Nasogastric (NG) feeding tubes are routinely inserted in patients who cannot swallow safely — following stroke, during critical illness, or in surgical recovery. Misplacement of the tube into the airway rather than the stomach — and failure to confirm correct position before feeding begins — can cause aspiration of feed into the lungs, aspiration pneumonia, and death. NG tube misplacement causing serious harm is a never event in the NHS. When it occurs because correct position confirmation procedures were not followed, a negligence claim may be available.
The required standard for NG tube position confirmation
- Gastric aspirate pH testing (pH ≤ 5.5 confirms gastric placement)
- Chest X-ray confirmation if pH test is inconclusive
- Never feed through an NG tube whose position has not been confirmed
- NPSA safety alerts (2011, 2012) provide explicit guidance on NG tube safety checking
Common failure scenarios
- Tube inserted into the bronchus or lung; X-ray not taken before feeding commences
- X-ray taken but misread — tube incorrectly assessed as correctly placed
- pH check performed but result misinterpreted
- Tube confirmed in correct position but displaced before next feed without re-checking
Frequently asked questions
Can I claim if feed was administered into the lung through an NG tube?
Yes. NG tube misplacement causing feed to enter the respiratory tract is a never event. Where the required safety checks were not performed or were performed incorrectly, a negligence claim is likely to succeed.