Disabling Outcomes After Peripheral Vascular Catheter Insertion in a Newborn Patient: A Case of Medical Liability?

Background: The positioning of peripheral venous catheters (PVC) is an invasive procedure commonly performed in pediatricshospital wards to obtain vascular access for the administration of fluids, medications and other intravenous(IV) therapies. Many studies exist about management of peripheral venous access in adults. On the contrary,scientific evidence on the management of this procedure in children and newborns, especially regardingthe optimal duration of infusion and the possible related side effects, is still poor.To minimize the risk of phlebitis, the guidelines of the US Centers for Disease Control and Prevention suggestthe replacement of the catheter every 72–96 hours in adult patients, while in pediatric patients the cathetercan remain in place for the entire duration of the IV therapy, unless complications arise.Case Report: In the presented case, after the positioning of a PVC in a newborn, no clear signs/symptoms of phlebitis wereregistered before the sixth day and, despite the immediate removal of the catheter, the thrombotic process,secondary to phlebitis, was already occurring, causing serious and permanent disabling outcomes, susceptibleto legal medical evaluation and financial compensation.Conclusions: The knowledge of this case is particularly interesting to clinicians working in the field of neonatal care and toclinical risk management services inside hospital structures, since similar cases may be the source of requestsfor extremely high financial compensations due to medical liability.