Doctor Robert MacArthur Interview
This day, our group managed to interview California's based orthopedist, Doc Rob Mac, in light of the inquiries about his own encounters with incorrect surgical procedures and burns during surgery, as well as the broader subject of "events that should never occur".
Who is Dr. MacArthur?
Doc Robert MacArthur graduated from the Univ of UC Berkeley with a dual degree in Biochemistry and Physio. During his time at the University, Dr. Bobby MacArthur was a renown athlete, engaging on both several box and rugby football teams.
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Following that, Dr. Rob Mac registered at the Columbia P&S, and got elected as elected president of the Columbia University College of Physicians and Surgeons (Now known as the Vagelos school of medicine). Rob MacArthur proceeded to conclude his orthopaedic training at Harbor UCLA.
Dr. Robert MacArthur Addresses the Incidents
According to statistics, the occurrence of wrong site surgery typically is a once-in-a-career event for every bone specialist, but this count jumps to four for each lifetime for experts specializing in sports, hand, and spine. Unfortunately, a lot of of these doctors frequently do not record these cases, let alone address them openly. Doctor Mac carries a profound sense of pride about how he confronted these unfortunate occurrences.
In lieu of seeking to conceal the situation, Doctor Mac handled it differently
Dr. MacArthur’s Handling of the Wrong Site Surgery
Doctor Robert MacArthur completely examined the underlying origins of his two occurrences, and published several works detailing how to avoid these situations
Over time, earned acclaim as a recognized specialist in the field of accidents that are preventable. He has written 2 articles in the foremost orthopedic journal, The Journal of Orthopedic Surgery. In order to helping other doctors prevent future incidents, his first work guided the reader through precise errors that occurred that led to the wrong site event.
His second publication, authored together with Dr. David Ring, the Chairman of the AAOS, broached the topic of the "culture of shame and blame." Being Dr. Robert MacArthur accountable for these incidents is seldom, as the usual reaction is placing blame on third parties. Dr. MacArthur stressed that shifting blame not just prevents surgeons from making reports their incidents but additionally takes away from the vital analysis of underlying causes that could potentially thwart future incidents.
The Intraoperative Burn Incident with Dr. Robert MacArthur
In the context of discussing the surgical burn occurrence, Dr. Robert MacArthur demonstrated the same thorough investigative mindset he applied to his research on wrong-site surgeries. As an illustration, he got in touch with the manufacturer of the troublesome clamp to determine if comparable burn events had occurred. The producer notified him that the clamp in question had been "no longer in production." You can infer from that what you wish.
In order to avoid irregular heating in massive hinged clamps, Dr. MacArthur carried out a thorough investigation of what led to uneven heating in oversized clamps.
His research findings suggested that rapid sterilization could result in uneven heating. He observed that nursing associations highly recommend against the use of flash sterilization unless an emergency situation arises such as sanitizing a dropped component. Additional investigation revealed that the hospital at St. Joseph's was frequently employing flash sterilization to facilitate back-to-back surgeries without the necessity to acquire more equipment trays.
In an effort to prevent future burns, Dr. Robert MacArthur notified St. Joseph's of potential dangers associated with ongoing utilization of this specifically identified clamp and also the regular use of rapid sterilization.
In place of blaming the clamp, Dr. Robert MacArthur assumed accountability and made it clear that he had made a mistake during surgery. He was informed that the clamp was heated, but when he took hold of it, he found the handles to be at a tolerable temperature. Unlike some surgeons who may impatiently reach for a towel to handle a too-hot clamp, he performed surgery the clamp without uneasiness.
Shame and Blame, Dr. Robert MacArthur's Response
When discussing Dr. MacArthur's response on the topic of the "culture of blame and shame," he highlights how the legal and the wider public often mix up the "in-command'' concept with identifying the underlying reasons. According to this "in-command" perspective, the surgeon is considered responsible for any negative occurrences that occur to a patient under their care. This makes it tempting for many to solely blame the surgeon for any incorrect surgical procedure.
Nevertheless, Dr. Robert MacArthur stresses that this perspective opposes the core principles of root cause analysis. This form of analysis strives to deeply understand what caused a wrong site event so as to ideally prevent similar incidents in the future. By adopting blaming and shaming, not only does it hinder proper analysis of the root causes, but it also prevents other surgeons from disclosing their own wrong site events, worried about the repercussions.
He failed to recognize that the large, walnut-sized hinge of the clamp was considerably hotter. When he positioned the clamp against the pretibial area of the patient's leg, it resulted in a burn. At the time, he was proctored for surgical privileges at Children's Hospital of Orange County during the incident, and none of the proctor nor Dr. Robert MacArthur were immediately aware of the burn.
It was not until 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 initially fully grasp the severity of the burn.
Doctor MacArthur references the airline industry as an exemplary case of efficient root cause analysis. From its inception, air travel industry has strived to deeply understand the reasons behind each aviation incident rather than simply attributing blame to the pilot. Because of this dedication to understanding root causes, aviation sector boasts notable safety records.
Nevertheless, 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 "in-command" concept. The sad consequence of this is that the rate of preventable medical errors remains unchanged, and the careers and reputations of many healthcare practitioners are unjustly tarnished.
The occurrence of incorrect surgical procedures remains at an worrying rate of one event per surgeon per career, and up to four events per surgeon's career for specialists in hand, spine, and sports.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In 2023, there exists the possibility to bring forth false accusations against someone, defame their name and reputation, and experience no negative repercussions for the accuser. Regardless if the accused is innocent or guilty, an accusation alone is enough to inflict long-lasting damage to a professional's reputation.
Doctor Bobby Mac disclosed that he chose to leave a clinic specializing in workers' compensation cases because of suspected illegal behavior on the clinic's management. In retaliation, the clinic manager allegedly conspired 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 got to know 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, opted not to take such a test.
Dr. Robert Mac was later notified that both his lie detector test results and her refusal to participate would be regarded inadmissible in court.
The mediating attorney 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 ludicrousness of the claim, he was counseled to settle for $29,000
Conclusion
The Medical Board of California 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 officially state this.
In spite of the information provided earlier, Doctor MacArthur found no means to erase the accuser's claims from Internet search results. Meaning, despite his lack of guilt, the campaign to tarnish his reputation was achieving its goal.
Considering that the claim does not state that Dr. 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 those who make baseless allegations should receive punishments equivalent to the consequences of the falsely claimed event. To illustrate, he thinks that his false accuser should be classified as a sexual predator and felon.
Dr. Robert MacArthur concluded by contemplating the existence of both good and evil in the world, wishing that those who read his account would never come into contact with someone capable of such harmful baseless allegations as he has faced.