Endoscopic removal of Fractured 3D-Printed Nasopharyngeal Swabs from the Olfactory Cleft During COVID-19

The severe acute respiratory syndrome SARS-CoV-2 pandemic has posed significant challenges to hospital and public health systems in the United States. In response to a shortage in nasopharyngeal swabs, our institution developed, tested, and deployed 3D-printed swabs to obtain a specimen for testing. A patient was tested in preparation for a scheduled Esophagogastrodeuodenoscopy. During the procedure the swab broke and a portion remained in the superior meatus and olfactory cleft. This case study describes the process of locating and removing the broken sections of the 3D-printed swab. In response to this incident, 3D-printing teams test swabs for sample collection and rheology with an elongation test. Additionally, we have implemented just-in-time training for staff including point-of-care durability testing, model simulation with feedback to ensure accurate trajectory, and suggestions on how to address anatomic and other challenges