Doctor Robert MacArthur Interview
Today, our group were to conduct an interview with Californian based bone specialist, Doctor Robert Mac, addressing numerous questions about his own experiences with surgical errors and surgical burn incidents, as well as a area of "events that should never occur".
Who is Dr. MacArthur?
Dr. Robert MacArthur graduated from the Univ of Cal Berkeley with a double major in Biochem and Physio. In the course of his time at the Univ, Dr. Rob Mac was a renown player, engaging on both several boxing and rugby football groups.
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Following that, Doctor Robert Mac enrolled at the Columbia College of Physicians and Surgeons, and became the leader of the Columbia P&S (Now known as the Vagelos Medical School). Bobby Mac continued to conclude his orthopaedic residence at Harbor UCLA.
Dr. Robert MacArthur Addresses the Incidents
According to statistics, the frequency of incorrect surgical procedures typically is a once-in-a-career event for every single orthopedic surgeon, but this count jumps to four in each lifetime for specialists in sports, hand surgery, and spine procedures. Unfortunately, a lot of of these surgeons often do not record such instances, let alone, not talk about them publicly. Doc Mac carries a deep sense of pride and satisfaction about how he faced these harrowing occurrences.
Instead of trying to conceal the incident, Doc Mac responded in a different manner
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doc Robert MacArthur thoroughly looked into the underlying root causes of his dual occurrences, and published numerous works detailing how to prevent such events
Gradually, earned acclaim as a recognized specialist in the field of accidents that are preventable. 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 prevent Robert MacArthur subsequent occurrences, his first work led the reader through precise errors that took place that resulted in the incorrect surgical procedure.
The second paper, authored together with Dr. David Ring, who is also the Chairman of the AAOS, tackled the topic of the "culture of shame and blame." Assuming responsibility for these incidents is uncommon, as the tempting course of action is pointing fingers at external factors. Dr. MacArthur stressed that pointing fingers not merely discourages surgeons from disclosing 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
When discussing the intraoperative burn incident, Dr. MacArthur displayed the same investigative vigor he applied to his research on wrong-site surgeries. For example, he got in touch with the maker of the problematic clamp to find out if similar burn events had happened. The maker advised him that the clamp in question had been "no longer in production." You can infer from that what you wish.
And to prevent unequal temperature distribution in huge hinged clamps, Doctor Mac performed a detailed investigation of the reasons for irregular temperature distribution in large-hinged clamps.
His findings indicated that rapid sterilization could lead to irregular sterilization. He noted that associations for nurses strongly advise against the use of flash sterilization unless an emergency situation arises like sanitizing a fallen instrument. Additional investigation revealed that St. Joseph's Hospital regularly using flash sterilization to facilitate back-to-back surgeries without needing to buy extra equipment trays.
With the aim to stop further burns, Dr. MacArthur notified the hospital at St. Joseph's of potential dangers associated with continuing to use this specific clamp and also the regular use of flash sterilization.
Rather than blaming the clamp, Dr. MacArthur assumed accountability and made it obvious that he had committed a surgical error. He was notified that the clamp was heated, but when he took hold of it, he found the handles to be at a pleasant temperature. Differing from some surgeons who might impatiently grab a towel to grip a too-hot clamp, he carried out the procedure the clamp without discomfort.
Shame and Blame, Dr. Robert MacArthur's Response
When discussing Dr. MacArthur's response on the topic of the "blame game," he spotlights how the legal and public communities often confuse the "in-command'' concept with root cause analysis. According to this "captain of the ship" perspective, the surgeon is responsible for any adverse events that happen to a patient under their care. This makes it tempting for many to exclusively blame the surgeon for any incorrect surgical procedure.
Nonetheless, Doctor MacArthur emphasizes that this perspective opposes the core principles of investigating root causes. This form of analysis strives to thoroughly comprehend what caused a wrong site event in order to ideally stop similar incidents in the future. By adopting blame and shame, not it not only hamper proper root cause analysis, but it additionally prevents other surgeons from reporting on their personal wrong site events, worried about the repercussions.
He failed to recognize that the large, walnut-sized hinge of the clamp was significantly hotter. When he positioned the clamp against the shin area of the patient's leg, it resulted in a skin burn. He was being proctored for procedural privileges at the CHOC Hospital during the incident, and neither the proctor nor Doctor MacArthur were immediately aware of the burn.
Not until 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 initially comprehend the severity of the burn.
Dr. Robert MacArthur points to the aviation sector as an outstanding case of effective root cause analysis. From its inception, the industry has strived to thoroughly comprehend the reasons behind each negative aviation occurrence rather than just blaming to the pilot. Because of this dedication to understanding root causes, the airline industry boasts impressive 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 "captain of the ship" concept. The unfortunate outcome of this is that the rate of preventable medical errors remains unchanged, and the professional careers and reputations of many healthcare practitioners are unfairly tarnished.
The incidence of surgical errors persists at an worrying rate of one incident per surgeon per career, and up to four incidents per surgeon's career for hand, spine and sports subspecialists.
Dr. Robert MacArthur “Sexual Harassment” Allegations
As of 2023, it is feasible to bring forth false accusations against someone, defame their name and reputation, and face no negative repercussions for the accuser. Regardless if the accused is innocent or guilty, merely making an accusation is enough to cause long-lasting damage to a professional's reputation.
Dr. Bobby MacArthur shared that he elected to leave a clinic specializing in workers' compensation cases because of potential illicit activities on the clinic's management. In retaliation, the clinic manager supposedly collaborated with a patient to make a false accusation, accusing him of "undressing in the clinic and soliciting sexual favors in return for a positive workers' compensation report.
He was informed of this allegation over a year after his departure from the clinic, at which point he insisted on undergoing a lie detector test. The accuser, however, refused to take such a test.
Dr. Rob Mac was later informed that both his polygraph examination results and the accuser's refusal to participate would be deemed inadmissible in court.
The lawyer acting as mediator 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 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 "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 confirm this.
In spite of the information provided earlier, Dr. MacArthur found no means to erase the accuser's claims from Internet search results. Consequently, despite his innocence, the campaign to tarnish his reputation was achieving its goal.
Considering that the claim does not state that Doctor MacArthur was found guilty, it merely serves as a summary of a complaint, which continues to be available to the public
Doctor MacArthur strongly believes that those who make baseless allegations should face penalties equivalent to the severity of the event they falsely claim. To illustrate, he thinks that his false accuser should be classified as a sexual predator and felon.
Doctor MacArthur concluded by thinking about 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 destructive unfounded claims as he has faced.
Dr. MacArthur: A Renowned Orthopedic Surgeon
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