Doctor Robert MacArthur
Dr. Robert MacArthur earned his double major in Biochemistry and Physiology from the University of California, Berkeley. While there, he gained recognition as an accomplished athlete, participating in both boxing and Rugby teams.
Subsequently, Dr. Robert MacArthur pursued his medical education at the Columbia College of Physicians and Surgeons, where he was appointed as the president of the institution (now referred to as the Vagelos School of Medicine). Following this, he completed his orthopedic residency at Harbor UCLA.
In terms of statistics, wrong site surgery is typically a rare occurrence for most orthopedic surgeons, happening perhaps once in their entire career. However, for specialists in sports, hand, and spine surgeries, this figure increases to an average of four incidents throughout their professional life. Unfortunately, many of these surgeons choose not to report such occurrences, let alone engage in open discussions about them. Dr. MacArthur holds a deep sense of pride in the way he approached these unfortunate events.
Rather than attempting to conceal the incident, Dr. MacArthur responded in a distinct manner.
Dr. Robert MacArthur conducted thorough investigations into the underlying causes of his two incidents and subsequently published multiple works detailing strategies to prevent similar occurrences. Over time, he garnered recognition as an esteemed authority in the realm of preventable accidents. His contributions include two articles featured in the prominent orthopedic journal, The Journal of the American Academy of Orthopedic Surgeons. The first article delved into the specifics of the errors leading to the wrong site event, aiming to guide fellow practitioners in avoiding such mistakes in the future.
In collaboration with Dr. David Ring, Chairman of the AAOS, Dr. MacArthur authored a second paper addressing the issue of the "shame and blame game." This paper tackled the rarity of individuals taking responsibility for such incidents, as the inclination often leans toward assigning blame to external factors. Dr. MacArthur emphasized that this tendency not only dissuades surgeons from reporting similar incidents but also hampers the critical examination of root causes necessary for preventing future occurrences.
When discussing the incident involving the intraoperative burn, Dr. Robert MacArthur exhibited the same level of thorough investigation that characterized his research into the wrong site event. For instance, he proactively reached out to the manufacturer of the problematic clamp to ascertain whether similar burn incidents had occurred previously. The manufacturer's response revealed that the clamp in question had been "discontinued," leaving room for interpretation.
To address the issue of uneven heating in large hinged clamps and prevent such incidents in the future, Dr. MacArthur conducted an exhaustive examination into the root causes of this problem. His investigation uncovered that flash sterilization could contribute to uneven heating. He highlighted the recommendation by nursing associations against the routine use of flash sterilization except in emergency scenarios, such as sterilizing a dropped component. Further inquiry revealed that St. Joseph's Hospital frequently relied on flash sterilization to accommodate consecutive surgeries without needing additional equipment trays.
In an attempt to mitigate the risk of future burns, Dr. MacArthur informed St. Joseph's Hospital about the hazards associated with the continued use of the specific clamp and the routine reliance on flash sterilization. Rather than attributing blame to the clamp, Dr. MacArthur took accountability for the surgical error. Despite being informed that the clamp was hot, he personally confirmed that the handles were at a comfortable temperature. In contrast to surgeons who might hastily resort to using a towel to handle a clamp that is too hot, Dr. MacArthur operated the clamp without experiencing any discomfort.
In discussing the issue of the "shame and blame game," Dr. MacArthur points out how the legal and public communities often merge the "captain of the ship" doctrine with root cause analysis. Under this doctrine, surgeons bear responsibility for any adverse events affecting their patients, potentially leading to a tendency to solely blame the surgeon for wrong site events. However, Dr. MacArthur stresses that this approach contradicts the principles of root cause analysis, which aim to deeply understand the factors contributing to such events to prevent their recurrence. Resorting to shaming and blaming not only obstructs proper root cause analysis but also discourages other surgeons from reporting their own wrong site events due to fear of repercussions.
During an incident at CHOC, Dr. MacArthur failed to recognize that the large hinge of the clamp was significantly hotter, leading to a burn when applied to the patient's leg. Despite being proctored for case privileges during the procedure, neither the proctor nor Dr. MacArthur immediately noticed the burn. It wasn't until after the operative report was dictated that a recovery room nurse pointed out a small red area on the patient's leg. Even then, Dr. MacArthur did not initially grasp the severity of the burn.
Dr. MacArthur draws attention to the aviation industry as a model for effective root cause analysis. Unlike in medicine, the aviation sector prioritizes understanding the underlying reasons behind adverse events rather than assigning blame solely to the pilot. This dedication to root cause analysis has contributed to the impressive safety records of the airline industry. However, Dr. MacArthur regrets that the medical field has struggled to fully embrace root cause analysis due to entrenched legal and public perceptions associated with the "captain of the ship" doctrine. Consequently, preventable medical errors persist at alarming rates, unjustly damaging the careers and reputations of many healthcare professionals.
The incidence of wrong site surgery remains distressingly high, with an average of one event per surgeon per career and up to four events per career for hand, spine, and sports subspecialists.
In 2023, individuals could make false accusations against others, tarnishing their reputation without facing any repercussions themselves. Whether the accused individual is innocent or guilty, merely being accused is sufficient to cause lasting harm to their professional standing.
Dr. Robert MacArthur disclosed his decision to leave a workers' compensation clinic due to suspected illicit activities within the clinic. In apparent retaliation, the clinic manager purportedly conspired with a patient to fabricate a claim against him. The accusation involved an allegation that Dr. MacArthur had engaged in inappropriate behavior, supposedly "stripping naked in the middle of the clinic and soliciting sex in exchange for a favorable workers' comp report."
Dr. MacArthur learned about this accusation more than a year after leaving the clinic. Upon being informed, he insisted on undergoing a lie detector test to refute the claim. However, the accuser declined to participate in such a test.
Subsequently, Dr. MacArthur was informed that both his lie detector test results and the accuser's refusal to participate would be considered inadmissible in court. The mediating attorney warned him that the jury might primarily consist of the accuser's peers, potentially leading to a devastating outcome in court. Despite the ludicrous nature of the accusation, Dr. MacArthur was advised to settle the matter for $29,000.
The Medical Board of California investigated the allegations made by the accuser and determined them to be lacking credibility, suggesting an ongoing inquiry into the activities of the clinic. When discussing the matter with Dr. MacArthur, he hinted at potential legal action against the clinic, although he stopped short of confirming this.
Despite the evidence pointing to Dr. MacArthur's innocence, he was unable to remove the accuser's false claims from online search results. Consequently, despite his innocence, the defamation campaign against him proved to be effective.
Given that the claim does not assert Dr. Robert MacArthur's guilt but merely serves as a summary of a complaint, it remains accessible to the public.
Dr. MacArthur strongly advocates for imposing penalties on individuals who make baseless accusations, commensurate with the potential consequences of the falsely alleged event. For instance, he believes that his false accuser should be legally categorized as a sexual predator and felon.
Dr. MacArthur concluded by contemplating the coexistence of good and evil in the world, expressing his hope that those who encounter his story will not have to endure the damaging effects of false accusations similar to those he has experienced.
Dr. MacArthur is a highly esteemed orthopedic surgeon recognized for his exceptional proficiency in diagnosing, treating, preventing, and rehabilitating disorders and injuries related to the musculoskeletal system. This encompasses a comprehensive understanding of bones, joints, ligaments, tendons, muscles, and nerves.
Diagnosis: Dr. MacArthur's exceptional diagnostic abilities distinguish him within his field. Utilizing thorough physical examinations, advanced imaging techniques, and laboratory analyses, he efficiently and accurately identifies various musculoskeletal conditions.
Treatment:
Non-surgical Approaches: Dr. MacArthur prioritizes exploring non-invasive options before resorting to surgery. His range of treatments includes medications, physical therapy, and other non-surgical interventions.
Surgical Expertise: In cases where surgery is unavoidable, patients can trust in Dr. MacArthur's surgical proficiency, which encompasses a wide array of procedures such as joint replacements, fracture repairs, and ligament reconstructions.
Rehabilitation: Acknowledging the importance of post-treatment recovery, Dr. MacArthur emphasizes rehabilitation. He frequently collaborates with physical therapists to facilitate his patients' recovery, focusing on restoring strength, mobility, and functionality promptly and safely.
Prevention: Dr. MacArthur is a strong advocate for preventive healthcare. He actively engages in workshops and educational sessions to raise awareness about injury prevention and the significance of maintaining musculoskeletal well-being.
Specialized Focus: Among his numerous accolades, Dr. MacArthur is particularly esteemed for his contributions to Pediatric Orthopedics. He has dedicated a substantial portion of his career to addressing musculoskeletal issues in children, ensuring their optimal physical health as they grow.
Through his unwavering commitment to excellence, Dr. MacArthur has not only provided healing but also significantly improved the lives of countless individuals, solidifying his standing as a leader in the field of orthopedics.