An infectious disease expert witness opines on a case happened in Hawaii where a patient suffers a severe surgical wound infection resulting in lower limb amputation following inadequate sterilization of medical equipment. This case involves a sixty-one-year-old female who presented to the hospital with a past medical history of osteoarthritis. Due to the severity of her condition, the patient underwent left ankle arthrodesis to relieve the chronic pain she was experiencing. The procedure took place without incident and the patient was discharged from hospital following an uneventful post-operative course. Three weeks following the surgery the patient returned to her primary care physician’s office for suture removal. A medical assistant employed by the physician removed the patient’s sutures using unsterilized forceps. Additionally, the medical assistant claimed that the utensils used for suture extraction were “exposed all day long” through multiple patient encounters. Two days following her visit to the physician’s office the patient developed a serious wound infection requiring hospitalization. She required constant medical care and multiple incision and drainages of the wound site, antimicrobial therapy (requiring a PICC line), skin grafts, and ankle hardware removal. The wound remained unhealed and the patient is left with an open hole on the medial aspect of her ankle. She then underwent a flap surgery, which later failed. Finally, the patient had to undergo a below-the-knee amputation (BKA) due to unsuccessful attempts to eradicate the infection.