In Reply:- In the case described in this letter to the editor, it was fortunate to have observant and knowledgeable professionals performing the procedure. Arrow International agrees with the conclusion of the practitioners: care must be used when handling and inserting all catheters through an introducer system.
The Arrow TwistLock Cath-Gard catheter contamination shield is designed to pass an 8-French catheter without resistance. Additionally, to accommodate variations in catheter outside diameters, which can vary among catheter manufacturers, the minimum inside diameter of the Arrow Cath-Gard is intentionally larger than 8 French. Arrow was not informed of this incident and unfortunately did not have the opportunity to inspect the sample of the catheter and introducer involved. Therefore, it is difficult to draw further conclusions without a physical inspection of the components. We encourage inspection of the catheter and introducer before and during use. The product instructions for both the catheter and the introducer system recommend ways for reducing the potential for catheter complications and for optimizing product performance. Should a problem occur, Arrow encourages prompt and accurate reporting of the incident to the manufacturer so that the cause may be investigated; this includes retaining and returning the involved product for analysis.
Matthew J. Moore
Product Specialist; Critical Care Products; ARROW INTERNATIONAL, INC.; Reading, Pennsylvania
(Accepted for publication April 24, 1998.)