Pneumothorax After Acupuncture: Medicolegal Consequences and Prevention

• Published in: Medical acupuncture Vol. 35; no. 1; pp. 9 - 12
• Main Author: Ochi, James W.
• Format: Journal Article
• Language: English
• Published: Mary Ann Liebert, Inc., publishers 01.02.2023
• Subjects: Brief Report; acupuncture; licensing board; complication; medicolegal; medical expert witness; pneumothorax
• ISSN: 1933-6586; 1933-6594
• DOI: 10.1089/acu.2022.0056

Objective: Pneumothorax is the most common serious complication of acupuncture and can be fatal. The aim of this research was to review publicly available documents from the California Acupuncture Board on pneumothorax after acupuncture. Materials and Methods: Searches for accusations involving pneumothorax filed against licensees were conducted on September 21, 2021, and on July 3, 2022. Results: Nine cases of pneumothorax were found for a timeperiod over 12 years. There was no evidence in any of the cases that precautions were taken to avoid pneumothorax. Two practitioners voluntarily surrendered their licenses, 6 were required to complete a court-ordered remediation program, and 1 received a public reprimand from the Board. The mean cost to the practitioners for investigation and enforcement was $7,868.35. None of the 9 patients were immediately referred to a physician by the practitioner as required by law. Conclusions: Patients are vulnerable to pneumothorax when acupuncture points between the shoulder blades are needled, as the distance from the skin to pleural surface is only 10–20 mm in this area. GB-21 should also be used with care, as this acupoint is close to the pleural apex. Using shorter needles, grasping the skin to retract the soft tissue away from the chest wall, and inserting needles at an oblique angle are techniques to minimize this possibility. If a patient has chest pain or shortness of breath during or after acupuncture, emergency services should be called to have the patient evaluated without delay.