A Florida surgeon is facing manslaughter charges following a catastrophic surgical error in which he removed a patient's liver while attempting to perform a splenectomy, according to documents from the Florida Department of Health. The patient, a 70-year-old man, died as a result of the mistake.

Dr. Thomas Shaknovsky allegedly attempted to persuade other members of the surgical team that the organ he had removed was indeed the patient's spleen, despite objections from colleagues in the operating room, as reported by the New York Times. The incident raises profound questions about surgical protocols, anatomical verification procedures, and the mechanisms meant to prevent such errors in modern operating theaters.

Anatomical Distinctions and Surgical Protocols

The liver and spleen, while both located in the upper abdomen, are anatomically distinct organs with different sizes, textures, and vascular supplies. The liver, the body's largest internal organ, sits primarily on the right side of the abdomen and weighs approximately three pounds in adults. It has a characteristic reddish-brown color and a smooth, firm texture with distinct lobes.

The spleen, by contrast, is a fist-sized organ located on the left side of the abdomen, weighing roughly six ounces. It has a darker purple-red color and a softer, more fragile consistency. The organs also differ fundamentally in their blood supply architecture—the liver receives blood from both the hepatic artery and portal vein, while the spleen is supplied by the splenic artery.

"The anatomical differences between these organs are taught in the first year of medical school," said Dr. Patricia Mendez, a general surgeon at Johns Hopkins Hospital who was not involved in the case. "There are multiple checkpoints during any abdominal surgery where organ identification should occur, including visual inspection, palpation, and verification of vascular anatomy before any excision."

The Fatal Consequences of Liver Removal

The removal of a healthy liver is incompatible with life. Unlike the spleen—which can be removed in its entirety with patients subsequently managing on preventive antibiotics and vaccinations—the liver performs hundreds of essential metabolic functions that cannot be replicated by other organs or medical interventions.

The liver synthesizes critical proteins including clotting factors, processes toxins and medications, produces bile for digestion, and regulates blood glucose levels. Complete hepatectomy, the medical term for liver removal, results in acute liver failure within hours. Symptoms include severe coagulopathy leading to uncontrolled bleeding, hepatic encephalopathy as toxins accumulate in the bloodstream, and multi-organ system failure.

The only potential intervention for complete liver removal is emergency liver transplantation, a procedure requiring donor organ availability, extensive surgical infrastructure, and hours of preparation—resources rarely available in the immediate aftermath of an unexpected surgical error.

Regulatory Response and Medical Accountability

The Florida Department of Health's investigation into the incident represents one pathway for accountability in cases of severe medical error. State medical boards have the authority to suspend or revoke medical licenses, impose fines, and require additional training or supervision.

However, the decision to pursue criminal manslaughter charges elevates this case beyond typical medical malpractice territory. Criminal charges in surgical error cases remain relatively rare and are generally reserved for situations involving gross negligence, impairment, or willful disregard for patient safety.

According to legal experts, prosecutors must demonstrate that the surgeon's actions went beyond simple negligence and rose to the level of reckless disregard for human life. The allegation that Dr. Shaknovsky attempted to convince colleagues that he had removed the correct organ, if proven, could support such a characterization by suggesting awareness of the error combined with a failure to take immediate corrective action.

Broader Implications for Surgical Safety

This case underscores ongoing challenges in surgical error prevention despite decades of safety improvements. The World Health Organization's Surgical Safety Checklist, introduced in 2008, has significantly reduced surgical complications and deaths globally through standardized verification procedures before, during, and after operations.

Modern surgical protocols typically include "time-outs" before incisions, during which the entire surgical team verbally confirms the patient's identity, the planned procedure, and the correct surgical site. Many institutions also employ multiple verification steps during organ removal procedures, including photographic documentation and immediate pathological consultation when feasible.

"Wrong-site, wrong-procedure, and wrong-patient errors are classified as 'never events' in surgery—mistakes so egregious they should never occur," explained Dr. Atul Gawande, a surgeon and public health researcher, in previous commentary on surgical safety. "When they do happen, it typically represents a breakdown of multiple safety systems simultaneously."

The case also raises questions about how surgeons respond when they recognize errors intraoperatively. Medical ethics require immediate disclosure and corrective action when mistakes are identified, even when correction may not be possible.

Patient Safety and Systemic Reform

For patient advocates, cases like this highlight the need for continued vigilance in surgical safety despite overall improvements in outcomes. Transparency in reporting surgical errors, robust peer review processes, and systems that encourage speaking up when team members observe concerning practices all contribute to preventing catastrophic mistakes.

The hospital where the surgery occurred has not been publicly identified in available reports, and it remains unclear what institutional review processes are underway. Typically, such incidents trigger comprehensive root cause analyses examining everything from credentialing and privileging procedures to operating room culture and communication patterns.

As this case proceeds through both the criminal justice system and medical regulatory channels, it serves as a stark reminder that even in an era of advanced surgical techniques and safety protocols, the fundamental requirement for anatomical knowledge and careful verification remains paramount. The outcome will likely influence discussions about surgical training, supervision, and the balance between professional self-regulation and external accountability in medicine.