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Feeding Tubes Can Save a Life or End It

Steven E. North and Laurence M. Deutsch

Patients who have trouble swallowing or who are unable to consume sufficient nutrients to remain healthy may require a feeding tube. The insertion used to be, and sometimes still is, a “blind” procedure, but three different enteral access systems (EAS’s) for guided insertions, two of which are marketed in the United States, have been approved by the US Food and Drug Administration (FDA).

Unfortunately, these technologies do not guarantee a successful placement. While pneumothorax (lung collapse) is a known – if rare – complication of blind insertions, the FDA has received numerous reports of pneumothorax events associated with EAS’s, according to a recent Medscape.com article.

“Most reports indicate these pulmonary events required urgent intervention, including needle decompression or chest tube placement. Several of these events were associated with cardiopulmonary arrest and patient death," the FDA said in a safety communication issued January 11, 2018.1

Is pneumothorax resulting from a feeding tube insertion grounds to bring a medical malpractice suit? It is possible, but according to the FDA, “the relationship between the pulmonary event and the death cannot be concluded definitively in all cases."2

However, there are circumstances in which pneumothorax could result in a sound case. For example, a case might be successfully brought if:

  • An insertion guiding device is used by a staff member who has not received the required training developed by the manufacturer
  • A person performing the insertion is not credentialed for the procedure within the institution where the insertion is taking place
  • A patient has contraindications for naso-enteric feeding tubes in general
  • The device (specifically, the device manufactured by Cortak) was used in close proximity to other electrical equipment (especially those emitting in the 20 to 300 kHz frequency band) because readings may be affected

The FDA is working with manufacturers of EAS devices to better understand the risks associated with their use and contributing factors. We advise clients facing the insertion of a feeding tube to verify that the medical personnel who will be doing the procedure are credentialed in the use of the specific device that will be employed.

1“Pneumothorax Events Linked to Placement of Enteral Feeding Tube,” Megan Brooks, Medscape.com, January 11, 2018)

2Feeding Tube Placement Systems: Letter to Health Care Providers - Reports of Pneumothorax Events