The largest vein in the body, the inferior vena cava, takes blood from the legs to the heart and lungs. A patient may receive an inferior vena cava filter, also known as an IVC filter, to capture a blood clot that breaks loose from a deep vein in one of the legs. This keeps it from reaching the pulmonary artery.
A doctor implants this small, cone-shaped device in the inferior vena cava below the kidneys to allow blood to flow around the clot until natural anticoagulants in the blood dissolve it. This procedure is performed to prevent a pulmonary embolism, which is a blockage that may cause shortness of breath, chest pain or death. Conflicting guidelines on the recommendations for filter insertion in various professional groups indicate there is not enough data to develop safe practices, increasing the likelihood for medical mistakes.
Insertion procedures lack regulations
Patients typically receive an IVC filter when anticoagulant therapy is not effective or is unadvisable because of other conditions. The number of filters placed has grown each year. However, studies show that filters left in the vein longer than 30 days may cause severe long-term risks, including the following:
- Organ and vein penetration
- Strut fracture of the filter
- Filter migration
- The formation of new blood clots
The longer the filter is left in the vein, the greater the risk of serious injury to the patient. After reviewing reports of filter-related complications in 2010, the FDA recommended that all IVC filters be removed immediately following the reduction of risk from the blood clot.
Not all filters are removed
The Journal of the American Medical Association Internal Medicine published a study involving the review of the charts of nearly 700 patients who received a retrievable IVC filter. Nearly half of those receiving the filter were trauma patients who were at risk for a blood clot but did not have one at the time. Many filters were inserted after the threat passed, or when anticoagulant therapy may have been a viable choice.
Only 8.5 percent were removed, in spite of the hazards of leaving them in place, and doctors were unable to retrieve the filters in 18.3 percent of the removal attempts. The study concludes that erratic usage of anticoagulant therapy, low removal rate and defective products make insertion of the filters a questionable practice in many cases.
A patient who is damaged by the improper use or insertion of an IVC filter may benefit from the advice of a medical malpractice attorney who is knowledgeable of the Illinois legal system.