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Keven Moore: Life-saving MRI machines can be hazardous to your health, or even fatal

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Anyone who has undergone an MRI scan (magnetic resonance imaging) will tell you how uncomfortable and loud they can be, and if you are claustrophobic, then discomfort increases significantly.

But did you know they can actually be hazardous or even fatal?

Several weeks back, my wife and I received news that her best friend, Melissa Reed, had been seriously injured in a workplace incident as an MRI technologist. Not knowing any of details, as a safety and risk management consultant, I was a bit puzzled at first, as I tried to play out all the potential risks that she could have be exposed to in her so called “not-so-threatening” work environment.

As it turned out, while she was administering a scan, a patient entered the room with a metallic three-pronged walking cane, after she was told to remain outside the room. Recognizing this hazard, her training immediately kicked in and she immediately ordered her to stop.

The patient continued towards her, failing to follow her directives, and before she knew it, the cane went airborne toward the magnetic machine traveling at 25 feet per second, striking her in the face.

When she came to her senses, she was bleeding and discovered that she had fractured her nose, had a break to the orbital bone, and needed four stitches.

Over the years, I have had three MRI’s and can remember being told to remove all ferromagnetic metallic jewelry and being asked if I had any metal medical implants. This made sense at the time, but I never knew the magnitude of the threat this can be to the patient and to anyone else working near the machine.

As it turns out this projectile risk is a significant threat, one that isn’t taken lightly in that industry.

The first MRI machine was first invented in the 1970’s, and was first used on humans in 1977. Today they are used to diagnose health conditions by creating images of the human body using the principle of nuclear magnetic resonance.

It uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. The MRI gives different information about structures in the body that normally cannot be seen with an x-ray, ultrasound or computer tomography (CT) scan.

On average more than 35 million MRI scans are performed annually and the costs for these machines average about $1 million, and can cost upwards of $5 million. They use a very powerful magnet to align the nuclei of atoms inside the body, and a variable magnetic field that causes the atoms to resonate, a phenomenon called nuclear magnetic resonance, and that is where the risk lies.

The force of a 10-ton magnet in one of these devices is about 30,000 times as powerful as earth’s magnetic field, and 200 times stronger than a common refrigerator magnet.

In the years since the device came into widespread use, there have been thousands of documented incidents where objects became magnetized and attracted to MRI machines. The enormity of the risk is hard to actually quantify, as the majority of these incidents, go unreported to the FDA database, according to safety experts in the field.

With over 10,000 MRI’s in the United States, they are not just found in hospitals, but in storefront clinics and even mounted on trucks, making rounds of small hospitals or parking at malls to do scans for a fee.

These machines have made deadly weapons out of chairs, paperclips, drills, staplers, floor buffers, clipboards, cigarette lighters, gurneys and even a loaded gun, which apparently fired into a wall upon impact in a Rochester, N.Y. hospital after coming out of a police officer’s holster.

One patient, who forgot to pull a hairpin out, later was required to have a procedure to extract it after the pin traveled up her nose and lodged in her pharynx. Shrapnel and machine-shop debris can also cause problems. A welder who had a piece of metal imbedded in his eye, was later blinded as a result of the magnetic field of the machine.

As these magnets quadrupled in power, careless accidents soon became frequent, causing serious injuries and even death.The first MRI fatality occurred in 2001, when a 6-year-old boy was tragically killed in Westchester Medical Center in New York, after the incredibly powerful force grabbed a nearby metal oxygen canister and sent it flying toward the machine like a guided missile, striking him in the head.

Another patient died after suffering from fatal adverse interactions with the MRI’s magnetic field because she did not reveal to the technician that she had an implanted metal aneurysm clip in her brain, which became dislodged.

Patients with pacemakers generally cannot be scanned because the intense magnetic field can interfere with the function of electronic devices.

The fact is these powerful magnets used by MRIs are “on” all the time, so it is not a question of flipping it on and off. The magnets are never off and cutting the electricity will not affect them. They draw most of their power from super-cooled helium, which must be vented to shut down the magnet, a process that takes several minutes and has hazards of its own.

Anytime an object comes into the magnet’s field it can become a projectile, pulling it into the machine at a very high rate of speed. Not only is the patient at risk, but so is anyone who happens to be in the same room.

Technologist, hospitals and medical facilities that utilize these MRI’s have all learned to take this risk very seriously and have employed several control methods to better control incidents with an MRI machine.

They have have improved their screening procedures for ferromagnetic threats and for medical devices / implants; and have double-down on the safety training for all authorized and potentially affected employees. All patients are now required to remove their street clothes and to wear gowns that are provided.

Patients are now questioned twice about implants or accidents with metal. When a patient is unconscious or unsure, checks for scars and x-rays are required.

Access to these restricted magnetic field area are now being better controlled with security systems. They have employed the use of walk through metal detectors and they are now even substituting instruments, tools and other necessary equipment with non-ferromagnetic material.

For instance there are now non-metallic fire extinguishers in MRI rooms.

Approximately 1 in 10 Americans had an MRI last year and all went through some type of screening, passing signs with warnings as they entered locked doors to the examination suite.

If you were like me, you noticed the signs and the purpose of the line of questions, but never really comprehended the significance of that risk.The screening and warnings are intended to prevent serious accidents and injuries, so take them seriously.

Melissa’s accident serves as proof that even with the best risk control countermeasures, accidents can still happen when human decisions or mistakes are introduced into the equation.

Be Safe My Friend.

Keven-Moore_10221

Keven Moore works in risk management services. He has a bachelor’s degree from University of Kentucky, a master’s from Eastern Kentucky University and 25-plus years of experience in the safety and insurance profession. He lives in Lexington with his family and works out of both the Lexington and Northern Kentucky offices. Keven can be reached at kmoore@roeding.com.

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