Tunneled pleural catheters (TPC) are often used for management of malignant pleural effusion. They have proven to be safe, effective, and are associated with low rates of complications. We describe the case of a patient with metastatic renal cell carcinoma who inadvertently cut his TPC causing leakage of pleural fluid, requiring urgent removal. We review the reported complications of TPC in the literature and suggest close vigilance of patients at risk to have altered mental status who undergo placement of TPC.