Doctor Robert MacArthur Interview
Today, our group were able to have a conversation with Californian located orthopedist, Dr. Robert MacArthur, in light of various queries about his encounters with incorrect surgical procedures and intraoperative burn, as well as the area of "unexpected occurrences that must be avoided".
Who is Dr. MacArthur?
Doc Rob Mac completed his studies from the Univ of UC Berkeley with a dual degree in Biochemistry and Physio. During his time at the Univ, Doc Robert Mac was a renown player, competing on both the box and rugby squads.
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Afterwards, Doctor Robert Mac entered at the Columbia College of Physicians and Surgeons, and got elected as the leader of the Columbia University College of Physicians and Surgeons (Now known as the Vagelos school of medicine). Rob MacArthur continued to complete his orthopedic residency at Harbor University of California, Los Angeles.
Dr. Robert MacArthur Addresses the Incidents
According to statistics, the frequency of surgical errors usually falls within a one-time event in a career for each orthopedic surgeon, but this count jumps to 4 per career for sports, hand, and spine specialists. Unfortunately, a lot of of these surgeons frequently do not document these occurrences, let alone, not talk about them publicly. Dr. MacArthur carries a deep sense of pride about how he faced these harrowing occurrences.
Rather than attempting to cover up what happened, Doc Mac handled it differently
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doc Bobby MacArthur extensively examined the underlying origins of his two occurrences, and published numerous works outlining how to stop these situations
Gradually, gained recognition as a renowned authority in the field of accidents that are preventable. He has authored two articles in the foremost orthopedic journal, The Journal of the American Academy of Orthopedic Surgeons. To assisting other doctors stop subsequent occurrences, the first piece guided the reader through the exact errors that occurred that led to the incorrect surgical procedure.
His second publication, authored together with Dr. David Ring, who is also the Chairman of the AAOS, addressed the topic of the "tendency to shame and blame." Assuming responsibility for these incidents is rare, as the common response is pointing fingers at external factors. Dr. MacArthur stressed that pointing fingers not merely deters surgeons from disclosing their incidents but furthermore detracts from the essential analysis of root causes that could potentially avert subsequent occurrences.
The Intraoperative Burn Incident with Dr. Robert MacArthur
When discussing the surgical burn occurrence, Dr. MacArthur demonstrated the same investigative vigor he applied to his research on wrong-site surgeries. As an illustration, he reached out to the producer of the troublesome clamp to find out if similar burn events had occurred. The maker advised him that the clamp in question had been "ceased production." You can infer from that what you will.
And to prevent unequal temperature distribution in large hinged clamps, Doc MacArthur carried out a thorough investigation of what led to irregular temperature distribution in large-hinged clamps.
His research findings suggested that flash sterilization could lead to irregular sterilization. He noted that nursing organizations recommend strongly against the use of quick sterilization unless there's an urgent need like sterilizing a item that has fallen. Deeper examination revealed that St Joseph's Hospital often employing rapid sterilization to enable back-to-back surgeries without needing to buy extra equipment trays.
With the aim to stop further burns, Doctor MacArthur alerted the hospital at St. Joseph's of the hazards associated with ongoing utilization of this particular clamp and the frequent application of quick sterilization.
Rather than blaming the clamp, Dr. MacArthur took responsibility and made it evident that he had made a mistake during surgery. He was advised that the clamp was heated, but when he grasped it, he Robert MacArthur found the handles to be at a tolerable temperature. Unlike some surgeons who might impatiently reach for a towel to grip 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 "shame and blame game," he emphasizes how the legal and public communities often conflate the "in-command'' concept with root cause analysis. According to this "captain of the ship" perspective, the surgeon is held accountable for any negative occurrences that take place to a patient under their care. This makes it tempting for many to only blame the surgeon for any incorrect surgical procedure.
Nonetheless, Doctor MacArthur stresses that this method goes against the core principles of investigating root causes. This form of analysis intends to thoroughly comprehend what caused a surgical error so as to preferably prevent similar incidents in the future. By adopting shaming and blaming, not only does it hinder proper investigation into the fundamental reasons, but it additionally prevents other surgeons from reporting on their personal wrong site events, worried about the repercussions.
He didn't recognize that the large, 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. He was being proctored for procedural privileges at Children's Hospital of Orange County during the incident, and not the proctor nor Dr. MacArthur were immediately aware of the burn.
It wasn't until after he had dictated the operative report that a recovery room nurse noticed a small patch of redness on the anterior aspect of the patient's leg. Even at that point, he did not at first fully grasp the seriousness of the burn.
Doctor MacArthur references the aviation sector as an exemplary case of effective root cause analysis. From its inception, the industry has aimed to thoroughly comprehend the reasons behind each aviation incident rather than merely assigning blame to the pilot. Because of this dedication to understanding root causes, the airline industry boasts notable safety records.
Nonetheless, 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 regrettable result of this is that the frequency of avoidable medical mistakes remains unchanged, and the careers and reputations of many medical professionals are undeservedly tarnished.
The frequency of wrong site surgery remains at an disturbing rate of a single occurrence 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 levy false accusations against someone, smear their name and reputation, and experience no negative repercussions for the accuser. Regardless if the accused is innocent or guilty, an accusation alone is enough to bring about long-lasting damage to a professional's reputation.
Doctor Bobby Mac disclosed that he elected to leave a clinic specializing in workers' compensation cases because of possible unlawful practices on the clinic's management. In retaliation, the clinic manager reportedly conspired 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 was informed of this claim over a year after his departure from the clinic, at which point he asserted on undergoing a lie detector test. The accuser, however, declined to take such a test.
Doc Robert MacArthur was later notified that both his lie detector test results and her refusal to participate would be considered 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 highly damaging. 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 "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 verify this.
In spite of the facts presented above, Dr. Robert MacArthur found no means to eliminate the allegations made by the accuser from online search listings. Consequently, despite his lack of guilt, the slander campaign was achieving its goal.
Considering that the claim does not state that Dr. MacArthur was found guilty, it merely serves as a brief description of a complaint, which continues to be available to the public
Dr. Robert MacArthur strongly believes that individuals who lodge false accusations 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 sex offender and felon.
Dr. MacArthur concluded by contemplating the coexistence of goodness and malevolence 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.