This past weekend I had the privilege of participating in OSU MRI conference. I was able to sit-in on a number of the presenters, plus I presented, and was asked to sit-in on a panel discussion on safety with Bill Faulkner and Candi Roth. The conference provided me the opportunity to hear from a number techs regarding their most recent Joint Commission surveys, and I was encouraged by what they had to say.

My (longstanding) prior criticism of the Joint Commission and their MRI patient safety survey efforts have centered around one simple fact… they didn’t do anything with respect to MRI safety. JCAHO hasn’t ever had MRI-specific standards or survey criteria, but I was certain that the 2008 release of Sentinel Event Alert #38 on MRI accidents and injuries would change that, instantaneously (a SEA being the Joint Commission’s ultimate patient safety warning). It didn’t.

I was certain that the change to the Joint Commission’s 2009 changes to their Environment of Care (EC) standard which specifically invoked Sentinel Event Alerts would immediately change their survey methods. Reports I received from JCAHO accredited providers who were surveyed in the first half of 2009 indicated that I was to be disappointed again. But at the OSU conference, the clouds parted and glorious beams of hope shot down from the sky and landed on me.

Yes, I did hear several of the expected ‘their shadow never crossed our doorway’ stories of JCAHO surveyors ignoring MRI. There were also the accounts of ‘checked fire extinguisher and walked out.’ As little as one year ago, I would have expected that to be the end of the list, but several people came up to me and recounted recent surveys in which Joint Commission surveyors asked about…

• Screening forms
• ACR four-zone separations
• MR Conditional equipment
• Infection control procedures
• Emergent / code procedures, and,
• Ferromagnetic screening

One person told me of how the surveyor spent more than 30 minutes in their department, tracing the entire sequence of the screening and care of an MRI patient.

These heartening stories of surveyor attention to MRI were the minority, but given that JCAHO surveys occur on a 3-year interval, that there was any change in the status quo in the past year is likely an indicator of a significant prioritization of MRI safety at the Joint Commission.

The hazards of MRI come from the fact that – as soon as you step into that room – the fundamental laws of physics change, without any outward indication. Non-ferromagnetic objects still fall down, but ‘gravity’ works in a different direction for magnetic materials. This simple, invisible truth requires a host of MRI-specific safety protocols. Application of generalized hospital-wide patient safety standards to MRI hasn’t worked terribly well (as in, not at all) in the past, so I can’t tell you how encouraged I am by this recent news.

If one is truly interested in patient safety, and has been critical of others for a lack of attention to these issues, there is no sweeter sound than to hear that you are wrong. When weighed against the benefits to be realized by MRI patients, staff and providers from enhanced safety (fewer accidents), any swelling of my personal ego is of zero importance. I hope that the degree of my wrongitude only grows from here going forward.

‘On the Joint Commission,’ I should add. I do have my weekly PowerBall lottery ticket, and I would very much love to be right on that.

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Nearly nine years after the accident, the lawsuit was settled for $2.9 million, a settlement that was likely both diminished by, and made possible by, a pre-trial motion which excused GE Healthcare as a defendant to the suit.

The county-owned hospital, which almost immediately asserted its responsibility for the accident, ultimately settled the case on behalf of all of the remaining defendants, which included the head of radiology and the technologist who administered the boy’s scan.

Perhaps now, with the lawsuit resolved, we can actually learn something about the events that precipitated this tragedy, beyond the fragmentary slivers of information gleaned from court documents and news accounts.

That’s right, despite the fact that this one event has become the touchstone for MRI safety, there has not been a single root-cause analysis to inform MRI suite design, departmental operations, regulatory and accreditation frameworks… at least not one that has been shared with the public.

Hopefully, with the lawsuit resolved and jeopardy attached for all defendants, we can have an open conversation about what contributed to the accident and what can be done, at the thousands of MRI suites across the country, to help see that this sort of accident never recurs. Based on recent news accounts and last year’s shocking collection of ferromagnetic projectile accidents, the lessons from the Colombini tragedy are still profoundly needed.

If we are willing to explore this darkest chapter in the brief history of MRI, we may learn lessons that will help protect the 30 million Americans who will receive MRI’s this year, and next year, and the year after that.

If we fail, next year we’ll be able to look back at this moment, wistfully, and imagine young Michael getting his drivers’ license, or attending his junior prom, on the verge of adulthood. But he is forever trapped in 2001… a victim of circumstances he had no control over.

Let’s see what we can do, together, to help make sure that this never happens again.

My heartfelt thoughts and prayers are extended to the Colombini family.

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Many people in the medical industry, even within radiology, are quick to dismiss stories of accidents in the MRI suite as ‘fish stories’ which, though they may be based on a kernel of truth from the original telling, grow and grow as the story gets passed along the line. What may have begun as a pager getting drawn into the MRI scanner, winds up becoming a telephone repairman… or so goes the rationalization. And some seem to think that most MRI accident stories aren’t even really exaggerations, but rather pure fiction, akin to what you would see on some nighttime television medical drama. To these people, any account of a patient bed hitting the MRI could only have come from an episode of ER (as opposed to a real accident having become the basis of the TV show’s fictionalized version)…

Not that there haven’t been cases of gurneys drawn to MRI scanners before, because the MRI professional communities are awash in stories of all manners of ferromagnetic materials inadvertently becoming MRI-homing magnet missiles. Everything from personal computers, iPods, pagers, cell phones, anesthesia machines, ‘sand’ bags, medical gas (oxygen) cylinders, welding tanks, rolling carts, wheelchairs, hand-tools, canes & walkers, furniture, filing cabinets, hand-trucks, and the list goes on, and on, and on (to see pictures of a number of items, please check out this prior post). And yes, even hospital gurneys…

MRI Scanner Eats an ICU Patient Bed

Much to my chagrin, I’ve heard people dismiss the above as somebody’s Photoshop fantasy. Those sorts of statements, sadly, work to diminish all efforts toward MRI safety. But a recent account should, permanently, put to rest any question of whether this sort of thing can really happen. Late last year I posted a story that included links to a number of FDA MRI accident reports. One of the reports to the FDA’s MAUDE database described an incident in which a patient had their foot-ankle-leg injured when they were transported into the MRI scanner room on a conventional gurney (click here to download the PDF file from the FDA’s data). The date in the FDA’s anonymized report coincides very nicely with this somewhat-less-than-anonymous newspaper article that just came out…

Hoag Hospital has been fined $50,000 by the state Department of Public Health after an MRI patient on a metal gurney was magnetically pulled into the imaging machine, the hospital said Friday.

[Dr. Richard] Afable, [chief executive officer of Hoag Memorial Hospital Presbyterian], said that last January a woman was taken into an MRI room on a metal gurney that was not compatible with the machine. The powerful magnet in the MRI pulled the gurney into the machine and the patient’s leg was trapped for about three minutes. She was taken to the emergency room and spent three days in the hospital for treatment of fractures in her lower leg and foot.

The above quote is taken from the January 22nd, 2009 article appearing on the Orange County Register’s website (click here to go straight to the article). Based on the dates, the description of the accident, and the patient injuries, it sounds as if the FDA account is the same incident as what is described in this newspaper article. The $50,000 fine may sound like steep punishment, but considering the cost to restore the magnet after the quench (described in the FDA account), the cost of downtime and lost revenue between the accident and the time the MRI was returned to service, the cost of care to treat the patient, the cost of internal safety / quality / regulatory investigations, the legal costs for the hospital, and any lawsuit settlement costs, the state’s penalty is likely to just be icing on the cake. The cost to the hospital for this transgression could very easily be into 7-figures! All of this simply demonstrates two critical points about MRI safety.

1. MRI accidents do happen, and at greater frequency and cost than many are led to believe.
2. The costs of the safety provisions to help prevent these accidents are peanuts when compared to the costs of accidents.

My soap-box pontificating on this point will likely become moot over the next many months. In a ‘perfect storm’ of regulatory and accreditation attention to MRI safety, we’re very likely to see requirements for MRI safety provisions, such as ferromagnetic detectors (which could have been instrumental in helping to avoid this gurney accident). I will share more about each of these efforts, as I’m able. In the meantime, MRI providers should put a great deal more stock in the validity of MRI accidents accounts and ask themselves, “Do I have adequate physical protections in place, beyond what’s written in my policy manual, to help prevent this sort of accident?” The likely answer is “No.”

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ThermaCare HeatWrap Products Contain Iron And May Be Drawn Into MRI Scanners

According to the report, this patient was not injured and the MR staff was able to successfully remove the wrap from the MRI magnet. But any time you have ferromagnetic materials flying through the air near patients and staff, there is the very real risk of injury. Not only to people, but also to a million-dollar MRI scanner!

And assuming that it didn’t go flying, if there’s enough iron in this product that there’s that possibility, there’s likely enough iron to create some significant spatial distortions in the general vicinity of the wrap. And if the little iron ‘nuggets’ were to escape the wrap material and get under the covers to the bore of the magnet, you could wind up with shim problems that require a service call to correct.

According to the ThermaCare website:

“Protected inside ThermaCare^® HeatWraps are air-activated heat discs made of heat-generating materials (iron, charcoal, table salt and water).”

We’re in the process of testing the capabilities of the SAFESCAN® ferromagnetic detectors to detect these materials and I hope to have an update for you on this very soon.

In the meantime, whether you have the SAFESCAN® ferromagnetic screening products or not, please add these types of wraps to your ‘watch list’ of potentially dangerous materials to be kept out of your MRI suites.

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Some insurance payers are beginning to refuse reimbursement for care that is necessitated by certain ‘never events’, and that list is likely to grow. And while they may not always result in patient injury, I’d like to propose my own list of 5 MRI ‘never events’ which should at least trigger an investigation…

#5 Unauthorized Access: If any person, patient, visitor or staff member, gains access to the restricted areas of the MRI suite (Zones III and IV) without having been appropriately screened and supervised, this should raise red-flags and be the impetus for a review of the physical protections and operational protocols. Too often, because these safety-symptoms don’t immediately result in injury, they are disregarded as harmless, which couldn’t be further from the truth. If unscreened people or equipment are making it into the controlled access areas of the MRI suite, it’s only a matter of time before one of them is involved in a real accident.

#4 NSF / Renal Function Screening: A year ago, this may have appeared as the #1 item on this list, but the fact is that, today, many facilities are doing a great job of this. Essentially, we need to provide, at a minimum, a renal function risk-factor screening for every patient prior to being administered Gadolinium-based contrast agents. And, minimally, for patients identified as falling within one of the higher-risk profiles, a calculated eGFR should be taken for verification of patient risk and to inform the treatment of that patient. As with the #5 never event above, the failure to provide effective screening, even if it doesn’t result in an adverse outcome, is enough to warrant a review of operational protocols.

#3 Contraindicated Implants: There are times when, as a concurrent result of poor patient history / records, and inconspicuous (or absent) indicators for medical devices, patients (or visitors) enter the MRI scanner room with contraindicated devices. Nobody expects MR Technologists to be omniscient about what is on or inside their patients, but it is critical that we provide an appropriately thorough screening for the circumstances to try and ascertain whether the patient has any of the potpourri of shunts, pacers, stimulators, clips, pins, plates, etc… that may be dangerous to them. Any failure to use the appropriate means available to identify contraindications should, minimally, spur an evaluation of policies & procedures.

#2 RF Burns: This one factor may be the fastest-growing source of patient injury in MRI. By verifying that unneeded coils and leads are removed, that remaining leads are appropriately positioned and insulated from the patient, that the patient’s body is not positioned to form large-caliber loops, and that there is appropriate distance / insulation between the patient and any transmitting RF coils are all integral, requisite elements to minimizing the risks of MR burns. A failure to follow the appropriate steps to protect the patient, even if the shortcut doesn’t result in a visible burn, should (as with the proceeding never events) trigger a review of operational procedures.

#1 Projectiles / Missiles: Screening protocols should do everything to make sure that ferromagnetic materials are not brought into the MRI scanner room. Any discovered ferromagnetic material inside the MRI room indicates a breakdown in screening and presents all of the ingredients for injury or equipment damage. Particularly for MRI providers that don’t gown all of their patients, the use of a ferromagnetic detector is more than just recommended, it is codified in the ACR Guidance Document for Safe MR Practices as a part of the MR safety best practice. And as with all of the MRI never events before #1, any discovery of a ferromagnetic threat inside the magnet room should trigger a review of existing protections, operations and protocols.

While these 5 don’t encompass all of MRI safety, they do clearly represent 5 of the most common (and most avoidable) hazards in the MRI environment. MRI providers should have rigorous protocols and protections to minimize these risks to patients, staff, visitors and, in the case of projectile accidents, millions of dollars of MRI equipment.

Eight years ago this month (July 27th, 2001, to be exact), young Michael Colombini was fatally injured in an MRI accident involving a portable oxygen cylinder. The week surrounding the date of that accident is set aside each year as MRI Safety Week. This year, 2009, it falls July 27th through August 2nd.

During MRI Safety Week, MRI providers are encouraged to provide additional emphasis on safety provisions, training, inspection and equipment. This could serve as the anniversary date for annual inspections (cryogen safety systems, infection control, etc…). It is sometimes the additional motivator for special projects like labeling all portable equipment with the contemporary MR Safe, MR Conditional, MR Unsafe labels and designations. And sometimes it can be an opportunity to reinforce safety training for our MR staff and share a little bit of our daily safety mission with those outside MRI.

To make this easier, I’m posting two free Jeopardy-styled MRI safety quizzes (in Power Point format) for you to use for your staff, or for those who may not be quite so familiar with MRI safety. These resources are available at my new MRI Safety Week webpage.

But beyond sharing these resources with you, I am also offering for this to serve as a clearinghouse of MRI safety resources that you want to share with your colleagues. Drop me an email (my contact information is always at the foot of each post, or in the ‘about Tobias Gilk, editor’ in the box above and to the right) and we’ll see if we can share your posters, table-tents, questionnaires, articles, quizzes, or other downloadable resource with the broader MRI community.

This year, MRI Safety Week is more important than ever. The number of MRI exams continues to slowly climb, year-over-year, but rates of reported accidents are skyrocketing! We’ve seen nearly a 3-fold increase in the number of MRI accident reports to the FDA in just the last 4 years. Collectively, we have the opportunity to make a substantial impact in MRI safety.

Thanks to Mednovus for allowing me the time and resources to prepare these materials for you. But mostly, thank you for joining with me in again celebrating and promoting excellence in MRI safety through this special week.

It took a while, but slowly I realized that tellin‘ and getting in trouble were two, very different things. This is a lesson that we in the MRI community would do well to learn regarding accidents.

MRI accidents – in which materials, devices and implants which have no business in the MRI scanner room – occur all the time. Mostly, these are caught in advance, before anyone is injured or anything is damaged. Fairly frequently though, the MRI’s magnet ‘finds’ cell phones, money clips, pocket-knives, unsafe wheelchairs, etc…. And fairly frequently large ‘black hole’ artifacts on initial scans expose ferromagnetic devices or implants that the patient disavowed in their clinical pre-screen. (A veritable photo album of projectile accidents is available in one of my recent posts, which you can access here.)

Because these sorts of events are often rationalized to be statistical inevitabilities, brushed-off as events that occur at all MR facilities (and, therefore, are certainly not news to anyone), little – if anything – changes as a result.

Now, because these accidents and ‘near-events’ are typically accepted as unavoidable, they are very, very rarely reported outside of mandatory reporting structures, such as the State of Pennsylvania’s Patient Safety Authority. And even within mandatory structures such as Pennsylvania’s, many projectile events never get a 2nd thought, much less an event report. The upshot is that others, who might have learned from these surrogate mistakes, are more likely to have the same mishap because neither the nature or the frequency are shared with the community at large.

‘But wait, Mr. MRI-safety man. There is a national MRI accident database kept by the FDA and reporting to the FDA’s database is mandatory.’

Yes, there is a FDA accident database. And yes, technically, reporting is mandatory. The accident reporting system is called MDR (Medical Device Reporting) and the data is published in the FDA’s MAUDE database (which anyone with an internet connection can access and search). The three criteria for mandatory accident reporting are:

• Death (pretty unequivocal)
• Serious Injury
• Unreasonable Risk of Death or Serious Injury

What constitutes serious injury? Well, if you’re a healthcare provider, you get to make that call as there is no standard that the FDA uses. Want to call a traumatic amputation a ‘slightly-less-than-serious’ injury? OK. Want to not report it because you’ve determined that it isn’t a ‘serious’ injury? The FDA says that’s OK, too.

We don’t even need to touch on unreasonable risk unless, of course, we’re talking about the risk of death, but then we open the question of what makes something ‘unreasonable.’ I suspect that the FDA leaves that determination up to the individual as well.

So given the two indisputable truths above (1) MRI accidents are reported only a mere fraction of the time and (2) even the reporting requirements have loopholes that you could drive a truck through, what is the point of this article?

Ignore precedent. Ignore lawyerly readings of the reporting language. Report every MRI accident and near-event that occurs.

‘What? OK, Mr. MRI-safety man, you’ve really gone off the deep end on this one!’

Hear me out. Remember my intro to this article… the difference between being ‘told on’ and getting in trouble? That wasn’t just a cute story to draw you into an unrelated article, it’s an analogy for what happens when MRI providers report accidents and near misses to the FDA.

First, accident reports go through your MRI manufacturer and do not need to go directly from you to the FDA (except in cases of death). Second, accident data is anonymized. There is nothing that needs to identify you, your facility, your location, anything other than the scanner involved in the accident.

But the most important reason to have your MRI manufacturer report these events is that, by sharing the information about the types and frequencies of accidents, our entire industry will be able to better respond, as a whole, to the [wink, wink] events that are too often taken for granted.

With a more accurate picture of what goes wrong and, even more importantly, what steps we can all take to make things right, we can each do our small part in helping to improve the safety and effectiveness of the entire MRI industry.

There is no 7-foot tall troll waiting for you at the other end of your accident report to the FDA. There is no enhanced regulatory scrutiny that follows. Heck, nobody external to your organization will even ask you if you’ve done anything to increase your chances of catching that same mistake again. In short, there is no real downside, though the information you provide may ultimately help another MR provider prevent a costly or dangerous accident.

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:

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:

And here:

And here:

And here:

And here:

And here:

And here:

And here:

And here:

And here:

And here:

And here:

And here:

And here:

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.

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.

Would using ferromagnetic detection (FMD), to add a new and effective layer of pre-MRI screening, be reimbursed? What I mean is, is there a CPT code to get paid back for providing this additional service?

No, but the lack of a CPT code has little to do with the fact that using FMD can contribute, directly, to an MRI provider’s bottom-line. In fact, there are two concrete ways, off of the top of my head, that I know have provided financial ‘payback’ to users of ferromagnetic detection systems.

First, the indirect. If you owned a million-dollar house on the Florida coast, don’t you think you’d spring for hurricane insurance? What if there was an insurance policy that didn’t pay you back a proportion of your loss, leaving you to start all over, but instead offered the promise of making it less likely that the hurricane would even hit you in the first place?

This is what ferromagnetic detection does… when used correctly it reduces the risks of unplanned maintenance for shim disturbances, interrupted throughput for incomplete patient screenings, downtime associated with extracting cell phones, jewelry, furniture, etc… from the bore, or worse, damage to your MRI system.

What is this preventative effect worth? Well, the Veterans Administration published their average cost for an MRI projectile accident at $43,172 per incident. This average included a number of lesser projectile accidents, such as cell phones, indicating that some of these accidents are likely into the 6-figure range. Plus, because the VA doesn’t operate on a per-procedure reimbursement rate, the $43,172 cost does not include lost patient revenue.

The published VA data does not give frequency information, so if we turn to the only peer reviewed publication that does (Chaljub, Cramer, et. al.), and extrapolate the frequency they give for only medical gas cylinder accidents and assume that the same frequency of once every 6 years applies to all projectile events, even the smaller projectiles (it would, in reality, be far more frequent), the annualized cost of projectile accidents is roughly $7,200 (this is the VA’s $43,172 cost per projectile accident, divided by the Chaljub frequency determination of 1 medical gas cylinder accident every 6 years of MRI operation).

This is a hyper-conservative number, given that it doesn’t include lost scan-time reimbursement from projectile accidents, is based on data that is approaching 10 years old (indications are that accident rates have been on a steady increase year-over-year), and doesn’t include smaller projectiles in the frequency determination. The above figure also doesn’t take into account unplanned shim-correction or lost throughput from patient re-screening. Based on expert information from a former co-director of the VA’s National Center for Patient Safety, the annualized cost of projectile accidents exceeds $20,000 per year per MRI.

Anybody who claims to be able to drive that cost to $0 is selling snake oil. Accidents will continue to happen because MRI is just too dynamic and complicated an environment to assure 100% effectiveness in managing all the variables, all the time. But what if ferromagnetic detection could help cut that cost in half? What if we could help slash that annualized cost to just 10% of what it was, would that be worthwhile?

The second way that I know of that FMD has paid for itself is through a reduction in linen costs. One of Mednovus’ clients went from requiring all outpatients to gown (at a laundry cost of about $3 per patient) to only having about 1/4 of their patients gown (who was gowned was a function of the type of exam and the degree to which the staff felt comfortable with the patient’s ability to comply with screening instructions). All patients were screened with a hand-held ferromagnetic detector. This client reduced ongoing laundry costs, reduced average patient prep time, and improved screening effectiveness.

In a way, this provider found a way to get automatic reimbursement for using ferromagnetic detection pre-screening. It isn’t a CPT code, but the savings for linen service drops to the bottom line, just as a per-procedure reimbursement would.

So if we set aside the entire question of safety for patients and staff in the MRI environment and look at ferromagnetic detection solely though a lens of cost effectiveness, smartly deployed FMD systems can have very rapid return on investment (ROI) periods, in some cases only a matter of months!

Whether you look at ferromagnetic detection systems as something of a risk-management ‘insurance policy’, or a throughput management tool, or cost-containment for laundry services, or any of the other creative and constructive ‘revenue-positive’ solutions, a serious look comes away with the assessment that, “Yes, ferromagnetic detection is cost effective.”

And this is just the financial aspect, we haven’t even touched on the safety, best practice and accreditation parts of the equation…

1. Resistance, or “What the [bleep] is this thing and who’s making me use it?”

One of the first steps in the path to embracing ferromagnetic detection is often resistance. Some MR staffers assume that the presence of a ferromagnetic screener demonstrates an implicit lack of faith in their ability to screen patients. This couldn’t be further from the truth!

The problem with effective patient screening has always been with the patient. At UPMC, where the Technologists work with the MR-safety-minded Dr. Emanuel Kanal, they found that 44% of all patients that had professed to be free of ferromagnetic material were, in fact, just about to walk into the MRI scanner room with some type of ferromagnetic material on them! That’s almost half the patients at one of the most MRI safety conscious sites in the whole world!

Ferromagnetic screening tools aren’t an indication that administration doesn’t have faith in the Techs, they’re protection for the Techs because it’s patient compliance that we don’t have faith in.

In fact, even with ferromagnetic detection we depend on the conscientious screening and observation of patients by skilled MR Technologists. No technology, not even ferromagnetic detection, is 100% foolproof, but this additional layer of protection has helped Techs to find threats that would have otherwise slipped past.

2 Annoyance, or “Why the [bleep] is this thing alarming on these subjects?”

One of the first thing that sites that ‘plug in’ ferromagnetic detection into their existing protocols find is just how poor patient compliance really is! We thought we did a great job of getting patients to follow our instructions… that is until there was a tool that could actually help measure patient compliance. Without that alarm, the person would more than likely have sauntered into the MR scanner room with whatever we didn’t know about in their pocket. Often, the bits of ferromagnetic-contraband that patients sneak in with wouldn’t cause any harm and can be rationalized-away, but that’s not always the case. Sometimes what get’s missed in conventional screening and access protocols is big, ugly, and scary…

3. Utter surprise, or “How the [bleep] did that get past screening!?”

This might not happen for the first hundred or more patients, but sooner or later you’re likely to be stunned by something identified by the detector that would have been very dangerous if it made it into the scanner room.

What sorts of things? Toolboxes, conventional wheelchairs, steel IV poles, medication pumps, knives, weights, gas cylinders, and the list goes on, and on… These are precisely the sorts of things that ferromagnetic detectors find at facilities across the country. They’re the things that aren’t supposed to be there in the first place, or, if they are there, are supposed to be immediately ID’d by the staff and kept way-far away from the magnet room. But all procedures break down at some point, and the maintenance contractor, or the new person in transport, may not know about your policies.

4. Gratitude, or “Thank goodness this got found!”

It only takes one or two rude awakenings to things that were about to enter the magnet room to change one’s entire outlook on ferromagnetic detection. Imagine the potential damage from that found oxygen cylinder, or the injury that might have resulted from the non-MR infusion pump that nearly made it into the room, and all of the sudden any alerts from the detector become music to Technologists’ ears because they’re the warning for the accident that hasn’t yet happened (and may now, for the first time, be caught before it does).

5. Reliance, or “I couldn’t imagine not doing this for a patient now.”

Some people are unduly concerned about MR staffers jumping right to this final stage and that the Techs will think that ferromagnetic detection technology is going to absolve them of of patient screening responsibility. Personally, I’ve seen many ferromagnetic detection installations and have yet to witness anything like this. The greater concern is that sites give-up trying before step 3 and fail to realize the tremendous benefits to patient safety that ferromagnetic detection provides.

We have clients who tell us about what their SAFESCAN® detector has found on ‘cleared’ patients, or on doctors or nurses who have come down from the floors with a patient. If you found the objects that many of our clients have found (and they generally tend to run top-notch MRI centers, so it’s not as if they need ferromagnetic detection more than anyone else), you’d be instantly convinced of the value, too.

It is worth noting that no technology is 100% foolproof, not even ferromagnetic detection. It’s a tool, and a tremendously helpful one at that, but it has limitations. But just because it can’t do everything isn’t a reason to not use it.

If you’re blindfolded at the edge of a cliff, you don’t know how much that first wrong-step is going to hurt, and hurt badly. And if you don’t know what patients and staff have been carrying into the MRI suite, risking their lives (and perhaps yours), you have no reason to be concerned. But as soon as you begin quantifying how much dangerous material is trying to get into your MRI room, you, like our clients, will never again want to go without the protection of a ferromagnetic screening!