Witnesses in OR Give Harrowing Account of Spleen Surgery Gone Wrong

The Florida Department of Health has suspended the license of Thomas Shaknovsky, DO, who removed a patient’s liver instead of his spleen, contributing to his death.

An emergency suspension order from the health department details how Shaknovsky severed William 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 documents that Shaknovsky had removed a portion of a patient’s pancreas when he was supposed to remove an adrenal gland a year earlier.

“Dr. Shaknovsky’s continued practice of osteopathic medicine constitutes an immediate, serious danger to the health, safety, or welfare of the citizens of the State of Florida,” the order stated.

Interviews with operating room staff conducted by the health department painted a starkly different picture than Shaknovsky’s operative report regarding William Bryan’s spleen removal surgery.

Shaknovsky said he started a laparoscopic procedure, but switched to an open one due to poor visibility created by a distended colon and blood in the abdomen — though he didn’t document that in his report.

He then discovered a splenic artery aneurysm that ruptured, leading to significant blood loss — but said he went on to remove the spleen, even though it was enlarged and deformed.

However, witnesses in the operating room “consistently and clearly recounted a summary of events that is markedly more troublesome than Dr. Shaknovsky’s written account of what occurred.”

According to the report, witnesses said that when the patient’s abdomen was opened, “a megacolon burst out of the abdominal cavity, disrupting visibility.” As the operating room staff “cleared the field by moving the large colon and suctioning blood,” Shaknovsky “identified a blood vessel he intended to cut and noted he could feel it pulsing under his finger. He told the staff member assisting him, ‘that’s scary.'”

He grabbed the vessel, positioned a surgical stapling device around it, and fired the stapler, the report said. Immediately after that, the patient began to severely hemorrhage and went into cardiac arrest. A code was called and staff began performing CPR.

While staff worked the code, Shaknovsky continued his dissection even though the abdomen was full of blood and there was no visibility, the report stated.

Eventually, he removed the liver and identified it as a spleen — even though the operating room staff knew better.

“The staff looked at the readily-identifiable liver on the table and were shocked when Dr. Shaknovsky told them that it was a spleen. One staff member felt sick to their stomach,” the report noted.

Despite the staff’s best efforts, Bryan was pronounced dead, and Shaknovsky went on to tell staff that he died of a ruptured splenic artery aneurysm. He requested that the organ be labeled as spleen and sent to pathology. “The person responsible for labeling the specimen knew it was not a spleen but did as they were instructed,” the report stated.

Ultimately, the pathologist confirmed it was an “intact liver.”

Staff also said they felt like Shaknovsky was trying to convince them that the patient died of a splenic artery aneurysm “even though they witnessed something different,” according to the report.

During an autopsy, the medical examiner confirmed the spleen was still in place, but the liver was still missing, and the inferior vena cava had been severed. There was no evidence of a ruptured splenic artery aneurysm, according to the report.

Yet in his operative report, Shaknovsky described in very specific detail his removal of the spleen, “identifying that he dissected specific structures and ligaments that were never touched.”

“There is no other explanation for this other than Dr. Shaknovsky attempting to avoid blame for severing a significant vessel,” the report stated.

“Dr. Shaknovsky’s blatant disregard for the truth, falsification of an operative report, and attempt to convince [operating room] staff to acquiesce to his version of events is a breach of the public trust,” it concluded.

The patient’s wife, Beverly Bryan, said last month that her husband’s death “was exceptionally unnecessary and brutal.” She hired Joe Zarzaur of the Florida-based firm Zarzaur Law to bring legal action in the case.

The family hasn’t filed a lawsuit yet because medical malpractice lawsuits in Florida must first go through a pre-suit process, which can take 6 to 9 months, Zarzaur said previously. The Walton County Sheriff’s Office also previously said that it was reviewing the facts of the case to determine “if anything criminal took place.”

Despite the emergency suspension of his license in Florida, Shaknovsky maintains an active license in Alabama, and as of press time it was not impacted by the Florida discipline.