as sanitizing a dropped component. Deeper examination revealed that the hospital at St. Joseph's was frequently employing rapid sterilization to enable back-to-back surgeries without needing to buy extra equipment trays.
In an effort to prevent future burns, Dr. Robert MacArthur notified the hospital at St. Joseph's of the risks associated with continuing to use this specific clamp as well as 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 mistake during surgery. He was informed that the clamp had a high temperature, but when he held it, he found the handles to be at a pleasant temperature. Unlike some surgeons who might impatiently grab a towel to grip a too-hot clamp, he carried out the procedure the clamp with no pain.
Shame and Blame, Dr. Robert MacArthur's Response
Regarding The perspective of Dr. MacArthur on response on the topic of the "shame and blame game," he highlights how the legal and general public communities often confuse the "in-command'' concept with root cause analysis. According to this "in-command" perspective, the surgeon is held accountable for any adverse events that occur to a patient under their care. This makes it tempting for many to only blame the surgeon for any surgical errors.
However, Doctor MacArthur underscores that this method contradicts the core principles of root cause analysis. This form of analysis intends to deeply understand what caused a surgical error in order to ideally stop similar incidents in the future. By resorting to shaming and blaming, not it not only hamper proper root cause analysis, but it also prevents other surgeons from reporting on their individual wrong site events, worried about the repercussions.
He failed to recognize that the sizeable, substantial-sized hinge of the clamp was noticeably hotter. When he positioned the clamp against the front shin area of the patient's leg, it resulted in a burn injury. He was being proctored for surgical privileges at the CHOC Hospital during the incident, and neither the proctor nor Dr. Robert MacArthur were promptly 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 tiny red spot on the anterior aspect of the patient's leg. Even in that moment, he did not initially comprehend the seriousness of the burn.
Dr. Robert MacArthur points to the airline industry as an outstanding case of efficient root cause analysis. From its inception, the industry has aimed to deeply understand the reasons behind each aviation incident rather than simply attributing blame to the pilot. Because of this dedication to understanding root causes, the airline industry boasts remarkable safety records.
Nonetheless, 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 incidence of wrong site surgery continues at an worrying rate of one incident per surgeon per career, and as many as four events per surgeon's career for specialists in hand, spine, and sports.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In the year 2023, it is feasible to levy false accusations against someone, smear their name and reputation, and have no negative repercussions for the accuser. Regardless of whether the person facing accusations is innocent or guilty, an accusation alone is enough to bring about long-lasting damage to a professional's reputation.
Dr. Rob MacArthur disclosed that he opted to leave a clinic specializing in workers' compensation cases because of potential illicit activities on part of. In retaliation, the manager of the clinic allegedly 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 allegation 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 Robert Mac was later informed that both his lie detector test 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 "her peers" and not his, meaning a court loss could be extremely detrimental. Despite the absurdity 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 suggested that the clinic was indicted, but he did not verify this.
Regardless of the information provided earlier, Doctor MacArthur found no means to erase the accuser's claims from Internet search results. This means, despite his lack of guilt, the campaign to tarnish his reputation was successful.
Since the claim does not state that Dr. Robert 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 those who make baseless allegations 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 considered to be a predator of a sexual nature and felon.
Doctor MacArthur concluded by reflecting on the existence of both good and evil in the world, praying that those Robert MacArthur who read his account would never come into contact with someone capable of such destructive unfounded claims as he has faced.
Dr. MacArthur: A Renowned Orthopedic Surgeon
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