FMD. Don’t We Have Screening Protocols For That?

One of the most oft-cited rationalizations for not complying with contemporary best practices that call for using ferromagnetic detection (FMD) for MRI pre-screening is that ‘FMD doesn’t catch anything that existing screening protocols aren’t meant to catch.’ What you may find surprising about this statement is that I agree with it wholeheartedly… I would just change the inflection a bit. I would say it more like…

Ferromagnetic detection doesn’t catch anything that existing screening protocols aren’t meant to catch.

That inflection makes a world of difference, as you’ll see in just a moment…

We’ve been screening for ferromagnetic materials as long as MRI has existed, but our historic technique of simply asking if someone has magnetic materials has not proven very effective. There are many accounts of magnet damage, injuries, and fatalities resulting from a failure to identify ferromagnetic materials before they were brought into the MRI room. And despite a universal familiarity with the risks of ferromagnetic materials, we as an industry seem unable to prevent them from recurring by using only these ‘old school’ screening protocols.

There was a policy in place to screen for ferromagnetic materials at this New York hospital in 2001:

Steel Oxygen Cylinder Kills Boy

And they had a policy to screen for ferromagnetic materials at this Seattle hospital in 2005:

They had a policy to screen for ferromagnetic materials at this hospital:


And here:

MRI Scanner Eats an ICU Patient Bed

And here:

MRI Eats Floor Buffer

And here:

MRI vs. Floor Buffer... MRI Wins!

And here:

MRI Eats A Wheelchair

And here:

Welding Torch Gas Cylinder In MRI

And here:

Oxygen Cylinder / Tank In MRI

And here:

Another Oxygen Tank Inside an MRI

And here:

Another Chair In An MRI

And here:

Basket Chair In MRI

And here:

Floor Cleaner Stuck To MRI

And here:

Floor Buffer In MRI

And here:

Removing Oxygen Cylinder From MRI

And here:

Anesthesia Vent on MRI

And here:

Dolly On MRI

And here:

And here:

And lots, and lots of places that you can see here:

Honestly, I could drown you in pictures and accounts of ferromagnetic materials in the MRI suite. Suffice it to say that the accounts above are only the tip of the iceberg.

One of the most ironic (in light of what you’ve seen above) arguments against the need for ferromagnetic detection is that it isn’t foolproof.

Foolproof!?!? If that’s the standard, how can we reconcile the results of our conventional screening practices against this expectation of perfection? Clearly, we’re a very, very long way from that goal.

Instead of willfully disbelieving everything shown above… Instead of insisting on the infallibility of patient and visitor compliance with screening instructions, or the unblinking door-watching vigilance of the Technologists, or the guaranteed long-term effectiveness of MRI safety training for housekeeping, transport, engineering, security, anesthesia, ICU and respiratory staff, why can’t we accept that each of these protections, as valuable as they are, are imperfect, and that if maximum safety is our goal, we need to augment these long-standing – and incomplete – strategies with something new.

I freely state that ferromagnetic detection is not perfect. Under certain circumstances, it can miss things that we may want to find. It does, however, provide us with an entirely new feedback mechanism that helps us to more effectively monitor, train, screen, and protect people in the MRI environment. Imperfect though it is, it is remarkably effective at helping to improve the safety of everyone inside the MRI suite.

Tobias Gilk, President & MRI Safety Director
Mednovus, Inc.

PS: I would like to thank the following people who have helped me by providing some of the images you’ve seen above, Moriel Ness Aiver, Raj Sangoi, and Keith Del Guercio.

4 thoughts on “FMD. Don’t We Have Screening Protocols For That?

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