A COVID test being conducted through a woman's neck at a hospital in the U.K. went wrong after the swab snapped off and entered her lungs, a case report shows.
The 51-year-old patient had recently undergone brain surgery and as part of her treatment had been fitted with a tracheostomy tube—a device inserted into a hole made in the neck and windpipe that is designed to help an individual breathe.
Following the operation, medical staff at University Hospitals of Leicester NHS (National Health Service) Trust sent the woman to get a COVID-19 test as part of normal protocol prior to discharging her to a nursing home.
Staff decided to take a swab for the virus through the tracheostomy tube, given that the patient had been breathing through the hole in her neck and, thus, could potentially have become infected via this airway.
But during the procedure, the nurse responsible felt part of the swab snap, with one end falling into the windpipe, a case study published in the BMJ described.
The report says the patient became "momentarily unsettled" and she began breathing more heavily for a moment before quickly returning to normal.
Medical staff subsequently performed a CT scan of her chest but initial inspection of the images did not reveal any signs of a foreign object, although they did indicate the presence of some inflammation in the lower part of the right lung.
Further analysis of the images raised suspicions that a foreign object was present so doctors then decided to conduct a procedure known as an endoscopy in which a long, thin, flexible tube with a camera and light at the end—known as an endoscope—is used to look at organs inside the body.
The authors of the case report said that while this common procedure is safe and reliable, it is "high-risk" in the era of COVID-19 due to the potential of infection with the SARS-CoV-2 virus.
Medical staff inserted the endoscope into the tracheostomy site and eventually identified the swab stuck in the right lung. It was later removed using an endoscope fitted with a special device designed for removing objects from the body.
The authors said this case "highlights the need for clear guidance" on how SARS-CoV-2 virus samples are taken from patients who have had undergone a tracheostomy or laryngectomy—surgical removal of the larynx—and have holes in the front of their necks for breathing.
A spokesperson for the University Hospitals of Leicester NHS Trust told the BBC that "additional safety measures" had been put in place following the incident.
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Aristos is a Newsweek science reporter with the London, U.K., bureau. He reports on science and health topics, including; animal, ... Read more
