Answers are grounded in this paper and cite their sources.
Case report discusses clinical, legal, and ethical issues when a patient leaves AMA with a neuraxial catheter.
A male in his 30s underwent retroperitoneal mass excision. A T8–T9 epidural catheter was placed for postoperative analgesia, infusing 0.0625% bupivacaine and 2 µg/mL fentanyl at 8 mL/h. That evening, the patient left against medical advice (AMA) while declining epidural catheter removal. The patient returned 2.5 hours later for an uneventful epidural removal. We examine the clinical, legal, and ethical considerations of a patient leaving AMA with a neuraxial catheter. While medical ethics and US law guarantee patient autonomy, this situation conflicts with obligations to prevent harm including potential neuraxial infection, hematoma, or retained catheter fragments. We describe our response to this scenario and discuss steps to mitigate this uncommon but high-stakes situation.
No takes yet. Share an insight, caveat, or question.
Murgoi et al. (2026) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: