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Misplacement of subclavian vein catheter in a neonate: What went wrong?

Malpositioning is a known complication of central venous catheterization in neonates.[1] We describe a misplacement of the right subclavian vein (SCV) catheter into the contralateral SCV in an infant. Such misplacement not only can impede the venous return but also can distort the central venous pressure measurement[2] that may be significant in a neurosurgical patient. Repositioning also adds to the operating room cost and time. We present a hypothesis involving a possible anatomical factor contributing to the misplacement.