Mild stroke due to air embolus
When patients are in the hospital, they often have different lines or catheters that are in place,
and from time to time, those lines are re-positioned or removed. When that happens, it is most
important that doctors and nursing staff follow appropriate procedures when manipulating the
lines. One of the most serious complications that can occur with an IV line that is not properly
handled is an air embolus. If air enters an IV line and travels to the brain, it can cause a stroke.
Therefore, there are specific procedures that are to be followed in order to avoid entry of air into
In this particular case, our client, a woman in her mid-50’s, was recovering from lung surgery
and was doing quite well. She had a central venous catheter in place for a few days, and then
when it was no longer needed, a nurse entered the room and removed the line. Any time a
central venous is removed, there are two important precautions for the nursing staff to take.
First, the patient should be lying flat on their back, i.e., the bed should not be inclined at all.
Second, the patient should be told to hold their breath for a few seconds while the line is being
removed as that reduces the chance of air being drawn into the line. In this case, the nurse failed
to place the bed in a flat position and instead, had it elevated to well over 45 ◦ . Soon after she
removed the line, the patient started to develop some neurologic changes, and she was
immediately sent for a CT scan of the brain. That scan showed the presence of air which had
caused some small areas of infarct in her brain. In simple language, the air had caused a mild
While the patient survived the episode, she was left with some moderate loss of function in her
right arm and her lower right leg. Her arm was weaker. This woman lived alone and as a result
of these moderate limitations, she needed some assistance around the house in performing her
daily affairs. She was not working and, therefore, we had no claim for loss of wages. Instead,
the focus of the damage claim was on the need for assistance at home and the change in her