Surgical Scrub First Assistant Trauma Nurse Expert Witness.

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Surgical Scrub First Assistant Trauma Nurse Expert Witness.

Provides Opinion & Testimony In:

Surgical nurse, circulate, scrub, and first assist, general, vascular, thoracic, ophthamalology, ENT, OB-GYN, Urology, Trauma, Cardiovascular, Clinical OR nurse, Operating Room, RN First Assistant, Perioperative Nurse Educator, Perioperative Nurse Manager,


Owner –Legal Nurse Consultants
Medical analyst, collaborator, and strategist for all areas of medically related litigation 30+ years clinical and administrative experience including: surgical nurse (circulate, scrub, and first assist) all surgical disciplines including, General, Orthopedic, Vascular, Thoracic, Ophthalmology, ENT, OB-GYN, Urology, Trauma, with a specialty in Cardiovascular surgery for 22 years Perioperative roles in nursing:
Clinical OR nurse
Operating Room Cardiovascular Team Leader
RN First Assistant
Perioperative Nurse Educator
Perioperative Nurse Manager
Perioperative Nurse Director
Director of Physician Assistants
Preoperative, PACU, GI Lab, and Infusion Center Manager


Legal Nurse Consulting, San Bernardino, CA – 2013 – Present
Legal Nurse Consultant
Experience from pre-suit to verdict in medical malpractice and personal injury litigation, both plaintiff and defense, with a focus on surgical cases.
Provide appropriate expert witnesses for cases.
Review and evaluate billing records.
Provide Medical Cost Projections.
Attend Defense Medical Exams (DMEs).
Develop medical cost projections.
Create cost-effective chronologies and reports to provide efficient and effective timelines with correlation to the significant issues and standards of care.
Provide summary reports.
Educate attorneys, attorney staff, and clients regarding medical issues.
Research applicable literature.
Review and analyze medical documents.
Define and evaluate standards of care.
Provide support during discovery, depositions, trial, and other legal proceedings.
Provide education to nurses working in the legal field with a focus on intraoperative issues, including standards of care.
Redlands Community Hospital, Redlands, CA – 2009 to 2011
Manager, Post Anesthesia Care Unit, GI Lab, Pre-op Screening, Pre-op Admitting, Ambulatory Infusion Center
Oversaw all activities of the above departments.
Developed and implemented policies and procedures based on current standards of care.
Participated on multiple hospital-wide committees.
Collaborated with other managers to affect smooth operations.
Conducted staff meetings.
Initiated and maintained responsible staff scheduling practices and daily communications to create permanent records.
Managed departmental budgets.
OSA project

Long Beach/Anaheim Memorial, Long Beach, CA and Anaheim, CA – 2005 to 2009
Clinical Operations Manager, Women’s Operating Room
Accountable for efficient and cost-effective operations of the Women’s Operating Room Identified and directly addressed issues that affected quality of service.
Collaborated with managers, physicians, and others to maintain standards of care.
Integrated appropriate team members onto committees, teams, and projects.
Made employment decisions for personnel based on competencies and social skills required for specific job functions.
Ensured safe quality of care as defined by industry standards, regulatory bodies, and company policies and procedures.
Followed up on all unusual occurrences; participated on root cause analysis (RCA) teams.
Interdisciplinary Committee, Infection Control Committee.
Actively participated on women’s Careline and Best Practice system-wide teams to support and promote quality service – Code White project – managing blood loss in OB emergencies.

Anaheim Memorial Medical Center, Anaheim, CA
Interim Director, Perioperative Services
Simultaneously served as interim director of perioperative services (Operating Room, Recovery Room, GI Lab, and other related departments) for sister facility while maintaining full responsibility of Long Beach Women’s Operating Room.
Coordinated activities of all departments within perioperative services: OR, PACU, GI Lab, Pre-admitting, Pre-op, Observation Care, and Sterile Processing Department (SPD)
Investigated all unusual occurrence records.
Collaborated with CEO, Director of Nursing, Chief of Anesthesia, and Chief of Medical Staff to ensure continual safe delivery of patient care in all areas.

Kaiser Permanente, Anaheim – 2001 to 2004 Perioperative Educator/Staff Nurse

Responsible for development, coordination, implementation, and evaluation of nursing education programs and clinical competencies for all staff in the Operating Room and PACU.
Coordinated orientation of students.
Performed new employee evaluations.
Developed, maintained, and organized education records.

Initiated education for equipment, products, and procedures.
Developed and revised policies and procedures.
Followed up on all unusual occurrence reports.
Time Out/Human Factors project.
Recipient of National David O. Lawrence Patient Safety Award.

Star Lady Herbs, 100 East Market Street, Orwigsburg, PA
Owner and proprietor
Owner and proprietor of retail health food store serving as local source of quality herbs, vitamins, and health foods.
Focused on preventative medicine and holistic approaches to improve quality of life through public education and support groups.
Responsible for all activities necessary for efficient management of the business including advertising, funding, maintenance of products and supplies, scheduling of classes, and coordination of activities of associated therapists.
Provided health related classes to the community.

Good Samaritan Medical Center, Pottsville, PA – 1996 to 2000 Director of Physician Assistants
Proactively established role of RNFA (including job description, standardized procedures, and policies and procedures)
Hired and coordinated all activities of PA-Cs; worked closely with supervising physicians.
Managed department budget.
First assisted on all types of procedures provided by this 220-bed acute care center.
Formatted and revised policies and procedures for PA department.
Responsible for staff schedules and assignments, budget, employee evaluations, setting agendas and conduction of staff meetings.
Liaison between physicians and employees.
Coordinated activities of physician assistant students.
Participated on numerous hospital-wide interdisciplinary committees.
As director, continued to first assist on surgical procedures on a daily basis.
Preceptor: Clinical Instructor, PA Program – De Sales University, Allentown, Pennsylvania (formerly Allentown College).

St. Jude Medical Center, Fullerton, CA – 1974 to 1996 Positions held:
Assistant Nurse Manager, Surgical Services (acting manager)
Facilitated communications between physicians, staff, and sales reps.
Performed staff evaluations, made daily and monthly assignments for all staff.
Counseled staff as appropriate.
Continual staff development.

Ensured adherence to hospital policies and procedures and compliance with standards of care and regulatory agencies.
Created policies and procedures to effect necessary changes.
Conducted monthly staff meetings.
Clinical Instructor, Surgical Services (OR, PACU, GI Lab, Same Day Admitting, and Sterile Processing Department)
Developed, coordinated, implemented, and evaluated nursing education programs and clinical competencies for all staff.
Coordinated student activities within all of perioperative services.
Organized and maintained nursing education records.
Participated in establishment of department goals.
Initiated education for new equipment, products, and procedures to improve patient care.
Surgical Cardiovascular Coordinator
Responsible for development of cardiac service and maintenance of cardiovascular supplies, equipment, and implants.
Developed cardiac surgery teaching manual for hospital.
Coordinated education of staff.
Scrubbed and circulated for all types of procedures.
Served as preceptor, and trained personnel in specific procedures.
Responsible for procurement of all departmental supplies for all services.
Developed “Open Heart Teaching Manual” for facility.


Cypress College – AS in Nursing
Chapman University – BS in Health Science
UCLA – RNFA Certificate
Vickie Milazzo Institute – Legal Nurse Consulting Certification


Registered Nurse – CA #247337
Registered Nurse – PA – inactive
Certified Legal Nurse Consultant (CLNC) – Vickie Milazzo Institute, a division of Medical-Legal Consulting Institute, Inc. – expired
Legal nurse consulting certification through AALNC – in process
Certified Nurse Operating Room (CNOR) – active 1983-2012 – currently inactive


American Association of Legal Nurse Consultants (AALNC) – #19326403
West Virginia Upper Ohio Valley Chapter (AALNC)

Association of Operating Room Nurses (AORN) – #134318
Society of Gastroenterology Nurses and Associates (SGNA) – #269511
National Association of Orthopaedic Nurses (NAON)


Legal Nurse Consulting Conferences
Juris Education Resource Knowledge LNC 2014
American Association of Legal Nurse Consultants 2015, 2016, 2017, 2018
2013 Classes
Legal Boundaries and California Nursing Practice
CLNC Certification Program
NACLNC Apprenticeship Program
2014 Classes
Utilizing Lexis Nexis Case Map Suite for LNCs
How Much Does 3 Pounds of Matter, Matter?
Delayed Diagnosis in Breast Cancer
Analysis of Motor Vehicle Accidents
Discovering Pathology
Demonstrable Evidence in Radiology
When to Use an Expert to Add Value to Your Case
Death Investigation Basics
2015 Classes
Death Investigation Cultural Competency
Death Investigation Mental Health First Aid

Death Investigation Terminology and Diseases
Death Investigation Advanced Topics
AALNC Legal Nurse Consulting Educational and Networking Conference
Reptilian Theory and the LNC
Blunt Force Trauma
Understanding DUIs
Jail House Rock: Understanding Health Care Legal Risk in The Criminal Justice System
Sitting Linked to All-Cause Mortality, Even for Exercisers
Care of the Peri Anesthesia Patient
Legal Case Study: Acute Compartment Syndrome
Issues in Correctional Nursing
2016 Classes
Don’t Advertise Incompetency: How to Market Your Expertise and Skill Without Inadvertently Breaching Your Professional Obligations
Behavior Related to Injury “Who is This Person”
Insurance Defense: Corporate LNC Role
Nurse Malpractice Claims and Risk Management
The Case of the Wandering Wound: A Plaintiff Perspective in Litigation of the Long- Term Care Pressure Ulcer Case
Sepsis: The Medicine, Claims and Defenses

Patient Advocacy/Legal Obligation
Risk Tsunami in Health Care
Evaluating Risk/Patient Safety Programs in Physician Practices with a Standardized Tool: Using Data and Trends to Focus Improvement
Writing Skills for LNCs: How to Thrill Your Client
Defining Standards of Care for Radiology Nursing
Developing and/or Critiquing a Professional CV
Writing for Publication
The Down and Dirty on Duodenoscopes, Superbugs, and the FDA
Round Table Webinar: Report Writing
Traumatic Brain Injuries & the Role of the Neuropsychological Reports
Medical Cost Projections
Medical Treatment Utilization Schedule (MTUS)
2017 Classes
Insurance 101 and Other Relevant Legal Developments
Dealing with High Conflict People
How Bias Can Affect your Case
Walking the Line: The Past, Present, and Future of Unlawful Practice of Law
Making Valid Contracts
Research: Integral part of LNC role
Legal Implications in Cases Involving Limb Loss
Important Implications of the Informed Consent – Two Cases of Negligence
Neonatal Negligence: Aspects of Practice Liability
Pleadings, Discovery, and Trial: How Cases are Prepared for Trial from Day One

Hot OB Issues for the LNC
Anatomy of a Lawsuit: The LNC’s Role from Initial Screening Through Trial
Foot and Ankle Injuries, Malpractice and Medicine
2018 Classes
Boolean and Beyond: Research Skills to Make a Winning Case
Back to Basics: Pneumatic Tourniquet Use
Guideline Implementation: Positioning the Patient (in surgery)
Demystifying Interventional Radiology
Enhancing Pediatric Perioperative Patient Safety
Epilesy: Clinical Review and Surgical Options
Local Anesthetic Systemic Toxicity
Medicolegal Consequences of Post-Traumatic Stress Disorder in Civilian and Military Populations
The Case of the Elusive EMR: Discovering the Truth
Utilizing Adobe Pro in Your Medical Record Reviews
Issues in Dental Anesthesia Malpractice Cases
2019 Classes
Bariatric Surgery: A Unique Surgery with Unique Liabilities
Introduction to the Lost and Forgotten Surgical Item
A Change in Focus: Shifting from Treatment to Prevention of Perioperative Pressure
Using Interventional Radiology to Treat Postpartum Hemorrhage
Surgical Specimen Management in the Preanalytic Phase: Perioperative Nursing Implications
Bone Cement Implantation Syndrome: Key Concepts for Perioperative Nurses
Regenerative Wound Surgery: Practical Application of Regenerative Medicine in the OR

2020 Classes
Mesenteric Ischemia: Concepts of Care for the Bedside Nurse
An Overview of Retinoblastoma and Enucleation in Pediatric Patients
Back to Basics: Medication Safety (AORN)
Lymphedema and Lymphovenous Bypass: Perioperative Nursing Implications
Cardiothoracic Surgery and the Horrible Complications
Understanding PTSD
Dentistry & COVID-19
Intraoperative Irrigation: Fluid Administration and Management Amidst Conflicting Evidence
Vascular Assessment of the Foot Surgery Patient
The Good, Bad, and Ugly of Spinal Fusion
Postpartum Hemorrhage
2021 Classes
Culture of Safety in IR: Perspectives of an Expert Witness


AALNC Editor Committee member and peer reviewer since 2015
WVUOV Chapter Education Committee member – 2017-2019
WVUOV Chapter President-Elect 2017 (AALNC)
WVUOV Chapter President 2018 (AALNC)
AALNC Social Media Committee Chair – 2020, 2021
WVUOV Chapter Newsletter Co-chair – 2020
WVUOV Chapter LNC Advisor Co-chair – 2020
Peer reviewer for Legal Nurse Consulting Principles and Practices, 4th Edition New York, NY: Rutledge, Taylor, & Francis Group.
Peer reviewer for A Core Curriculum for Nurse Life Care Planning (2021) American Assoc of Nurse Life Care Planners, Hoffman Estates IL.