You are answering a USMLE-style medical question. Question: A 33-year-old man presents to the emergency department after a motor vehicle collision. He was the front seat unrestrained driver in a head-on collision. The patient has a Glasgow Coma Scale of 5 and is subsequently intubated. Physical exam is notable for subcutaneous emphysema in the clavicular area. Needle decompression and chest tube placement are performed, and the patient is stabilized after receiving 2 units of blood and 2 liters of fluid. Chest radiography demonstrates proper tube location and resolution of the pneumothorax. The patient is transferred to the trauma intensive care unit. On the unit, a repeat chest radiograph is notable for a recurrent pneumothorax with the chest tube in place. Which of the following is the most likely diagnosis? Options: A) Inappropriate chest tube placement B) Spontaneous pneumothorax C) Tension pneumothorax D) Tracheobronchial rupture Reply with ONLY the letter of the correct answer (A, B, C, or D). No explanation.