This chest x-ray shows a pulmonary aery catheter inseed through the internal jugular vein. The PA catheter extends peripherally beyond the right ventricular shadow and past the main pulmonary aery branches into the subsegmental vessels. The patient presents with sepsis and septic shock. It is impoant to determine the fluid status of the patient, especially if no improvement is noted with initial fluid challenge. The procedure performed was a placement of a pulmonary aery catheter to determine the capillary wedge pressure. The PA catheter in this case extended peripherally into the small vessels and thereby caused pulmonary infarction. The hemoptysis represents that complication, and withdrawal of the catheter is of utmost priority. Other options outlined are inappropriate or inapplicable.