by
Gus Iversen, Editor in Chief | September 15, 2015
From the September 2015 issue of HealthCare Business News magazine
There have been reports of all kinds of heavy metal objects getting pulled into an MR, such as oxygen tanks and floor buffers. Those situations can be fatal for someone sandwiched in that gravitational pull, and even if there are no causalities, the repair process can be costly and trigger prolonged downtimes.
The FDA established the Manufacturer and User Facility Device Experience (MAUDE) database to keep track of these kinds of accidents, but according to Kanal, many of these incidents never make it to that database. Part of the problem, he says, is the way facilities discourage openly discussing adverse events.
“The No. 1 instruction if anything comes close to happening is always the same: Keep your mouth shut,” he says, adding that this kind of culture hampers the ability to learn from errors and reduce them in the future. Kanal believes hospitals can take a tip from pilots, who utilize the Air Force Aviation Safety Action Program (ASAP) to report accidents and incidents in an identity-protected, Web-based model without penalty. If the error was neither criminal nor intentional, their record becomes clean again after six months. In this way, a better record is kept of mistake patterns and improvements can be made.
Vigilant screening and the four zones
At Mount Sinai Roosevelt, Robberstad and her colleagues utilize the American College of Radiology’s four zones of MRI safety. She says the first zone is for the general public and might be accessed by just about anyone, including doctors dropping off paperwork or someone coming to schedule an appointment. The second zone is limited to patients who have satisfied a written screening form.
Robberstad and her colleagues are making sure people remove things like hair clips and watches, but they are also screening for pacemakers, implanted devices and medicine patches. “People need to understand they can’t just walk in there. You have to play by the rules in order to keep everybody safe,” she says.
The third zone is for patients and staff members who have completed the written screening and also answered verbal questions to ensure they don’t have anything on them that would make proximity to the MR potentially hazardous. According to Robberstad, it’s common for a visitor to check a box saying they do not have something on their body, but then when asked verbally, they remember that they do.
The fourth and final zone is the exam room itself, with entry requiring passing through ferromagnetic detectors. “There have been times when patients go in with a paperclip in their sweatpants pocket which could get lodged in the scanner, but a situation like that does not necessarily cause harm,” says Robberstad.
