Fractured Metallic Tracheostomy Tube: Report of a Fractographic Study

Objective: To investigate the cause of a broken metallic tracheostomy tube. Material and Methods: In this study, we performed a fractographic investigation of a broken tracheostomy tube from an elderly patient using surface visualization, scanning electron microscopy, energy dispersive X-ray spectroscopy, and chemical composition analysis using X-ray fluorescent and metallographic testing. Results: Surface visualization revealed multiple corrosive pits which were confirmed by liquid penetrant testing. Scanning electron microscopy and energy dispersive X-ray spectroscopy revealed the chemical composition of the tube to be an austenitic chromium-nickel-manganese stainless steel alloy. Metallographic analysis suggested that the fracture site originated from the inner surface from intergranular corrosion. Conclusion: The evidence suggests that the corrosion resistance properties of this material might not be suitable for long term use in the human trachea. Higher grade stainless steel or more frequent device change is recommended.