Fehlinsertion

Fehlinsertion, literally “misinsertion” in German, describes the incorrect placement or insertion of a device, instrument, or component within a system or body. It is a generic term used across disciplines—most commonly in medicine and dentistry—to denote instances when an item is not located or oriented as intended, leading to reduced performance or potential harm.

In clinical settings, misinsertion can involve tubes or lines, such as a nasogastric tube positioned in the airway, a central venous catheter outside the venous system, or an endotracheal tube placed incorrectly in or near the airway. It can also refer to inaccurate placement of implants or prosthetic components during surgery or dental procedures, where a device sits in a wrong location or angulation.

Causes include anatomical variation, patient movement, limited visualization, insufficient training or experience, fatigue, and equipment limitations or failure. High-risk procedures and urgent situations increase the likelihood of misinsertion.

Detection is commonly via imaging or verification techniques, including radiographs, ultrasound, fluoroscopy, or endoscopic confirmation, often performed after the device is inserted or when function is abnormal. Consequences range from ineffective therapy and need for repositioning to serious injury, infection, or organ damage.

Prevention focuses on standardized protocols, checklists, adequate training, and real-time guidance such as ultrasound or image-guided navigation. Post-insertion verification and careful documentation are standard practices. If misinsertion is identified, removal or repositioning is undertaken as clinically appropriate, with monitoring for complications.