Nurse’s IV Placement Technique Contributes to Cellulitis and Sepsis

This case involves a patient who was transported to a hospital after experiencing a cardiac event. While the patient was being worked up and awaiting treatment, a nurse had several failed attempts at placing an IV line and reportedly deviated from the aseptic technique. The description from the patient’s wife was that the nurse never swabbed the skin with antiseptic solution and repeatedly dropped the exposed needle onto the bed before inserting it into the skin on a second attempt. Subsequently, the patient developed cellulitis at the IV puncture site and severe sepsis during his hospital stay.

Question(s) For Expert Witness

Expert Witness Response E-000168

Yes, sterile technique is absolutely required when starting an IV line or taking blood from a patient. The situation described above could very well be the cause of the patient’s cellulitis. If the cellulitis was missed for some time or improperly treated, it may have progressed, causing serious illness by uncontrolled contiguous spread, including via the lymphatic or circulatory systems. Certain species, most notably group A beta-hemolytic Streptococcus and S aureus, produce toxins that may mediate a more severe systemic infection, leading to septic shock and death.

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