U.S. surgeon Thomas Shaknovsky has been charged with second-degree manslaughter after a patient who was in the theatre for a spleen-removal surgery ended up with his liver removed.

Mr Shaknovsky, 44, was indicted on Monday by a grand jury in Walton County following the avoidable death of William Bryan, a 70-year-old patient whom the surgeon persuaded to undergo the procedure in August 2024.

When Mr Bryan felt a sharp pain during a visit to his property in Okaloosa County, he went to the Ascension Sacred Heart of the Emerald Coast Hospital in Miramar Beach. 

Imaging showed that he had an enlarged spleen, but there was no haemorrhage, even as blood filled up the membrane in his abdomen.

Mr Shaknovsky recommended surgery to remove the spleen, a procedure considered minimally invasive, albeit a major surgery. Mr Bryan lived in Alabama with his family. He insisted on returning there for further medical checks to ascertain what Mr Shaknovsky had told him.

But the surgeon “continued to pressure” Mr Bryan to undergo the procedure, persuading him for three days until he agreed.

The hospital scheduled Mr Bryan for the surgery on a Saturday, when few medical staff were on duty.

Trouble began when Mr Shaknovsky switched from minimally invasive laparoscopy to open surgery because the patient’s distended colon partially obstructed the organ, a complication that could have been avoided had it been properly documented, the jury heard. 

According to Mr Shaknovsky’s colleagues, the patient’s colon “burst out of his abdominal cavity” after he opened the abdomen, causing the surgical team to suction blood to provide the surgeon with a clear view of the organ.

Mr Bryan went into cardiac arrest after haemorrhaging as other medical staff scrambled to suction the excess blood. The nurses tried to restore the blood loss with an emergency blood transfusion.

Mr Bryan eventually died.

Mr Shaknovsky defended his actions, claiming that the spleen aneurysm ruptured, resulting in severe bleeding. But his account differed from the narrations of witnesses present in the theatre.

Mr Shaknovsky’s medical licence was suspended for one month after Mr Bryan died.

Mr Shaknovsky was not a first-time offender. In 2023, he was sanctioned and fined $400,000 to settle a malpractice case where he erroneously extracted a section of the pancreas of another patient instead of removing part of the adrenal gland.