After a venipuncture, a patient experienced severe nerve damage and lost feeling in his fingers. Which of the following actions by the phlebotomist most likely led to this event?

The scenario presented indicates that the patient experienced severe nerve damage and lost feeling in his fingers after a venipuncture. The most likely action that led to this unfortunate event is the use of an incorrect needle angle during the procedure.

Using the wrong angle can cause the needle to penetrate tissues inappropriately, which may lead to injury to nearby nerves. When performing a venipuncture, it is critical to insert the needle at the correct angle to target the vein accurately and minimize any risk of damaging adjacent structures, such as nerves. A steep angle, for instance, could inadvertently push the needle deeper than intended, increasing the likelihood of impacting nerve pathways.

The other actions, while significant in the overall quality of the venipuncture, are less directly related to causing nerve damage. A larger needle might cause discomfort but typically wouldn't lead to nerve damage itself. Not applying enough pressure may lead to complications like hematoma rather than nerve injury. Finally, maintaining sterility is crucial for infection control but does not pertain to damaging nerves during the venipuncture. Therefore, the use of an incorrect needle angle is the most plausible explanation for the severe nerve damage experienced by the patient.