I read "After the Error" by David Ring, MD, PhD, and Robert J. MacArthur, MD, in the June 2017 issue of AAOS Now, and found it almost unbelievable. The repercussions Dr. MacArthur suffered are amazing. I have read some statistics about the effectiveness of the "Sign Your Site" protocol and have been surprised that errors still occur. I started practice at a time when this protocol had not been established. In the 22 years that I did orthopaedic surgical procedures, I never "signed my site" nor did I ever have a wrong-site surgery. I think the main difference between "then and now" is that I usually had seen my patient several times before doing a procedure, I never had a physician's assistant in my office to do the work ups, and I did my own pre-op history & physical (H&P), so I really knew my patients. Both the anesthesiologist and I asked the patient which body part was being operated on so even though the site wasn't signed, we knew what operation we were performing. I would put the appropriate X-rays on the view box, which was another check. The H&P, which was in the chart, also identified the procedure that was to be done.

Having said all this, I realize that I was probably very fortunate in that I had no wrong-site surgeries. The repercussions and disciplinary actions that followed Dr. MacArthur's incident are reprehensible. No surgeon should have to suffer such actions for making the unfortunate error made by Dr. MacArthur.

John W. Thompson, MD
Lake Oswego, Ore.

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