Iatrogenically-related, fatal haemorrhage occurring in end-stage renal failure: a series of three cases

Three patients with end-stage renal failure died from acute haemorrhage which, in the first two cases, was related to the use of internal jugular catheters for haemodialysis. In the third instance, severe haemorrhage was caused by the apparent self-insertion of a 16-gauge butterfly needle, connected to a siliconised cannula (also designed for haemodialysis) into the superficial median cubital vein of the left forearm. The hazards associated with the use of internal jugular catheters and the medicolegal implications of these cases are briefly discussed.