Document Detail

Injuries and liability related to central vascular catheters: a closed claims analysis.
MedLine Citation:
PMID:  15166560     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: To assess changing patterns of injury and liability associated with central venous or pulmonary artery catheters, the authors analyzed closed malpractice claims for central catheter injuries in the American Society of Anesthesiologists Closed Claims database. METHODS: All claims for which a central catheter (i.e., central venous or pulmonary artery catheter) was the primary damaging event for the injury were compared with the rest of the claims in the database. Central catheter complications were defined as being related to vascular access or catheter use or maintenance. Statistical analysis was performed using the chi-square test, Fisher exact test, or Z test (proportions) and the Kolmogorov-Smirnov test (payments). RESULTS: The database included 110 claims for injuries related to central catheters (1.7% of 6,449 claims). Claims for central catheter injuries had a higher severity of injury, with an increased proportion of death (47%) compared with other claims in the database (29%, P < 0.01). The most common complications were wire/catheter embolus (n = 20), cardiac tamponade (n = 16), carotid artery puncture/cannulation (n =16), hemothorax (n =15), and pneumothorax (n =14). Cardiac tamponade, hemothorax, and pulmonary artery rupture had a higher proportion of death (P < 0.05) compared with the rest of the central catheter injures. The proportion of claims for vascular access injury increased (47% to 84%) and use/maintenance injury decreased (53% to 16%) in 1994-1999 compared with 1978-1983 (P < 0.05). CONCLUSIONS: Claims related to central catheters had a high severity of patient injury. The most common complications causing injury were wire/catheter embolus, cardiac tamponade, carotid artery puncture/cannulation, hemothorax, and pneumothorax.
Karen B Domino; T Andrew Bowdle; Karen L Posner; Pete H Spitellie; Lorri A Lee; Frederick W Cheney
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Anesthesiology     Volume:  100     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-05-28     Completed Date:  2004-06-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1411-8     Citation Subset:  AIM; IM    
Department of Anesthesiology, University of Washington, Seattle, 98195-6540, USA.
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MeSH Terms
Catheterization, Central Venous / adverse effects*,  statistics & numerical data*,  trends
Chi-Square Distribution
Databases, Factual / statistics & numerical data,  trends
Insurance Claim Review / statistics & numerical data*,  trends
Intraoperative Complications / epidemiology*
Malpractice / statistics & numerical data*,  trends
Statistics, Nonparametric

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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