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A 72-year-old woman who was a candidate for percutaneous dilatational tracheostomy (PDT) using the Ciaglia Blue Rhino single dilator was examined. After dilation, a stoma was created on the guide wire, but the dilator could hardly pass through and pulled in the endotracheal tube with it. Bronchoscopy was therefore performed. The guide wire that was inside the Murphy eye of the endotracheal tube was then removed. So the dilator and guide wire was removed. The endotracheal tube was pulled back slightly and the tracheostomy tube was inserted once again. Fiberoptic bronchoscopy is recommended in cases of a problematic anatomy or when the PDT tube placement is suspicious.