This case takes place in Indiana and involves a patient with a past medical history of intravenous drug abuse. The patient was due to undergo a radiology procedure, and the patient’s PCP requested that a PICC line -as opposed to a standard catheter – be used to inject the contrast fluid. Instead of using a PICC line, as was ordered by the patient’s PCP, the radiologist elected to use a standard catheter. Because of the patient’s long history of drug abuse, the catheter ruptured the vein in which it was placed, and as a result a significant amount of contrast material entered the patient’s body. The patient suffered compartment syndrome and carpal tunnel syndrome, requiring additional treatments and causing permanent injury.
Question(s) For Expert Witness
1. Do you have experience inserting PICC lines?
2. Was a PICC line indicated in the case outlined in the above summary?
Expert Witness Response E-007952
I have extensive experience inserting PICC lines. I am unclear about which "radiology procedure" the patient was to undergo. I assume it was a contrast-enhanced CT scan. Based on this assumption, in most "uncomplicated" patients, a PICC line is not necessary for contrast administration. A standard angiocatheter can be used most of the time. However, a patient with a past medical history of IV drug abuse represents a "complicated" patient. Repeated peripheral access with infusion of non-medical substances can cause peripheral venous stenoses and occlusions. In that instance, it is neither unreasonable nor uncommon to request a PICC or other type of central venous catheter for contrast administration. So, if my assumptions are correct given the provided history, a PICC (or other central venous catheter) was indeed indicated.
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.
