A Florida doctor is facing charges of second-degree manslaughter following a fatal surgery where he allegedly removed a patient’s liver instead of the spleen.
Dr. Thomas Shaknovsky, 44, was arrested Monday after a two-year investigation into the August 2024 death of a 70-year-old Alabama man conducted by local and state law enforcement in collaboration with medical authorities, the Walton County Sheriff’s Office said.
Dr. Shaknovsky, who is licensed to practice medicine in Florida, Alabama and New York, is now being held at the Walton County Jail on a $75,000 bond, according to correction records, after a grand jury returned an indictment. His medical licenses were all suspended or turned in before his recent arrest.
“The Grand Jury has spoken, and our responsibility is to ensure the charges are carried out through the proper legal process,” Walton County Sheriff Michael Adkinson said in a statement.
A chaotic operative scene
When the Alabama man first arrived at Ascension Sacred Heart Emerald Coast in Miramar Beach with abdominal pain on Aug. 18, 2024, Dr. Shaknovsky recommended surgery.
The patient refused an operation at first and wanted to return home, Florida health officials said in a 2024 emergency application to suspend Dr. Shaknovsky’s license. Ultimately, the patient conceded under pressure from Dr. Shaknovsky, an osteopathic physician, to a laparoscopic splenectomy.
The procedure was scheduled late in the day on Aug. 21, 2024, after 5 p.m., raising concerns among the operating room staff who noted they only had a skeletal crew available. Staff also raised concerns about the doctor’s lack of experience and skills in the emergency department.
Walton County Sheriff’s Office 
Operating room staff “knew splenectomies were complicated procedures that could quickly deteriorate and were not regularly performed at Ascension,” documents read. Dr. Shaknovsky started the laparoscopic procedure but then elected to convert to an open procedure, without properly documenting the reasons, the emergency application said. During the operation, the patient started to hemorrhage, and his vitals dropped, so the operating staff called an emergency code.
A spokesperson for Ascension Sacred Heart said in a statement that “Dr. Shaknovsky was never a Sacred Heart Emerald Coast employee and has not practiced at any of our facilities since August 2024. We remain focused on upholding the standards our patients and community expect of us.”
Dr. Shaknovsky said in an interview with officials following the operation that he tried to control the patient’s bleeding. He claimed he blindly fired a stapling device into the abdomen, removing an organ he presumed to be the spleen, despite later admitting he was unable to properly identify it due to shock and chaos. He also alleged that the patient’s spleen was grossly enlarged and the liver was unusually positioned, contributing to his misidentification.
Accounts from operating room witnesses paint a chaotic scene and markedly different recollections. Upon opening the patient’s abdomen, a megacolon allegedly burst, obstructing visibility, the emergency application said. While staff attempted to clear the field, Dr. Shaknovsky is said to have identified a pulsing vessel, stapled it, and continued to dissect even as the abdomen was full of blood, failing to ask for essential tools like a clamp or cauterizer.
Dr. Shaknovsky identified a vessel that he intended to cut and noted that he could feel it pulsing under his finger. He told the staff member assisting him, “that’s scary.” He ultimately removed the liver, identifying it as the spleen, an organ distinct in size, color, and location.
Staff members said in the emergency application that they were reportedly shocked by this misidentification.
Despite resuscitation efforts, the patient was pronounced dead. Dr. Shaknovsky informed staff that the cause was a ruptured splenic artery aneurysm and insisted that the removed organ be labeled as a “spleen” for pathology. However, the medical examiner found no evidence of a ruptured splenic artery aneurysm.
Dr. Shaknovsky has denied wrongdoing, the emergency application said, asserting that the patients’ organs presented with abnormal anatomy or had “migrated” to an unusual location.
A checkered medical history
Applications to suspend or revoke Dr. Shaknovsky’s physician licenses document a checkered medical history. In an application for an emergency suspension of the Florida medical license of Dr. Shaknovsky, which was issued in 2020, Florida health officials detail another incident leading to patient harm. Just two months before the fatal surgery, Dr. Shaknovsky had operated on a 58-year-old man, removing a portion of his pancreas instead of the adrenal gland during an adrenalectomy, according to Florida’s Department of Health.
Dr. Shaknovsky documented removing the left adrenal gland and later claimed the adrenal gland had “migrated.” The patient suffered permanent harm from this error, department of health officials said. The Florida Department of Health suspended Dr. Shaknovsky’s license in September 2024, according to public records.
The wife of the patient who died in 2024 contacted the Alabama Board of Licenses to alert them to Dr. Shaknovsky’s alleged role in her husband’s death. The Alabama Board of Medical Examiners filed a complaint against Dr. Shaknovsky, temporarily suspending his license, which he has held since 2016 in Alabama. Dr. Shaknovsky “may constitute an immediate danger to his patients and the public,” the Alabama Medical Licensure Commission said in its order.
He surrendered his license on Nov. 7, 2024, according to Alabama’s medical license records. The Alabama application to suspend Dr. Shaknovsky’s license documented two prior operating mistakes in 2023 – one of which, the documents said, led to another fatality.
According to the Alabama State Board of Medical Examiners in July 2023, Dr. Shaknovsky was scheduled to perform an ileostomy, an operation that diverts the small intestine through the abdominal wall, but instead opted to perform a bowel resection on the patient, which resulted in a perforation. The patient was transferred to the intensive care unit, where she later died.
His New York State medical license, which he has held since 2015, was suspended in 2025.
Dr. Shaknovsky did not respond to a request for comment.
