Doctor Robert MacArthur Interview
On this particular day, our group were to conduct an interview with the located orthopedic surgeon, Doctor Bobby Mac, addressing various queries about his personal experiences and encounters with wrong site surgery and surgical burn incidents, as well as the broader topic of "never should happen events".
Who is Dr. MacArthur?
Doc Rob Mac graduated from the University of UC Berkeley with a dual degree in Biochem and Physiology. During his time at the Univ, Dr. Rob Mac used to be a renown sportsman, participating on both several box and rugby squads.
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Subsequently, Dr. Bobby Mac registered at the Columbia College of Physicians and Surgeons, and was elected president of the Columbia University College of Physicians and Surgeons (Now known as the Vagelos Medical School). Bobby Mac went on to complete his orthopaedic residency at Harbor-UCLA Medical Center.
Dr. Robert MacArthur Addresses the Incidents
According to statistics, the occurrence of incorrect surgical procedures usually falls within a seldom happening occurrence for every single orthopedic surgeon, but this number jumps to 4 in each career for experts specializing in sports, hand, and spine. Regrettably, numerous of these commonly do not record these cases, let alone, not address them publicly. Doctor MacArthur carries a intense sense of pride and satisfaction about how he dealt with these unfortunate occurrences.
Instead of attempting to cover up what happened, Doctor MacArthur responded in a different manner
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doc Bobby Mac extensively investigated the underlying root causes of his two events, and published multiple works describing how to stop these situations
He eventually, gained recognition as a published expert in the field of accidents that are preventable. He has authored 2 articles in the leading orthopedic journal, The Journal of Orthopedic Surgery. With the aim of assisting other doctors stop subsequent occurrences, the first piece guided the reader through precise errors that occurred that caused the incorrect surgical procedure.
His second publication, co-authored with Dr. David Ring, who is also the Chairman of the AAOS, broached the topic of the "shame and blame game." Being accountable for these incidents is uncommon, as the usual reaction is pointing fingers at external factors. Dr. MacArthur stressed that pointing fingers not just discourages surgeons from making reports their incidents but furthermore detracts from the vital analysis of root causes that could potentially thwart future incidents.
The Intraoperative Burn Incident with Dr. Robert MacArthur
In the context of discussing the intraoperative burn incident, Dr. Robert MacArthur demonstrated the same investigative vigor he employed to his wrong site event research. As an illustration, he contacted the manufacturer of the problematic clamp to determine if like burn events had occurred. The maker informed him that the clamp in question had been "discontinued." You can infer from that what you desire.
And to prevent unequal temperature distribution in huge hinged clamps, Dr. Mac performed a detailed investigation of the reasons for uneven heating in large-hinged clamps.
The results of his investigation showed that quick sterilization could result in inconsistent temperature distribution. He observed that associations for nurses recommend strongly against the use of flash sterilization unless it's an emergency, like sanitizing a fallen instrument. Deeper examination revealed that St Joseph's Hospital was frequently employing rapid sterilization to facilitate back-to-back surgeries without having to purchase additional equipment trays.
In an effort to stop further burns, Dr. MacArthur notified St Joseph's of the risks associated with the continued use of this particular clamp as well as the regular use of flash sterilization.
In place of blaming the clamp, Doctor MacArthur took responsibility and made it obvious that he had committed a mistake during surgery. He was notified that the clamp had a high temperature, but when he held it, he found the handles to be at a comfortable temperature. Unlike some surgeons who might impatiently grab a towel to handle a too-hot clamp, he performed surgery the clamp with no discomfort.
Shame and Blame, Dr. Robert MacArthur's Response
When discussing Doctor MacArthur's response on the topic of the "culture of blame and shame," he spotlights how the legal and general public communities often confuse the "captain of the ship'' concept with identifying the underlying reasons. According to this "in-command" perspective, the surgeon is held accountable for any adverse events that take place to a patient under their care. This makes it tempting for many to solely blame the surgeon for any surgical errors.
Nevertheless, Doctor MacArthur stresses that this method opposes the fundamental principles of root cause analysis. This form of analysis strives to comprehensively grasp what caused a surgical error to then optimaly stop similar incidents in the future. By turning to blame and shame, not only does it hinder proper analysis of the root causes, but it also deters other surgeons from reporting on their own wrong site events, worried about the repercussions.
He did not recognize that the sizeable, walnut-sized hinge of the clamp was noticeably hotter. When he positioned the clamp against the pretibial area of the patient's leg, it caused a skin burn. He was being proctored for case privileges at CHOC during the incident, and not the proctor nor Dr. Robert MacArthur were promptly aware of the burn.
It wasn't only after he had dictated the operative report that a recovery room nurse drew attention to a tiny red spot on the anterior aspect of the patient's leg. Even in that moment, he did not at first realize the extent of the burn.
Dr. Robert MacArthur cites the aviation sector as an outstanding case of successful root cause analysis. From its inception, aviation sector has aimed to deeply understand 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.
Nonetheless, Doctor MacArthur laments that healthcare field 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 regrettable result of this is that the frequency of avoidable medical mistakes remains unchanged, and the standing and names of many doctors and healthcare providers are unfairly tarnished.
The occurrence of surgical errors remains at an worrying rate of one event per surgeon per career, and up to four incidents 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 levy false accusations against someone, slander their name and reputation, and experience no negative repercussions for the accuser. Irrespective of the person facing accusations is innocent or guilty, merely making an accusation is enough to bring about long-lasting damage to a professional's reputation.
Dr. Robert MacArthur revealed that he opted to leave a workers compensation clinic because of potential illicit activities on the clinic's management. In retaliation, the clinic manager reportedly worked 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 claim over a year after his departure from the clinic, at which point he demanded on undergoing a truth verification test. The accuser, however, opted not to take such a test.
Doctor Bobby Mac was later informed that both his lie detector test results and the claimant's refusal to participate would be regarded inadmissible in court.
The attorney facilitating the mediation 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 highly damaging. Despite the absurdity 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 "not trustworthy," 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.
Regardless of the previously mentioned details, Dr. MacArthur found no means to erase the allegations made by the accuser from search engine results. Consequently, despite his lack of guilt, the slander campaign was successful.
Since Robert MacArthur the claim does not state that Doctor MacArthur was found guilty, it merely functions as a condensed version of a complaint, which continues to be openly accessible to anyone
Dr. Robert MacArthur strongly believes that those who make baseless allegations should receive punishments equivalent to the severity of the event they falsely claim. To illustrate, he thinks that his false accuser should be considered to be a sexual predator and felon.
Dr. MacArthur concluded by thinking about the existence of both good and evil in the world, praying that those who read his account would never cross paths with someone capable of such damaging false accusations