MRI Risk Isn't Standing Still:
Are You?

By Tobias Gilk

MRI magnet technology marches steadily forward, improving year over year. As the technology improves, we find new clinical applications to allow us to expand the use of these phenomenal devices. We may see a change the mix of patients in response to a dynamic referral situation. Overall, MRI is treating more patients every year with ever-growing acuity levels but our MRI facilities are frozen testaments to our assessments of needs of years past. So why is it so vitally important to re-evaluate the safety provisions of our MRI facilities?

One of the key reasons is the rise of interventional applications for MRI. While intraoperative systems are the extreme end of the interventional trend, the more immediate impact is in the growing number of image-guided minimally-invasive procedures, such as biopsies. If nothing else, biopsies require staff, equipment and supplies in the magnet room that wouldn’t otherwise be there. Every additional person and piece of equipment entering the suite is an opportunity for accidents.

The same can be said for the increasing use of sedation for MRI exams. Whether it is indicated for claustrophobic or for high-acuity patients, anecdotal reports suggest increasing patient safety concerns paralleling the growing use of anesthesia. In fact, the American Society of Anesthesiologists has formed a task force specifically charged with addressing the MRI safety concerns and stemming the rising tide of accidents.

Apart from growth in interventional applications, we are also seeing increasing use of MRI for emergent scans. For cord compressions, stroke assessments, and some traumas, hospitals are beginning to view MRI as a 24-hour service. Often these emergent patients are brought to the MRI suite with a trailing phalanx of clinicians and a variety of monitors and support devices. The expedited screenings needed for emergent patients provide an enormous window of opportunity to wheel the patient in with the ferrous oxygen cylinder under the bed sheet or connected to an unsafe IV pump or pulse oximeter.

Where do we see evidence of all of these anecdotal increases? As reported in a previous feature of the MRI Newsletter, the FDA’s MAUDE database recorded a doubling of MRI accidents in the 12-month period ending mid 2006 from the year prior. Add to that the fact that this month the Joint Commission is also expected to release a Sentinel Event Alert on MRI accidents. As anemic as the reporting standards currently are, the FDA and JCAHO are logging increasing rates of accidents which all point to an alarming trend.

In this month’s accompanying article, MRI Suite Safety Score, you can begin to measure the specific risks and preventions for your facility, but the overall message is clear, our ‘safe modality’ is becoming more and more hazardous to patients, staff and our expensive equipment. Accidents rates are climbing and there is not a single ‘silver bullet’ solution.

MRI providers must recognize that the risks have grown and take the opportunity to reassess what preventative measures are in place. Managing the risks as they were measured five years ago may be leaving facilities open to accidents, lost magnet time, injuries and lawsuits today.

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