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Fatal Cardiac Tamponade Associated With Central Venous Catheter: A Report of 2 Cases Diagnosed in Autopsy

dos Santos Modelli, Manoel Eugenio PhD; Cavalcanti, Felipe Barbosa MD

American Journal of Forensic Medicine & Pathology: March 2014 - Volume 35 - Issue 1 - p 26–28
doi: 10.1097/PAF.0000000000000084
Case Reports

Abstract: The authors present 2 cases of fatal cardiac tamponade associated with the insertion of a central venous catheter. The first case occurred soon after the insertion of the catheter (early complication), and the second case, 4 days after (late complication). In both cases, the post–catheter insertion check chest x-ray film showed the tip of the catheter located within the heart silhouette. The diagnosis of cardiac tamponade was made only during the cadaverous examination. In the first case, the catheter was found to be in the right internal jugular vein at autopsy. The postmortem examination showed a clear liquid inside the pericardial cavity and the inferior vena cava injury. In the second case, the catheter had been inserted via the right subclavian vein puncture and there was a perforation of the right atrium at autopsy. The child was using total parenteral nutrition, and the intrapericardial liquid was milky. The incorrect placement of the catheter tip and unrecognized complications led the 2 children to death.

From the Institute of Legal Medicine of Federal District, Brasilia, Brazil.

Manuscript received March 22, 2013; accepted June 12, 2013.

The authors report no conflicts of interest.

Reprints: Manoel Eugenio dos Santos Modelli, PhD, Institute of Legal Medicine of Federal District, SPO, Cj B, Lt 23, Complexo da PCDF, CEP 70.610-907 Brasilia, Brazil. E-mail: manoelmodelli@gmail.com.

© 2014 by Lippincott Williams & Wilkins.