Using Ultrasound Guidance to Recognize and Correct  A Flipped Intrathecal Pump in the Pain Clinic: A Case Report 

An intrathecal (IT) drug delivery system is an FDA approved intervention for pain and spasticity management to deliver medications such as opioids or baclofen. 

The IT pump medication reservoir is implanted subcutaneously and requires regular interval filling every few weeks to months. 

Failure to ensure proper access of the pump reservoir before injecting medication is a significant safety issue as spilling of drugs can lead to drug overdose or withdrawal. 

We present a medically challenging case of a flipped IT pump detected in the clinic during a medication refill visit. The complication was corrected using ultrasound guidance.