It does not only happen to others!

Marie is a young mother of two children. She discovered a small mass by self-breast examination. After doing a mammography, a breast tumor was confirmed. Later, she had a partial mastectomy and an axillary node clearance. She was also prescribed an adjuvant chemotherapy with a port catheter in jugular vein placement.

Michele was a junior resident who was a few months away from getting her degree as a Gynecologic Surgeon. She took care of the device’s placement.

The introducer was advanced with only a small resistance and Michele discovered a pulsatile red flow. She asked the operating room nurse to call the senior surgeon. His answers were: “It is an infrequent problem but not that important” and “you can remove the devices and compress”.

Mary was starting to breath with difficulty when the Anesthesiologist called, diagnosed her with coma (Glasgow 7) and put a tracheal tube. An Angio CT scan was then performed, and a massive stroke attack was confirmed.

Mary unfortunately passed away.

Michele, the Senior Surgeon, and the Nurse were interviewed by the police.