CT Contrast Injection Leak Causes Patient Compartment Syndrome

This case involves a 28-year-old male patient who underwent an IV infiltration at a radiology clinic prior to having imaging. In the process of having a CT scan with contrast, the contrast extravasated into the patient’s left hand. The patient noted severe swelling and pain and notified the technologist. Once the technologist was notified, the patient was sent to the emergency room. The patient was then urgently sent to the operating room where he had a fasciotomy due to compartment syndrome in the left hand with a carpal tunnel release. Following the surgery, the patient was put on a 5-pound lift, push, and pull restriction for his left hand.

Question(s) For Expert Witness

1. How often do you place IVs in patients prior to the performance of imaging studies?

2. What factors contribute to contrast extravasation?

Expert Witness Response E-135834

inline image I'm a CT technologist with a master's degree in health administration and a certification as a radiology administrator. IV's are used commonly in CT to provide enhancement of infections, lesion/tumors, and highlight structures, such as arteries and veins and bleeds. Approximately 25-35% of cases require contrast injections. Contrast must also be given at specific speeds based on the enhancement required. Pulmonary emboli studies have to be injected at a high rate and contrast given and the machine engaged within 25 seconds of the start of that injection. Based on this, many variables can lead to contrast extravasation including patients habitus, injection site, etc.

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.

CT Contrast Injection Leak Causes Patient Compartment Syndrome

Question(s) For Expert Witness

Expert Witness Response E-135834

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