A 67-year-old woman complained to her primary care physician of persistent abdominal pain that she had endured for four years. She described the pain as a dull ache that persisted constantly, made worse by movement and eating. When the physician looked into her medical history, he saw that she previously had multiple instances of deep vein thrombosis (DVT) and hypercoagulability.
She had received a Günther Tulip vena cava filter made by Cook Medical five years prior.
Because of a lack of other symptoms, an esophagogastroduodenoscopy (EGD) was performed. Everything seemed normal at first, until the scope was advanced further. A thin, metallic foreign body was discovered puncturing the duodenum wall. After the EGD, the patient was questioned, and she assured doctors she wasn’t aware of ingesting anything that could have contained something like that.
After a thorough CT scan, doctors discovered that a leg of the patient’s inferior vena cava (IVC) filter had punctured through the vena cava wall and stabbed into the the adjacent portion of the duodenum. Because retrieval of the filter would have been a major surgery, doctors opted not to operate.
But for the unfortunate patient, the pain persisted. She returned, weeks later, with the exact same complaints of pain.
Doctors attempted to retrieve the IVC filter by interventional radiology, but failed, and the inferior vena cava was perforated. The patient then underwent an exploratory laparotomy, where the filter was successfully removed and the perforation repaired.
Her pain resolved immediately.
Retrievable IVC filter manufacturers such as C.R. Bard and Cook Medical currently face a number of lawsuits alleging injuries and death linked to filters that have migrated, fractured or tilted inside the body after they have been inserted.