Damn, forget about the malpractice. If I ever get caught looking like that in my mugshot, deny my parole and tack on 10 more years.

Yep the main driver is that people didn't need to fly, it's an option, so they had incentives to make it look safe (just being safe is very hard but not enough).

While most surgeries are not really optional and the only incentives are profit by hospitals. What are you going to do, not have surgery?

Yeah there's a reason they have kinda long checklists when doing operations.

People have had the wrong leg cut off etc. Although that's perhaps a more understandably a bureaucratic mistake instead of a surgeon mistaking a liver for a spleen. But granted, I've never cut into the human body so even though they're pretty distinct in graphics, once covered in blood and whatnot they might not look so different. Idk. But I think he should have.

Totally agree and this has been discussed a lot. We learn about the Swiss cheese model https://en.wikipedia.org/wiki/Swiss_cheese_model, I've read The Checklist Manifesto, we talk a lot in med school about listening to nurses and scrub techs and pharmacists...it goes on.
I've sat in on a lot of morbidity and mortality rounds. If there's an adverse event it's reviewed, and yes it can be very embarrassing for the people involved. We had a breast cancer patient who needed more exploration involving the axillary lymph nodes and an artery got nicked and vascular had to be called, and the next day she was bleeding significantly and had to be brought back to the OR with me, as the med student, holding pressure on her armpit. She lived. A few days later both attending surgeons (breast and vascular) had to do the Morbidity and Mortality in front of the whole hospital, and it felt like a movie.

This should be investigated exactly how you said but there is no way that surgeon was sober. Unless the patient's anatomy was crazy weird, there's no way that was an honest mistake.

It's been a while since I've operated on anyone (consentually, at least). I know some doctors can be so arrogant that you don't ever want to second-guess them or correct them for fear of bring berated. Aren't there other people directly over the patient who might butt in and say "hey, are you sure that's the right part?"

... comparing this surgeon's patient survival rate to that of other surgeons should determine whether he is to blame.

If his patients are significantly more likely to die than on average, it is probably the surgeon's fault. If he has a pristine record, on the other hand, it was probably beyond his control.

Like, wouldn’t you see he was working on the wrong side of the abdomen? Investigate everyone in that operating room IMO

According to the article the patient was actively bleeding to death at the time, so he (and everyone else) was frantically trying to save his life:

“It was like a overflown sink that’s clogged up, and I am looking for a fork at the bottom, trying to feel and find the bleed, and I was not able to do so,” Shaknovsky said. He added: “After 20 minutes of struggling – desperately trying – to save his life, that’s when the wrong-site event took place.

There was a post about this case a month or two ago on Lemmy. I can’t find the link right now, I’m sorry. But in there, someone had posted a link to the case files for the court. You could see summaries of testimony from multiple nurses and scrub techs. The short version was that many of them had strong reservations about the surgeon prior to this case due to other errors. When this case happened, they were all pretty certain it was not the spleen immediately.

Reading the report that was posted last time this was discussed it was equally the fault of the hospital as it was the doctors. Apparently he had a bunch of botched surgeries before this one, he was sent to a Continuing Medical Education (CME) program where he failed his evaluation, and he was allowed to take it again after the hospital intervened and he came back to work.

The hospital had reporting systems that nurses and tech were supposed to use to report issues such as these, nobody did even though after they were interviewed they said they had concerns about that specific doctor such as him being late to scheduled operations and other issues. Some nurses stated that they would not bring family to the hospital if they knew that specific doctor was on rotation. The operation where he killed this guy also started late in the afternoon and the doctor didn't perform a splenectomy before this one.

The operation report was also quite surreal. Apparently they started the surgery laparoscopically but then the doctor decided to convert it into a normal surgery because he couldn't see properly. Once they opened the guy the nurses noticed that he had an enlarged colon that was blocking most of the surgical field and this was not mentioned in the post-op report even once. Then the doctor started cutting and caused a hemorrhage that made what visibility there was even worse. He continued the operation and removed what he called the spleen. Most of the operating tech immediately noticed it wasn't the spleen since even an enlarged spleen doesn't usually get over 800 grams. The thing he pulled out was almost 2 kilograms. Also apparently a different surgeon walked into the room and pointed at the organ on the table and asked what that is. The doctor said: "It's the spleen." to which the other surgeon retorted: "That's no fucking spleen" before storming out. Then they sent it to a pathologist which said that he didn't even need to put it under the microscope to see that it wasn't a spleen.

The coroner that did the autopsy of the dead man stated that the spleen was untouched in the place where it should be but the liver has been surgically resected with the surgeon cutting through the portal vein without any evidence of clamping.

Edit: Here is the report if anyone wants to look through it themselves.

https://zarzaurlaw.com/wp-content/uploads/2024/10/AHCA-Report-1.pdf

There are so many people who are good at their jobs and have imposter syndrome. If anyone should have it, it is probably this person.

Just being a devil's advocate here. If they are removing the spleen, it's probably because there is something wrong with the spleen.

And I've seen splenomegaly cases where the spleen is bigger than the liver. Like almost twice as big.

Seriously.

Also, left and right. Like they shift a bit but not that much. My spleen got lost too (radiology, not surgery, longer story involving indium than I want to tell in text) but if you think a liver is an inflamed spleen you better have identified that the inflamed spleen is the size of a liver first.

Also don't they have a different number of tubes coming offa them? This is not my area of anatomy specialty.

I read that and thought "dude, you DID fail him"

That's basically the function of most state medical licensing boards. They primarily act as lobbying organizations on behalf of their members to limit civil/legal liability, and to bring a sense of internal regulatory action. My state license costs thousands of dollars a year and is necessary to practice, but all they do is ask me once a year if I've committed any crimes or are currently addicted to any illicit substances.

A bunch of physicians like to bitch about malpractice suits making the field difficult to work in, but in reality you really almost have to be acting maliciously to lose a case. For example the last guy in my city to have lost a malpractice case in my field was years ago, and it was because he forgot to order a titanium rod for spinal fusion and installed the shaft of a stainless steel screwdriver instead. Like.... Yeah buddy, you should be in jail.

Disgraced doctors that can't be hired for insurance reasons get hired by health insurance to deny claims too, as per propublica. I think one of their examples was a doctor from florida too.

I think it's this one: https://www.propublica.org/article/mental-health-insurance-denials-unitedhealthcare-cigna-doctors