Responding to a code, two experienced endoscopists attempted intubation with what seemed to be a correctly functioning laryngoscope (Welch Allyn fiberoptic Mach 3, Skaneateles Falls, NY). Both examined the laryngoscope before insertion, but at laryngoscopy, illumination of the glottis was not achieved.

Closer examination of the blade revealed a misassembled laryngoscope blade with the fiberoptic light source on the outside of the blade (fig. 1) instead of its correct position (fig. 2). Another laryngoscope was used at this point, and intubation was performed easily, revealing normal anatomy.

Fig. 1. Misassembled laryngoscopic blade. 

Fig. 1. Misassembled laryngoscopic blade. 

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Fig. 2. Normal laryngoscopic blade. 

Fig. 2. Normal laryngoscopic blade. 

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The fiberoptic component of this type of laryngoscopy blade is removable for cleaning or can spontaneously come loose. Care should be taken during its reassembly.

Laryngoscopy and intubation can be difficult enough. We present one more possible pitfall.

When examining a laryngoscope before use, it is not enough only to “see the light.”

*Shaarei Zedek Medical Center Jerusalem, Israel. dbri306@hotmail.com