Keywords
heart
catheter
surgery
positional asphyxia
malpractice
Abstract
The paper presents the case of a 55-year-old man whose body was found at home at the foot of the stairs. The inspection of the body at the scene showed that the probable cause of the man’s death was positional asphyxia after falling down the stairs. The forensic autopsy revealed a 10-cm-long tip of a nephrostomy catheter. To determine the time and circumstances of the foreign body’s entry into the heart and its possible impact on the man’s death, the medical history was analyzed. It indicated that the piece of the catheter entered the circulatory system during surgery performed few years before man’s death. The results of the postmortem examination, taking into consideration the obtained medical information, excluded the foreign body in the right ventricle of the heart as a contributory cause of the man’s death.
References
LeMaire SA, Wall MJ, Mattox KL. Needle embolus causing cardiac puncture and chronic constrictive pericarditis. Ann Thorac Surg. 1998;65(6):1786-1787.
Actis Dato GM, Arslanian A, Di Marzio P, Filosso PL, Ruffini E. Posttraumatic and iatrogenic foreign bodies in the heart: report of fourteen cases and review of the literature. J Thorac Cardiovasc Surg. 2003;126(2):408-414.
Symbas PN, Picone AL, Hatcher CR, Vlasis-Hale SE. Cardiac missiles. A review of the literature and personal experience. Ann Surg. 1990;211(5):639-647.
Moncada R, Matuga T, Unger E, Freeark R, Pizarro A. Migratory traumatic cardiovascular foreign bodies. Circulation. 1978;57(1):186-189.
Schechter DC, Gilbert L. Injuries of the heart and great vessels due to pins and needles. Thorax. 1969;24(2):246-253.
Mannea C, Sarafoleanu C. Iatrogenic foreign bodies in the maxillary synus: between malpraxis and medico-legal consequences. Rom J Leg Med. 2015; 23: 14-18.
Bobylev D, Meschenmoser L, Boethig D, Horke A. Migration of an endovascular stent into the right ventricle following deployment in the inferior vena cava after liver transplantation. Eur J Cardiothorac Surg. 2014. https://doi.org/10.1093/ejcts/ezu436
Vertolli U, Davis PA, Calò LA. Fractured catheter guide wire in the right ventricle of a dialysis patient. Nephrology. 2014;19(1):61-62.
Holdefer WF, Lyons C, Edwards WS. Indications for removal of intracardiac foreign bodies: review and report of four cases. Ann Surg. 1966;163(2):249-256.
Choi CH, Elahi MM, Konda S. Iatrogenic retained foreign body in the right atrium. Lessons to Learn. International Journal of Surgery Case Reports. 2013;4(11):985-987.
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Copyright (c) 2015 Karol Karnecki- Michał Kaliszan- Zbigniew Jankowski