Difficult ventilation with a double-lumen endotracheal tube: An unusual manufacturing defect

We report an unexpected difficult ventilation with a double-lumen endotracheal tube in a patient receiving left upper lobe lung mass resection. The manufacturing defect in both limbs of the Opti-Port Right Angle Double Swivel Connector of the double-lumen tube resulted in this problem. This defect is difficult to localize by the usual recommended methods. We discuss a modified algorithm for difficult ventilation with a double-lumen endotracheal tube.