When misconduct strikes in scientific research, it triggers a domino effect of ruined reputations, compromised integrity, and shattered public trust in science. But when it happens in medical practice, the consequences are far graver: real human pain, suffering, and death. In the summer of 2024, Beverly and William Bryan would arrive in Florida together to visit family. But only one of them would return home from the trip. In a nightmare turn of events on an operating table in Ascension Heart Sacred Emerald Coast hospital, William Bryan would die from severe hemorrhaging and cardiac arrest during a splenectomy procedure. Most shocking, the autopsy report would note that the patient’s spleen was completely intact. It would also show that the patient had a severed inferior vena cava—the vein connecting the liver to the heart—and a missing liver.
What is truly sickening is that, during the procedure, the surgeon, Dr. Thomas Shaknovsky, would look at the “readily identifiable” liver on the table—according to witnesses in the operating room—and repeatedly call it a spleen. Worse still, he instructed that it be labeled as a spleen before being sent to pathology.
Having hired lawyer Joe Zarzaur, now-widowed Beverly Bryan seeks both civil and criminal proceedings in this case. A news report on the Zarzaur Law, P.A. website provides the entire 47-page Agency for Health Care Administration (AHCA) investigation report, but I will share some of the key points below.
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The case report begins by immediately demonstrating how Dr. Shaknovsky attempted to cover up his error in the operative report, noting the report’s convenient omission and/or misrepresentation of significant details of the surgery:
In August 2024, during a scheduled splenectomy (a surgical procedure to remove the spleen), Surgeon A mistakenly removed Patient #1’s liver instead of the spleen. The operative report documents that the spleen was removed. The operative report failed to mention the patient’s abdominal distention, failed to mention the presence of a megacolon (a condition where the colon, or large intestine, abnormally dilates – become wider and larger), and failed to mention the removal of the liver. Additionally, the operative report contradicts portions of staff interviews regarding damp usage, the sequence of events, the timing of the hemorrhage (severe bleeding), and the cause of death. (pg. 2; (X4) ID Prefix Tag: H 191)
The operative report documents ‘no complications’ … The word ‘liver’ appeared nowhere on the operative report. The report also did not mention the abdominal distension or severe megacolon described by operating room staff. (pg. 4; (X4) ID Prefix Tag: H 191)
Following this, the case report provides clear evidence supporting the inaccuracy of Dr. Shaknovsky’s operative report through the accounts of the pathologist and the medical examiner. The pathologist notes the following:
On 09/10/2024 at approximately 1:45 PM an interview was conducted with the Pathologist. He stated the whole organ was received in a specimen bucket labeled as ‘spleen’, however, he did not see the specimen only photos. He received about 8-10 slides to review. He states he was able to ‘diagnose it within a millisecond, pretty obvious it was the liver. From the pictures and histology, there was little question about portal inflammation but otherwise the liver, was a little heavy -as upper limits are 1800 grams, and this one was about 2100 grams. (pg. 4-5; (X4) ID Prefix Tag: H 191)
The medical examiner notes the following:
On 09/11/2024 at approximately 1:00 PM a telephone interview was conducted with the local Medical Examiner (ME). The ME stated they were initially notified of Patient #1’s death on August 21st. Initially the ME’s office was informed that this was an inpatient death from complications of splenectomy. We were informed the death was not due to trauma but a cyst, and we declined jurisdiction_ We were then renotified on August 25th or 26th by the Risk Manager who said we need to tell you this death is not how it was reported, the liver was removed. The autopsy confirmed there was no liver. The liver was perfectly dissected off the diaphragm. As a forensic pathologist, that is one of the hardest things to learn to do. ”Essentially the liver was autopsied out of that man”. There was no evidence of cross clamping, no sutures. no evidence of cautery. The Inferior Vena Cava (the major vein that brings oxygen-poor blood from the lower body back to the heart) was clearly dissected by the surgeon. Everything surrounding this liver was completely untouched. The spleen showed no evidence of aneurysm, no rupture. and no evidence this spleen was touched. The spleen stayed where it was born to be. The spleen was 420 grams total. There was no evidence it was touched, not even looked at. The Medical Examiner said that a man’s liver is between 1800 and 2800 grams. The size of a man’s spleen is typically between 200 and 350 grams, but a diseased spleen can be bigger. The ME stated the biggest he/she has seen was 800 grams. (pg. 5-6; (X4) ID Prefix Tag: H 191)
Even further evidence is provided on pages 6-15, which provide eyewitness accounts of various individuals—registered nurses, operating room scrub technicians, a general surgeon, and even the CMO—in the operating room. Although the full details are too long to include here, the basic premise is this: even the registered nurses could readily identify the organ on the table as a liver. And yet Dr. Shaknovsky insisted, and even wrote up in his report, that the organ was a spleen.
Dr. Shaknovsky’s—i.e., Surgeon A—own account is found on pages 15-19 of the report, which concludes with the following statement:
Surgeon A verified that the operative report was true and accurate to best of his knowledge at the time and he has not made any addendums to the operative report learning it was the liver. (pg. 19; (X4) ID Prefix Tag: H 191)
Despite all of the evidence presented in previous pages of the report, Surgeon A—Dr. Shaknovsky—clearly claims that his operative report is “true and accurate.”
How in the world does a surgeon—a surgeon with supposedly “over 15 years of experience in the medical field”—make a mistake like this?
If the situation could not get any more gruesome, the Independent reports that this is not the first, nor the second, but the THIRD case of medical malpractice involving Dr. Shaknovsky. This article reports that in two other malpractice cases. Dr. Shanknovsky pierced a patient’s bowel during a cholecystectomy—gallbladder removal—as well as removed portions of a patient’s pancreas instead of the adrenal gland during an adrenalectomy. Furthermore, an article in Pensacola News Journal alludes to a series of “adverse surgical outcomes” associated with Dr. Shanknovsky prior to the splenectomy incident.
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Although Dr. Shanknovsky previously held medical licenses both in Alabama and in Florida, his licenses have now been “temporarily” suspended in both states, awaiting more concrete results in this case.
All of this leads one to question where such a horrific downward spiral begins.
One can’t help but wonder if this situation traces back to academia. Is Dr. Shaknovsky’s incompetence a result of poor medical training, or did he cheat his way through school? Or could Dr. Shaknovsky have had an underlying problem with alcohol or substance abuse, which hindered his judgment?
Although all scenarios are plausible, none of these questions can be answered as of now. And it is entirely likely they will never be answered. That being said, it will leave many, including myself, to speculate.
Explore more from Hannah Hutchins on Muck Rack, and visit our Minding the Science column for in-depth analysis on topics ranging from wokeism in STEM, scientific ethics, and research funding to climate science, scientific organizations, and much more.
Image: ‘Cardiac operating room” by Ruhrfisch on Wikiemedia Commons
This article was originally published at www.mindingthecampus.org
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