Doctor Robert MacArthur Interview
On this particular day, we managed to interview Californian resident orthopedist, Dr. Bobby Mac, in light of various questions about his personal encounters with wrong site surgery and intraoperative burn, as well as the topic of "never should happen events".
Who is Dr. MacArthur?
Dr. Rob MacArthur completed his studies from the Univ of California, Berkeley with a double major in Biochem and Physiology. During his time at the Univ, Dr. Rob MacArthur used to be a renown player, engaging on both the box and rugby groups.
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Following that, Doctor Bobby Mac entered at the Columbia P&S, and got elected as the chosen president of the Columbia P&S (Now known as the Vagelos Medical School). Bobby Mac proceeded to finish his orthopedic training at Harbor University of California, Los Angeles.
Dr. Robert MacArthur Addresses the Incidents
In statistical terms, the occurrence of incorrect surgical procedures typically is a once-in-a-career event for each orthopedic surgeon, but this number jumps to 4 per career for sports, hand, and spine specialists. Regrettably, a lot of of these doctors frequently do not document these cases, let alone, not discuss them freely. Doc Mac carries a intense sense of pride and satisfaction about how he faced these harrowing occurrences.
Rather than trying to conceal the situation, Doctor MacArthur reacted differently
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doc Bobby MacArthur extensively looked into the underlying origins of his two occurrences, and released multiple works outlining how to stop such events
He eventually, earned acclaim as a published expert in the field of preventable accidents. He's written 2 articles in the foremost orthopedic journal, The Journal of the American Academy of Orthopedic Surgeons. With the aim of aiding other doctors stop future incidents, his first work walked the reader through the specific errors that happened that caused the incorrect surgical procedure.
His second publication, jointly written with Dr. David Ring, the Chairman of the AAOS, broached the topic of the "culture of shame and blame." Assuming responsibility for these incidents is rare, as the common response is placing blame on external factors. Dr. MacArthur stressed that shifting blame not just deters surgeons from making reports their incidents but also diverts from the crucial analysis of root causes that may avert subsequent occurrences.
The Intraoperative Burn Incident with Dr. Robert MacArthur
When discussing the surgical burn occurrence, Dr. MacArthur exhibited the same dedicated investigative approach he utilized to his wrong site event research. For example, he contacted the manufacturer of the problematic clamp to find out if like burn events had happened. The maker notified him that the clamp in question had been "no longer in production." You can make your own inferences based on that what you will.
And to prevent unequal temperature distribution in huge hinged clamps, Dr. MacArthur carried out a thorough investigation of what led to irregular temperature distribution in big-hinged clamps.
The results of his investigation showed that flash sterilization could cause inconsistent temperature distribution. He observed that nursing associations highly recommend against the use of quick sterilization unless it's an emergency, for instance, disinfecting a fallen instrument. Deeper examination revealed that the hospital at St. Joseph's was frequently using quick sterilization to enable back-to-back surgeries without having to acquire more equipment trays.
In an effort to stop further burns, Dr. Robert MacArthur notified the hospital at St. Joseph's of the hazards associated with ongoing utilization of this specific clamp and the routine deployment of rapid sterilization.
In place of blaming the clamp, Dr. Robert MacArthur accepted responsibility and made it clear that he had made a surgical error. He was advised that the clamp had a high temperature, but when he held it, he found the handles to be at a pleasant temperature. In contrast to some surgeons who could impatiently reach for a towel to manage a too-hot clamp, he performed surgery the clamp with no pain.
Shame and Blame, Dr. Robert MacArthur's Response
In Doctor MacArthur's response on the topic of the "culture of blame and shame," he emphasizes Dr. Robert MacArthur how the legal and the wider public often confuse the "in-command'' concept with identifying the underlying reasons. According to this "in-command" perspective, the surgeon is held accountable for any unfavorable outcomes that happen to a patient under their care. This makes it tempting for many to solely blame the surgeon for any incorrect surgical procedure.
Nevertheless, Doctor MacArthur emphasizes that this method contradicts the core principles of root cause analysis. This form of analysis strives 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 hamper proper investigation into the fundamental reasons, but it additionally discourages other surgeons from reporting on their individual wrong site events, afraid of the repercussions.
He didn't recognize that the sizeable, walnut-sized hinge of the clamp was considerably hotter. When he positioned the clamp against the front shin area of the patient's leg, it triggered a burn. At the time, he was proctored for case privileges at Children's Hospital of Orange County during the incident, and none of the proctor nor Dr. MacArthur were immediately aware of the burn.
It wasn't only after he had dictated the operative report that a nurse in the recovery ward drew attention to a small patch of redness on the anterior aspect of the patient's leg. Even in that moment, he did not at first comprehend the severity of the burn.
Doctor MacArthur cites the air travel industry as an model case of successful root cause analysis. From its inception, aviation sector has sought to comprehensively grasp the reasons behind each aviation incident rather than just blaming to the pilot. Because of this focus on understanding root causes, air travel industry boasts impressive safety records.
However, Dr. MacArthur laments that healthcare field hasn't been successful in fully implementing 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 doctors and healthcare providers are unfairly tarnished.
The frequency of surgical errors continues at an disturbing rate of one incident 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 2023, there exists the possibility to bring forth false accusations against someone, slander their name and reputation, and have no negative repercussions for the accuser. Regardless if the individual being accused is innocent or guilty, just making an allegation is enough to bring about long-lasting damage to a professional's reputation.
Dr. Bobby MacArthur revealed that he chose to leave a workers compensation clinic because of possible unlawful practices on the clinic's management. In retaliation, the clinic manager allegedly worked with a individual under treatment 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 got to know of this accusation over a year after his departure from the clinic, at which point he demanded on undergoing a polygraph examination. The accuser, however, opted not to take such a test.
Doc Robert MacArthur was later informed that both his truth verification test results and the claimant's refusal to participate would be deemed inadmissible in court.
The mediating attorney cautioned him that the jury would likely be composed of "her peers" and not his, meaning a court loss could be potentially catastrophic. Despite the ludicrousness 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.
In spite of the facts presented above, Doctor MacArthur found no means to erase the allegations made by the accuser from Internet search results. Consequently, despite his innocence, the defamatory campaign was effective.
As 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
Doctor MacArthur strongly believes that those who make baseless allegations 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 contemplating the existence of both good and evil in the world, praying that those who read his account would never encounter with someone capable of such destructive unfounded claims as he has faced.