A 42-year-old male with a history of asthma and several hospital admissions due to severe bronchial asthmatic concrete, five times during the previous eight years.
On this occasion he was admitted from his home with suspected hemoptysis, and bronchoscopy and gasoscopy were normal.
On the morning of the third day of hospitalization, a antecubital Drum is placed to ensure a venous access route in case of severe bleeding.
In the early morning, about 20 hours after the placement of the above mentioned Drum, she suffers a deterioration of her general condition with profuse sweating, vomiting and cardiorespiratory arrest that, in spite of resuscitation.
A medico-legal autopsy is performed, both because physicians are unaware of the cause of death and because family members, in the event of the unexpected death, denounce an alleged professional malpractice.
The autopsy revealed a normal male of 1.67 m, 80.5 kg and body mass index of 28.69 (overweight), with orotracheal tube properly inserted and antecubital Drum coflex in the right.
Tension hemopericardium, 345 ml of diluted liquid blood with few clots are collected.
Once the pericardial effusion has been evaccinated, it is observed in the pericardium cavity 4 cm from the end of a venous catheter that exits through an orifice of about 3 mm in diameter in the anterior side of the atrial appendage.
The borders of this orifice are irregular, lacerated, and have adhered fibrin and coagulated remains.
The catheter is continued with the antecubital Drum.
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The internal face of the right atrial appendage, in an area of 3.5 × 2.5 cm in maximum dimensions, surrounding the point at which the catheter is exteriorized, shows endocardium with numerous bleeding points and endoleaks.
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The rest of the organs do not present significant alterations, except intense generalized congestion.
Histopathological study confirmed the macroscopic findings.
In the chemical-toxicological analysis only the drugs with which the patient was being treated were detected at therapeutic concentrations.
