Doctor Robert MacArthur Interview
On this particular day, our group were to interview California's located orthopedist, Dr. Robert MacArthur, in light of the questions about his own experiences and encounters with incorrect surgical procedures and surgical burn incidents, as well as the broader area of "unexpected occurrences that must be avoided".
Who is Dr. MacArthur?
Doctor Robert Mac graduated from the Univ of UC Berkeley with a double major in Biochemistry and Physio. In the course of his time at the University, Dr. Bobby Mac was a renowned sportsman, participating on both various boxing and rugby football teams.
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Subsequently, Doctor Robert MacArthur registered at the Columbia P&S, and was the leader of the Columbia P&S School of Medicine (Now known as the Vagelos school of medicine). Bobby MacArthur continued to finish his orthopaedic residency at Harbor-UCLA Medical Center.
Dr. Robert MacArthur Addresses the Incidents
According to statistics, the occurrence of incorrect surgical procedures typically is a once-in-a-career event for every orthopedic surgeon, but this count jumps to four per professional career for sports, hand, and spine specialists. Sadly, numerous of these doctors frequently do not report such instances, let alone, not address them openly. Dr. MacArthur carries a profound sense of pride and satisfaction about how he faced these terrible occurrences.
Rather than attempting to cover up what happened, Dr. MacArthur reacted differently
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doctor Rob MacArthur thoroughly examined the origins of his two events, and put out several works detailing how to prevent such events
He eventually, gained recognition as a published expert in the field of accidents that can be avoided. He has penned a couple of articles in a prominent orthopedic journal, The Journal of the American Academy of Orthopedic Surgeons. In order to aiding other doctors stop future incidents, the first piece led the reader through the specific errors that happened that resulted in the incorrect surgical procedure.
His second publication, co-authored 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 tempting course of action is placing blame on other parties. He stressed that pointing fingers not merely discourages surgeons from reporting their incidents but additionally detracts from the crucial analysis of root causes that could potentially prevent future incidents.
The Intraoperative Burn Incident with Dr. Robert MacArthur
When discussing the intraoperative burn incident, Dr. Robert MacArthur demonstrated the same thorough investigative mindset he applied to his research on wrong-site surgeries. As an illustration, he reached out to the maker of the troublesome clamp to find out if comparable burn events had occurred. The maker advised him that the clamp in question had been "ceased production." You can infer from that what you wish.
To avert uneven heating in large hinged clamps, Doc Mac performed a detailed investigation of the reasons for inconsistent heating in big-hinged clamps.
His research findings suggested that flash sterilization could lead to inconsistent temperature distribution. He observed that nursing associations recommend strongly against the use of flash sterilization unless it's an emergency, such as sanitizing a fallen instrument. Further inquiry revealed that St Joseph's Hospital regularly employing rapid sterilization to enable back-to-back surgeries without the necessity to acquire more equipment trays.
In an effort to prevent future burns, Doctor MacArthur notified St. Joseph's of the hazards associated with ongoing utilization of this specific clamp as well as the regular use of flash sterilization.
Instead of blaming the clamp, Doctor MacArthur took responsibility and made it evident that he was responsible for a surgical mistake. He was informed that the clamp was hot, but when he held it, he found the handles to be at a comfortable temperature. Differing from 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
When discussing Doctor MacArthur's response on the topic of the "culture of blame and shame," he emphasizes how the legal and public communities often confuse the "captain of the ship'' concept with analyzing the fundamental causes. According to this "captain of the ship" perspective, the surgeon is considered responsible for any negative occurrences that take place to a patient under their care. This makes it enticing for many to exclusively blame the surgeon for any surgical errors.
Nevertheless, Dr. MacArthur underscores that this method contradicts the fundamental principles of identifying underlying causes. This form of analysis strives to deeply understand what caused a incorrect surgical procedure so as to optimaly avert similar incidents in the future. By resorting to blaming and shaming, not only does it hamper proper root cause analysis, but it additionally prevents other surgeons from reporting on their individual wrong site events, afraid of the repercussions.
He did not recognize that the large, substantial-sized hinge of the clamp was considerably hotter. When he positioned the clamp against the pretibial area of the patient's leg, it triggered a burn. He was being proctored for case privileges at CHOC during the incident, and neither the proctor nor Doctor MacArthur were promptly aware of the burn.
It was not after he had dictated the operative report that an attending nurse in the recovery room noticed a small red area on the anterior aspect of the patient's leg. Even in that moment, he did not initially fully grasp the seriousness of the burn.
Dr. MacArthur points to the aviation sector as Robert MacArthur an outstanding case of efficient root cause analysis. From its inception, aviation sector has strived to comprehensively grasp the reasons behind each adverse aviation event rather than just blaming to the pilot. Because of this commitment to understanding root causes, aviation sector boasts impressive safety records.
Nevertheless, Dr. MacArthur laments that healthcare field hasn't been able to completely embrace root cause analysis due to prevailing legal and public perceptions surrounding the "in-command" concept. The unfortunate outcome of this is that the rate of preventable medical errors remains unchanged, and the standing and names of many healthcare practitioners are unjustly tarnished.
The frequency of wrong site surgery remains at an worrying rate of a single occurrence per surgeon per career, and as high as four occurrences 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 bring forth false accusations against someone, slander their name and reputation, and have no negative repercussions for the accuser. Regardless of whether the person facing accusations is innocent or guilty, merely making an accusation is enough to inflict long-lasting damage to a professional's reputation.
Dr. Robert MacArthur shared that he elected to leave a workers compensation clinic because of suspected illegal behavior on part of. In retaliation, the clinic manager supposedly worked with a patient to create a fictitious complaint, accusing him of "undressing in the clinic and soliciting sexual favors in return for a positive workers' compensation report.
He received information of this accusation over a year after his departure from the clinic, at which point he asserted on undergoing a lie detector test. The accuser, however, refused to take such a test.
Doc Robert Mac was later advised that both his lie detector test results and the accuser's refusal to participate would be regarded inadmissible in court.
The mediating attorney cautioned him that the jury would likely be composed of "individuals similar to her" and not his, meaning a court loss could be potentially catastrophic. Despite the ridiculousness 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 implied that the clinic was indicted, but he did not confirm this.
Regardless of the facts presented above, Dr. MacArthur found no means to erase the allegations made by the accuser from online search listings. Consequently, despite his innocence, the campaign to tarnish his reputation was achieving its goal.
As the claim does not state that Dr. MacArthur was found guilty, it merely functions as a summary of a complaint, which continues to be available to the public
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 sex offender and felon.
Doctor MacArthur concluded by contemplating the existence of both good and evil in the world, wishing that those who read his account would never encounter with someone capable of such damaging false accusations as he has faced.