This case involves a patient who was transported to a hospital after experiencing a cardiac event. While the patient was being worked up and awaiting treatment, a nurse had several failed attempts at placing an IV line and reportedly deviated from the aseptic technique. The description from the patient’s wife was that the nurse never swabbed the skin with antiseptic solution and repeatedly dropped the exposed needle onto the bed before inserting it into the skin on a second attempt. Subsequently, the patient developed cellulitis at the IV puncture site and severe sepsis during his hospital stay.
Question(s) For Expert Witness
1. Could the poor sterile technique be the cause of the patient's skin infection and eventual septic state?
Expert Witness Response E-000168
Yes, sterile technique is absolutely required when starting an IV line or taking blood from a patient. The situation described above could very well be the cause of the patient’s cellulitis. If the cellulitis was missed for some time or improperly treated, it may have progressed, causing serious illness by uncontrolled contiguous spread, including via the lymphatic or circulatory systems. Certain species, most notably group A beta-hemolytic Streptococcus and S aureus, produce toxins that may mediate a more severe systemic infection, leading to septic shock and death.
About the author
Wendy Ketner, M.D.
Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.
Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.
Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.
