Doctor Robert MacArthur Interview
This day, our group were able to interview the based orthopedist, Doctor Rob Mac, in response to the inquiries about his encounters 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 completed his studies from the Univ of Cal Berkeley with a double major in Biochem and Physio. Throughout his time at the Univ, Doctor Robert Mac was a well-known sportsman, participating on both the box and rugby groups.
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Following that, Doctor Rob MacArthur entered at the Columbia College of Physicians and Surgeons, and became the chosen president of the Columbia University College of Physicians and Surgeons (Now known as the Vagelos school of medicine). Robert Mac continued to finish his orthopaedic residency at Harbor UCLA.
Dr. Robert MacArthur Addresses the Incidents
According to statistics, the frequency of incorrect surgical procedures tends to be a once-in-a-career event for every single orthopedic surgeon, but this number jumps to fourfold for each professional career for experts specializing in sports, hand, and spine. Unfortunately, many of these commonly do not record these occurrences, let alone or address them openly. Doctor MacArthur carries a deep sense of pride about how he confronted these terrible occurrences.
Instead of trying to cover up what happened, Dr. Mac handled it differently
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doctor Robert Mac thoroughly looked into the origins of his two events, and put out numerous works describing how to stop these situations
Over time, earned acclaim as a recognized specialist in the field of accidents that can be avoided. He's written 2 articles in a prominent orthopedic journal, The Journal of Orthopedic Surgery. To aiding other doctors stop upcoming events, his first work led the reader through the specific errors that took place that resulted in the incorrect surgical procedure.
The follow-up article, authored together with Dr. David Ring, broached the topic of the "tendency to shame and blame." Being accountable for these incidents is uncommon, as the tempting course of action is blaming external factors. Dr. MacArthur stressed that shifting blame not only discourages surgeons from making reports their incidents but furthermore diverts from the crucial analysis of underlying causes that might prevent subsequent occurrences.
The Intraoperative Burn Incident with Dr. Robert MacArthur
In the context of discussing the incident of burns during surgery, Dr. Robert MacArthur demonstrated the same dedicated investigative approach he applied to his research on wrong-site surgeries. As an illustration, he reached out to the manufacturer of the problematic clamp to determine if similar burn events had occurred. The manufacturer advised him that the clamp in question had been "ceased production." You can draw your own conclusions from that what you will.
And to prevent irregular heating in large hinged clamps, Doc Mac carried out a comprehensive investigation of what led to uneven heating in big-hinged clamps.
The results of his investigation showed that rapid sterilization could result in uneven heating. He noted that nursing organizations recommend strongly against the use of quick sterilization unless there's an urgent need like sterilizing a fallen instrument. Deeper examination revealed that St. Joseph's Hospital often utilizing quick sterilization to facilitate back-to-back surgeries without the necessity to acquire more equipment trays.
With the aim to prevent future burns, Doctor MacArthur alerted St Joseph's of the hazards associated with ongoing utilization of this specifically identified clamp as well as the regular use of quick sterilization.
In place of blaming the clamp, Doctor MacArthur took responsibility and made it obvious that he had made a surgical mistake. He was informed that the clamp was heated, but when he grasped it, he found the handles to be at a pleasant temperature. Unlike some surgeons who may impatiently use a towel to handle a too-hot clamp, he carried out the procedure the clamp with no uneasiness.
Shame and Blame, Dr. Robert MacArthur's Response
Regarding The perspective of Dr. MacArthur on response on the topic of the "culture of blame and shame," he emphasizes how the legal and general public communities often conflate the "in-command'' concept with root cause analysis. According to this "captain of the ship" perspective, the surgeon is responsible for any negative occurrences that occur to a patient under their care. This makes it tempting for many to exclusively blame the surgeon for any wrong site event.
Nonetheless, Doctor MacArthur underscores that this method goes against the core principles of identifying underlying causes. This form of analysis intends to comprehensively grasp what caused a wrong site event in order to ideally avert similar incidents in the future. By adopting blaming and shaming, not only does it impede proper root cause analysis, but it also deters other surgeons from reporting on their individual wrong site events, worried about the repercussions.
He did not recognize that the big, walnut-sized hinge of the clamp was significantly hotter. When he positioned the clamp against the front shin area of the patient's leg, it caused a burn. At the time, he was proctored for procedural privileges at the CHOC Hospital during the incident, and neither the proctor nor Doctor MacArthur were right away aware of the burn.
It was not until after he had dictated the operative report that a recovery room nurse pointed out a small patch of redness on the anterior aspect of the patient's leg. Even then, he did not at the outset realize the extent of the burn.
Dr. MacArthur references the airline industry as an outstanding case of effective root cause Dr. Robert MacArthur analysis. From its inception, the industry has aimed to deeply understand the reasons behind each negative aviation occurrence rather than merely assigning blame to the pilot. Because of this focus on understanding root causes, air travel industry boasts notable safety records.
However, Doctor 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 "in-command" concept. The sad consequence of this is that the frequency of avoidable medical mistakes remains unchanged, and the professional careers and reputations of many medical professionals are unjustly tarnished.
The frequency of surgical errors persists at an disturbing rate of one event per surgeon per career, and up to four events per surgeon's career for specialists in hand, spine, and sports.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In 2023, there exists the possibility to bring forth false accusations against someone, defame their name and reputation, and experience no negative repercussions for the accuser. Irrespective of the person facing accusations is innocent or guilty, just making an allegation is enough to bring about long-lasting damage to a professional's reputation.
Doc Robert Mac revealed that he opted to leave a clinic specializing in workers' compensation cases because of suspected illegal behavior on the clinic's management. In retaliation, the clinic's manager reportedly 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 got to know of this allegation over a year after his departure from the clinic, at which point he asserted on undergoing a truth verification test. The accuser, however, opted not to take such a test.
Doc Bobby MacArthur was later notified that both his truth verification test results and the claimant's refusal to participate would be considered inadmissible in court.
The mediating attorney 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 Medical Board of California examined the accuser's claims and found them to be "not trustworthy," 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, Doctor MacArthur found no means to eliminate the allegations made by the accuser from search engine results. This means, despite his lack of guilt, the slander campaign was effective.
As the claim does not state that Dr. Robert MacArthur was found guilty, it merely functions as a condensed version of a complaint, which continues to be available to the public
Doctor MacArthur strongly believes that people making false claims should receive punishments equivalent to the consequences of the falsely claimed event. To illustrate, he thinks that his false accuser should be classified as a sexual predator and felon.
Dr. Robert MacArthur concluded by contemplating 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 harmful baseless allegations as he has faced.