A “never event” is an event that, in the opinion of the specialist, should never occur during an operation.
Family of deceased Alabama man claims surgeon removed wrong organ
The family of Alabama native William Bryan claims he died after his liver was mistakenly removed during surgery at a Florida hospital.
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It’s like something out of a nightmare: someone is undergoing surgery and a fatal mistake happens.
An Alabama family is living a nightmare after a surgeon at a Florida hospital removed a man’s liver instead of his spleen, causing the patient to bleed to death in the operating room, according to Zarzaur Law, the law firm investigating the death and the family’s attorney.
According to Zarzaur Law, it was not the first time the surgeon made a similar mistake.
“It is one of the worst cases of medical malpractice I have ever dealt with,” said attorney Joe Zarzuar. Civil and possibly criminal action is being considered.
Such errors are not uncommon in the USA. According to a study by Johns Hopkins University, operations are performed on the wrong part of the body 20 times a week.
Here you can find out what we know and how often such errors occur.
Where did the fatal operation take place?
William “Bill” Bryan, 70, and his wife Beverly of Muscle Shoals, Alabama, were visiting their home in Destin, Florida, when Bill Bryan began to feel pain in his left side.
He was admitted to Ascension Sacred Heart Emerald Coast Hospital in Miramar Beach for suspected spleen problems.
The Bryan family’s attorney, Zarzaur of Pensacola, said general surgeon Dr. Thomas Shaknovsky and hospital chief medical officer Dr. Christopher Bacani convinced the Bryans not to return home for the surgery but to have it done in Florida because transport was too dangerous and could rupture the spleen.
What happened during the surgery at Florida Hospital in Miramar Beach?
According to medical records provided to USA Today by Zarzaur Law, Shaknovsky underwent a hand-assisted laparoscopic splenectomy on August 21, 2024. A splenectomy involves removing the spleen.
During the surgery, Shaknovsky removed Bryan’s liver, severing the liver’s major vasculature, causing immediate and catastrophic blood loss that resulted in Bill Bryan’s death.
The medical records show that Dr. Shaknovsky referred to the liver as the spleen
According to medical records, the surgeon was apparently unaware of his mistake at the time of surgery and referred to the liver sample taken as a “spleen.”
After the procedure, Shaknovsky told nurse Beverly Bryan that the “spleen” was so diseased that it was four times larger than normal and had “migrated” to the other side of Bill Bryan’s body.
The medical examiner found that Bill Bryan’s liver was missing, but his spleen was still in his body with a cyst attached to it, the lawyer said.
Family discovers Dr. Shaknovsky operated on the wrong body part of another person
When Zarzaur’s lawyers began investigating Bill Bryan’s death, they discovered that this was not the first time Shaknovsky had accidentally operated on the wrong part of a person’s body.
In a previous operation at the wrong site in 2023, according to Zarzaur, Shaknovsky mistakenly removed part of a patient’s pancreas instead of performing the planned adrenalectomy (cutting out tissue or part of an organ) at the same hospital.
The case was settled confidentially and Shaknovsky continued to work as a surgeon at Ascension Sacred Heart Emerald Coast Hospital until August 2024.
How often is the wrong body part removed during surgery?
According to a Johns Hopkins Medicine article in ScienceDaily, 4,044 “Never Events” occur each year in the United States.
“Never Events” were defined as those “events for which there is general agreement among experts that they should never occur during an operation.”
“After a careful and thorough analysis of national medical malpractice lawsuits, patient safety researchers at Johns Hopkins University estimate that a surgeon in the United States leaves a foreign object such as a sponge or towel in a patient’s body after surgery 39 times per week, performs the wrong procedure on a patient 20 times per week, and operates on the wrong body part 20 times per week,” the study said.
“Reporting online in the journal Surgery, the researchers estimated that 80,000 of these so-called ‘never events’ occurred in American hospitals between 1990 and 2010 – and believed their estimates were likely underestimated.”
“The events we estimate are entirely preventable. This study shows that we are far from where we should be and there is still much work to be done,” said study leader Marty Makary, MD, MPH, associate professor of surgery at Johns Hopkins University School of Medicine.
What can doctors and hospitals do to avoid surgical errors?
“Makary said many medical centers have long had patient safety procedures in place to prevent unexpected events, including mandatory ‘timeouts’ in the operating room before surgery begins to ensure medical records and surgical plans match the patient on the table,” the Johns Hopkins University article in ScienceDaily said.
“Next steps include marking the surgical site with indelible ink before the patient is anesthetized.
“There have long been practices to count sponges, towels and other surgical supplies before and after operations, but these measures are not foolproof, Makary said. Many hospitals are moving to equip instruments and materials with electronic barcodes to enable accurate counts and avoid human error.”
“We take such allegations very seriously,” said Ascension Sacred Heart
Ascension Sacred Heart officials released the following statement: “We take allegations of this nature very seriously, and our leadership team is conducting a thorough investigation of this incident. Ascension Sacred Heart Emerald Coast has a long history of providing safe, high-quality care since the hospital opened in 2003.
“Patient safety is and will remain our top priority. Our thoughts and prayers are with the family. The privacy of our patients is our highest priority. We do not comment on specific patient cases or ongoing litigation.”
Will Dr. Thomas Shaknovsky be held criminally or civilly liable?
Under Florida law, a six- to nine-month pretrial process must take place before a formal medical malpractice lawsuit can be filed in court, Zarzaur said. Bryan’s family and Zarzaur intend to file a lawsuit, he said.
According to Zarzaur, it could take months for the medical association to revoke Shaknovsky’s license.
In addition, criminal investigations are ongoing into the death of Bill Bryan.
The Walton County Sheriff’s Office sent an email to USA TODAY saying:
“The Walton County Sheriff’s Office, in conjunction with the Precinct 1 Coroner’s Office and the District Attorney’s Office, is reviewing the facts surrounding the death of William Bryan to determine if any criminal activity occurred.
“At this point in time, it would be wrong to say that criminal charges have been filed.”
