IATROGENIC INJURIES DURING CENTRAL LINE PROCEDURES AND RELATED MEDICO-LEGAL ISSUES: A CASE SERIES OF FOUR CASES
DOI:
https://doi.org/10.48165/jfmt.2024.41.2.44Keywords:
Central line, complication, pneumothorax, guide wire, artefact, neck compressionAbstract
A central venous line is frequently placed for a number of reasons in various therapeutic contexts. Central lines come with a number of risks, and the procedure can lead to several complications. The nature of complications varies depending on the kind of central venous access and might manifest either immediately or later on. Iatrogenic injuries associated with central venous access can lead to significant morbidity and mortality. These injuries are medico-legally very important, as they may cause the wrong interpretation by an inexperienced autopsy surgeon due to artefacts. Artefacts as a result of iatrogenic injuries in the form of diffuse effusion along neck muscles may be interpreted as neck compression by blunt force. Wrong technique during the procedure of central line may lead to fatal injuries due to guide wire or puncture needle insertion. Such iatrogenic injuries causing death may be grounds for a charge of medical negligence against treating doctors. This article discusses four cases of iatrogenic injuries due to the central line and its relevant medico-legal aspects.
Downloads
References
Taylor RW, Palagiri AV. Central venous catheterization.Crit Care Med. 2007;35:1390–6.
Olds K, Byard RW, Langlois NE. Injuries associated with resuscitation – an overview. J Forensic Leg Med. 2015;33:39–43.
Khasawneh F.A., Smalligan R.D. Guidewire-related complications during central venous catheter placement: a case report and review of the literature. Case Rep Crit Care. 2011.
Kornbau C, Lee KC, Hughes GD, Firstenberg MS. Central line complications. Int J CritIllnInj Sci. 2015;5:170–8.
Bowdle A. Vascular complications of central venous catheter placement: evidence-based methods for prevention and treatment. J CardiothoracVascAnesth. 2014;28:358–68.
Vats HS. Complications of catheters: tunneled and nontunneled. Adv Chronic Kidney Dis. 2012;19:188– 94.
Pillai L, Zimmerman P, d’Audiffret A. Inadvertent great vessel arterial catheterization during ultrasound guided central venous line placement: a potentially fatal event. J Vasc Surg. 2009;53:74.
Denys BG, Uretsky BF. Anatomical variation of internal jugular vein location: impact on central venous access. Crit Care Med. 1991;19:1516–19.
Harm T, Rajs J. Face and neck injuries due to resuscitation versus throttling. Forensic Sci Int. 1983;23:109–16.
Bhutta ST, Culp WC. Evaluation and management of central venous access complications. Tech VascIntervRadiol. 2011;14:217–24.
McGee DC, Gould MK.Preventing complications of central venous catheterization. N Engl J Med. 2003;348:1123–33.