MRI accidents on the rise?
Each had sailed through the air from a pocket or a folder, drawn to the huge magnet that powers the magnetic resonance imaging machine's medical scanner.
Much less common is the kind of accident that killed 6-year-old Michael Colombini last weekend, when he was struck in the head by an oxygen tank at Westchester Medical Center in Valhalla, N.Y. The tank went flying when the machine was turned on.
Experts believe it was the first death caused by an outside object in an MRI room, although a recent study suggests that similar accidents may be on the rise. MRIs are used across the country for more than 1 million scans each year.
An MRI generates images of the body using an electromagnet, radio waves and a computer. It is used in the diagnosis of many diseases, including brain tumors, spinal disorders and heart disease. It is considered nearly risk-free.
Michael was sedated when he was struck, hospital officials said. The MRI was to check his progress after an operation to remove a benign brain tumor.
"You'd think that if you had survived all of that, you'd be sort of home free," said Diana Heaton, Michael's kindergarten teacher last year. "We're all shocked and saddened by this. He was just an awesome kid who liked having fun."
"What can you say? It's every parent's worst nightmare," a neighbor of the Colombini family, Jenny Anson, said. "Especially in a place where you expect them to be cared for."
But experts warned of the dangers of the MRI machine.
"You have to be so very careful," said Michael Rubin, attending radiologist at Sound Shore Medical Center and director of MRI at New Rochelle Radiology Associates. "MRIs are safe machines, as long as you follow certain rules and don't bring metal into the room."
Deaths have been reported before when an MRI machine's magnetic power disrupted metal aneurysm clips or cardiac pacemakers inside patients' bodies. At least once, a patient was blinded when a piece of metal, long embedded in his eye, moved in response to the machine.
Regulations to prevent accidents are strict. Operators insist that magnetic objects be kept out of the MRI room. Pockets are emptied; watches, earrings and eyeglasses are removed; patients are stripped and quizzed about implants, shrapnel and bullets in their bodies. Some patients are deemed ineligible for MRI.
There are MRI-compatible gurneys, wheelchairs and oxygen tanks, made of aluminum.
Still, accidents may be occurring more often than ever. Gregory Chaljub of the University of Texas medical branch in Galveston studied records covering 15 years and nearly 138,000 MRI scans for an article published in the American Journal of Roentgenology.
He found five cases in which tanks were mistakenly brought into MRI rooms and immediately headed toward the magnet. In one 1987 case, the oxygen tank hit the patient in the head and caused facial fractures.
The other cases did not cause injuries but were troubling for another reason. They all occurred in 1997 or later, leading him to suggest such incidents are on the increase.
"I think the reasons accidents are going to occur more often are twofold," Chaljub said. "There are magnets all over now; we're putting them up in shopping centers. And we're imaging sicker and sicker patients who have more life-support equipment with them — and not everything is MRI-compatible."
Chaljub noted that in all the cases he studied, the accidents could have been avoided if rules had been followed. He suggested that all of the tanks used in a hospital be made of aluminum, but noted they cost much more than other metal tanks.
"My bottom line is this kind of accident is preventable and MRIs are safe," he said. The Westchester tragedy, he said, "shouldn't scare people. It should alert people."
In New York City, Health Department spokesman Robert Kenny said investigators were checking records and interviewing staff members to see if there were any violations. The hospital and the Westchester District Attorney's Office also are reviewing the case.
In Rochester last year, an MRI magnet yanked a .45-caliber pistol out of the hand of a police officer, and the gun shot a round that lodged in a wall.
The Westchester Medical Center, with four hospitals and six other centers 15 miles north of New York City, is a major transplant center and has recently ventured into robot surgery.
The center, which is the teaching hospital for New York Medical College, recently had its accreditation lowered after the Joint Commission on Accreditation of Healthcare Organizations, the group that monitors hospitals, found that a medical resident and nurses altered a patient's chart.
Asked yesterday about whether patients should be concerned about care at the hospital, spokeswoman Carin Grossman, said: "The phone calls we've had from the community are only phone calls of sympathy and support."
Michael's family declined to comment.
Information from Newsday is included in this report.