Doctor Robert MacArthur Interview
This day, our group managed to interview Californian based orthopedist, Dr. Rob MacArthur, addressing the queries about his personal experiences with incorrect surgical procedures and burns during surgery, as well as the topic of "events that should never occur".
Who is Dr. MacArthur?
Dr. Rob Mac completed his studies from the University of UC Berkeley with a dual degree in Biochemistry and Physiology. In the course of his time at the Univ, Dr. Bobby MacArthur used to be a renowned player, competing on both various box and Rugby teams.
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Subsequently, Dr. Robert Mac enrolled at the Columbia University College of Physicians and Surgeons, and got elected as elected head of the Columbia P&S School of Medicine (Now known as the Vagelos school of medicine). Rob Mac went on to finish his orthopedic training at Harbor University of California, Los Angeles.
Dr. Robert MacArthur Addresses the Incidents
In statistical terms, the occurrence of wrong site surgery typically is a one-time event in a career for every single bone specialist, but this count jumps to fourfold in each career for experts specializing in sports, hand, and spine. Regrettably, many of these commonly do not report these occurrences, let alone, not talk about them freely. Doctor MacArthur carries a profound sense of pride and accomplishment about how he confronted these terrible occurrences.
Rather than seeking to hide what happened, Doctor MacArthur handled it differently
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doctor Robert MacArthur thoroughly investigated the root causes of his 2 events, and put out numerous works outlining how to prevent such events
He eventually, gained recognition as a renowned authority in the field of accidents that are preventable. He's authored 2 articles in the foremost orthopedic journal, The Journal of Orthopedic Surgeons at the American Academy. To assisting other doctors stop future incidents, his initial article walked the reader through the exact errors that occurred that led to the incorrect surgical procedure.
The second paper, authored together with Dr. David Ring, tackled the topic of the "tendency to shame and blame." Taking responsibility for these incidents is uncommon, as the tempting course of action is blaming third parties. He stressed that shifting blame not merely discourages surgeons from reporting their incidents but also diverts from the essential analysis of root causes that may thwart future incidents.
The Intraoperative Burn Incident with Dr. Robert MacArthur
In the context of discussing the incident of burns during surgery, Dr. MacArthur displayed the same dedicated investigative approach he applied to his research on wrong-site surgeries. As an illustration, he got in touch with the producer of the problematic clamp to find out if like burn events had happened. The manufacturer notified him that the clamp in question had been "no longer in production." You can draw your own conclusions from that what you wish.
To avert irregular heating in large hinged clamps, Dr. Mac performed a comprehensive investigation of the causes behind uneven heating in big-hinged clamps.
The results of his investigation showed that flash sterilization could cause inconsistent temperature distribution. He pointed out that nursing organizations highly recommend against the use of flash sterilization unless there's an urgent need like sterilizing a fallen instrument. Deeper examination revealed that St Joseph's Hospital regularly utilizing flash sterilization to enable back-to-back surgeries without the necessity to purchase additional equipment trays.
In an effort to prevent future burns, Dr. Robert MacArthur alerted St. Robert MacArthur Joseph's of the hazards associated with ongoing utilization of this particular clamp and also the frequent application of flash sterilization.
Instead of blaming the clamp, Dr. Robert MacArthur assumed accountability and made it clear that he had made a mistake during surgery. He was informed that the clamp was hot, but when he held it, he found the handles to be at a comfortable temperature. In contrast to some surgeons who might impatiently reach for a towel to handle a too-hot clamp, he operated the clamp with no discomfort.
Shame and Blame, Dr. Robert MacArthur's Response
Regarding Dr. MacArthur's response on the topic of the "blame game," he spotlights how the legal and public communities often conflate the "captain of the ship'' concept with root cause analysis. According to this "in-command" 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.
Nevertheless, Doctor MacArthur emphasizes that such an approach opposes the core principles of investigating root causes. This form of analysis aims to comprehensively grasp what caused a incorrect surgical procedure to then optimaly stop similar incidents in the future. By resorting to blame and shame, not only does it impede proper root cause analysis, but it furthermore discourages other surgeons from reporting on their own wrong site events, fearing the repercussions.
He did not recognize that the large, hinge-like hinge of the clamp was considerably hotter. When he positioned the clamp against the pretibial area of the patient's leg, it triggered a skin burn. At the time, he was proctored for surgical privileges at Children's Hospital of Orange County during the incident, and neither the proctor nor Doctor MacArthur were right away aware of the burn.
Not until only after he had dictated the operative report that a nurse in the recovery ward pointed out a tiny red spot on the anterior aspect of the patient's leg. Even in that moment, he did not at the outset comprehend the seriousness of the burn.
Doctor MacArthur points to the airline industry as an exemplary case of effective root cause analysis. From its inception, aviation sector has aimed to thoroughly comprehend the reasons behind each adverse aviation event rather than simply attributing blame to the pilot. Because of this commitment to understanding root causes, the airline industry boasts notable safety records.
However, Dr. 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 regrettable result of this is that the frequency of avoidable medical mistakes remains unchanged, and the professional careers and reputations of many medical professionals are unfairly tarnished.
The frequency of incorrect surgical procedures persists at an disturbing rate of one event per surgeon per career, and as many as four incidents per surgeon's career for hand, spine and sports subspecialists.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In 2023, it is feasible to bring forth false accusations against someone, defame their name and reputation, and experience no negative repercussions for the accuser. Regardless of whether the accused is innocent or guilty, just making an allegation is enough to bring about long-lasting damage to a professional's reputation.
Doc Rob Mac disclosed that he chose to leave a workers compensation clinic because of suspected illegal behavior on the clinic's management. In retaliation, the manager of the clinic allegedly worked with a patient to fabricate a claim, accusing him of "undressing in the clinic and soliciting sexual favors in return for a positive workers' compensation report.
He received information of this allegation over a year after his departure from the clinic, at which point he demanded on undergoing a lie detector test. The accuser, however, opted not to take such a test.
Dr. Bobby MacArthur was later informed that both his lie detector test results and her refusal to participate would be considered inadmissible in court.
The attorney facilitating the mediation cautioned him that the jury would likely be composed of "individuals similar to 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 "lacking credibility," 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 confirm this.
Regardless of the information provided earlier, Doctor MacArthur found no means to eliminate the allegations made by the accuser from online search listings. This means, despite his lack of guilt, the campaign to tarnish his reputation was achieving its goal.
As the claim does not state that Dr. Robert MacArthur was found guilty, it merely serves as a summary of a complaint, which continues to be publicly accessible
Doctor MacArthur strongly believes that people making false claims should face penalties equivalent to the severity of the event they falsely claim. To illustrate, he thinks that his false accuser should be treated as a predator of a sexual nature and felon.
Dr. Robert MacArthur concluded by contemplating the coexistence of goodness and malevolence in the world, wishing that those who read his account would never come into contact with someone capable of such damaging false accusations as he