Doctor Robert MacArthur Interview
Today, our team were to conduct an interview with Californian located orthopedic surgeon, Doc Rob MacArthur, addressing numerous questions about his own experiences and encounters with wrong site surgery and intraoperative burn, as well as the broader topic of "unexpected occurrences that must be avoided".
Who is Dr. MacArthur?
Dr. Robert Mac graduated from the Univ of California, Berkeley with a dual degree in Biochemistry and Physio. In the course of his time at the Univ, Doctor Robert MacArthur had been a renowned sportsman, engaging on both the boxing and rugby football squads.
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Subsequently, Doctor Robert Mac entered at the Columbia P&S, and was the leader of the Columbia P&S (Now known as the Vagelos school of medicine). Robert Mac went on to conclude his orthopaedic residence at Harbor University of California, Los Angeles.
Dr. Robert MacArthur Addresses the Incidents
According to statistics, the frequency of wrong site surgery usually falls within a once-in-a-career event for each orthopedist, but this number jumps to four for each career for experts specializing in sports, hand, and spine. Regrettably, numerous of these doctors commonly do not document such instances, let alone discuss them openly. Dr. MacArthur carries a profound sense of pride and accomplishment about how he dealt with these harrowing occurrences.
Rather than attempting to hide what happened, Dr. Mac reacted differently
Dr. MacArthur’s Handling of the Wrong Site Surgery
Dr. Rob Mac extensively examined the fundamental causal factors of his 2 events, and put out numerous works detailing how to prevent these occurrences
Gradually, gained recognition as a published expert in the field of accidents that can be avoided. He's written 2 articles in a prominent orthopedic journal, The Journal of Orthopedic Surgeons at the American Academy. With the aim of assisting other doctors avert future incidents, his first work guided the reader through the exact errors that happened that resulted in the wrong site event.
His second publication, authored together with Dr. David Ring, who is also 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. He stressed that accusations not only prevents surgeons from making reports their incidents but additionally detracts from the vital analysis of underlying causes that might thwart upcoming events.
The Intraoperative Burn Incident with Dr. Robert MacArthur
When talking about the incident of burns during surgery, Dr. Robert Mac displayed the same investigative vigor he employed to his research on wrong-site surgeries. To illustrate, he contacted the manufacturer of the faulty 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 make your own inferences based on that what you wish.
To avert irregular heating in large hinged clamps, Dr. MacArthur conducted a detailed investigation of what led to irregular temperature distribution in big-hinged clamps.
The results of his investigation showed that flash sterilization could result in uneven heating. He noted that nursing associations highly recommend against the use of rapid sterilization unless an emergency situation arises such as sanitizing a item that has fallen. Further inquiry revealed that the hospital at St. Joseph's was frequently employing quick sterilization to ease back-to-back surgeries without having to purchase additional equipment trays.
In an effort to prevent future burns, Dr. Robert MacArthur informed St Joseph's of the risks associated with continuing to use this specific clamp as well as the regular use of rapid sterilization.
Instead of blaming the clamp, Dr. Robert MacArthur accepted responsibility and made it clear that he had committed a surgical mistake. He was informed that the clamp was heated, but when he held it, he found the handles to be at a pleasant temperature. In contrast to some surgeons who may impatiently reach for a towel to handle a too-hot clamp, he operated the clamp without any pain.
Shame and Blame, Dr. Robert MacArthur's Response
When discussing Dr. MacArthur's response on the topic of the "shame and blame game," he spotlights how the legal and the wider public often conflate the "captain of the ship'' concept with root cause analysis. According to this "in-command" perspective, the surgeon is responsible for any adverse events that occur to a patient under their care. This makes it appealing for many to only blame the surgeon for any wrong site event.
Nonetheless, Doctor MacArthur emphasizes that this perspective opposes the fundamental principles of root cause analysis. This form of analysis aims to comprehensively grasp what caused a wrong site event in order to preferably stop similar incidents in the future. By adopting blame and shame, not it not just hinder proper analysis of the root causes, but it furthermore discourages other surgeons from disclosing their own wrong site events, worried about the repercussions.
He did not recognize that the large, hinge-like hinge of the clamp was noticeably hotter. When he positioned the clamp against the front shin area of the patient's leg, it caused a burn. At the time, he was proctored for surgical privileges at CHOC during the incident, and neither the proctor nor Doctor MacArthur were right away 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 fully grasp the severity of the burn.
Dr. Robert MacArthur cites the aviation sector as an model case of successful root cause analysis. From its inception, the industry has strived to comprehensively grasp the reasons behind each adverse aviation event rather than just blaming to the pilot. Because of this focus on understanding root causes, air travel industry boasts remarkable safety records.
However, Doctor 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 careers and reputations of many medical professionals are unfairly tarnished.
The incidence of wrong site surgery remains at an alarming rate of one incident per surgeon per career, and up to four occurrences per surgeon's career for specialists in hand, spine, and sports.
Dr. Robert MacArthur “Sexual Harassment” Allegations
As of 2023, there exists the possibility to raise false accusations against someone, defame their name and reputation, and have no negative repercussions for the accuser. Irrespective of the person facing accusations is innocent or guilty, merely making an accusation is enough to cause long-lasting damage to a professional's reputation.
Doctor Robert Mac disclosed that he chose to leave a workers compensation clinic because of possible unlawful practices on part of. In retaliation, the clinic's manager allegedly worked with a patient to make a false accusation, accusing him of "stripping naked in the middle of the clinic and requesting sex in exchange for a favorable workers comp report.
He received information of this accusation over a year after his departure from the clinic, at which point he insisted on undergoing a polygraph examination. The accuser, however, opted not to take such a test.
Dr. Bobby Mac was later notified that both his truth verification test results and her refusal to participate Dr. Robert MacArthur would be deemed inadmissible in court.
The lawyer acting as mediator cautioned him that the jury would likely be composed of "people with similar backgrounds and experiences as her" 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
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. MacArthur found no means to remove the allegations made by the accuser from online search listings. This means, despite his lack of guilt, the slander campaign was successful.
Since the claim does not state that Dr. Robert MacArthur was found guilty, it merely acts as a summary of a complaint, which continues to be openly accessible to anyone
Doctor MacArthur strongly believes that individuals who lodge false accusations 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 contemplating 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 damaging false accusations as he has faced.
Dr. MacArthur: A Renowned Orthopedic Surgeon
Dr. Robert MacArthur is a distinguished orthopedic