A US grand jury had indicted Florida surgeon Thomas Shaknovsky (44) on a second-degree manslaughter charge for allegedly removing a patient’s liver instead of his spleen in 2024, resulting in copious bleeding and then death, reports MedPage Today.
Shaknovsky, who faces up to 15 years in prison if convicted, was released on bail and and is scheduled to be arraigned on 19 May.
Prosecutors said that in what was scheduled to be a laparoscopic splenectomy, Shaknovsky removed 70-year-old William Bryan’s liver, resulting in “catastrophic blood loss and the patient’s death on the operating table”.
Florida suspended his medical licence a month after the surgery.
Bryan’s widow, Beverly Bryan, filed a wrongful death lawsuit against Shaknovsky, the hospital, and the health system last year. They were told that Bryan had died of a splenic artery aneurysm, and that the spleen was sent to pathology.
However, a pathologist report stated that there was “no splenic tissue identified”. Instead, the pathologist wrote that it was a “grossly identifiable 2 106 g liver”.
The pathologist notified the medical examiner, who conducted an autopsy, confirming that Bryan still had his spleen but was missing his liver.
The emergency suspension order against Shaknovsky’s licence in Florida reported that he severed Bryan’s inferior vena cava, the vessel that connects the liver with the heart, “resulting in the bleeding event that precipitated his death”.
It also documented that a year before, Shaknovsky had removed a portion of another patient’s pancreas when he was supposed to remove an adrenal gland.
Bryan’s widow said she hoped that the “culture of silence around medical events is broken, and that (hospitals) will be more transparent when things like this happen”.
Not our surgeon
The hospital where Bryan was treated, Ascension Sacred Heart Emerald Coast Hospital, said in a statement that surgeons face “rigorous credentialing standards” and must hold a licence from the state to practise, reports The New York Times.
The statement added that “Shaknovsky was never a Sacred Heart Emerald Coast employee and has not practiced at any of our facilities since August 2024”.
Bryan and his wife had been visiting Florida in August 2024 when he was seized by pain. Diagnostic imaging at the hospital indicated his spleen was possibly enlarged. There was blood in the membrane lining his abdomen, but no signs of haemorrhaging.
Shaknovsky told Bryan he needed to have his spleen removed, a minimally invasive procedure that is still considered major surgery, with a recovery time of up to six weeks. The procedure, which was not regularly performed at Ascension Sacred Heart Emerald Coast Hospital, could have serious complications, a Health Department statement said.
Over three days, Bryan declined to have the surgery and said he wanted to return home to Alabama for further medical care, but the Health Department said Shaknovsky “continued to pressure” Bryan.
He eventually agreed to have the surgery in Florida and the procedure was scheduled for 21 August.
Colleagues in the operating room “had concerns that Dr Shaknovsky did not have the skill level to safely perform this procedure”, the Health Department said.
The signs of trouble came almost immediately.
Shaknovsky began the procedure as a laparoscopy but switched to open surgery because he could not clearly see the organs, having failed to document that Bryan had a distended colon that would have partly obstructed the view.
Theatre staff later reported that Bryan’s colon “burst out of the abdominal cavity” after Shaknovsky opened his abdomen, and they began suctioning blood to clear visibility.
Shaknovsky then took a surgical stapling device to a vessel that he planned to cut to remove the organ, and fired the stapler.
Bryan immediately began haemorrhaging and went into cardiac arrest, with blood pouring out as nurses and other staff attempted to suction it. They began an emergency transfusion and tried to revive him, the report said.
Shaknovsky did not ask his colleagues for a clamp or cauteriser to quell the bleeding, and instead continued to dissect Bryan’s organ “even though the abdomen was full of blood”, the state said.
He eventually removed Bryan’s liver, thinking it was his spleen. The Health Department noted in its report that, in addition to being on different sides of the abdomen, “spleens and livers are anatomically distinct, have different consistencies, and are different colours”.
After Shaknovsky removed the organ, “The staff looked at the readily identifiable liver on the table and were shocked when Shaknovsky told them that it was a spleen”, documents said.
In follow-up interviews with the Health Department, Shaknovsky claimed that he dissected the spleen from its surrounding tissue when an apparent aneurysm in the spleen ruptured suddenly, and caused severe bleeding – an account that conflicts with those of other witnesses in the operating room.
An autopsy revealed that his liver was missing, but his spleen was intact and there was no evidence of a ruptured aneurysm.
Shaknovsky tried to persuade his colleagues in the operating room that the liver he removed was Bryan’s spleen, the Health Department said in its report.
See more from MedicalBrief archives:
Surgeon, hospital sued after wrong organ removed
Operating team describes spleen surgery gone horribly wrong
Trust in US doctors plunged in pandemic – and still low, finds survey