William Bryan (left) and his wife Beverly Bryan (right) (Zarzaur Law).
After multiple wrong-site surgeries that resulted in permanent harm or death — including a procedure in which a patient’s liver was removed instead of his spleen — a surgeon’s license has been suspended in Florida.
The Sunshine State’s Department of Health and Surgeon General Joseph Ladapo ordered an emergency suspension of Dr. Thomas Shaknovsky’s license to practice osteopathic medicine Tuesday. The 21-page order detailed the troubling circumstances surrounding two botched surgeries — and Shaknovsky’s apparent attempts to cover up his own errors.
The order first described the case of a patient identified as “G.D.” — a 58-year-old man scheduled for surgery to remove his left adrenal gland at Ascension Sacred Heart Emerald Coast hospital. During the procedure, Shaknovsky did not remove the man’s adrenal gland at all, but rather, removed a portion of the man’s pancreas. The order noted the stark anatomical differences between the two organs: adrenal glands are small triangular glands located on the top of each kidney while the pancreas is a large gland located behind the stomach and surrounded by the gallbladder, liver, and spleen.
When Shaknovsky was alerted to the error, he claimed the adrenal gland had “migrated” to a different part of the patient’s body. The patient suffered permanent harm as a result of the surgical error.
The suspension order next detailed the case of 70-year-old William Bryan, identified in the order as W.B.,” an Alabama man who came to Ascension Sacred Heart Emerald Coast hospital for tests to assess an abnormal spleen.
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After medical staff advised Bryan that immediate surgery was required to prevent serious spleen-related complications, Bryan reluctantly agreed to an emergency laparoscopic splenectomy. The operation was scheduled for 4 p.m., and per the order, “staff were concerned with it being done so late in the day because they only had a skeleton crew.”
Further, said the order, “OR staff knew splenectomies were complicated procedures that could quickly deteriorate and were not regularly performed at Ascension.”
Perhaps most damning, the order said, “OR staff had concerns that Dr. Shaknovsky did not have the skill level to safely perform this procedure.”
Ultimately, according to the order, Shaknovsky arrived at the surgery an hour late, and opted to change course for the surgery, converting a laparoscopic procedure to an open one to mitigate difficulties in visibility. The order went on to note that Shaknovsky first reported that he was able to control a ruptured aneurysm during the procedure, but later said that he had never been able to control the aneurysm.
It also said that Shaknovksy “fired a stapling device blindly” into Bryan’s abdomen, removed an organ that he “believed” was the spleen, but was so affected by the “shock and chaos of the situation” that he was unable to properly identify the organ that he actually removed.
The Department of Health said in its order that Shaknovsky’s operative report contained “deceptive and untrue statements that failed to accurately describe what occurred in the procedure.” Specifically, it said, witness accounts of what happened in the operating room were “markedly more troublesome” than what Shaknovsky detailed in his written notes.
The order also provided some basic information about the difference between spleens and livers, noting that they are “anatomically distinct,” have different consistencies and colors, and are located on opposite sides of the abdomen.
According to the order, operating staff saw that the surgeon had removed the wrong organ.
“The staff looked at the readily-identifiable liver on the table and were shocked when Dr. Shaknovsky told them it was a spleen,” said the order. “One staff member felt sick to their stomach.”
Moreover, it said, Shaknovksy had another staffer label the organ “spleen” for transport to the pathology lab. According to the report, the person followed Shaknovksy’s instructions and labeled the organ “spleen,” all while knowing that the label was incorrect.
Afterward, said the report, Shaknovksy returned to the operating room three times and told staff that Bryan’s spleen had ruptured, causing bleeding.
“The staff in the room felt that Dr. Shaknovsky was attempting to convince them that this is what occurred, even though they witnessed something different,” said the health department.
The department said that Shaknovsky’s failure to admit his error illustrates either a “lack of clinical understanding ” or “lack of integrity.”
Further, it said, Shaknovsky’s action after the surgery “indicates his reckless conduct is likely to continue.”
The Department of Health said that it initially considered a less drastic measure than suspending Shaknovsky’s license altogether, but ultimately decided that given the doctor’s egregious errors in identifying basic anatomy, as well as his egregious conduct of fabricating medical records, the only option sufficient to protect public safety is to suspend Shaknovksy’s license altogether.
Shaknovsky is also facing an eventual civil lawsuit filed by Bryan’s surviving family over his error. Under Florida law, a claimant in a medical malpractice case is not permitted to file a complaint directly following a malpractice event that results in death. Rather, a pre-litigation process must first precede the filing of any lawsuit. Bryan’s attorney has indicated that he plans to file a lawsuit at the appropriate time.
You can read the full order by the Department of Health here.
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