A 46 year old woman was admitted into the hospital to remove a small bowel obstruction. Several attempts to insert a central vein catheter for total parenteral nutrition (TPN) were made and an x-ray indicated the right subclavian catheter extended down into the vena cava with the tip in the right atrium. After surgery, the patient experienced severe distress, became hypotensive, went into cardiac arrest and died. Although subsequently the catheter appeared to be in the correct location and there was no well-defined area of perforation of the heart, we contended that an endocardial hemorrhage in the right atrium and the accumulation of milky white fluid in the pericardial sac indicated perforation of the heart by the subclavian catheter. The defendant manufacturer of the catheter contended the physician had placed the tip of the catheter below the junction of the superior vena cava into the right atrium contrary to the warnings on the catheter kit. The physicians, hospital and product manufacturer contributed to the settlement. The settlement was limited by the cap on damages in a Medical Malpractice case.