title: [A fatal bleeding complication following central venous catheterization in end-stage pancytopenia. Medical and legal consequences].
abstract: An attempt to insert a central venous catheter into the internal jugular vein of a patient suffering from pancytopenia failed and due to massive bleeding into the cervical tissue the patient developed severe dyspnoea and died during unsuccessful endotracheal intubation. A five-year judicial inquiry finally discharged the anaesthesiologist revealing that forensic aspects like a valid patient's consent, exact documentation of operations and therapies, clear arrangement with patient's relatives as well as an early detailed written epicrisis play a major role. This may be the only way to early counteract medically inane causal relationship being presented by the relative's advocate. Especially in the patient at high risk central venous catheterisation requires strict checking the indication, the corresponding choice of the correct technique during venipuncture, and a sufficient haemostatic pretreatment and care after catheterisation.
authors.affiliation: Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum der GHS Essen.
authors.forename: R
authors.initials: R
authors.lastname: Scherer
authors.forename: M
authors.initials: M
authors.lastname: Günnicker
authors.forename: A
authors.initials: A
authors.lastname: Marichal
authors.forename: L
authors.initials: L
authors.lastname: Stöcker
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005858:Germany; D006470:Hemorrhage / Q000209:etiology* / Q000401:mortality; D006801:Humans; D007601:Jugular Veins / Q000293:injuries*; D007603:Jurisprudence; D008297:Male; D008499:Medical Records / Q000592:standards; D010198:Pancytopenia / Q000150:complications*
vernacular_title: Tödliche Blutungskomplikation nach zentralem Venenkatheterismus bei behandelter Panzytopenie im Finalstadium. Medizinische und strafrechtliche Konsequenzen.