Learning from litigation - Pneumothorax from acupuncture and/or dry needling

Drawing on claims and experience of the CSP public liability insurance scheme, this briefing sets out the avoidable nature of pneumothorax that may occur through the negligent application of needles.

an acupuncturist working on a patient

Important note

The CSP PLI scheme no longer covers fertility-related acupuncture treatments. 

There are many, often-contested clinical opinions on the evidence base for the effectiveness of acupuncture and/or dry needling.

This paper doesn't analyse those conflicts of opinion, or act as a definitive guide to the safe use or application of acupuncture and/or dry needling.

This paper highlights practice issues associated with litigation claims arising from the use of needles near the apex of the lung.

Acupuncture and/or dry needling use can be associated with personal injury to a patient when incorrectly or negligently applied.

The most common injury reported to the CSP is iatrogenic pneumothorax, a collection of air in the pleural cavity causing lung collapse.

Signs and symptoms include sudden onset of chest pain and a varying degree of shortness of breath. Iatrogenic pneumothorax is an avoidable risk and an unacceptable consequence. 

In all reported cases the physiotherapist has either admitted or been proven to be clinically negligent.