Unrecognized tracheal intubation: a complication of the esophageal obturator airway

Esophageal obturator airway (EOA) use is not without risk. We present here the fatal cases of three patients in whom the trachea was inadvertently intubated with the EOA. In all three cases, the presence of tracheal intubation was unrecognized during the initial prehospital resuscitation, but was recognized and documented in the emergency department.