Doctor Robert MacArthur Interview
This day, our team were able to conduct an interview with California's based bone specialist, Dr. Rob Mac, in response to the questions about his experiences with surgical errors and intraoperative burn, as well as the broader topic of "events that should never occur".
Who is Dr. MacArthur?
Dr. Bobby MacArthur completed his studies from the Univ of UC Berkeley with a dual degree in Biochemistry and Physiology. Throughout his time at the University, Doc Robert Mac had been a renown player, participating on both several combat sports and rugby football groups.
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Following that, Doctor Robert Mac registered at the Columbia College of Physicians and Surgeons, and was the president of the Columbia P&S (Now known as the Vagelos School of Medicine). Rob MacArthur continued to complete his orthopaedic residence at Harbor UCLA.
Dr. Robert MacArthur Addresses the Incidents
Statistically, the incidence of wrong site surgery usually falls within a one-time event in a career for every orthopedist, but this figure increases to fourfold in each professional career for sports, hand, and spine specialists. Unfortunately, a lot of of these doctors often do not report these cases, let alone discuss them freely. Dr. Mac carries a profound sense of pride and satisfaction about how he faced these unfortunate occurrences.
Rather than seeking to cover up the situation, Doc Mac responded in a different manner
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doc Rob Mac completely examined the fundamental origins of his 2 occurrences, and released multiple works describing how to stop such events
Over time, earned acclaim as a published expert in the field of accidents that are preventable. He's penned 2 articles in the foremost orthopedic journal, The Journal of the American Academy of Orthopedic Surgeons. To helping other doctors prevent future incidents, the first piece led the reader through the specific errors that occurred that led to the wrong site event.
The second paper, jointly written with Dr. David Ring, who is also the Chairman of the AAOS, broached the topic of the "tendency to shame and blame." Being accountable for these incidents is uncommon, as the tempting course of action is blaming third parties. Dr. MacArthur stressed that accusations not just deters surgeons from making reports their incidents but furthermore detracts from the vital analysis of underlying causes that might avert future incidents.
The Intraoperative Burn Incident with Dr. Robert MacArthur
When discussing the intraoperative burn incident, Dr. Robert MacArthur demonstrated the same thorough investigative mindset he utilized to his research on wrong-site surgeries. To illustrate, he contacted the manufacturer of the faulty clamp to Dr. Robert MacArthur ascertain if like burn events had happened. The manufacturer notified him that the clamp in question had been "discontinued." You can infer from that what you will.
To avert irregular heating in large hinged clamps, Dr. MacArthur performed a comprehensive investigation of what led to uneven heating in big-hinged clamps.
His research findings suggested that quick sterilization could lead to uneven heating. He noted that associations for nurses strongly advise against the use of quick sterilization unless there's an urgent need for instance, disinfecting a fallen instrument. Additional investigation revealed that St Joseph's Hospital was frequently using rapid sterilization to ease back-to-back surgeries without needing to acquire more equipment trays.
With the aim to avoid future burn incidents, Dr. Robert MacArthur alerted St Joseph's of potential dangers associated with the continued use of this particular clamp and also the regular use of rapid sterilization.
Instead of blaming the clamp, Dr. MacArthur took responsibility and made it evident 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 comfortable temperature. In contrast to some surgeons who could impatiently use a towel to handle a too-hot clamp, he operated the clamp without uneasiness.
Shame and Blame, Dr. Robert MacArthur's Response
When discussing Dr. MacArthur's response on the topic of the "shame and blame game," he emphasizes how the legal and public communities often mix up the "captain of the ship'' concept with root cause analysis. According to this "in-command" perspective, the surgeon is considered responsible for any adverse events that take place to a patient under their care. This makes it enticing for many to exclusively blame the surgeon for any surgical errors.
Nonetheless, Doctor MacArthur stresses that such an approach contradicts the core principles of investigating root causes. This form of analysis intends to comprehensively grasp what caused a wrong site event to then preferably stop similar incidents in the future. By adopting shaming and blaming, not it not just hamper proper analysis of the root causes, but it additionally discourages other surgeons from disclosing their own wrong site events, afraid of the repercussions.
He failed to recognize that the sizeable, walnut-sized hinge of the clamp was considerably 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 surgical privileges at Children's Hospital of Orange County during the incident, and none of the proctor nor Dr. Robert MacArthur were right away aware of the burn.
It was not only after he had dictated the operative report that a nurse in the recovery ward drew attention to a small red area on the anterior aspect of the patient's leg. Even at that point, he did not at first realize the severity of the burn.
Dr. MacArthur cites the aviation sector as an exemplary case of successful root cause analysis. From its inception, the industry has sought to comprehensively grasp the reasons behind each aviation incident rather than simply attributing blame to the pilot. Because of this commitment to understanding root causes, aviation sector boasts impressive safety records.
Nevertheless, Dr. 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 unfortunate outcome of this is that the rate of preventable medical errors remains unchanged, and the professional careers and reputations of many medical professionals are unjustly tarnished.
The occurrence of incorrect surgical procedures continues at an alarming rate of a single occurrence per surgeon per career, and as many as four events per surgeon's career for hand, spine and sports subspecialists.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In the year 2023, it is feasible to levy false accusations against someone, defame their name and reputation, and experience no negative repercussions for the accuser. Regardless of whether the individual being accused is innocent or guilty, merely making an accusation is enough to inflict long-lasting damage to a professional's reputation.
Doc Robert MacArthur shared that he opted to leave a clinic specializing in workers' compensation cases because of potential illicit activities on the clinic's management. In retaliation, the manager of the clinic allegedly collaborated 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 allegation over a year after his departure from the clinic, at which point he demanded on undergoing a polygraph examination. The accuser, however, opted not to take such a test.
Doc Rob MacArthur was later informed that both his lie detector test results and the accuser's refusal to participate would be regarded inadmissible in court.
The lawyer acting as mediator 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
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 officially state this.
Regardless of the previously mentioned details, Doctor MacArthur found no means to remove the allegations made by the accuser from search engine results. Meaning, despite his clear conscience, the campaign to tarnish his reputation was successful.
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 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 predator of a sexual nature and felon.
Dr. MacArthur concluded by reflecting on the existence of both good and evil in the world, wishing that those who read his account would never cross paths with someone capable of such destructive unfounded claims as he has faced.