Doctor Robert MacArthur Interview
This day, our team managed to conduct an interview with California's resident orthopedist, Doctor Bobby MacArthur, addressing various questions about his own encounters with surgical errors and burns during surgery, as well as a topic of "unexpected occurrences that must be avoided".
Who is Dr. MacArthur?
Doctor Rob MacArthur graduated from the University of Cal Berkeley with a dual degree in Biochem and Physiology. Throughout his time at the Univ, Doc Robert MacArthur was a renown sportsman, engaging on both several box and Rugby groups.
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Afterwards, Dr. Bobby MacArthur registered at the Columbia College of Physicians and Surgeons, and got elected as elected leader of the Columbia University College of Physicians and Surgeons (Now known as the Vagelos Medical School). Bobby Mac went on to finish his orthopaedic residency at Harbor-UCLA Medical Center.
Dr. Robert MacArthur Addresses the Incidents
Statistically, the frequency of wrong site surgery tends to be a seldom happening occurrence for every bone specialist, but this figure increases to four per professional career for experts specializing in sports, hand, and spine. Sadly, numerous of these surgeons frequently do not document these occurrences, let alone talk about them publicly. Doc MacArthur carries a intense sense of pride about how he dealt with these terrible occurrences.
Instead of trying to conceal what happened, Doc Mac responded in a different manner
Dr. MacArthur’s Handling of the Wrong Site Surgery
Dr. Rob Mac extensively looked into the underlying root causes of his dual occurrences, and put out several works detailing how to stop such events
Over time, became acknowledged as a published expert in the field of preventable accidents. He's written a couple of articles in the leading orthopedic journal, The Journal of the American Academy of Orthopedic Surgeons. In order to assisting other doctors stop future incidents, the first piece guided the reader through precise errors that occurred that caused the incorrect surgical procedure.
The follow-up article, jointly written with Dr. David Ring, the Chairman of the AAOS, tackled the topic of the "culture of shame and blame." Taking responsibility for these incidents is uncommon, as the tempting course of action is placing blame on other parties. Dr. MacArthur stressed that shifting blame not just prevents surgeons from disclosing their incidents but additionally diverts from the essential analysis of primary reasons that may prevent upcoming events.
The Intraoperative Burn Incident with Dr. Robert MacArthur
In the context of discussing the incident of burns during surgery, Dr. MacArthur demonstrated the same dedicated investigative approach he utilized to his research on wrong-site surgeries. For example, he reached out to the maker of the problematic clamp to ascertain if comparable burn events had happened. The producer 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 massive hinged clamps, Doc MacArthur conducted a detailed investigation of the causes behind inconsistent heating in oversized clamps.
His findings indicated that rapid sterilization could Robert MacArthur cause uneven heating. He pointed out that nursing organizations strongly advise against the use of flash sterilization unless there's an urgent need like sterilizing a fallen instrument. Additional investigation revealed that St Joseph's Hospital was frequently utilizing rapid sterilization to enable back-to-back surgeries without the necessity to buy extra equipment trays.
With the aim to stop further burns, Doctor MacArthur notified St. Joseph's of the hazards associated with ongoing utilization of this specifically identified clamp and the routine deployment of quick sterilization.
Instead of blaming the clamp, Dr. MacArthur accepted responsibility and made it obvious that he had made a mistake during surgery. He was notified that the clamp had a high temperature, 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 handle a too-hot clamp, he performed surgery the clamp without uneasiness.
Shame and Blame, Dr. Robert MacArthur's Response
Regarding The perspective of Dr. MacArthur on response on the topic of the "culture of blame and shame," he emphasizes how the legal and the wider public often conflate the "captain of the ship'' concept with analyzing the fundamental causes. According to this "in-command" perspective, the surgeon is responsible for any unfavorable outcomes that occur to a patient under their care. This makes it appealing for many to only blame the surgeon for any surgical errors.
Nevertheless, Dr. Robert MacArthur emphasizes that this perspective contradicts the principles of root cause analysis. This form of analysis aims to comprehensively grasp what caused a wrong site event in order to optimaly stop similar incidents in the future. By turning to shaming and blaming, not only does it hinder proper analysis of the root causes, but it also deters other surgeons from reporting their personal wrong site events, worried about the repercussions.
He didn't recognize that the sizeable, walnut-sized hinge of the clamp was significantly 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 none of the proctor nor Dr. Robert MacArthur were promptly aware of the burn.
It wasn't until after he had dictated the operative report that a recovery room nurse noticed a tiny red spot on the anterior aspect of the patient's leg. Even in that moment, he did not at first realize the seriousness of the burn.
Dr. MacArthur references the air travel industry as an outstanding case of efficient root cause analysis. From its inception, air travel industry has strived to thoroughly comprehend the reasons behind each adverse aviation event rather than just blaming to the pilot. Because of this focus on understanding root causes, aviation sector boasts notable safety records.
Nevertheless, Dr. MacArthur laments that medical profession 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 sad consequence of this is that the incidence of preventable healthcare errors remains unchanged, and the professional careers and reputations of many doctors and healthcare providers are unjustly tarnished.
The frequency of surgical errors remains at an worrying rate of a single occurrence per surgeon per career, and as many as four incidents per surgeon's career for hand, spine and sports subspecialists.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In the year 2023, it is possible to bring forth false accusations against someone, defame their name and reputation, and face no negative repercussions for the accuser. Irrespective of the individual being accused is innocent or guilty, an accusation alone is enough to cause long-lasting damage to a professional's reputation.
Doctor Robert Mac shared that he chose to leave a workers compensation clinic because of possible unlawful practices on the clinic's management. In retaliation, the manager of the clinic reportedly worked with a client 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 received information 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.
Doc Bobby Mac was later notified that both his polygraph examination 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 extremely detrimental. Despite the ludicrousness of the claim, he was counseled to settle for $29,000
Conclusion
The California 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 information provided earlier, Dr. MacArthur found no means to remove the allegations made by the accuser from online search listings. Meaning, despite his clear conscience, the slander campaign was successful.
Considering that the claim does not state that Doctor MacArthur was found guilty, it merely functions as a brief description 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 considered to be a sex offender and felon.
Dr. Robert MacArthur concluded by contemplating the existence of both good and evil in the world, hoping that those who read his account would never cross paths with someone capable of such harmful baseless allegations as he has faced.