Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The study is essentially unchanged from prior except for a right - sided PICC catheter which is now seen malpositioned , coursing through the right subclavian and then upwards into the right internal jugular before kinking and turning downward and terminating within the mid SVC . Tracheostomy tube is unchanged position . There is no pneumothorax or pleural effusion . Cardiomediastinum is stable and within normal limits . Pleural surfaces are unremarkable .
    OUTPUT:
    
Change in position of right - sided PICC catheter which now travels short distance up the right internal jugular before looping downward and terminating within the mid SVC . It is recommended that this right - sided PICC catheter be repositioned . Remainder of the study is unchanged .