Dr. Robert MacArthur
Doctor Robert MacArthur earned a dual degree in Biochemistry and Physiology from the University of California, Berkeley. Throughout his tenure there, he gained recognition as a skilled athlete, participating in both boxing and Rugby teams.
Subsequently, Doctor Robert MacArthur joined the Columbia College of Physicians and Surgeons, where he later became the president of the institution (now recognized as the Vagelos School of Medicine). He pursued his orthopedic residency at Harbor UCLA following his time at Columbia P&S.
Typically, wrong-site surgeries occur as a rare event in the career of an orthopedic surgeon, but specialists in sports, hand, and spine surgeries may encounter up to four such incidents throughout their careers. Unfortunately, many of these professionals choose not to report or openly address such occurrences. Dr. MacArthur, however, holds a deep sense of pride in how he confronted these unfortunate situations. Rather than attempting to conceal the incident, he responded differently.
Dr. Robert MacArthur conducted thorough investigations into the underlying causes of his two incidents and subsequently authored multiple publications outlining strategies for preventing such occurrences. Through his efforts, he became recognized as an expert in the field of preventable accidents, publishing two articles in the prominent orthopedic journal, The Journal of the American Academy of Orthopedic Surgeons. The first article aimed to guide readers through the specific errors that led to the wrong-site event, with the intention of assisting other medical practitioners in preventing similar incidents.
His second publication, co-authored with Dr. David Ring, Chairman of the AAOS, addressed the issue of the "shame and blame game." In this paper, Dr. MacArthur highlighted the rarity of surgeons taking responsibility for such incidents, as it is often more tempting to assign blame to other parties. He emphasized that this tendency not only discourages surgeons from reporting incidents but also hinders the critical analysis of root causes necessary for preventing future occurrences.
When addressing the incident of intraoperative burn, Dr. Robert MacArthur exhibited the same level of investigative determination as he did in his research on wrong-site events. For instance, he proactively contacted the manufacturer of the problematic clamp to inquire about any similar burn incidents. The manufacturer's response indicated that the clamp in question had been discontinued, leaving room for interpretation.
In order to mitigate uneven heating in large hinged clamps, Dr. MacArthur conducted a comprehensive investigation into the root causes of this issue. His research revealed that flash sterilization could contribute to uneven heating, a practice discouraged by nursing associations unless under emergency circumstances such as sterilizing a dropped component. Further investigation uncovered that St. Joseph's Hospital frequently utilized flash sterilization to facilitate consecutive surgeries without acquiring additional equipment trays.
In an effort to prevent future burn incidents, Dr. MacArthur alerted St. Joseph's Hospital to the risks associated with both the specific clamp and the routine use of flash sterilization. Rather than assigning blame to the clamp, he took responsibility for the surgical error. Despite being informed that the clamp was hot, Dr. MacArthur personally assessed its temperature and found the handles to be comfortable. In contrast to some surgeons who might hastily use a towel to handle a hot clamp, he operated the clamp without experiencing any discomfort.
In discussing the issue of the "shame and blame game," Dr. MacArthur underscores how both legal and public communities often confuse the "captain of the ship" doctrine with root cause analysis. According to this doctrine, surgeons are deemed responsible for any adverse events occurring to patients under their care, leading many to exclusively blame surgeons for wrong-site events. However, Dr. MacArthur argues that this approach contradicts the principles of root cause analysis, which aim to thoroughly understand the causes of such events to prevent their recurrence. By resorting to blame and shame, not only does it impede proper root cause analysis, but it also discourages surgeons from reporting wrong-site events due to fear of consequences.
During an incident where he inadvertently caused a burn using a clamp, Dr. MacArthur, who was under supervision for case privileges, initially did not realize the extent of the burn. It wasn't until a recovery room nurse pointed out a small red area on the patient's leg after he had completed the operative report that he became aware of the severity of the burn. He failed to recognize that the large hinge of the clamp was significantly hotter, leading to the inadvertent burn on the patient's leg.
Dr. MacArthur cites the aviation industry as a model for effective root cause analysis. Unlike medicine, where blame often overshadows analysis, the aviation industry prioritizes understanding the underlying reasons behind adverse events rather than solely blaming the pilot. This dedication to root cause analysis has contributed to the industry's impressive safety records.
However, Dr. MacArthur expresses disappointment that the medical community has not fully embraced root cause analysis due to entrenched legal and public perceptions associated with the "captain of the ship" doctrine. This failure to adopt comprehensive root cause analysis perpetuates the occurrence of preventable medical errors and unfairly damages the careers and reputations of medical professionals.
The incidence of wrong-site surgery remains alarmingly high, with one event per surgeon per career and up to four events for specialists in hand, spine, and sports surgeries.
In 2023, it became apparent that individuals could make false accusations against others, tarnishing their reputation without facing any consequences themselves. Regardless of the innocence or guilt of the accused, mere allegations have the power to inflict enduring harm on a professional's standing.
Dr. Robert MacArthur revealed that he chose to depart from a workers' compensation clinic due to suspicions of illicit activities within the establishment. In response, the clinic manager purportedly conspired with a patient to fabricate a claim against him, alleging that he engaged in inappropriate behavior such as requesting sexual favors in exchange for a favorable workers' compensation report, under the pretext of stripping naked in the clinic.
Dr. MacArthur only learned of these allegations more than a year after leaving the clinic, prompting him to insist on undergoing a lie detector test to refute the claims. However, the accuser declined to participate in such a test.
Subsequently, Dr. MacArthur was informed that both his lie detector results and the accuser's refusal to undergo the test would not be admissible in court. Advised by the mediating attorney that the jury might be biased against him, he faced the potential catastrophic consequences of a court loss despite the baselessness of the accusation. Consequently, he was counseled to settle the matter for $29,000.
The Medical Board of California reviewed the allegations made by the accuser and deemed them "non-credible," suggesting an ongoing inquiry into the operations of the clinic. When interviewed, Dr. MacArthur hinted at the clinic's possible indictment but refrained from confirming this information.
Despite the aforementioned evidence, Dr. MacArthur encountered challenges in removing the accuser's claims from online search results. Consequently, despite his innocence, the defamatory campaign against him proved effective.
As the claim does not assert Dr. Robert MacArthur's guilt but rather serves as a synopsis of a complaint, it remains publicly accessible.
Dr. MacArthur strongly advocates for imposing penalties on individuals who make false accusations equivalent to the repercussions of the falsely alleged event. For instance, he believes that his false accuser should be labeled as a sexual predator and felon.
In concluding his remarks, Dr. MacArthur contemplated the coexistence of good and evil in the world, expressing his hope that those who encounter his narrative would not have to face individuals capable of inflicting such damaging false accusations as he has endured.
Dr. MacArthur is a respected orthopedic surgeon known for his expertise in diagnosing, treating, preventing, and rehabilitating disorders and injuries of the musculoskeletal system. This encompasses a deep understanding of bones, joints, ligaments, tendons, muscles, and nerves.
Diagnosis: Dr. MacArthur stands out for his sharp diagnostic abilities. Using a combination of physical examinations, advanced imaging studies, and laboratory tests, he swiftly 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 necessary, patients can trust Dr. MacArthur's skillful hands. His surgical proficiency encompasses a broad spectrum of procedures, from joint replacements to fracture repairs and ligament reconstructions.
Rehabilitation: Acknowledging that treatment is just one aspect of recovery, Dr. MacArthur emphasizes post-treatment rehabilitation. He often collaborates with physical therapists to help patients regain strength, mobility, and function safely and efficiently.
Prevention: Dr. MacArthur advocates for preventive healthcare and regularly conducts workshops to educate the community on injury prevention and the significance of maintaining musculoskeletal health.
Specialized Focus: Among his numerous achievements, Dr. MacArthur is particularly celebrated for his contributions to Pediatric Orthopedics. He has dedicated a significant portion of his career to addressing musculoskeletal issues in children, ensuring optimal physical health as they grow.