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Halle,
I had a case like this, but in my case the tip of
the catheter wasbroken off when the line was d/c'd. the patient went to
the hospital because the PICC that came out was 42cm and the length I recorded
was 48cm. They were unable to see the catheter on xray because it was 4fr
and the patient was heavy, so it did not show up. The ER Dr. decided that
I recorded the wrong lenth and sent the patient home. I spoke to this
patient about 6 months later and he told me what had happened and I told him
that he had about 6cm of cathter still in him and to remember this because it
would probably come up in the future...6 months after this, I had a cardiologist
approch me and ask me "do you remember Mr. so-n-so" and I said.."you found the
rest of my catheter!" Sure enough, the patient was admitted with an
arrythmia and they did a TEE on him and this allowed them to see the
catheter. They took the patient to specials and used a snare to remove
it. Very interesting case! Of course it went to risk
management.
I don't see any other way a PICC could be
responsible for an arrythmia 3 years later.
Dave R.N.
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