Defective spinal needle: failure in piercing the skin during lumbar puncture.

Sir,

Through this letter I wish to highlight a failure to pierce the skin with a defective single use Qiuncke type spinal needle. A standard and apparently normal looking 26 G × 9.0 mm Qiuncke type needle failed to pierce the skin despite use of moderate force in a 50 yr old patient posted for vaginal hysterectomy. The needle was replaced with another 26G needle of the same company and the lumber puncture was performed easily.

Careful naked eye examination of the first needle revealed slightly elevated tip of its stylet. Since this incidence occurred in multispeciality camp in a remote area of this mountainous state, we did not have microscopic equipment. However a digital photograph on magnification of image revealed that bevel of the stylet was rotated at 180°, was facing the bevel of needle and was acting as a fork (Fig. 1–2). Application of force was possibly further separating the needle from the stylet (Fig. 3). Deformed1 and broken23 needles have been reported previously but this type of defect is a new experience. It is therefore suggested that in case of excessive resistance or grating feel while inserting a spinal needle, it should be minutely examined for any deformity of its stylet.

Figure 1

Magnified photograph of the defective needle

Figure 2

Magnified backlit image of the needle clearly showing the defect

Figure 3

A drawing to illustrate that force to insert the needle was further separating the stylet from needle