This case involves a male patient who underwent placement of a percutaneous endoscopic gastrostomy (PEG) tube. While the physician was awaiting confirmation that the PEG tube had been placed properly, the patient’s PEG tube became dislodged. The patient was subsequently discharged from the hospital without confirmation that the PEG tube was functional. An expert in gastroenterology was sought to discuss the standard protocols used to confirm the correct placement of the PEG tube.
Question(s) For Expert Witness
1. What has been your experience managing dislodged PEG tubes?
2. What are the standard protocols used to confirm the correct placement of the PEG tube?
Expert Witness Response E-216119
I have significant experience in the diagnosis and managing PEG tube complications. I have received numerous referrals for difficult PEG access, dislodged PEG, buried bumper syndrome, peritonitis, and even necrotizing soft tissue infections from dislodged PEG. I have repaired these using a variety of endoscopic, laparoscopic, and open techniques. I organized a symposium on management of PEG tube complications at the annual meeting of a parenteral nutrition society and have given several talks on the topic. There is no standard protocol for verifying PEG but verification generally consists of careful physical exam, tube injection study, CT scan if there is concern about the site. It is important to note a tube injection study alone can fail to diagnose a dislodged PEG, particularly if there is buried bumper syndrome.
About the author
Victoria Negron
Victoria Negron has extensive experience in journalism and thought leadership in the legal space, with a background crafting content, whitepapers, webinars, and current event articles pertaining to the role of expert witnesses in complex litigation matters. She is a skilled professional specializing in B2B product marketing and content marketing. Currently, she serves as an Enterprise Product Marketing Manager at Postman, and previously held the position of Technical Product Marketing Manager at Palantir Technologies, where she developed her skills in launch strategies, go-to-market strategy, and competitive analysis.
Her expertise in content marketing was further refined during her tenure at the Expert Institute, where she progressed from a Marketing Writer to Senior Content Marketing Manager, and eventually to Associate Director of Content & Product Marketing. In these roles, she honed her abilities in digital marketing, SEO, content strategy, and thought leadership.
Educationally, Victoria holds a Master of Business Administration from the University of Florida - Warrington College of Business and a Bachelor of Arts in Literature, Art, and Hispanic Studies from Hamilton College. Her diverse educational background and professional experience have equipped her with a robust skill set in product marketing, content development, and strategic marketing initiatives.
