A Florida grand jury has indicted a surgeon on a second-degree manslaughter charge after he allegedly removed a 70-year-old man's liver instead of his spleen, killing the patient on the operating table in what state officials called a catastrophic and avoidable error.
Dr. Thomas Shaknovsky faces the charge in connection with the August 21, 2024 death of William Bryan, an Alabama resident who went in for a laparoscopic splenectomy at a surgical facility in Miramar Beach, Florida. Bryan never left the operating room alive. NBC News first reported the indictment, which escalates what began as a licensing matter into a criminal prosecution.
The stakes here cut two ways. A man is dead after what should have been a routine procedure. And prosecutors now must prove that the surgeon's conduct crossed the line from medical negligence into criminal culpability, a high bar in any jurisdiction.
Bryan, 70, traveled from Muscle Shoals, Alabama to undergo the splenectomy. The Associated Press reported that prosecutors allege Shaknovsky removed Bryan's liver rather than his spleen during the procedure. The mistake, officials said, triggered catastrophic blood loss that killed Bryan while he was still on the table.
The Florida Department of Health's emergency order against Shaknovsky laid out a grim sequence. State investigators alleged the surgeon severed and extracted the liver, causing severe hemorrhaging and cardiac arrest. Bryan could not be revived.
Operating room staff witnessed the error in real time, according to the state's account. A witness described in the emergency order offered a striking detail about the moment Shaknovsky identified the organ he had removed.
"The staff looked at the readily identifiable liver on the table and were shocked when Dr. Shaknovsky told them it was the spleen."
The state's emergency order went further, characterizing the misidentification as something beyond a split-second lapse. As the order stated:
"Dr. Shaknovsky's misidentification of the liver was not a momentary mistake."
That language matters. If prosecutors can establish that Shaknovsky's conduct reflected sustained disregard rather than a fleeting error, it strengthens the manslaughter theory. In Florida, second-degree manslaughter requires proof of culpable negligence, a standard above ordinary malpractice but below intentional harm.
The indictment alone would be extraordinary. But state investigators allege the misconduct did not end when Bryan died. Fox News reported that the Florida Department of Health accused Shaknovsky of fabricating operative notes after the surgery, mislabeling the removed organ as a spleen in medical records, and pressuring staff to support a false narrative about the cause of death.
State officials alleged Shaknovsky tried to attribute Bryan's death to a splenic artery aneurysm rather than the organ misidentification. If those allegations hold up, they could prove devastating at trial. Jurors tend to view alleged cover-ups as consciousness of guilt, and prosecutors in manslaughter cases often lean heavily on post-incident conduct to establish the defendant's awareness that something went terribly wrong.
The distinction between a tragic surgical error and a criminal act often turns on exactly this kind of evidence. High-profile criminal cases across the country frequently hinge on whether defendants took steps to conceal their conduct after the fact.
Bryan's death was not the first time Florida officials flagged concerns about Shaknovsky's surgical performance. The New York Post reported that the state's emergency order referenced a prior 2023 surgery in which Shaknovsky allegedly removed part of a patient's pancreas instead of the left adrenal gland.
That earlier incident did not result in a patient death, but it adds a layer of context that prosecutors may attempt to use. A single misidentified organ might be framed as a terrible accident. Two alleged organ misidentifications by the same surgeon in roughly a year raises questions about competence and pattern that a defense team will have to confront.
Investigators have not publicly confirmed whether the 2023 incident led to any formal disciplinary action at the time. That gap raises its own set of questions about institutional oversight and whether earlier intervention could have prevented Bryan's death.
Florida Surgeon General Joseph Ladapo issued an emergency order suspending Shaknovsky's medical license. The order described Shaknovsky as an "immediate, serious danger" to the public, language that signals the state viewed the risk as ongoing rather than isolated.
The suspension and the indictment represent two separate legal tracks. The licensing action is administrative, handled through the Florida Department of Health and the Board of Medicine. The manslaughter charge is criminal, carrying potential prison time if Shaknovsky is convicted. Both tracks can proceed simultaneously, though the criminal case typically takes priority in terms of public attention and legal consequences.
Walton County Sheriff Michael Adkinson addressed the indictment in a statement that struck a measured tone.
"Our duty is to follow the facts wherever they lead, without fear or favor."
That framing positions the prosecution as fact-driven rather than politically motivated, a posture that law enforcement officials often adopt in cases involving licensed professionals. Questions about prosecutorial authority and professional accountability have surfaced in several recent legal disputes, and this case will test how aggressively Florida pursues criminal liability for alleged medical misconduct.
Beverly Bryan, a family member of the deceased patient, spoke publicly after the license suspension. Her statement reflected both grief and a sense of relief that the state had acted.
"I can say this. My family and I and friends in Walton County and the surrounding area that use that hospital are simply relieved that the Florida Board of Medicine has made the decision to suspend the medical license of Dr. Thomas Shaknovsky."
Her words point to something beyond one family's loss. Residents in Walton County and the surrounding area relied on the same facility where Bryan died. The suspension addressed their immediate safety concern, but the criminal case will determine whether the system delivers accountability proportional to what allegedly happened.
Cases involving alleged wrongdoing in medical settings tend to draw intense public scrutiny precisely because patients place extraordinary trust in their doctors. When that trust is allegedly violated with fatal consequences, the public expects the justice system to respond with more than a licensing review.
Second-degree manslaughter in Florida requires the state to prove culpable negligence, meaning conduct that goes beyond ordinary carelessness. Prosecutors must show that Shaknovsky's actions demonstrated a reckless disregard for human life. That standard sits well above what a medical malpractice plaintiff would need to prove in civil court, but below the intent threshold required for murder charges.
The prosecution will likely focus on several questions. Investigators will need to determine how a trained surgeon could misidentify the liver as the spleen, two organs that differ substantially in size, shape, color, and anatomical position. They will also need to establish whether Shaknovsky followed standard pre-operative protocols, including imaging review and surgical planning.
The alleged post-operative conduct, if proven, could prove equally important. Fabricating records and pressuring staff to support a false account suggests awareness that the error was serious and identifiable. Courts weighing accountability claims in other contexts have treated post-incident concealment as strong circumstantial evidence.
Authorities have not publicly confirmed whether other medical staff face any investigation related to the surgery or the alleged records falsification. That question remains open as the criminal case advances.
Shaknovsky now faces arraignment and the full weight of a criminal prosecution. His defense team will have the opportunity to challenge the state's characterization of events, contest the admissibility of the emergency order's findings, and present their own account of what happened in the operating room on August 21.
The case will test a principle that conservatives have long championed: accountability should follow the facts, regardless of the defendant's professional status. Life-and-death accountability disputes demand that the legal system treat every case with the seriousness the facts warrant.
William Bryan went into surgery expecting to come out without his spleen. He came out without his life. Whether the system that licensed his surgeon will now hold that surgeon criminally responsible is the only question that matters.
