Patient is Injured by Negligent Port Implantation
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Case Overview
This case takes place in Nebraska and involves a male patient who was diagnosed with a rare blood disease, for which he was receiving medical treatment. A port was to be placed to help administer the needed drugs. During the catheter placement surgery, the physician accessed a large vein but could not get the access that he needed – he then used an alternative approach that was apparently successful on the first try. Some weeks later, the patient returned to hospital for the first round of therapy. A nurse placed a syringe needle into the port and pulled the syringe plunger back to draw blood and informed the patient that it was working properly. However, the patient informed the nurse that he did not see any blood return. Nevertheless, the nurse proceeded with the therapy. Despite the fact that the man repeatedly told the nurse that he was in severe pain, the nurse continued to administer the treatment. When the patient left the hospital that afternoon he was in pain which was worsening as time went on. It became increasingly difficult for the patient to breathe, at which point he was taken to the emergency room by his wife. The patient presented to the ER with pain in his chest, where it was discovered that a large amount of the drug administered during his treatment had pooled within the tissues in his chest.
Questions to the General Surgery expert and their responses
Do you insert these ports? If so, how often?
I have placed PortaCaths in the past but I don't believe I have ever placed this brand.
What measures should be taken to ensure that the port is correctly positioned?
During the placement of the port they would have inserted a needle followed by a wire. The needle would have been removed and the dilator placed over the wire. The wire and dilator would have been removed and the catheter placed through the peel away sheath. This could have been done with or without fluoroscopy to confirm wire placement. After placement of the catheter, they should have checked for blood return. Final position is confirmed by X ray or fluoro at the end of the procedure.
About the expert
This double board certified surgeon specializes surgical critical care, and is the director of bariatric surgery at her university. She is a member of such prestigious professional societies as the American College of Surgeons and the Society of Laparoendoscopic Surgeons. In addition to her clinical appointments she also serves as an associate professor of surgery at a university medical center. She has published multiple peer-reviewed articles in several medical journals such as the World Journal of Gastrointestinal Surgery and the Journal of Robotic Surgery. In addition to her journal articles, this highly qualified surgeon has authored a book chapter gastric bypass surgery in an obesity management textbook. She lectures widely on laparoscopic surgery, gastric bypass surgery and the treatment of obese patients.

E-004704
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About the author
Joseph O'Neill
Joe has extensive experience in online journalism and technical writing across a range of legal topics, including personal injury, meidcal malpractice, mass torts, consumer litigation, commercial litigation, and more. Joe spent close to six years working at Expert Institute, finishing up his role here as Director of Marketing. He has considerable knowledge across an array of legal topics pertaining to expert witnesses. Currently, Joe servces as Owner and Demand Generation Consultant at LightSail Consulting.
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