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December 2004, Volume 34 Number 12 , p 74 - 74




  • Source

    IN NOVEMBER 2000, Howard Carver, 73, went to the ED at Orlando (Fla.) Regional Medical Center (ORMC) complaining of chest pain. Admitted to the telemetry unit to rule out myocardial infarction (MI), he also was to receive antibiotic therapy to treat a urinary tract infection. On November 8, Annette Combs, RN, placed a peripherally inserted central catheter (PICC), as ordered.

    The next day, 23 hours after catheter placement, an X-ray revealed that the PICC was looped with its tip resting in the right atrium. To properly reposition the tip in the superior vena cava, a nurse trained to place and remove PICCs pulled the catheter back approximately 5 cm. Carver's heart rate rose to 120, and he was transferred to the CCU. He died several days later. The cause of death was listed as heart failure following an acute MI stemming from a prolonged history of ischemic cardiomyopathy.

    Caroline Carver served ORMC with a notice of intent to ...

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