The patient is currently in serious condition. Photo: Felix Wong

Family lodges complaint as Hong Kong girl, 19, suffers stroke after operation for kidney condition

Internal review of procedure conducted after catheter insertion into neck hits artery

The family of a 19-year-old girl has lodged a complaint after she suffered a stroke possibly due to complications during surgery to treat her for kidney failure.

An internal review of the clinical procedure was conducted after a catheter insertion into her neck hit an artery – a known complication in the high-risk operation.

The teenager is currently in serious condition in a public hospital intensive care unit.

The incident took place after the patient was admitted to the Princess Margaret Hospital renal ward on April 11 for pneumonia, a Hospital Authority spokesman said.

On April 21, she was transferred to the intensive care unit after doctors noted a drop in oxygen concentration in her blood. She was also found to have dilated cardiomyopathy – a condition in which the heart becomes enlarged and cannot pump blood efficiently, leading to poor cardiac function.

Five days later, on April 26, a catheter was inserted to facilitate continuous kidney dialysis.

The insertion was carried out through her neck to her vein guided by ultrasound. But the doctor immediately stopped the procedure after realising the insertion had hit her artery, the spokesman said.

It was later confirmed that the artery had been punctured, and a hematoma, or abnormal bleeding, was found in her neck. The doctor immediately administered a drug to prevent the formation of a blood clot.

The patient was then transferred to Queen Elizabeth Hospital on April 27 for cardiothoracic surgery.

The spokesman said an operation was conducted the next day, and her damaged artery was successfully repaired. Her condition later stabilised.

However, from early this month, the patient developed weakness on the right side of her body and had difficulty speaking.

Magnetic resonance imaging (MRI) showed narrowing of her cerebral artery, and she was diagnosed with a stroke afflicting her right side.

The spokesman said it was revealed that a cardiac condition had given rise to the blood clot, which resulted in a stroke.

The concerned catheter insertion is a high-risk medical procedure with known complications, which contains risk of arterial puncture and may lead to stroke.
Hospital Authority spokesman

He added that the patient’s family had lodged a complaint. An internal review of the procedure had been carried out in the department concerned. The two hospitals will meet the family next week to explain what happened.

The spokesman said: “The concerned catheter insertion is a high-risk medical procedure with known complications, which contains risk of arterial puncture and may lead to stroke.”

The attending doctor had informed the patient and her family about the risk of the procedure, he added.

Former Society of Nephrology chairman Dr Chau Ka-foon said the incident was an unfortunate event and agreed that the catheter insertion was a procedure with known complications, considering how close the artery and vein on the neck were.

She said it was “not uncommon” to see an insertion hitting the artery, not the vein, and this was usually quickly noticed due to the distinctive differences between blood in an artery and a vein.

Both the repair surgery for the artery and the patient’s weak cardiac function could contribute to the formation of a blood clot, she said.