Samples of cases in which Pamela Fruechting has consulted and/or provided expert witness testimony:
A man who underwent knee arthroscopy subsequently developed a septic knee that required multiple surgeries. The question was raised if the orthopedic nurse practitioner met the standard of care for outpatient post-operative care of an otherwise uncomplicated knee arthroscopy patient.
An adolescent boy experienced pain and swelling of the wrist after repetitive trauma to the wrist during a basketball game. He was diagnosed with a common childhood fracture (Salter Harris I) that is typically not evident on early x-rays. Orthopedic care was provided by a nurse practitioner and an MD. His symptoms worsened over the next week, and he was subsequently diagnosed with a sub-periosteal bone abscess, pyomyositis, and renal failure. After undergoing multiple surgeries for the infection, he died from septic shock and multiple organ failure.
An adolescent football player suffered an open tibia fracture, developed compartment syndrome in the hospital, and underwent amputation ten days later. The nursing standard of care was analyzed relative to the recognition and treatment of the evolving compartment syndrome symptoms, nursing documentation of neurovascular findings, and requirements for physician notification.
Within the first two days after a knee replacement, a woman suffered dehiscence of the incision when she fell while being assisted in a transfer from the chair to her bed. A second surgery was required to wash and explore the knee. The nursing standard of care was evaluated with respect to fall prevention guidelines for knee replacement patients, hospital policy, and nurse actions.
After multiple revisions of a hip replacement in the context of massive acetabular defects of the pelvis, an elderly gentleman filed suit for chronic hip pain. Questions of merit centered on the validity of the claim relative to the medical indications for revision, co-morbidities, type of revision, and post-operative care.
Sleep Apnea in a Knee Replacement Patient
A middle-aged man with a history of untreated sleep apnea was discharged home on the day of surgery following knee replacement. The next day he became very groggy and suffered a severe anoxic brain injury from narcotic oversedation. The cornerstone issues in this case focused on narcotic administration, patient monitoring, physician notification, nursing documentation, respiratory complications of sleep apnea, and phone triage.
A young woman’s foot deformity was treated surgically by a podiatrist. A plaster posterior leg splint was applied at a post-operative office visit. The patient suffered a 3rd degree leg burn that required skin grafting and resulted in permanent scarring. The central topics of this consultation included the standard of care for plaster splints and thermal properties of plaster.