Ryan Fogg, left, and Louis La Cava, deliver opening statements in a medical negligence trial against a physician and physician assistant who treated a woman following a fall that dislocated her knee. The woman ultimately had her leg amputated below the knee. Watch the trial.
Fort Myers, FL—Jurors Wednesday previewed evidence surrounding why a Florida woman’s dislocated knee eventually led to her losing part of her leg, as a medical malpractice trial opened against the emergency room medical professionals who treated her. Knowles v. Ensley, D.O., et al., 2024-CA-006125.
Rebecca Knowles, then 55, was forced to undergo a below-the-knee amputation of her left leg following a fall that dislocated her knee on December 14, 2022. Knowles claims that Dr. Tyler Ensley and Alexandria Erickson, the ER physician and physician assistant at Cape Coral (Florida) Hospital who treated her, failed to timely diagnose and treat a blocked artery caused by the dislocation.
Knowles arrived at the Cape Coral ER at about 3:40 p.m. and was under Ensley and Erickson’s care for roughly four-and-a-half hours before she was admitted to the hospital, so that time period and the care they provided promise to serve as the main focus of the trial.
In his opening statement Wednesday, Knowles’ attorney, Ryan Fogg, of the Fogg Law Group, walked jurors through the timeline of Knowles’ care. And he contended Erickson and Ensley didn’t do enough to discover and treat the blockage in time to save her leg.
Fogg told jurors that testimony would show that a blocked artery like Knowles’ must be revascularized, or unblocked, within four to six hours in order to save the leg. He said X-rays that came back a little after 5 p.m. revealed Knowles’ knee was dislocated, leaving a high likelihood that she suffered a blocked artery. While Ensley unsuccessfully attempted to realign the knee, neither Erickson nor Ensley called for a vascular surgeon, and neither noticed that Knowles’ leg was discolored, another sign of arterial blockage.
Fogg added that Erickson learned Knowles had definitely suffered an arterial blockage when results from a CT angiogram came back around the time Knowles was to be admitted to the hospital and leave Erickson and Ensley’s care. However, Fogg said, neither medical professional called a vascular surgeon.
After undergoing a reduction, or realignment of the knee, by an orthopedic surgeon that night, Knowles was transferred to another hospital the following evening. She ultimately didn’t see a vascular surgeon until roughly 30 hours after her accident, and her leg could not be saved.
Comparing the arterial blockage to a ticking time bomb, Fogg told jurors, “There’s an opportunity to defuse that bomb if you act reasonably, if you act timely. But if you don’t, that bomb is going to detonate. Time is of the essence.”
Erickson and Ensley contend that they followed appropriate protocol while treating Knowles and that any errors that led to the loss of her leg were committed by others.
In his opening Wednesday, their attorney, Louis La Cava, of La Cava Jacobson, told jurors that, soon after X-rays revealed Knowles’ dislocation, Erickson ordered a CT angiogram, which the attorney said was the “gold standard” for discovering arterial injury. And he reminded jurors that Ensley attempted to pop the knee back into place, which, La Cava said, often has the effect of unblocking an injured artery.
La Cava noted that, as soon as Erickson learned of the arterial blockage from the CT results, she reported them to the orthopedic surgeon called in to repair the knee, as Knowles was leaving Erickson and Ensley’s care.
On the other hand, La Cava said, it was the orthopedic surgeon’s decision not to call in a vascular specialist he had initially requested. And unexplained delays in hospital transfers led to Knowles not seeing a vascular surgeon at that facility until the following evening.
“[Erickson and Ensley] did their job,” La Cava said. “And they did it with Ms. Knowles leaving that emergency room with a viable, salvageable leg. No amputation in sight at that point in time.”
Erickson and Ensley are the only defendants at trial.
Email Arlin Crisco at acrisco@cvn.com.
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