As an anesthesiologist I routinely gave anesthesia to patients (usually children) undergoing MRIs over a 38-year career.
I never had anxiety in my daily practice in the OR but anesthesia in the MRI suite ALWAYS provoked anxiety because:
1. I had to anesthetize the patient in the sub-basement, two floors below the main OR — where there were always other anesthesiologists able to help in an emergency. In the MRI suite, no one could hear my silent screams if I got in trouble nor were there knowledgeable extra hands to, for example, squeeze the breathing bag if I needed to prepare for an emergency intubation.
2. Once the patient was anesthetized and the heavy door to the MRI machine room was closed and locked, I could only monitor my unconscious patient through a darkened heavy glass window. Sure, I had monitors for EKG and oxygen saturation outside the MRI room, near the control board where technicians operated the machine, but the automatic blood pressure cuff inflator dial on the anesthesia machine was inside the room and hard to see through the dark glass.
3. It was my good fortune to never have had an emergency in the MRI suite, but events such as that reported above in the OP happened from time to time in hospitals throughout the U.S. and were occasionally reported in the anesthesia literature with the expected cautionary advice. Many more events occurred than were reported.
>1. I had to anesthetize the patient in the sub-basement, two floors below the main OR — where there were always other anesthesiologists able to help in an emergency. In the MRI suite, no one could hear my silent screams if I got in trouble nor were there knowledgeable extra hands to, for example, squeeze the breathing bag if I needed to prepare for an emergency intubation.
You are allowed to put patients under general with no one else present? That doesn't seem like it should be possible
>You are allowed to put patients under general with no one else present? That doesn't seem like it should be possible
Every day in ORs around the world manuy thousands of anesthesiologists — and CRNAs where approved — put patients under general with no one else present. Are you proposing that two anesthesiologists be assigned per patient, like scheduled airlines?
Should piloting a plane solo be outlawed?
If, after three years of residency and roughly 1,500 cases done under supervision, many more done without supervision, a written examination, and an oral examination, you aren't qualified to administer a general anesthetic solo, then you have NO business giving general anesthesia no matter how many other qualified or unqualified others are present.
I agree you should be able to provide solo, but there is also substantial evidence supporting the addition of a CRNA to make anesthesia teams, that are safer (and even more expensive) than either CRNA or MD operating alone. In many countries, teams are the standard of care.
Accreditation is a thing. You don't have to be accredited to practice medicine. But you might want to be if you want insurance or the government to pay you for practicing medicine.
Im sorry but how does this possibly jive with what you literally just said?
> In the MRI suite, no one could hear my silent screams if I got in trouble nor were there knowledgeable extra hands to, for example, squeeze the breathing bag if I needed to prepare for an emergency intubation.
Presumably the patient just dies in that scenario that you are supposedly qualified and prepared for?
> Presumably the patient just dies in that scenario that you are supposedly qualified and prepared for?
Yeah, can happen. That doesn't mean you did something wrong. Sometimes (very rarely), shit happens even though you've planned it all according to guidelines. What he's saying is that when shit hits the fan, he's really grateful if someone's there to assist with basic moves while he's trying to control the more pressing matters. I can relate.
To me it reads like anesthesia in the MRI shouldn't be allowed or needs better supervision.
>he's really grateful if someone's there to assist with basic moves while he's trying to control the more pressing matters.
I think they were saying theres literally no one there to help.
>Yeah, can happen. That doesn't mean you did something wrong. Sometimes (very rarely), shit happens even though you've planned it all according to guidelines.
Emblematic of the broken US healthcare system. The guideline creates an easily preventable scenario where the patient is highly likely to die for no real reason.
> To me it reads like anesthesia in the MRI shouldn't be allowed or needs better supervision.
It must certainly be allowed, as it greatly benefits some patients. Believe me, I'd be most happy if I was forbidden to enter MRI rooms.
> I think they were saying theres literally no one there to help.
This might happen quite infrequently, and usually just for a very short time. Problem is that others have their own jobs to do, and sometimes you get unlucky at just the worst time. It's certainly not common that no one's there, and theres almost always someone near. But since you can't leave the patient, it might be that you have to yell for 20-30s before someone notices you're in trouble.
> Emblematic of the broken US healthcare system. The guideline creates an easily preventable scenario where the patient is highly likely to die for no real reason.
I'm not currently practicing in the US. I don't think that's a fair assessment. Guidelines are born in patient blood, and although adaptation is a must deviating from guidelines still remains a bad idea most of the time.
Pretty sure that at the very least you are not operating the scanner. And the scanner generally nowadays must operate under the plus one staffing model (one certified technologist per scanner plus at least one additional level 2 MRI safety trained staff in the immediate vicinity). So no, you are not "alone".
Indeed, but you won't find yourself alone during the MRI. When you're preparing or finishing the case though, the RX tech and the radiologists often suddenly feel a need for a break. Same thing happens everywhere we go: the anesthesiologist comes in, everyone's here. 2 min later, you look around and everybody magically disappeared.
That's never happened anywhere I work unless you're counting being in the control room as "magically disappearing". To be fair I only have 25 years in the field and don't use AI to answer so what do I know.
Look, he might use AI but I'm not. I also have 20 years in the field, and I've lost count of how many times I found myself alone with a risky patient. Yes, oftentimes people are just 10m away. Yes, that's not supposed to happen. But that's often far enough for us anesthesiologists to wish we'd be somewhere else. Perspectives and empathy matter. Try to put yourself in our shoes, sometimes. For the record, I'm the main hybrid MRI OR guy in my hospital, so I work near MRIs most days.
The only way anything you are saying makes sense is if you are counting people being in the control room as not being there. They can see you, they can hear you, you can hear them. You are not "alone" except in an overly dramatic sense. This goes in triplicate for a hybrid system operating today.
The RX bay over here is like 150m^2, serves 6 MRI rooms, has nooks and corners and doubles as the patient waiting bay. Having the tech busy elsewhere while putting people under or waking them up is not a rarity. I agree the security is better for hybrid rooms, as they have their own separate control rooms and techs won't leave when the machine is running. I don't think I'm being dramatic, but you sure seem to have a cozy job if you're allowed to constantly sit around in the control room while anesthesia is under way.
No idea what an RX bay is but your choice of units certainly seems non-American. But thanks for derailing a story about someone who died in the US in a situation that has nothing to do with anesthesia to whine that you feel lonely and important and while chiding others for their supposed lack of empathy. And now you're whining that you feel alone while outside the MRI room? I guess? MRI has no control over anesthesia staffing in the US. That's your own problem.
That's not a fair assessment of our conversation, and it seems to me you've been aggressive from the start. Honestly, you reek of the typical US prejudice that 'all-docs-are-arrogant-and-speak-only-to-spite-others'. You can't imagine the relief when I got out of US healthcare and that kind of daily interaction with hospital staff and patients.
Yeah, I agree that we can find ourselves alone sometimes, although that's not really supposed to happen. For sure, most people usually aren't that useful anyway.
The MRI+anesthesia problem has recently got much worse, since we're now seeing MRI hybrid ORs pop up. Compounded with the 'lean management' principles en vogue in hospitals, this is a disaster waiting to happen. Personnel is often affected to multiple ORs, including standard and hybrid sites.
> Once the patient was anesthetized and the heavy door to the MRI machine room was closed and locked, I could only monitor my unconscious patient through a darkened heavy glass window.
There's some sort of latching mechanism to seal the faraday cage. Sometimes it's a latch, sometimes it's pneumatic or a bladder that inflates.
The doors can also lock (I'm pretty sure they are required to be locked when qualified personnel are not present) but usually they are not locked when the scanner is staffed and in use.
Faraday cage makes sense considering the RF sensitivities involved with MRI.
I do wonder if someone being in the room is enough to distort a scan? As there's no ionising radiation danger, it always seemed odd that you were left alone in there.
No, people in the room won't interfere unless they are doing things inside the scanner during the scan. MRI generally operate at radiowave frequencies (the faraday cages mostly keep radio stations out). There's other stuff they're blocking but radio stations are the strongest interference.
I don't understand your question. The anesthesiologist was describing equipment that was not safe to have in the room and was positioned outside the room to be viewed through the observation window.
Many sites screen individuals to accompany patients. It's fairly common in pediatrics.
If by "the above case" you are talking about the accident that happened, it has nothing whatsoever to do with anesthesia in the first place. It was an outpatient knee MRI performed without anesthesia at a free standing clinic (not a hospital). Based on the wife's description of what happened, the technologist brought her husband into the room at her request to help her up after the scan had finished and the technologist failed to screen him.
Sorry, I completely misunderstood what they said. My mental picture was the equipment being _in_ the room attached to the patient (and safe to be so), but the person being stuck outside unable to easily intervene. My experience with MRIs is always being alone in a room which backed that up.
I'm not even thinking of this incident. My base query is why MRI patients seem to always be alone in the room. Ignore all the anaesthetics too; I've seen them refuse to let a nervous patients family member stand in the room during the scan even though it could completely calm the patient... that's what seems odd to me. This is based on UK hospital experiences; I'm not sure if it's universal.
The incident in question is sad and seems avoidable, but I hadn't even got that far yet; I got stuck on the top(ish) comment of "(Once the patient was anesthetized and the heavy door to the MRI machine room was closed and locked,) - I could only monitor my unconscious patient through a darkened heavy glass window". My thinking went "surely being in the room would be better" -> "they never seem to let anyone in the room" -> "why not?" - and then I confused you and we ended up here :)
> I've seen them refuse to let a nervous patients family member stand in the room during the scan even though it could completely calm the patient... that's what seems odd to me. This is based on UK hospital experiences; I'm not sure if it's universal.
We do let family members in, we just try to avoid it. Having extra people there is extra problems, extra safety issues and makes everything slow. ‘It completely calms’, is rarely true. We are good at getting patients through scans - we do it 50x a day.
So no one can accidentally walk into the room while wearing metal while it is on, to prevent injuries like the post we're commenting on, from happening.
No, that's wrong. The locks are because the magnet is always on but the scanner is not always staffed. The scanner door is never locked when the scanner is staffed or a patient is inside.
Thanks for the insight. re:#3 how do mistakes not get reported? Is it because this incident resulted in a police report and is unusual in this context?
Deaths in the OR like cardiac arrests, fatal hemorrhage from burst aneurysms, etc. are always reported within the hospital. Whether others outside learn about such things is often a matter of persistent family and relatives demanding to see the actual death report and contemporaneous notes.
Fatal mistakes usually stay within hospital departments and are discussed at length in regular confidential Morbidity and Mortality conferences.
The EM shielding is simply a wire mesh, not tint. The glass doesn't have to be darkened, and probably wasn't, but often the room is darkened to make the scan more comfortable and calming. Also, in my experience the room doesn't have many lights, and the patient is inside the bore, making them hard to see.
MRI and other radiology suites use lead glass windows, which are incredibly thick and tinted dark-yellowish-orange. Visibility through them is okay, but not great.
MRI windows aren't leaded, that would do nothing for RF or magnetic interference. MRI windows contain copper mesh and are designed to integrate with the rest of the Faraday cage to both keep the RF generated by the machine in the room, and keep external radiation away from the sensors. Also keep the acoustic noise in the room.
This also doesn't do anything against the (static) magnetic field, which is really hard to block except with material like steel, which don't make very good windows. Newer machines have a counter-magnet to redirect the field to extend less far from the machine.
To add to the sibling comment, being stuck in a small, incredibly loud tube usually pinned under some receiver isn't great for claustrophobic patients either.
A lot of people get panic attacks / claustrophobia and are incapable of getting in or staying still for a scan.
I have a lot of sympathy. I'm pretty good in confined spaces usually, but even after multiple MRIs it's still a surprisingly stressful experience. The buildup and safety questions make the pre-experience worrying. The aperture is surprisingly small. Depending on the scan, part of you might be caged in place, and it's extremely noisy and you're aware of a lot of mass and power spinning very close to your face.
Also, some of the radiologists don't help. It's not deliberate, but they're entirely desensitised to the experience (and often haven't actually gone through it themselves; which again seems crazy considering the lack of radiation). My last scan was of my lower back, but they were already set up (from the previous scan) to feed me in head first rather than feet first. From their point of view it saves a bit of faffing with the software and moving the pillow to the other end. From a patients point of view it makes all the difference in the world; it's a very different psychological experience having your legs inside with your head free, vs being stuck head first in something and having it whizz past next to your head.
I've had a goodly (read unhealthy) number of CT and MRI scans and I'm bright enough to understand which one is significantly more detrimental to my long term health. I'm also aware that on a subconscious almost cellular level, it's the benign one that absolutely terrifies me every time...
For anyone wondering why they didn’t just turn the magnet off immediately: Quenching the magnet is not instant. From what I’ve read, it can take 30 seconds to multiple minutes for the magnetic field to dissipate after pressing the button.
Also, the person wearing the 20lb chain was not the patient. There was an access control failure (someone peeking their head into the room?) combined with the extraordinary amount of metal resulting in a lot of pull.
A gofundme setup by his step-daughter for funeral costs says he was stuck to the magnet for over one hour. Which if accurate seems like the timescale for ultimately being quenched but after a lot of indecision about punching the button. Probably they waited for EMS to arrive and be screened etc and they had to decide etc.
Calling a 9 kg chain a "necklace" is a bit misleading. It makes it seem like it could have gone in unnoticed. "medical episode" is also very vague, what was the actual cause of death?
Given that the chain drug him across the room, I can imagine that the actual death might be quite grisly - if it can cause a man to be "hurled towards the machine" it's possible it was worse than a mere strangulation, and that sort of detail isn't really required in the article.
There is a video of it floating around for the morbidly curious. I won't link it here. It is very NSFL. I was accidently shown it while scrolling instagram and wish I hadn't seen it.
He is able to talk, you can make out his words, but he is clearly choking or being strangled. He was fully sucked into the machine. There was a very strong guy trying with everything to pull him out. He made some pretty sad and harrowing words when he realized he wasn't going to make it. Again, the video is out there if you really want to see it. I do NOT recommend it though.
Apparently, oxygenated hemoglobin and blood plasma are diamagnetic, while deoxygenated hemoglobin is paramagnetic. Meaning, magnetic properties are determined by the molecules, not its elements. I assume that whatever attraction or repulsion caused by even the MRI magnets are weak compared to the forces involved in Brownian motion. So don't expect anything substantial.
I've seen a lot of gruesome stuff so I'm not bothered by that, but curious how someone got a camera, presumably with ferrous parts, in there without it also getting pulled into the magnet.
The article covers the timeline of his death. Whatever the details they weren't so incapacitating as to prevent him from saying goodbye to his wife before losing consciousness.
> He endured “a medical episode” at that point which left him in critical condition at a hospital, and he was pronounced dead a day later, police said.
> Adrienne told News 12 that her late husband had suffered several heart attacks after the incident with the MRI machine and before his death.
If it was any kind of weight training vest it would be wrapped around the chest and therefore any orientation would involve him being squeezed by the magnetic force. Imagine two dinner plates, front and back; whether he was facing forward or back wouldn’t change much.
I don't think the human body is that fragile, the magnet probably dragged his body, head first, until it hit a solid object, in this case the cover of the MRI machine. Slamming your head at that speed isn't that healthy.
This was my assumption as well. What the heck has everyone assuming it’s a decapitation? Dude was dragged by the neck at high speed towards a large machine. Massive head injury sounds very reasonable, maybe even expected.
Inside the scanner the back-of-the-envelope is a 20lb weight ferrous object experiences 2000lb force and his neck was in the middle of that. Unconfirmed reports have described it as an "internal decapitation".
The article says he had time to say goodbye to his wife before he suffocated and later died at a hospital.
Which makes sense since it's about the same timeline of death and outcome you'd expect from an industrial accident involving big industrial chain at a hundred pounds per link or whatever.
That wasn't a necklace, 20lb and a lock isn't jewelry, it's a collar. Probably bdsm, or pup play. It definitely was not jewelry. Also likely iron or steel, which probably made this incident worse.
As much as I would like to say “What are you doing weight training in an MRI room?”, a bigger pressing question is “How did the staff miss this?”.
MRI is extremely dangerous when it comes to having magnetic metals on you and it’s SOP from the hospital to ensure there is none when the patient goes in. The one time I had to get it done (in a different country) I had to walk through TSA like metal detectors before I get into the MRI room. Is that not common here? Not even hand held wands? We just trust the patient now?
He wasn't the patient, and the article says he entered without permission when his wife called him in after the scan was done. It sounds like she called him and he went in either before anyone could stop him, or against the protests of hospital staff (no speculation either way).
I wonder why it isn't interlocked so the door is locked while the MRI is on. Maybe fire code? Emergency medical response seems unsafe unless there's a team of people with special non-ferrous gear waiting around. They'd have to shut off the MRI anyways to avoid stethescopes and what not becoming projectiles.
I guess the timeline suggests maybe they never expected him to go in, until the wife called out to him.
Maybe he's a big dude and it was just under his shirt/vest or something?
When I look up "weight training necklace" it looks like a weight disk at the end of some rope, so maybe it wasn't particularly apparent from the technicians view.
Man, I don't wanna bag a dead guy, but I know fuckall about medicine, and even less about MRI's, the ONLY thing I know about MRI's is that they're composed of giant ass magnets and you do not want to be wearing any metal near them.
I guess there's no guarantee anyone would learn that but fuuuuck. What a way to go.
>Ms Jones-McAllister said the visit on 16 July was not her and her husband's first time at the MRI facility. It was also not the first time that the employee had seen her husband's weight that he used for training, she said.
>She claimed an employee and her husband previously "had a conversation about it before: 'Oh that's a big chain'".
I had MRI a lot of times (I have MS). Every single time as we are walking to the machines, the nurse / technician / whoever asks me a couple of questions (which I have to fill before going in as well). Then I have to take off my clothes in the changing room. They would have never missed it. And no one can just simply walk into the corridor (there is a door) that has the door to the MRI machine. Even if they do so, they would be noticed immediately.
1) ah yes, 5kg if gold in this guy's neck has to be real!
2) a non-magnetic metallic mass that large will still likely screw up the image, if not the machine.
I seems like an easy mistake to make. The imaging was done, per the article "His wife told local media she had called him into the MRI room after her scan" and so the technician could have looked at it being gold colored and didn't apply critical thinking to presume it wasn't real. There was no concern about screwing up the image.
This explains so much. I was wondering how in the hell the damn chain I've already broken twice with mere snags was going to hurl my body through the air towards a machine like that.
Yeesh, what would happen with a wedding ring? If it was a magnetic band would it just sheer through your finger whizzing towards the machine?
I read the article, I don't buy it was for weight training. Certainly doesn't require a padlock around your neck to add resistance weights. Also I have never seen a person wearing a chain daily for resistance training. I've seen weighted vests, and other easier to wear gear. I do however know many people in kink who wear chain collars, and don't tell strangers what it actually is.
It’s notable that he was not the patient, he was the patient’s husband who somehow was allowed to enter the room with the MRI machine.
The superconducting magnet in an MRI scanner is always on even when not performing a scan.
This was pure and simple negligence by the MRI operators. Access control is the most basic part of MRI safety!
Even if he was not wearing this “chain”, he never should have been allowed to enter the room. He could’ve been wearing a steel wristwatch, had a keyring in his pocket, etc.
> "I'm saying, 'Could you turn off the machine? Call 911. Do something. Turn this damn thing off!'" [pleaded the victim's wife].
The journalist missed a golden opportunity for education here: most MRI scanner magnets cannot be turned off like that. For the few that can, it's going to cost >$50,000 just to refill the liquid helium, not to mention the real and opportunity costs associated with rendering the machine offline for days or weeks.
If people don't know about the magnet, or don't know that it can't be turned off (or perhaps assume it's "off" because the scan was over, as I would guess happened here), accidents happen.
> The journalist missed a golden opportunity for education here: most MRI scanner magnets cannot be turned off like that.
Thanks for that - and it reminded me of the sad state media is today. I read the same story in about 4 papers and nowhere was written _why_ they couldn't turn off the machine.
Miss the days where journalists actually read what they have written.
I’m pretty sure when some guy gets sucked into the machine, the downtimes/lawsuits/etc and pressing the emergency button and having a ton of down time is a sunk cost at that point and you are basically obligated to do everytyhing you can to avoid catastrophe to reduce your legal peril.
Quenching the magnet takes up to several minutes. There are also alarms to warn people to get away because the rapidly expanding helium could displace oxygen in the room.
It’s not about the cost. If there’s an emergency that necessitates pressing the button they’ll be pressing it as soon as someone can reach it. It still takes time for the magnetic field to dissipate.
MRI techs do not think about it cost when life is at danger. If someone is in life danger due to the magnet, you quench. This is standard MRI education.
I think the big question here is why they didn’t..
> most MRI scanner magnets cannot be turned off like that. For the few that can, it's going to cost >$50,000 just to refill the liquid helium, not to mention the real and opportunity costs associated with rendering the machine offline for days or weeks.
I thought these days, most MRIs did have an emergency quench button.
Yeah I would say all modern MRIs do. However one misconception is that loss of field strength is instantanous, it's not. The field strength drops off over about 15s or so as the helium boils off and the magnet losses superconducting properties.
So the emergency quench is less useful than it sounds in these situations... it's very likely if an MRI is going to kill you it's going to do it fast enough for it not to be relevant.
Surely you'd hit the quench button straight away? I cannot imagine policy being "check if the victim is dead, and if not hit the button."
I also wonder what the field decay is like. If it takes 15s and it's linear it's much worse than if it's 15s but decays exponentially. You don't need to field to be gone, you need the field to diminish enough to stop strangling the poor guy.
Figure half that to start since most of the loop is gonna wind up laying flat and only the half of it is prevented from doing so by one's neck. Then maybe cut it by 2/3 again since the sides aren't gonna do a ton of direct squishing. That still leaves you with hundreds of pounds, which roughly aligns with the timeline of suffocation in the article High hundreds low thousand likely would be neck snapping or otherwise instantly incapacitating.
Not disagreeing, just saying the tech running the machine couldn't have known that and should have quenched the machine in case the damage was survivable.
Yeah so this video shows exactly what I am talking about, the chair and other objects don't fall immediately, it takes ~15s for them to drop to the ground after the quench starts.
Takes more than 15sec to strangle someone. 30 shouldn't cause any serious damage beyond whatever mechanical damage there is from being tugged around. Heck, 2-3min is probably fine if the MRI is located at a hospital.
Edit: Per the article that I would like to remind everyone is well worth reading, he had time to say goodbye to his wife, that would seem to me to imply he wasn't tossed hard enough to be incapacitated.
honestly, probably, yeah, but the guy running the MRI can't know that and should have quenched immediately. You don't just go "oh well he's probably dead, nothing I can do about it now."
Per the article, his wife claims that he had time to wave goodbye to her.
A man getting dragged by the neck and hitting an MRI machine head-first is going to make all sorts of hand movements that his grieving widow might interpret as waving goodbye in hindsight.
Causing severe head trauma or crushing the trachea can be almost instant. A lot of the more serious MRI related injuries are objects flying across the room and hitting someone, especially over the head.
If anyone is curious what pushing the button to turn off (AKA "quench) the magnet looks like, there's this video of an MRI machine being decommissioned:
You push the button, then 15 seconds later the liquid helium is vented through a pipe on the roof of the hospital (it's quite a spectacular display), and then the superconductor starts to heat up and no longer be a superconductor so the current that's been flowing through the coils (they are energized once, when the machine is first installed, and then continue flowing forever so long as the superconductor is superconducting since there's no resistance) and the magnetic field decays to nothing.
They can be quenched (as you note), but there was that one time that GE didn’t connect the quench button to prevent accidental/expensive usage and n India, and someone died.
Surprise! It turns out there is a reason it should be connected.
In the US the federal government uses numbers around $10 million for the statistical value of a human life when doing cost benefit analysis for various programs or interventions. Any sort of lifesaving medical care can easily come in at more than $50,000. The operators shouldn't be hesitating to shut down that machine to save someone's life, and I would be willing to be that they are trained to do so.
Now you are at the Trolley problem: shut down the machine to (maybe) save one person, but preventing all MRIs for the next x weeks, causing y indirect deaths?
The Trolley problem is only a problem because there is perfect information in the hypothetical about the consequences of your actions. In real life, you have far less information to go on, which often leads to a more obvious right answer. Shutting down the machine to try to save the one person right in front of you that you know is in immediate danger is the right answer, versus the far less knowable hypothetical future where some number of people may or may not have delayed or relocated scans which may or may not have delayed treatment that may or may not have been immediately necessary as a life-saving matter. As a private MRI operator, you are not morally responsible for keeping your machine functional in order to help keep (figurative) passers-by alive. But you are morally responsible for the health and safety of the patients and visitors on your premises.
It'll need to be shut down anyway to pull the giant metal chain out. You might as well do it right away. Patients can and will be rescheduled to other MRI facilities.
That's a huge deal. I read the article and assumed the machine was mistakenly thought to be turned off or was "winding down". That's especially frustrating as the patient seems to be blaming the hospital staff for the incident.
> most MRI scanner magnets cannot be turned off like that. For the few that can, it's going to cost >$50,000 just to refill the liquid helium,
I now nothing about MDI so please tell me: why does it need to refuel the helium? Aren't the magnets “just” superconductive electromagnets? Why can't the current powering the magnet be stopped?
Edit: thanks everyone for your explanations, I appreciate it.
You actually don't need to actively supply current -- it just keeps going round and round, and you can't "short" it out because the path of least resistance will always be the superconducting winding.
You also can't open a switch to stop the current because it's basically a giant inductor, it really wants to keep the magnetic field (and current) constant. Meaning if you suddenly disconnected the winding, it would arc across the gap (continuously, for quite a while until the stored energy was spent).
So what they do is vent/boil off the liquid helium which is keeping the magnet cold, such that it's no longer superconducting and the current will die off. You can't reclaim the helium, hence you need a fresh refill to chill down the magnet again.
They require extremely low cooling from the helium to achieve superconductivity.
And with superconductivity, by definition, current flows without resistance; it continues even without energy, so turning off the power won't stop it. Nor will it heat up and decay from resistance. Modern MRIs are well-insulated enough to maintain their field without power from days to weeks.
The only thing that collapses the field is to warm it up to where superconductivity stops, which can be done slow and expensively, or in an emergency, fast and even more expensively.
By venting the supercooled gases in what's called a quench, you can turn it off faster, but the time it needs can depend on the model. It could be 20 seconds, or it could be 2 minutes, which, depending on the emergency, may be insufficient.
A quench itself can be dangerous, though usually less so than a patient pinned to the magnet. There's a chance that poor ventilation can flood the room with helium, causing loss of consciousness in seconds. The increase in pressure can also make it impossible to escape if the door's not built for that. You'd have to break a window. On top of which, it's dangerously cold, and the explosive bang can rupture your eardrums.
"Any change to the current through the magnet must be done very slowly, first because electrically the magnet is a large inductor and an abrupt current change will result in a large voltage spike across the windings, and more importantly because fast changes in current can cause eddy currents and mechanical stresses in the windings that can precipitate a quench [...]. So the power supply is usually microprocessor-controlled, programmed to accomplish current changes gradually, in gentle ramps. It usually takes several minutes to energize or de-energize a laboratory-sized magnet."
If it's a loop of superconducting material, which seems likely as that's how you prevent losses, then you don't have to supply current so there's no current to stop supplying.
Is there any indication this man was aggressively trying to enter the room before the technician eventually let him in? The article just says his wife called out to him, then the tech let him in and that's it.
This is already a common practice. One of the issues with the standard implementation is that it’s set up as an administrative control rather than an engineering control (which would be significantly more difficult/expensive/space-consuming). At least one other comment thread has discussed the airlock implementation that I’m sure a very large number of people have independently thought of.
I recently had an MRI in one of those full-body MRI machines.. and we went through two locked doors and they used a wand on me (like they have at airports) to scan my body, even after I answered that I had no metal anywhere in my body. There were 3 operators/nurses in the inner ring of all this, operating machines.. securing my limbs, etc.
Given the rather spectacular failure mode, isn't this rather a case of "better safe than sorry"? i.e. even if it's technically safe, why not require people to remove everything that triggers the detector just to be sure?
Unlike many facilities, we insist everyone strips down to underpants (no bra) and wears a gown. We push quite hard to remove all jewellery (including piercings), but many places do not.
It removes a whole category of problems, but is also slow, has an extra cost (laundry) and still patients leave things on, covered up by the gown.
But the percentage of people with something in them is very very high.
We are dealing with a population that by definition has health issues, and I’d estimate that 75%+ have something metal in them.
Sternal wires, fillings, clips, biopsy markers, screws, plates, braces, joint replacements (x6), ports, mesh, vascular stent, urinary stents, breast implants.
These are conditionally safe implants from yesterday. If we expanded it to a week we could add heart valves, hearing implants, vsd closure devices and about 20 other implants I’m sure.
We have either memorised or looked up the conditions for each. We pay techs well because we want good staff. Minimum staffing levels include using healthcare assistants and suchlike. There are potential downsides to this approach, particularly around safety.
Also how they have to get people in. One of my MRIs was hours after surgery - I was wheeled in on a stretcher while attached to IV and other machines. They slid me on and off the machine since I wasn't allowed to move myself (I'm not sure if I could have what with the drugs still in my system. take my story with some salt: because of the drugs I wouldn't trust my own memory of the event). Which is to say they need a lot of space around these machines and the doors/gates would need to be very big to fit all the people involved through.
There are locked doors with badges pretty much everywhere in a hospital in my country though (including the door leading to the ER, and the escalator which goes from the ER to the ICU, in my city's hospital), so I don't really understand what would prevent to put such a door at the entrance of the MRI room.
> The superconducting magnet in an MRI scanner is always on even when not performing a scan.
This should be placed on the entrance with big bold letters, I think that a lot of accidents could be avoided by simply providing "WHY" information.
I had MRI scan and I wasn't aware that machine was active even when not performing scan and now after knowing that I think that personnel there was very lax with allowing me to enter the room after instructing me to put metal objects away AND without enough emphasis how dangerous it could be if I forgot to do so.
They do. You'll be hard pressed to find a magnet room without this [0] sign on the door. That said, it's probably not that warning to most people. Fridge magnets are always on too.
Technically he entered "without permission" but at the urging of the patient. Still negligence, though more understable. I wonder if a metal detector that prevents opening the door would help? Perhaps with a big, scary red override button for emergencies?
Wide: "honey can you come in here and help me since I don't have my walker"
<dude walks right in and gets dead>
Not hard to imagine something like that happening too fast to be stopped, especially if staff is distracted by the transition from running an MRI to getting the patient in/out.
It seems like there could be a double door situation. Go through the first door, close it. The room detects metal, and only unlocks the door to the MRI if the other door is closed and no metal is in the room.
I’m not sure what kind of emergency would warrant allowing metal to pass through when metal is detected, if there is a risk of death for using it.
A false negative is also dangerous, if the magnet hasn't been quenched. In a case like this, trying to use metal bolt cutters to cut off a necklace or something is just going to compound the disaster if the magnet is still active.
A lot of patients and staff have small metal items that aren’t ferrous and it is fine. Many implants, lots of clothing (bra, jeans) and jewellery. You just have to be careful. I’m an MR tech.
I thought in this story the operator did let the person in, which if so was a grave mistake that they now have to carry with them. Though I wonder how you think an operator would know if people have metal on them? Definitely not by trusting people to decide/judge by themselves I hope?
The policy should be no one but the patient and staff is allowed in, the prep for the patient prior to procedure (both in advance and immediately prior) should cover them, and staff should be adequately trained.
There should be no need to evaluate random other people because they simply should not be allowed in at all.
Not sure why it would have to be a massive cost? Wouldn’t even need to be a room, a door like metal detector used normal security settings with its sensitivity turned up.
There is (at least according to one episode of _Grey's Anatomy_) a big scary red button to shut down the machine in an emergency, resulting in expensive to restore operation:
The dude suffocated. You don't need anything near "instant" to prevent that.
Edit: Since apparently some people need reminding, per the article he had time to say goodbye to his wife before he lost consciousness, this wasn't some liveleak skull splat type thing.
The chain apparently caused him to be hurled across the room. We don't know how he died, but given the inverse square law, the possibilities are quite grisly.
I am willing to bet a lot of money he was going into that room no matter how many times he was told not to or how many signs were posted. Some people have an extreme contempt for authority and will stubbornly ignore direction. Sometimes,bad things happen to them.
This doesn't track to me. People have been irrationally afraid of things since the dawn of time, based purely on hearsay (see religion). And surely even the simplest of language serves to warn about unseen dangers.
Entering the MRI room myself I was very familiar with the dangers of bringing metal inside, to the point where I would second guess myself and my own body. "What if my leg bone actually has metal in it for some reason?!"
There are people who flock towards information about technology (probably almost everyone here as well as many in their social circles) and there are people who run from information about technology.
I know people who if you tried to explain an MRI to them, would become visibly uncomfortable and search for any way to change the topic.
>I know people who if you tried to explain an $X to them, would become visibly uncomfortable and search for any way to change the topic.
Expected behavior. Explanations of complex topics are to be rejected if explainer does not have sufficient authority to make behaver hold-still-and-listen.
I know such folk, too, and this is among the thing about people which annoys me to no end. If a MRI tech tried to explain the shit to one such acquaintance, they would try to change the subject like you say. OTOH, if the doctor in charge tries the same, the listener will instead have to zone out. But zoning out is a more expensive operation, as any zooner knows. (Which is why they hold doctors, lawyers, and other semi-priests in high reverence, up to pushing kids to take up these rather joyless professions to the exclusion of all sense.)
Peeps here equally well-behaved other way round tho. C-f "mal" = 0. Geez I really needed to witness the absolute by-the-book Freudian slip that can be found at 1:55 of one of the probably infinite interview cuts, then have MRI safety explained to me by hacker noosers on their Monday morning.
Wouldn’t your head have started to get pulled towards it as you approached, so maybe you could stop approaching once you felt something weird going on in your head?
Both can be true. We learn to fear and respect modern technology because of training and reinforcement that might occur as part of learning.
Consider the “Things I Won’t Work With” column. There is a healthy degree of respect for various compounds that’s learned with experience. This is similar to the way that (properly trained) electricians work with electricity, and nuclear plant techs work around radioactive material.
There's lots of ways we could have metal in our body. A hip replacement, a forgotten piercing, old tooth fillings, maybe you accidentally swallowed some piece of metal.
If MRI scanners are this deadly, everybody should be really thoroughly screened and scanned to be allowed into the room. And even into the room next to it. How can the door of that room open while the machine is still turned on? (Edit: apparently the magnets in these machines usually can't be turned off, which changes the question to: how was he allowed to enter the room at all?)
But wearing such a heavy chain while accompanying your spouse to an MRI scan, is also not the best move.
> There's lots of ways we could have metal in our body. A hip replacement, a forgotten piercing, old tooth fillings, maybe you accidentally swallowed some piece of metal
One of the reasons they ask what you do for work is because if you're doing some sort of job that involves working with metal (e.x. cutting pipes, welding, etc) there are extra precautions to take.
Indeed. The hospital will pay a lot of money. Metal detectors are insanely cheap, there's no reason why there shouldn't be one before reaching the door as a default cautionary measure.
Depending on how or where they are installed, they risk being pointless. Every human has mental on them and it’s mostly safe (in shoes, bra, zips, buckles, access swipe card). Little bits of jewellery are fine. Surgically implanted metal is mostly fine.
Having an alarm that goes off for a staff member’s bra 200x a day leads to normalisation of hearing the alarm, and the unsafe things gets missed.
Of course you don't want to ignore that alarm 200 times a day. That's why I'd rather just ban everything with metal. All of these things have non-metal alternatives that you could easily enforce in such a specialized setting. Why wouldn't you, if it can save lives?
My first MRI I confirmed I have no metal on my body to the technician, but by the time I was inside I suddenly remembered I have metal fillings. I was so stressed by the time the machine turned on, but yeah no problems at all
True, but the RF coils do get turned on & off. Heating of non-magnetic metal from the radio waves used for scanning is another concern, not just magnetic force.
We don't have a sense for detecting 3 Tesla magnets because they don't happen in nature. People can see a tarantula, and, depending on the snake, hear it as well.
But you need to seriously piss off the tarantula for it to engage in a fight with an opponent our size. Most of them are sweet and just want to get on with their tiny lives. They are well aware we are not food. Poisonous snakes, on the other hand, tend to be much less chill. Much like wasps, they seem to enjoy causing pain and suffering.
Tarantulas covers A LOT of spiders (around 1100 different species). You still have to at least be a bit careful around them since they have urticating hairs.
> Poisonous snakes, on the other hand, tend to be much less chill. Much like wasps, they seem to enjoy causing pain and suffering.
Eh, I don't know about that. For example, sea snakes, despite being incredibly venomous, are actually pretty timid creatures.
Agreed, most wasps are super chill if you're not a jackass to 'em. Watching 'em lick up some sugar water is pretty neat in my experience, what with the way they clean their little legs.
Maybe if you instead phrased it as "there's a magnetic field in there that will shear anything magnetic straight through your body if you're holding it on the wrong side of you" that might help folk get the picture a bit better? I mean sheesh, I've got a B.S. in Computer Engineering and a 3 Tesla magnetic field doesn't mean much to me either
Just a sensitive metal detector around the doorway where you enter the MRI room. It sounds like this guy would have had the metal detector blaring before he even crossed the threshold.
"There's a huge evil magnet that will tear you apart if you have any metal on you" sounds much easier to grasp and less likely to lose the listener's attention. Then, when you have them listening: "It can grab you from outside the room and hurl you into the machine where the evil magnet lives! Any metal, be it coins, necklaces, pins in your bones, belt buckles, bra wiring, dog tags. Anything can be the end of you, be damn sure you don't have any metal on you."
Oh, wait, you still want them willing to go near the machine? That complicates things a bit ;)
Fear of heights is ingrained, fear of snakes is learned. We can definitely do better to educate people on the fear of magnets, I figure it’s not a priority since we’re not going to encounter many MRI machines in the wild.
How difficult would it be to install metal detectors to give an alarm to people who enter. I have had a few MRIs and they did seem too trusting that I properly remembered to remove anything magnetic.
Intellectually, you can think that "If a jet can move a plane, it can move me through space", but you never experience a fan even close to that in real life.
To be fair, most people aren't going to know what they means. If anything it's going to sound more like "only 3 huh? That doesn't sound very dangerous." Only 3 miles per hour isn't very fast. Only 3 degrees outside is cold, but it probably won't kill you.
The other side is also true though, "man gets killed by cobra venom" isn't sensational international news because it's an intuitive rational thing we expect to happen. A man getting killed by an MRI machine doesn't fit into our intuition so it gets much more interest than a snake bite.
„In the description of the fundraiser, which had raised more than $3,300 by Monday morning, Bodden said her mother and the technician “tried for several minutes to release him” before calling the authorities.“
https://www.independent.co.uk/news/world/americas/mri-machin...
Is there information on why they didn’t quench?
They teach anyone operating MRI or even sitting by - in the first instruction lesson - that if life is at danger in relation to the magnet, you quench (=release the helium to stop the magnet).
>he was wearing a 20lb (9kg) chain with a lock that he used for weight training.
That is not what any reasonable person would call a "necklace." Yes, metal and MRIs don't mix well, but normal jewellery won't be able to generate enough force to kill you. It might actually be more dangerous due to inducted currents heating the thing up and giving you burns.
If it weren't so dangerous, I'd love to pop along to my local tanning salon and get an MRI scan. I've always been quite interested to see an MRI of my brain. Alas, I'm stuck with waiting for some kind of medical testing to need some test subjects to scan, or a university student needing someone to learn to use an MRI on. Or I guess have a head injury serious enough to need an MRI, but that's less desirable
In Poland you can get one without doctors referal (for CT you need one because of ionizing radiation exposure), it cost between 100-200$ in normal, reputable hospital (not one like from the street view).
It isn't dangerous as long as you follow the safety protocol. This guy was very unlucky as he was wearing a weight training device made of metal, not just a watch or earring.
That's mostly true, but we're still finding new and interesting ways MRIs can kill people. E.g., non-magnetic metals are often safe, bit there was that guy who had his brain cooked as a spinal implant was the wrong length and focused the RF energy into his head. The additional protocol we developed is that objects can be certified safe for specific MRIs but not for all of them (and that being certified safe for a bigger machine doesn't say anything about safety in the presence of smaller machines).
Yes, they're pretty safe nowadays, but there's a lot of energy that gets dumped into a human body during an MRI, and I'd bet my last nickel that we haven't found every way that can cause problems.
I've seen many people make 3D prints of their own brain.
Once, I heard a story where some company was trying to get MRI test participants, and if you agreed they offered to print your brain for you as one of the perks.
Turns out, they gave everyone the same brain, like they would just always use the same file when 3D printing it. Probably had a box of pre-printed ones in the back. Dishonest, but I guess how would you ever find out?
You can volunteer for a study. Check for flyers at your hospital asking for volunteers. (Especially psychiatric institutions - they love brain MRIs for their research.)
That just doesn't make sense to me. If I'm going for a regular checkup or a non-surgical appointment, there's absolutely no reason that I need my doctor's office to be within a hospital complex. Sure, I could have an emergency on the way to my non-emergency appointment, but I could also have an emergency on the way to the grocery store or the gym or the park, and I don't demand that those facilities also be built within a hospital.
Agreed. It's also for patient convenience. More than once I was at a small medical office and was told that the doctor had prescribed a certain diagnostic test for which the facility didn't have the equipment for. So I make an appointment at a real hospital, and then make a follow-up appointment at the small medical office for reviewing the results. It's tiring.
You would have to do that anyway. Just because you are physically located in the hospital for your checkup does not mean there is magically some availability for this procedure.
> What we are learning is that "non hospital" medical facilities suck.
That's really not true, just because you have one bad example does not mean they all are. In general the non-hospital facilities just do one thing, and they do it very very well.
> I can tell you that I don't trust you as a doctor unless you are physically located in a hospital, preferably the larger the better.
That's terrible!! Really. Putting the doctor in a hospital makes him a hospital employee usually, you are asking for the end of private practice for Doctors, you are asking for the end of personal relationships with doctors.
Most people don't understand the danger of MRI, myself included. I trust the people and follow their directions but I can't really visualize what it would be like to get caught with metal in a MRI magnetic field.
For quoting the article : « According to the US Food and Drug Administration, MRI machines have magnetic fields that will attract magnetic objects of all sizes - keys, mobile phones and even oxygen tanks - which "may cause damage to the scanner or injury to the patient or medical professionals if those objects become projectiles". » the choice of words from both the bbc and the FDA don't really convey the risks.
Anyway there are very surprising issues in what is described : why did the wife needed her husband's help to get help although it is the role of the technicians ? Why was the husband in a place where he was able to hear his wife and not being prepped for MRI ? Why was it possible for him to enter ? And why wasn't the technician able to stop him entering ?
I got to take apart an MRI-safe(ish¹) video projector recently. Turns out it was just a regular DLP projector in an RF shielding box, but all the screws and components on the outside (anything that could be removed) were either plastic, non-magnetic stainless steel, or aluminum. They even converted the stock remote control to be powered with a cable instead of a AA battery (most batteries have steel cases).
They replaced the lens with a very long throw one so the projector could be located far away and bolted to the wall. It still had some steel components inside, but the manual made it very clear you were not supposed to open the case while in the same room with the magnet. No other manual I've read has warnings that trying to change a light bulb could kill you.
¹it was designed to be used within the same room as the MRI, but not to go into the magnet bore itself. You were supposed to securely mount it at a distance where the field strength was less than 100 gauss. Since it still contained steel, there were still warnings all over that "this device may become a projectile" if you got too close to the magnet. Installation must have been a bit nerve wracking!
>Installation must have been a bit nerve wracking!
They almost certainly just selected a drywall anchor based on the rating advertised on the package and sent it without any more thought, their ass was covered.
Big picture people who take a step back think about what they're doing don't tend to find themselves installing projectors in hospitals, or if they do they aren't there very long.
Likely true. For all the warnings the thing had about "securing" it, it did not have very many mount points or threaded holes to do so, just some rubber feet. Probably was just sat on a shelf and tied off with a nylon strap. I suppose you aren't going to casually walk past the magnet with a bulky projector like this as you would do with a screwdriver you forgot in your pocket.
> Big picture people who take a step back think about what they're doing don't tend to find themselves installing projectors in hospitals, or if they do they aren't there very long.
They're installed for fMRI research, to show stimuli to study participants.
I love this old GE training video around the time of MRI's introduction to the medical market. Even the oldest machines could show some significant power back then.
Watching the scale attached to a pipe wrench pulling some significant weight on a wrench will help show the forces that a 20 pound chain would have made...
(Oh, and stay for the 'old custodian' tale in the intro of this one...)
When that dude got to throw the wrench at the MRI, you know he was having his best day at work ever. I wouldn't be able to be on camera because of giggling.
This is probably the main one. I could completely understand wanting the assistance of a loved one for mundane things like standing up.
Although to your “not prepped for MRI” point, it is kind of wild that someone with a 20 lbs chain around their neck would be allowed even on the same floor as a MRI machine. Although last time I saw one in person, the door to the room did have some pretty blunt warning text in large print.
Last time I went to an MRI, there was a prep room before the MRI machine. There was a stern and visible warning to remove anything metallic from your body before going through the second door. I am fully aware if the pins on my leg were affected, the machine would gladly remove them from my, most likely along with the bone and the leg they are attached to.
A lot of fatal accidents are like that - a series of small mistakes nobody notices, each individually harmless, followed by THAT ONE BIG MISTAKE that ends up killing someone (or a lot of people).
I'm not sure what "engineering control" means. Just put it in front of the door to the MRI room. Alarm goes off, you do not get to enter, it should be as simple as that.
An engineering control is how your microwave works—if the door isn’t physically closed, it can’t run. The way many (most?) hospitals currently operate is called an administrative control—analogous to a sign on the microwave door telling people not to run the microwave with the door open or open the door when the microwave is on.
But MRI machines can't be turned on and shut off that easily. As someone here explained, it takes up to 15 minutes for the magnet in an MRI to "shut down", and costs $50,000 each time.
Why not just control access to the room behind a metal detector? It would be really simple, but effective. I don't think any MRI should be allowed to operate without this basic level of protection.
Sure, an engineering control for MRI room access would be implemented differently--that's just the canonical example that people are familiar with. One possible implementation for MRI access is the airlock method, where the inner access door would only be allowed to unlock with the outer door locked and no metal detected in the space between (also the outer door would be prohibited from unlocking when the inner door is unlocked, except for some kind of inner emergency override that might also be tied to the emergency quench).
Literally no one disagrees with you on this, and most (if not all) hospital administrators will say they already do it the way you suggest. I'm pointing out that the actual implementations I'm aware of are often ineffective because they use administrative rather than engineering controls, and this is a critical distinction people need to be more aware of when interacting with dangerous systems. Managers, at least in my experience, tend to wildly overestimate compliance rates with administrative controls, even ignoring any possibility of deliberate noncompliance.
A fist-sized powerful magnet that's next to impossible to straight-up pull out of ANYTHING. You need to slide it carefully and NOT let your fingers get in between it and anything else.
Now imagine a magnet that's infinitely more powerful than that.
A good N52 neodymium magnet can be 1.5 tesla- MRIs are usually 1.5 tesla. The pull force is around the same too- a steel object will experience say 20g, and 100 lb fishing magnets are not hard to find.
The difference is the size. Even a large magnet only hits that 20g force over an inch or two. An MRI pulls at that force over a full foot or more; equivalent to dropping the object from 20'+. Worse, the MRI starts pulling at 5 or 10 feet away. Objects can experience a tremendous amount of uncontrolled acceleration in fractions of a second.
It's not like a black hole- unless you are trapped under something very large, the crushing force is substantial but not incredible. In fact inside the tube the gradient is actually smaller than the entrance of the tube- you are pulled in strongly, but once inside the tube you are pressed against the wall somewhat less forcefully. Instead it's like an invisible waterfall, and any metal will be swept away in it, fast enough to put holes in you.
This was not the sort of "paint the room" liveleak tier accident that a hell of a lot of people seem to want to assume it was.
Per the article, the chain was stupid heavy because it was gym/weight training stuff, he was tossed and pinned to the machine where he suffocated, he died at the hospital.
I entered an MRI room once when my wife was getting ready to be scanned. I had a metal Cross pen in my shirt pocket. Although I was 10 feet back, the pen flew out of my pocket, across the room, and stuck to the magnet. It was scary.
Depending on the mass they may have been able to remove it manually. A colleague used to use paperclips to study the field lines, and those had very little force.
The problem is that normal MRI math tries its damnedest to avoid actually solving the right equations. Instead, with a flat enough field, you can assume linearity and just FFT the thing. They'll physically place bits of metal and magnets at various places on the big magnet to calibrate and better adjust the field to being approximately linear. A hunk of metal bigger than a shim sounds like it would mess with that.
Y’know, sometimes people saying you can’t do certain things isn’t them just being an asshole. Physics and biology really doesn’t care what people think…
I've been in a Zone II area waiting before and was surprised how easy it would be for an unauthorized person to get close to a 6T machine. The only thing preventing access was a plastic stop sign.
The machine itself should be able to detect that something anomalous is happening to the magnetic field as it is doing work on the metal item and immediately cut power.
> She said she had called him into the room after she had a scan on Wednesday.
Part of me wonders why the wife felt empowered to invite her husband, who she knew was wearing a giant metal necklace, into the MRI room after her scan. The hospital would have been very clear with her about the dangers of wearing any metal in the room even when the scanner was not running especially because it's common for women to wear jewelry containing various metals and alloys.
Presumably, the husband would have been part of those conversations as well, and thus, should have refrained from joining her in the room anyway, so he isn't completely absolved of responsibility.
Just force of habit. Being around such forceful magnets is not a daily occurrence so you don't really think about this sort of thing (for both the wife and husband). I can totally see how something like this happens.
I once bought a can of coke and put it in my backpack, then I forgot about it. At the airport a few hours later I went through security and didn't think about it at all. No idea why my bag was selected for a manual check. Until he pulled out the soda can. Big (but harmless) do'h moment. People's brains and memories are just wonky like that sometimes; most people have a few "I'm an idiot" anecdotes like that. Even with training by the way: which is why checklists exists for safety critical stuff. "They have been warned about MRI dangers" is pretty meaningless.
The failure is 100% on the facility for not properly controlling access to the MRI room, and people can just walk in apparently(?) And no, a sign or some briefing doesn't cut it.
This is also a risk for absent-minded staff by the way: I don't think I'm the only person who has walked in the wrong room by accident. Or just a small confusion about whether the MRI is operational. Things like that.
> The hospital would have been very clear with her about the dangers of wearing any metal in the room even when the scanner was not running especially because it's common for women to wear jewelry containing various metals and alloys.
I just got an MRI. No warning about dangers of having any metal in the room was mentioned verbally. Was asked if I had any metal in my body, not told why. I just said no to that question. That was it.
The people getting MRIs are sicker than the general population so the facility should have people available to help getting people up after being scanned.
Maybe if we reverted back to the original Nuclear Magnetic Resonance name, people would understand it could be a bit more dangerous that just an image when we are not careful.
Entering the room without permission and wearing a 20lb weight training chain ... I look forward to my next visit where they ask me if I've got some weight training equipment on me.
McDonald's was negligent. The coffee was hot enough to cause immediate lasting damage, having it that hot didn't benefit any party involved, reducing the temperature would have fixed the problem, been as simple as turning a knob, and increased customer satisfaction, and they knew about the dangers and repeatedly chose to do literally nothing about it.
If you tweak elements of the case then you can imagine the restaurant winning. As it stands, it's not surprising McDonald's lost.
Maybe this time they won't go on a PR campaign against the victim (it's also the UK where you only get real damages, so they probably won't care enough, no million pound lawsuits here even if it was as serious as the original case, which it isn't).
There's definitely a balance between hot drink being hot and absolutely scalding, especially when you know you're going to be handing it into a vehicle from a window. And it's not an especially onerous thing to turn the temperature down, and as you say, no one likes getting 98 degree paper cup of lava that you can't even sip for 10 minutes. They say they did control the temperature, so maybe it's indeed all on the customers, but I do know I have been given some really hot hot drinks in paper cups that seem excessive.
> knew about the dangers and repeatedly chose to do literally nothing about it
The dangers of... hot coffee? Yeah, everyone knows that. That's exactly why they shouldn't have lost to the extent that they did.
It's tragic for the person involved obviously; I get why emotionally the court would feel sympathy for the victim. But objectively speaking its pretty ridiculous for the legal system to be awarding punitive damages for companies exposing people to normal, reasonable risks that everyone encounters as part of everyday life. It creates a culture where businesses have to treat grown adults like children for fear of huge fines if something goes wrong.
At worst McDonald's was probably like 10% responsible for the incident but they got treated like they were 100,000% responsible.
(The jury actually did find the woman was partially responsible, it was the judge that decided on the absurd damages amount. It later got reduced and settled out of court so all in all I think the system ultimately worked okay despite the judge's ridiculous initial decision.)
Edit: I misread, it was actually the jury that made the initial ridiculous punitive damages ruling, the judge was the one who reduced it later before it got settled out of court for an undisclosed (possibly still ridiculously high) amount.
> At worst McDonald's was probably like 10% responsible
80%, according to the jury.
> The jury actually did find the woman was partially responsible
Correct, which was factored into the award of actual damages, reducing the $200,000 in damages to a $160,000 award, since it was in a comparative negligence jurisdiction.
> it was the judge that decided on the absurd damages amount. It later got reduced and settled out of court
No, it was the jury that returned the original $2.7 million punitive damage award, which the judge reduced to $480,000, for a total actual+punitive award of $640k in the trial judgement.
The parties did settle out of court while an appeal of the trial judgement was pending.
I see, so it was the jury that was responsible for the ridiculous ruling, not the judge. My mistake, I misread. Definitely seems like there were some systemic or possibly cultural issues at play here.
> I see, so it was the jury that was responsible for the ridiculous ruling, not the judge
No, a jury verdict that is not reflected in the trial judgement is not a ruling at all.
There was some rush-to-publish reporting of the jury verdict prior to the ruling which is the source of the whole popular perception of the case, because the misunderstanding of the case has deliberately magnified ao it can be weaponized by people wanting to limit perfectly warranted recovery from actually-at-fault corporatiojs by spinning false tales of out-of-control judgements.
That's a fair criticism of the media headlines, but the final ruling of $480,000 just in punitive damages ($1M inflation-adjusted) is still pretty ridiculous given, again, that handling too-hot-to-immediately-drink beverages is a normal, reasonable risk that almost everyone encounters as part of everyday life. We could quibble about about the compensatory damages (80% McDonald's fault seems too high to me, but it's also probably not 0%), but I feel that certainly there should be no punitive damages for such things.
> That's a fair criticism of the media headlines, but the final ruling of $480,000 just in punitive damages ($1M inflation-adjusted) is still pretty ridiculous
Given subsequent McDonald's incidents of the same type, it was clearly inadequate to serve the function of punitive damages, that is, to be sufficient to dissuade the willful tortfeasor from repeating the same willful tort. (It’s quite likely that the original $2.7 million award would also have been.)
> handling too-hot-to-immediately-drink beverages is a normal, reasonable risk that almost everyone encounters as part of everyday life.
That's not an argument that the punitive damage award was ridiculous, that's an argument that the jury assessment of comparative negligence that figured into the actual damage award was wrong. Punitive damages are not even in theory about the degree of care that the injured party should have applied, that's the comparative negligence part of actual damages.
Not just negligent, chronically negligent to the point that a court hit the "fuck you fix it" button (punitive damages). They had all the chances in the world to turn down the heat, use better cups, etc, etc, after any one of the prior accidents. They didn't, they just kept paying the settlements and the lawsuits, until someone got hurt so badly that the court said enough is enough.
It's a textbook perfect example of how punitive damages are supposed to work.
It comes to something when Fox News is more informative with background information about signage and safety protocols, and reporting about a technician's warning not to enter, than BBC News is.
That's a Fox Affiliate (a broadcast station in the Fox broadcast network) local news source. The much denigrated Fox News is a cable TV station rated for only for Entertainment that purports to be for News and has done much to confuse the boundaries between the two in the US skirting truth-in-advertising and truth-in-news laws/regulations/common decency for the seeming sake of far right propaganda. (I believe the British equivalent is The Sun if it was allowed its own 24 hour TV channel because despite showing "news-like things" "everyone" knows it is only for Entertainment purposes only, why else would they include celebrity gossip.)
Many of the Fox Affiliates are still best-in-class local news. (Though it varies from city to city.) The Fox News cable channel lowered the bar on what Americans think news is supposed to be to historic low levels.
The U.K. equivalent is GB News. Its reality is worse than your hypothetical. (-:
But the level of Foxness that I was alluding to was not that of GB News, but rather more that of Reach PLC; which isn't Murdoch-owned, but which runs a whole network of purportedly regional news outlets which turn out to be just localized skins applied to a big syndicated empire, and which BBC News often does better than locally.
Yeah in the US system thanks to some old competition requirements the Affiliate Network gets most of the name recognition and provides most of the prime time entertainment content (a few other content blocks), but the stations under that network have their own owners that can be more or less damaging, especially in news content, and more or less "invisible" in that maybe you only see their name in the fine print at the end of credits or copyright statements.
One other notorious example is Sinclair Broadcasting [1]. Sinclair-owned stations include all of the major Affiliate Networks in the US and some of the minor ones, but are known for how much they farm politically-biased news content across their platforms, including trying to pass off editorial content as news content.
(ETA: Which is to say that yeah a FOX affiliate gets entertainment programming from what is left of Rupert Murdoch's empire, but could be getting news content from all sorts of places from home-grown proper local journalism to content farms from their real owners.)
A tragic anecdote has shaken France recently, when an unsupervised 6-year old entered a NICU, took a premature baby and dropped her on the floor. She died of her injuries a few hours later.
The same questions are being asked: how come anyone can enter a NICU? How could the parents let an unsupervised child roam the hospital? How come no one intervened? The worst part is that other parents had complained about the unsupervised child the day before.
Failures all along... that's often how accidents happen.
I wish there was a solid way to balance the weight of a tragedy (sans the kneejerk human emotional reaction) against the proposed solution.
Freak accidents will always happen, and if mitigation is simple and cheap, we should do it. But as soon as we get into the territory of "NICU doors need to be locked with keycard access" (causing every doctor and nurse to do a badge scan 40-50 times a day) then I think it's ok to have 1 infant death every 50 years globally because of it.
My rule of thumb for any big organization (like a hospital) is that nothing changes until there's a body to explain away.
Yeah, sometimes enough fractional close calls add up (usually to a big lawsuit) and policy changes without and death, but don't bet on it.
But, on the other end of the spectrum, having all sorts of absurd policy and procedure because someone might die so incredibly rarely we can't quantify it is terrible too.
People have always thought they could do anything. If you think this is crazy you should see some of the stuff people have been doing with cars and motorcycles for the last 5 decades.
Dude, exactly what I was thinking. Even if the staff weren’t telling me to remove it I would instinctively do the math:
big fat metal chain +
big fat powerful magnet
= disaster.
In fact, whenever I hear MRI I instantly think dental fillings. You’d think the patients and their handlers would instinctively think about all the metal they carry. How could big fat metal chain on neck not come to mind?
I don't get it how in the world someone can just enter the room when the device is on. Trusting people to read signs and follow the rules is borderline insane. A simple lock mechanism could spare life here.
>> I don't get it how in the world someone can just enter the room when the device is on.
The magnet is always on. His wife was in the room. Unless you're previously aware of the dangers of an MRI machine it looks like any other exam room with some equipment in it. It's up to the staff to inform and keep people out and enforce that. IMHO he should not have even been in the outer room wearing a chain like that.
This article[1] has a good overview of safety procedures already in use at other facilities:
> Melonie Longacre, VP of Operations at Northwell Health, explained MRI safety protocols, emphasizing the importance of multizone procedures to ensure safety around the powerful magnet.
> "Zone I is just for awareness that there’s an MRI in the vicinity, Zone II is the patient screening zone where they get screened. Zone III is the post-screening zone, and Zone IV is the actual magnet room," she said. "It’s important to be educated and safe."
It's unclear if Nassau Open MRI (where this incident took place) had similar safety protocols. I'm guessing not.
Somebody told me that they knew of a case where a hospital porter tried to take a shortcut through the MRI room with a metal gas cylinder. Apparently it made quite a hole in the wall.
Why though? Why are we going to force society to spend hundreds of millions of dollars in equipment, wasted time and personal costs, to avoid a one in a million possibility that someone not caring about clear warning signs gets injured?
Interesting that he didn't feel gradual increase of pull force while he was approaching the MRI machine.
I guess cubic growth (?) changes from mild to dangerous so quickly when walking towards a MRI machine that once you realize what happening it's already too late.
> Interesting that he didn't feel gradual increase of pull force while he was approaching the MRI machine.
There isn't a gradual increase in pull when magnets are involved. My wife used to work for a company whose product involved powerful magnets. For a while they produced a demo kit in which a magnet would hold a large ball-bearing levitated against gravity. That thing was lethal. If the ball-bearing approached the magnet too closely it instantly became a dangerously fast finger-crushing hammer.
No, for "a magnet" it's an inverse cube law. I've often wondered if the force holding a nucleus together is really magnetism. No, physicists you don't need to correct me, I know how off the wall that sounds ;-)
For nuclear forces it's actually the strong force binding the nucleus (electromagnetic force is far, far, far too weak to do this) but you can theoretically unify the weak force and the electromagnetic force into the electroweak force : https://en.m.wikipedia.org/wiki/Electroweak_interaction
Ah, yes, I was assuming it was essentially like any other electromagnetic force, but apparently it being a dipole messes with things and it's inverse cube. TIL
This is international news, which means that this kind of event is extremely rare. People are often pretty dumb, and magnetic metal is common, so that means that the existing precautions are very effective. There's probably room for improvement, but there isn't some blisteringly obvious thing that's been overlooked that would save many lives.
> In 2001, a six-year-old boy died of a fractured skull at a New York City medical centre while undergoing an MRI exam after its powerful magnetic force propelled an oxygen tank across the room.
There shouldn't exist any metals in the room (that are not the machine itself), period. The smallest metallic object can fly off like a bullet. Everything and everyone that enters the room should be required to be scanned with a handheld metal detector.
The real story here is that breakaway connectors exist and yet are still not used.
While the MRI angle makes it "newsworthy," there are many ways in which a chain might be caught and cause injury if it does not disconnect at a lower energy level than the minimum amount of injury the wearer is willing to accept.
This is a sad episode, but you can see it in the language quoted from the wife's victim, that she already has an eye in some lawsuit to get money out of this.
"It was also not the first time that the employee had seen her husband's weight that he used for training, she said."
"She claimed an employee and her husband previously "had a conversation about it before: 'Oh that's a big chain'"."
"I'm saying, 'Could you turn off the machine?" she said. "Call 911. Do something. Turn this damn thing off!'"
This is really so sad, reminds me some facts about ancient Roman history and how everyone kept trying to sue somebody else for some easy money.
why doesn't the MRI machine do magnetic field checks to make sure there isn't some anomalous metal anywhere near it - and do near instant shut down if so?
It’s wild that the bottleneck keeping us from buying more MRI machines, achieving economies of scale for a no-radiation way of viewing soft tissues in high resolution, is supposedly the specialized technicians, and here we had a technician who couldn’t manage to turn it off in time when something went wrong, and apparently didn’t keep metal objects out of the room. (We use metal detectors any time you walk into a sporting event, why not an MRI room?)
I expect this story to be promoted by people who benefit from sales of x-ray / CT machines though. MRIs and all of their promise for public health could continue to be set back.
You can't turn it off, it's a static magnet with hundreds of amps flowing in a closed loop in a giant superconducting coil. The usual comparison is that a charged magnet has the same kinetic energy as a loaded 747 coming in to land. To "turn it off" you can bring it above superconducting temp, dissipate all that power as heat, and boil off thousands of liters of helium (fun fact, they usually have ducts to outside for this so everyone doesn't suffocate during a quench). Which might have happened in this case due to physical damage to the magnet, but is not as easy as flicking a switch and having it be "off".
> The usual comparison is that a charged magnet has the same kinetic energy as a loaded 747 coming in to land.
That sounds like it a bit of an overstatement. 200 tonnes of 747 at 250kph is nearly 500 MJ. Even the biggest, baddest high-tesla MRIs are maybe 10MJ. Which is still a 67-tonne M1 Abrams at 40 mph, so it's not like it's an unimpressive amount of energy!
Sure, a tank can stop from 40mph in not much time due to a very big braking system (https://youtu.be/f5XUQ2beGfM?t=85), but also a tank at 40mph will utterly demolish an MRI suite, patient and all if it drives into it.
A magnet yanking a chain around your neck isn't going to slowly suffocate you either. It's going to instantly crush your trachea and maybe your spinal chord, like a drop from a hanging.
The facts as reported in the article indicate that he was able to say goodbye before being suffocated. I wouldn't call that "instantly crush your trachea and maybe your spinal chord".
Okay, this sounds more serious than I thought. But then, why was someone able to walk into that room with metal around their neck if it was clearly so life-threatening?
Anyway, I’m complaining as someone who personally has turned down recommended medical procedures after checking radiation cancer risk numbers and realizing the radiation risk was being downplayed. When I saw the numbers, to me the cancer risk wasn’t worth it, so I went without a solution to my health problem. Had an MRI been an option, I would have more likely said yes.
> But then, why was someone able to walk into that room with metal around their neck if it was clearly so life-threatening?
Take a look at the Google Street View link someone posted. It's pretty clear this facility -shouldn't- have been able to acquire an MRI machine in the first place.
It also elucidates how such an accident could happen, i.e they clearly don't have the trained staff and protocols necessary given the danger of an MRI machine.
It's very likely the poor gentleman didn't understand the immense danger the machine poses.
They are expensive and rare for a reason IMO. Yes it would be great to have more of them but the best place for more of them is within proper hospitals and leveraging economies of scale to share technicians across a fleet of them in a well run facility.
You got the MRI magnet dissipation-time completely wrong, but it hasn't influenced your opinion on the radiation risk in other similarly sophisticated equipment that could save your life?
A hasty incorrect assumption that I revised on new information is obviously not the same as hard data on radiation doses and cancer implications considered over weeks.
The “could save my life” odds were not very clear and the risk of cancer for that radiation dose had been long ago quantified by scientists, though without considering the immunosuppressants I was taking at the time that elevate cancer risks, making those rates more of a best-case scenario than something to count on. Above all else, the number known to the healthcare facility was the dollar amount to bill to my insurance, with the facility receiving nothing but money in exchange for taking those risks with patients’ lives.
For reference, in exchange for 10 mSv of radiation, a moderate dosage for a CT scan, the cancer risk for a young adult is something like 1/1000 over the course of their life. This means that out of every 1000 young adults who receive a 10 mSv CT scan, 1 would go on to get cancer they otherwise would not have gotten, assuming those 1000 aren’t already at higher risk of dying sooner (this assumption is important to weigh but is not straightforward). Those odds sound low, but if there was a revolver with 1000 chambers and one bullet, would you play Russian roulette with that if your life wasn’t on the line? The risk of cancer for the same radiation dose is much higher for children.
A technically clear answer to this is to use MRIs wherever practical, and to make MRIs more practical as much as we can. Why accept 10 mSv of radiation when you could just do an MRI instead? We should be making MRIs more and more practical. I’m concerned about the potential fear-mongering over times like this one when the facility fails to perform an MRI safely, where the impression people get could be that MRIs are dangerous, when the hazard was really the facility doing a bad job. By contrast, a perfectly performed CT scan will deliver a known radiation dose to the patient every time.
> The usual comparison is that a charged magnet has the same kinetic energy as a loaded 747 coming in to land
So once you divide by the "lying to people allegedly for their own good and trading away credibility in the process" factor what does that come out to? A semi truck at highway speeds? Those can stop in under 10sec.
It isn't a binary like that with the MRI though. If it stops strangling you in 10sec you're great, 15 you're fine, 20 you need to be woken back up.
Edit: Per the article that you have all supposedly read, he wasn't instantly incapacitated. He was pinned onto/into the machine with enough weight on him that he suffocated over seconds and ultimately died at the hospital. This would have been a "close call" with an E-stop (which they likely had, just wasn't hit soon enough).
I don't know, I imagine getting suddenly jerked across the room by your neck is not a slow and gentle strangulation event. In addition, as I understand it, currents can be induced in metal objects causing them to heat up. So no, I'm not sure that 15 seconds of violent burning strangulation of an elderly individual is fine. It's not clear this fellow died from strangulation.
As an anesthesiologist I routinely gave anesthesia to patients (usually children) undergoing MRIs over a 38-year career.
I never had anxiety in my daily practice in the OR but anesthesia in the MRI suite ALWAYS provoked anxiety because:
1. I had to anesthetize the patient in the sub-basement, two floors below the main OR — where there were always other anesthesiologists able to help in an emergency. In the MRI suite, no one could hear my silent screams if I got in trouble nor were there knowledgeable extra hands to, for example, squeeze the breathing bag if I needed to prepare for an emergency intubation.
2. Once the patient was anesthetized and the heavy door to the MRI machine room was closed and locked, I could only monitor my unconscious patient through a darkened heavy glass window. Sure, I had monitors for EKG and oxygen saturation outside the MRI room, near the control board where technicians operated the machine, but the automatic blood pressure cuff inflator dial on the anesthesia machine was inside the room and hard to see through the dark glass.
3. It was my good fortune to never have had an emergency in the MRI suite, but events such as that reported above in the OP happened from time to time in hospitals throughout the U.S. and were occasionally reported in the anesthesia literature with the expected cautionary advice. Many more events occurred than were reported.
>1. I had to anesthetize the patient in the sub-basement, two floors below the main OR — where there were always other anesthesiologists able to help in an emergency. In the MRI suite, no one could hear my silent screams if I got in trouble nor were there knowledgeable extra hands to, for example, squeeze the breathing bag if I needed to prepare for an emergency intubation.
You are allowed to put patients under general with no one else present? That doesn't seem like it should be possible
>You are allowed to put patients under general with no one else present? That doesn't seem like it should be possible
Every day in ORs around the world manuy thousands of anesthesiologists — and CRNAs where approved — put patients under general with no one else present. Are you proposing that two anesthesiologists be assigned per patient, like scheduled airlines?
Should piloting a plane solo be outlawed?
If, after three years of residency and roughly 1,500 cases done under supervision, many more done without supervision, a written examination, and an oral examination, you aren't qualified to administer a general anesthetic solo, then you have NO business giving general anesthesia no matter how many other qualified or unqualified others are present.
I agree you should be able to provide solo, but there is also substantial evidence supporting the addition of a CRNA to make anesthesia teams, that are safer (and even more expensive) than either CRNA or MD operating alone. In many countries, teams are the standard of care.
Accreditation is a thing. You don't have to be accredited to practice medicine. But you might want to be if you want insurance or the government to pay you for practicing medicine.
Im sorry but how does this possibly jive with what you literally just said?
> In the MRI suite, no one could hear my silent screams if I got in trouble nor were there knowledgeable extra hands to, for example, squeeze the breathing bag if I needed to prepare for an emergency intubation.
Presumably the patient just dies in that scenario that you are supposedly qualified and prepared for?
> Presumably the patient just dies in that scenario that you are supposedly qualified and prepared for?
Yeah, can happen. That doesn't mean you did something wrong. Sometimes (very rarely), shit happens even though you've planned it all according to guidelines. What he's saying is that when shit hits the fan, he's really grateful if someone's there to assist with basic moves while he's trying to control the more pressing matters. I can relate.
To me it reads like anesthesia in the MRI shouldn't be allowed or needs better supervision.
>he's really grateful if someone's there to assist with basic moves while he's trying to control the more pressing matters.
I think they were saying theres literally no one there to help.
>Yeah, can happen. That doesn't mean you did something wrong. Sometimes (very rarely), shit happens even though you've planned it all according to guidelines.
Emblematic of the broken US healthcare system. The guideline creates an easily preventable scenario where the patient is highly likely to die for no real reason.
> To me it reads like anesthesia in the MRI shouldn't be allowed or needs better supervision.
It must certainly be allowed, as it greatly benefits some patients. Believe me, I'd be most happy if I was forbidden to enter MRI rooms.
> I think they were saying theres literally no one there to help.
This might happen quite infrequently, and usually just for a very short time. Problem is that others have their own jobs to do, and sometimes you get unlucky at just the worst time. It's certainly not common that no one's there, and theres almost always someone near. But since you can't leave the patient, it might be that you have to yell for 20-30s before someone notices you're in trouble.
> Emblematic of the broken US healthcare system. The guideline creates an easily preventable scenario where the patient is highly likely to die for no real reason.
I'm not currently practicing in the US. I don't think that's a fair assessment. Guidelines are born in patient blood, and although adaptation is a must deviating from guidelines still remains a bad idea most of the time.
There's always someone else. But the radiologist might not be at his/her most efficient doing anesthesia & resuscitation...
No — there is NOT always someone else. And if others present are nurses, aides, radiologists, etc., they are generally of zero help in a crunch.
Pretty sure that at the very least you are not operating the scanner. And the scanner generally nowadays must operate under the plus one staffing model (one certified technologist per scanner plus at least one additional level 2 MRI safety trained staff in the immediate vicinity). So no, you are not "alone".
He said he's been doing that for a long time. Plenty of time for stuff to happen, and security guidelines were not always as they are now.
An anesthesiologist was never operating an MRI scanner at any point in history.
Indeed, but you won't find yourself alone during the MRI. When you're preparing or finishing the case though, the RX tech and the radiologists often suddenly feel a need for a break. Same thing happens everywhere we go: the anesthesiologist comes in, everyone's here. 2 min later, you look around and everybody magically disappeared.
That's never happened anywhere I work unless you're counting being in the control room as "magically disappearing". To be fair I only have 25 years in the field and don't use AI to answer so what do I know.
Look, he might use AI but I'm not. I also have 20 years in the field, and I've lost count of how many times I found myself alone with a risky patient. Yes, oftentimes people are just 10m away. Yes, that's not supposed to happen. But that's often far enough for us anesthesiologists to wish we'd be somewhere else. Perspectives and empathy matter. Try to put yourself in our shoes, sometimes. For the record, I'm the main hybrid MRI OR guy in my hospital, so I work near MRIs most days.
The only way anything you are saying makes sense is if you are counting people being in the control room as not being there. They can see you, they can hear you, you can hear them. You are not "alone" except in an overly dramatic sense. This goes in triplicate for a hybrid system operating today.
The RX bay over here is like 150m^2, serves 6 MRI rooms, has nooks and corners and doubles as the patient waiting bay. Having the tech busy elsewhere while putting people under or waking them up is not a rarity. I agree the security is better for hybrid rooms, as they have their own separate control rooms and techs won't leave when the machine is running. I don't think I'm being dramatic, but you sure seem to have a cozy job if you're allowed to constantly sit around in the control room while anesthesia is under way.
No idea what an RX bay is but your choice of units certainly seems non-American. But thanks for derailing a story about someone who died in the US in a situation that has nothing to do with anesthesia to whine that you feel lonely and important and while chiding others for their supposed lack of empathy. And now you're whining that you feel alone while outside the MRI room? I guess? MRI has no control over anesthesia staffing in the US. That's your own problem.
That's not a fair assessment of our conversation, and it seems to me you've been aggressive from the start. Honestly, you reek of the typical US prejudice that 'all-docs-are-arrogant-and-speak-only-to-spite-others'. You can't imagine the relief when I got out of US healthcare and that kind of daily interaction with hospital staff and patients.
Yeah, I agree that we can find ourselves alone sometimes, although that's not really supposed to happen. For sure, most people usually aren't that useful anyway.
The MRI+anesthesia problem has recently got much worse, since we're now seeing MRI hybrid ORs pop up. Compounded with the 'lean management' principles en vogue in hospitals, this is a disaster waiting to happen. Personnel is often affected to multiple ORs, including standard and hybrid sites.
>In the MRI suite, no one could hear my silent screams
I understand it is caused the 'donut of death' for that reason.
> Once the patient was anesthetized and the heavy door to the MRI machine room was closed and locked, I could only monitor my unconscious patient through a darkened heavy glass window.
Why was the door locked?
There's some sort of latching mechanism to seal the faraday cage. Sometimes it's a latch, sometimes it's pneumatic or a bladder that inflates.
The doors can also lock (I'm pretty sure they are required to be locked when qualified personnel are not present) but usually they are not locked when the scanner is staffed and in use.
Faraday cage makes sense considering the RF sensitivities involved with MRI.
I do wonder if someone being in the room is enough to distort a scan? As there's no ionising radiation danger, it always seemed odd that you were left alone in there.
No, people in the room won't interfere unless they are doing things inside the scanner during the scan. MRI generally operate at radiowave frequencies (the faraday cages mostly keep radio stations out). There's other stuff they're blocking but radio stations are the strongest interference.
In that case, why (in the above example) does the anaesthetist have to monitor from, or a nurse or family member have to wait outside?
I understand there's magnet safety worries, but if the anaesthetist is knocking someone out on the scanner bed, doesn't that prove them magnet safe?
I don't understand your question. The anesthesiologist was describing equipment that was not safe to have in the room and was positioned outside the room to be viewed through the observation window.
Many sites screen individuals to accompany patients. It's fairly common in pediatrics.
If by "the above case" you are talking about the accident that happened, it has nothing whatsoever to do with anesthesia in the first place. It was an outpatient knee MRI performed without anesthesia at a free standing clinic (not a hospital). Based on the wife's description of what happened, the technologist brought her husband into the room at her request to help her up after the scan had finished and the technologist failed to screen him.
Sorry, I completely misunderstood what they said. My mental picture was the equipment being _in_ the room attached to the patient (and safe to be so), but the person being stuck outside unable to easily intervene. My experience with MRIs is always being alone in a room which backed that up.
I'm not even thinking of this incident. My base query is why MRI patients seem to always be alone in the room. Ignore all the anaesthetics too; I've seen them refuse to let a nervous patients family member stand in the room during the scan even though it could completely calm the patient... that's what seems odd to me. This is based on UK hospital experiences; I'm not sure if it's universal.
The incident in question is sad and seems avoidable, but I hadn't even got that far yet; I got stuck on the top(ish) comment of "(Once the patient was anesthetized and the heavy door to the MRI machine room was closed and locked,) - I could only monitor my unconscious patient through a darkened heavy glass window". My thinking went "surely being in the room would be better" -> "they never seem to let anyone in the room" -> "why not?" - and then I confused you and we ended up here :)
> I've seen them refuse to let a nervous patients family member stand in the room during the scan even though it could completely calm the patient... that's what seems odd to me. This is based on UK hospital experiences; I'm not sure if it's universal.
We do let family members in, we just try to avoid it. Having extra people there is extra problems, extra safety issues and makes everything slow. ‘It completely calms’, is rarely true. We are good at getting patients through scans - we do it 50x a day.
Sort of?
It should be lockable when no staff are present and no one is in there.
It just needs to close when in use.
So no one can accidentally walk into the room while wearing metal while it is on, to prevent injuries like the post we're commenting on, from happening.
No, that's wrong. The locks are because the magnet is always on but the scanner is not always staffed. The scanner door is never locked when the scanner is staffed or a patient is inside.
interesting!
The door shouldn’t be locked when staff are present.
It certainly shouldn’t with people inside.
I work in MRI.
Thanks for the insight. re:#3 how do mistakes not get reported? Is it because this incident resulted in a police report and is unusual in this context?
Deaths in the OR like cardiac arrests, fatal hemorrhage from burst aneurysms, etc. are always reported within the hospital. Whether others outside learn about such things is often a matter of persistent family and relatives demanding to see the actual death report and contemporaneous notes.
Fatal mistakes usually stay within hospital departments and are discussed at length in regular confidential Morbidity and Mortality conferences.
This time it killed someone. Usually, it's just a bed or a respirator that ends up stuck in the ring.
Back in 2001 a 6-year-old boy undergoing an MRI was killed when an unsecured oxygen tank was pulled in to the machine.
https://www.psqh.com/analysis/mri-safety-10-years-later/
Why darkened glass?
It's not darkened on purpose, but as a result of containing electromagnetic radiation shielding.
The EM shielding is simply a wire mesh, not tint. The glass doesn't have to be darkened, and probably wasn't, but often the room is darkened to make the scan more comfortable and calming. Also, in my experience the room doesn't have many lights, and the patient is inside the bore, making them hard to see.
MRI and other radiology suites use lead glass windows, which are incredibly thick and tinted dark-yellowish-orange. Visibility through them is okay, but not great.
MRI windows aren't leaded, that would do nothing for RF or magnetic interference. MRI windows contain copper mesh and are designed to integrate with the rest of the Faraday cage to both keep the RF generated by the machine in the room, and keep external radiation away from the sensors. Also keep the acoustic noise in the room.
This also doesn't do anything against the (static) magnetic field, which is really hard to block except with material like steel, which don't make very good windows. Newer machines have a counter-magnet to redirect the field to extend less far from the machine.
From a cursory search, seems like 1. Privacy, and 2. RF shielding of equipment behind the glass and from influencing the MRI scan itself.
Privacy is irrelevant: the MRI suite is so remote from the rest of the hospital that no one goes there who isn't supposed to be there.
Except this guy in the article, I suppose...
That's what happens when you open a neighborhood MRI facility...
Why is anyone getting general anesthesia for an MRI? It's a non-invasive procedure.
To add to the sibling comment, being stuck in a small, incredibly loud tube usually pinned under some receiver isn't great for claustrophobic patients either.
A lot of people get panic attacks / claustrophobia and are incapable of getting in or staying still for a scan.
I have a lot of sympathy. I'm pretty good in confined spaces usually, but even after multiple MRIs it's still a surprisingly stressful experience. The buildup and safety questions make the pre-experience worrying. The aperture is surprisingly small. Depending on the scan, part of you might be caged in place, and it's extremely noisy and you're aware of a lot of mass and power spinning very close to your face.
Also, some of the radiologists don't help. It's not deliberate, but they're entirely desensitised to the experience (and often haven't actually gone through it themselves; which again seems crazy considering the lack of radiation). My last scan was of my lower back, but they were already set up (from the previous scan) to feed me in head first rather than feet first. From their point of view it saves a bit of faffing with the software and moving the pillow to the other end. From a patients point of view it makes all the difference in the world; it's a very different psychological experience having your legs inside with your head free, vs being stuck head first in something and having it whizz past next to your head.
I've had a goodly (read unhealthy) number of CT and MRI scans and I'm bright enough to understand which one is significantly more detrimental to my long term health. I'm also aware that on a subconscious almost cellular level, it's the benign one that absolutely terrifies me every time...
Critically ill patients, animals, children/babies.
>I routinely gave anesthesia to patients
benzodiazepines?
General anesthesia; the nurse attending the patient was qualified to administer benzodiazepines.
For anyone wondering why they didn’t just turn the magnet off immediately: Quenching the magnet is not instant. From what I’ve read, it can take 30 seconds to multiple minutes for the magnetic field to dissipate after pressing the button.
Also, the person wearing the 20lb chain was not the patient. There was an access control failure (someone peeking their head into the room?) combined with the extraordinary amount of metal resulting in a lot of pull.
A gofundme setup by his step-daughter for funeral costs says he was stuck to the magnet for over one hour. Which if accurate seems like the timescale for ultimately being quenched but after a lot of indecision about punching the button. Probably they waited for EMS to arrive and be screened etc and they had to decide etc.
Calling a 9 kg chain a "necklace" is a bit misleading. It makes it seem like it could have gone in unnoticed. "medical episode" is also very vague, what was the actual cause of death?
Given that the chain drug him across the room, I can imagine that the actual death might be quite grisly - if it can cause a man to be "hurled towards the machine" it's possible it was worse than a mere strangulation, and that sort of detail isn't really required in the article.
There is a video of it floating around for the morbidly curious. I won't link it here. It is very NSFL. I was accidently shown it while scrolling instagram and wish I hadn't seen it.
He is able to talk, you can make out his words, but he is clearly choking or being strangled. He was fully sucked into the machine. There was a very strong guy trying with everything to pull him out. He made some pretty sad and harrowing words when he realized he wasn't going to make it. Again, the video is out there if you really want to see it. I do NOT recommend it though.
Here's a well known and SFW training video about MRI magnets. It'll put the problem into perspective without needing eye-bleach.
https://youtube.com/watch?v=kLjxhuybFWo
That seems to be very strong. What's the effect of this type of magnetic field on the iron in our blood?
Apparently, oxygenated hemoglobin and blood plasma are diamagnetic, while deoxygenated hemoglobin is paramagnetic. Meaning, magnetic properties are determined by the molecules, not its elements. I assume that whatever attraction or repulsion caused by even the MRI magnets are weak compared to the forces involved in Brownian motion. So don't expect anything substantial.
I've seen a lot of gruesome stuff so I'm not bothered by that, but curious how someone got a camera, presumably with ferrous parts, in there without it also getting pulled into the magnet.
The article covers the timeline of his death. Whatever the details they weren't so incapacitating as to prevent him from saying goodbye to his wife before losing consciousness.
The timeline supplied being "he waved goodbye to me and then his whole body went limp".
A day later, after being taken to a separate facility and suffering multiple heart attacks (I have no idea what the connection there is).
https://www.theguardian.com/us-news/2025/jul/21/new-york-mri...
> He endured “a medical episode” at that point which left him in critical condition at a hospital, and he was pronounced dead a day later, police said.
> Adrienne told News 12 that her late husband had suffered several heart attacks after the incident with the MRI machine and before his death.
That doesn't seem to be specified, is it?
Sorry, added a source and quote.
According to other articles I've read, multiple heart attacks.
Yes, and didn't die until the next day.
I believe many articles are leaving these parts unsaid due to sensational assumptions they benefit from in virality.
EDIT: source https://healthimaging.com/topics/medical-imaging/magnetic-re...
If it was any kind of weight training vest it would be wrapped around the chest and therefore any orientation would involve him being squeezed by the magnetic force. Imagine two dinner plates, front and back; whether he was facing forward or back wouldn’t change much.
9kg is nearly 20lbs in freedom units. That is an insane amount of metal to wear around your neck, let alone in the vicinity of an active MRI machine.
Very likely severed spinal column, if not complete decapitation.
I don't think the human body is that fragile, the magnet probably dragged his body, head first, until it hit a solid object, in this case the cover of the MRI machine. Slamming your head at that speed isn't that healthy.
This was my assumption as well. What the heck has everyone assuming it’s a decapitation? Dude was dragged by the neck at high speed towards a large machine. Massive head injury sounds very reasonable, maybe even expected.
Inside the scanner the back-of-the-envelope is a 20lb weight ferrous object experiences 2000lb force and his neck was in the middle of that. Unconfirmed reports have described it as an "internal decapitation".
The article says he had time to say goodbye to his wife before he suffocated and later died at a hospital.
Which makes sense since it's about the same timeline of death and outcome you'd expect from an industrial accident involving big industrial chain at a hundred pounds per link or whatever.
I wouldn’t %100 trust an eye witness account, especially for something so traumatic where an alternate outcome might give them some solace.
That wasn't a necklace, 20lb and a lock isn't jewelry, it's a collar. Probably bdsm, or pup play. It definitely was not jewelry. Also likely iron or steel, which probably made this incident worse.
It was for weight training (according to [0]). Weightlifters wear them on the neck to help build neck muscle.
[0] https://www.theguardian.com/us-news/2025/jul/21/new-york-mri...
As much as I would like to say “What are you doing weight training in an MRI room?”, a bigger pressing question is “How did the staff miss this?”.
MRI is extremely dangerous when it comes to having magnetic metals on you and it’s SOP from the hospital to ensure there is none when the patient goes in. The one time I had to get it done (in a different country) I had to walk through TSA like metal detectors before I get into the MRI room. Is that not common here? Not even hand held wands? We just trust the patient now?
He wasn't the patient, and the article says he entered without permission when his wife called him in after the scan was done. It sounds like she called him and he went in either before anyone could stop him, or against the protests of hospital staff (no speculation either way).
I wonder why it isn't interlocked so the door is locked while the MRI is on. Maybe fire code? Emergency medical response seems unsafe unless there's a team of people with special non-ferrous gear waiting around. They'd have to shut off the MRI anyways to avoid stethescopes and what not becoming projectiles.
> I wonder why it isn't interlocked so the door is locked while the MRI is on.
It’s always on. It’s always magnetic. The rf comes on when the scanner is imaging.
Well that would certainly explain it. I thought they were some form of electromagnet.
> He wasn’t the patient
Everyone had to go through the detectors including the staff to avoid accidents, which is why I brought my experience up.
I guess the timeline suggests maybe they never expected him to go in, until the wife called out to him.
Maybe he's a big dude and it was just under his shirt/vest or something?
When I look up "weight training necklace" it looks like a weight disk at the end of some rope, so maybe it wasn't particularly apparent from the technicians view.
Obviously, not excusing the tech here at all.
Man, I don't wanna bag a dead guy, but I know fuckall about medicine, and even less about MRI's, the ONLY thing I know about MRI's is that they're composed of giant ass magnets and you do not want to be wearing any metal near them.
I guess there's no guarantee anyone would learn that but fuuuuck. What a way to go.
>Ms Jones-McAllister said the visit on 16 July was not her and her husband's first time at the MRI facility. It was also not the first time that the employee had seen her husband's weight that he used for training, she said.
>She claimed an employee and her husband previously "had a conversation about it before: 'Oh that's a big chain'".
When I had a mri, they didn't use a wand or detector.
I wonder if the chain was gold colored and so the people assumed it was gold and safe.
I had MRI a lot of times (I have MS). Every single time as we are walking to the machines, the nurse / technician / whoever asks me a couple of questions (which I have to fill before going in as well). Then I have to take off my clothes in the changing room. They would have never missed it. And no one can just simply walk into the corridor (there is a door) that has the door to the MRI machine. Even if they do so, they would be noticed immediately.
Taking a large metal item into an RF transmitter is problematic too. Heating can burn people.
1) ah yes, 5kg if gold in this guy's neck has to be real! 2) a non-magnetic metallic mass that large will still likely screw up the image, if not the machine.
I seems like an easy mistake to make. The imaging was done, per the article "His wife told local media she had called him into the MRI room after her scan" and so the technician could have looked at it being gold colored and didn't apply critical thinking to presume it wasn't real. There was no concern about screwing up the image.
5kg gold makes a surprisingly slender chain, actually. I've heard 1kg gold is as big as an iphone.
Why wouldn't every human being involved in this be essentially screaming at him not to bring that thing anywhere near MAGNETIC resonance imaging?
The wife says the chain and lock were for weight training.
This explains so much. I was wondering how in the hell the damn chain I've already broken twice with mere snags was going to hurl my body through the air towards a machine like that.
Yeesh, what would happen with a wedding ring? If it was a magnetic band would it just sheer through your finger whizzing towards the machine?
Read the article.
>She said he was wearing a 20lb (9kg) chain with a lock that he used for weight training.
I read the article, I don't buy it was for weight training. Certainly doesn't require a padlock around your neck to add resistance weights. Also I have never seen a person wearing a chain daily for resistance training. I've seen weighted vests, and other easier to wear gear. I do however know many people in kink who wear chain collars, and don't tell strangers what it actually is.
My experience is different than yours.
I know many people who wear weighted chains everywhere as part of weight training. Some using locks to fasten the two ends together.
I don’t know anyone in kink who does this.
There are things in the world different than what I know.
Someone said it was a strength training thing, some crossfit cult thing of carrying heavy crap around your neck.
It’s notable that he was not the patient, he was the patient’s husband who somehow was allowed to enter the room with the MRI machine.
The superconducting magnet in an MRI scanner is always on even when not performing a scan.
This was pure and simple negligence by the MRI operators. Access control is the most basic part of MRI safety!
Even if he was not wearing this “chain”, he never should have been allowed to enter the room. He could’ve been wearing a steel wristwatch, had a keyring in his pocket, etc.
> "I'm saying, 'Could you turn off the machine? Call 911. Do something. Turn this damn thing off!'" [pleaded the victim's wife].
The journalist missed a golden opportunity for education here: most MRI scanner magnets cannot be turned off like that. For the few that can, it's going to cost >$50,000 just to refill the liquid helium, not to mention the real and opportunity costs associated with rendering the machine offline for days or weeks.
If people don't know about the magnet, or don't know that it can't be turned off (or perhaps assume it's "off" because the scan was over, as I would guess happened here), accidents happen.
> The journalist missed a golden opportunity for education here: most MRI scanner magnets cannot be turned off like that.
Thanks for that - and it reminded me of the sad state media is today. I read the same story in about 4 papers and nowhere was written _why_ they couldn't turn off the machine.
Miss the days where journalists actually read what they have written.
I’m pretty sure when some guy gets sucked into the machine, the downtimes/lawsuits/etc and pressing the emergency button and having a ton of down time is a sunk cost at that point and you are basically obligated to do everytyhing you can to avoid catastrophe to reduce your legal peril.
The cost isn’t the issue.
Quenching the magnet takes up to several minutes. There are also alarms to warn people to get away because the rapidly expanding helium could displace oxygen in the room.
It’s not about the cost. If there’s an emergency that necessitates pressing the button they’ll be pressing it as soon as someone can reach it. It still takes time for the magnetic field to dissipate.
What sort of decay curve can you plot from the magnetic field dissipating over time? Is it linear?
> For the few that can, it's going to cost >$50,000 just to refill the liquid helium
In this case, they were going to have to do that anyway. Might as well shut it down right away.
An emergency quench of the magnet takes about 1-2 minutes.
There isn’t a way to instantly turn it off.
All the more reason to push the button immediately.
Isn’t 2 minutes enough?
Fair, but these are split-second decisions and they likely didn't have a lot of time to react.
MRI techs do not think about it cost when life is at danger. If someone is in life danger due to the magnet, you quench. This is standard MRI education.
I think the big question here is why they didn’t..
> most MRI scanner magnets cannot be turned off like that. For the few that can, it's going to cost >$50,000 just to refill the liquid helium, not to mention the real and opportunity costs associated with rendering the machine offline for days or weeks.
I thought these days, most MRIs did have an emergency quench button.
Yeah I would say all modern MRIs do. However one misconception is that loss of field strength is instantanous, it's not. The field strength drops off over about 15s or so as the helium boils off and the magnet losses superconducting properties.
So the emergency quench is less useful than it sounds in these situations... it's very likely if an MRI is going to kill you it's going to do it fast enough for it not to be relevant.
Surely you'd hit the quench button straight away? I cannot imagine policy being "check if the victim is dead, and if not hit the button."
I also wonder what the field decay is like. If it takes 15s and it's linear it's much worse than if it's 15s but decays exponentially. You don't need to field to be gone, you need the field to diminish enough to stop strangling the poor guy.
In this case, he died after being removed from the machine and taken to a hospital.
The damage was likely done almost immediately; a heavy 20 pound "necklace" is going to apply a lot of crushing force.
And for the other readers: It wouldn’t be applying twenty pounds of force, it would be applying…
My rule of thumb calculation came to 3,000 lbf, which seems like a lot, but perhaps that’s actually accurate.
Seems spot on to me.
Figure half that to start since most of the loop is gonna wind up laying flat and only the half of it is prevented from doing so by one's neck. Then maybe cut it by 2/3 again since the sides aren't gonna do a ton of direct squishing. That still leaves you with hundreds of pounds, which roughly aligns with the timeline of suffocation in the article High hundreds low thousand likely would be neck snapping or otherwise instantly incapacitating.
> The damage was likely done almost immediately;
Not disagreeing, just saying the tech running the machine couldn't have known that and should have quenched the machine in case the damage was survivable.
Apparently he was lucid and speaking for some time before he passed out.
You're in luck. Video of an MRI magnet being quenched that I posted above:
https://www.youtube.com/watch?v=9SOUJP5dFEg
Yeah so this video shows exactly what I am talking about, the chair and other objects don't fall immediately, it takes ~15s for them to drop to the ground after the quench starts.
Takes more than 15sec to strangle someone. 30 shouldn't cause any serious damage beyond whatever mechanical damage there is from being tugged around. Heck, 2-3min is probably fine if the MRI is located at a hospital.
Edit: Per the article that I would like to remind everyone is well worth reading, he had time to say goodbye to his wife, that would seem to me to imply he wasn't tossed hard enough to be incapacitated.
strangle? dude's neck was probably crushed. if I had to guess this was a near decapitation, not a strangling.
honestly, probably, yeah, but the guy running the MRI can't know that and should have quenched immediately. You don't just go "oh well he's probably dead, nothing I can do about it now."
my point is even if he had quenched ASAP the damage might've been done already.
Per the article, his wife claims that he had time to wave goodbye to her.
A man getting dragged by the neck and hitting an MRI machine head-first is going to make all sorts of hand movements that his grieving widow might interpret as waving goodbye in hindsight.
Causing severe head trauma or crushing the trachea can be almost instant. A lot of the more serious MRI related injuries are objects flying across the room and hitting someone, especially over the head.
After GE got their shit together, yes. https://www.diagnosticimaging.com/view/everything-you-need-k...
If anyone is curious what pushing the button to turn off (AKA "quench) the magnet looks like, there's this video of an MRI machine being decommissioned:
https://www.youtube.com/watch?v=9SOUJP5dFEg
You push the button, then 15 seconds later the liquid helium is vented through a pipe on the roof of the hospital (it's quite a spectacular display), and then the superconductor starts to heat up and no longer be a superconductor so the current that's been flowing through the coils (they are energized once, when the machine is first installed, and then continue flowing forever so long as the superconductor is superconducting since there's no resistance) and the magnetic field decays to nothing.
It's not an instantaneous process.
They can be quenched (as you note), but there was that one time that GE didn’t connect the quench button to prevent accidental/expensive usage and n India, and someone died.
Surprise! It turns out there is a reason it should be connected.
https://www.diagnosticimaging.com/view/everything-you-need-k...
In the US the federal government uses numbers around $10 million for the statistical value of a human life when doing cost benefit analysis for various programs or interventions. Any sort of lifesaving medical care can easily come in at more than $50,000. The operators shouldn't be hesitating to shut down that machine to save someone's life, and I would be willing to be that they are trained to do so.
Now you are at the Trolley problem: shut down the machine to (maybe) save one person, but preventing all MRIs for the next x weeks, causing y indirect deaths?
The Trolley problem is only a problem because there is perfect information in the hypothetical about the consequences of your actions. In real life, you have far less information to go on, which often leads to a more obvious right answer. Shutting down the machine to try to save the one person right in front of you that you know is in immediate danger is the right answer, versus the far less knowable hypothetical future where some number of people may or may not have delayed or relocated scans which may or may not have delayed treatment that may or may not have been immediately necessary as a life-saving matter. As a private MRI operator, you are not morally responsible for keeping your machine functional in order to help keep (figurative) passers-by alive. But you are morally responsible for the health and safety of the patients and visitors on your premises.
It'll need to be shut down anyway to pull the giant metal chain out. You might as well do it right away. Patients can and will be rescheduled to other MRI facilities.
I'm not sure how this is a Trolley problem?
It's a logistics and legislation problem. Hospitals need to be adequately prepared for emergencies and handle backups.
I think a death machine that can't be stopped is an issue.
That's a huge deal. I read the article and assumed the machine was mistakenly thought to be turned off or was "winding down". That's especially frustrating as the patient seems to be blaming the hospital staff for the incident.
> most MRI scanner magnets cannot be turned off like that. For the few that can, it's going to cost >$50,000 just to refill the liquid helium,
I now nothing about MDI so please tell me: why does it need to refuel the helium? Aren't the magnets “just” superconductive electromagnets? Why can't the current powering the magnet be stopped?
Edit: thanks everyone for your explanations, I appreciate it.
You actually don't need to actively supply current -- it just keeps going round and round, and you can't "short" it out because the path of least resistance will always be the superconducting winding.
You also can't open a switch to stop the current because it's basically a giant inductor, it really wants to keep the magnetic field (and current) constant. Meaning if you suddenly disconnected the winding, it would arc across the gap (continuously, for quite a while until the stored energy was spent).
So what they do is vent/boil off the liquid helium which is keeping the magnet cold, such that it's no longer superconducting and the current will die off. You can't reclaim the helium, hence you need a fresh refill to chill down the magnet again.
They require extremely low cooling from the helium to achieve superconductivity.
And with superconductivity, by definition, current flows without resistance; it continues even without energy, so turning off the power won't stop it. Nor will it heat up and decay from resistance. Modern MRIs are well-insulated enough to maintain their field without power from days to weeks.
The only thing that collapses the field is to warm it up to where superconductivity stops, which can be done slow and expensively, or in an emergency, fast and even more expensively.
By venting the supercooled gases in what's called a quench, you can turn it off faster, but the time it needs can depend on the model. It could be 20 seconds, or it could be 2 minutes, which, depending on the emergency, may be insufficient.
A quench itself can be dangerous, though usually less so than a patient pinned to the magnet. There's a chance that poor ventilation can flood the room with helium, causing loss of consciousness in seconds. The increase in pressure can also make it impossible to escape if the door's not built for that. You'd have to break a window. On top of which, it's dangerously cold, and the explosive bang can rupture your eardrums.
From Wikipedia:
"Any change to the current through the magnet must be done very slowly, first because electrically the magnet is a large inductor and an abrupt current change will result in a large voltage spike across the windings, and more importantly because fast changes in current can cause eddy currents and mechanical stresses in the windings that can precipitate a quench [...]. So the power supply is usually microprocessor-controlled, programmed to accomplish current changes gradually, in gentle ramps. It usually takes several minutes to energize or de-energize a laboratory-sized magnet."
https://en.wikipedia.org/wiki/Superconducting_magnet
If it's a loop of superconducting material, which seems likely as that's how you prevent losses, then you don't have to supply current so there's no current to stop supplying.
The average MRI operator isn't going to start wrestling with a dude with a 20 pound metal chain around his neck.
They'll try to talk sense into you, but they're not security guards nor trained in close combat.
Nor are the doors locked or secured, they kinda assume that people don't just rush in and do as they're told.
Is there any indication this man was aggressively trying to enter the room before the technician eventually let him in? The article just says his wife called out to him, then the tech let him in and that's it.
How hard is it to gate the patient entrance to the MRI with a big-ass metal detector turned up to 11? Why is this still a problem?
This is already a common practice. One of the issues with the standard implementation is that it’s set up as an administrative control rather than an engineering control (which would be significantly more difficult/expensive/space-consuming). At least one other comment thread has discussed the airlock implementation that I’m sure a very large number of people have independently thought of.
I recently had an MRI in one of those full-body MRI machines.. and we went through two locked doors and they used a wand on me (like they have at airports) to scan my body, even after I answered that I had no metal anywhere in my body. There were 3 operators/nurses in the inner ring of all this, operating machines.. securing my limbs, etc.
So at least in some places, this is the SOP.
MRI operator here: the false alarms from all the metal that’s fine are an issue. Most people have some in/on them and it’s usually fine.
Given the rather spectacular failure mode, isn't this rather a case of "better safe than sorry"? i.e. even if it's technically safe, why not require people to remove everything that triggers the detector just to be sure?
You’d be surprised what people won’t do.
Unlike many facilities, we insist everyone strips down to underpants (no bra) and wears a gown. We push quite hard to remove all jewellery (including piercings), but many places do not. It removes a whole category of problems, but is also slow, has an extra cost (laundry) and still patients leave things on, covered up by the gown.
But the percentage of people with something in them is very very high.
We are dealing with a population that by definition has health issues, and I’d estimate that 75%+ have something metal in them.
Sternal wires, fillings, clips, biopsy markers, screws, plates, braces, joint replacements (x6), ports, mesh, vascular stent, urinary stents, breast implants. These are conditionally safe implants from yesterday. If we expanded it to a week we could add heart valves, hearing implants, vsd closure devices and about 20 other implants I’m sure.
We have either memorised or looked up the conditions for each. We pay techs well because we want good staff. Minimum staffing levels include using healthcare assistants and suchlike. There are potential downsides to this approach, particularly around safety.
What if people used their eyeballs and their common sense? Everyone failed here.
Or gate it, period - nobody should get in that easily.
I wonder if that's a problem in case a medical intervention is required.
Also how they have to get people in. One of my MRIs was hours after surgery - I was wheeled in on a stretcher while attached to IV and other machines. They slid me on and off the machine since I wasn't allowed to move myself (I'm not sure if I could have what with the drugs still in my system. take my story with some salt: because of the drugs I wouldn't trust my own memory of the event). Which is to say they need a lot of space around these machines and the doors/gates would need to be very big to fit all the people involved through.
It is.
There are locked doors with badges pretty much everywhere in a hospital in my country though (including the door leading to the ER, and the escalator which goes from the ER to the ICU, in my city's hospital), so I don't really understand what would prevent to put such a door at the entrance of the MRI room.
> The superconducting magnet in an MRI scanner is always on even when not performing a scan.
This should be placed on the entrance with big bold letters, I think that a lot of accidents could be avoided by simply providing "WHY" information. I had MRI scan and I wasn't aware that machine was active even when not performing scan and now after knowing that I think that personnel there was very lax with allowing me to enter the room after instructing me to put metal objects away AND without enough emphasis how dangerous it could be if I forgot to do so.
They do. You'll be hard pressed to find a magnet room without this [0] sign on the door. That said, it's probably not that warning to most people. Fridge magnets are always on too.
0 - https://www.zzmedical.com/exclusives/mri-warning-wall-sign-m...
I tried to look. "Access Denied - Sucuri Website Firewall"
Technically he entered "without permission" but at the urging of the patient. Still negligence, though more understable. I wonder if a metal detector that prevents opening the door would help? Perhaps with a big, scary red override button for emergencies?
Tech: "ok we're done here"
Wide: "honey can you come in here and help me since I don't have my walker"
<dude walks right in and gets dead>
Not hard to imagine something like that happening too fast to be stopped, especially if staff is distracted by the transition from running an MRI to getting the patient in/out.
It seems like there could be a double door situation. Go through the first door, close it. The room detects metal, and only unlocks the door to the MRI if the other door is closed and no metal is in the room.
I’m not sure what kind of emergency would warrant allowing metal to pass through when metal is detected, if there is a risk of death for using it.
> I’m not sure what kind of emergency would warrant allowing metal to pass through when metal is detected, if there is a risk of death for using it.
The risk would be in the false positive during an emergency situation.
A false negative is also dangerous, if the magnet hasn't been quenched. In a case like this, trying to use metal bolt cutters to cut off a necklace or something is just going to compound the disaster if the magnet is still active.
A lot of patients and staff have small metal items that aren’t ferrous and it is fine. Many implants, lots of clothing (bra, jeans) and jewellery. You just have to be careful. I’m an MR tech.
"The room detects metal" is a massive cost compared to just, you know, doing what the operators tell you to do, which works in 99.99999% of the cases.
I thought in this story the operator did let the person in, which if so was a grave mistake that they now have to carry with them. Though I wonder how you think an operator would know if people have metal on them? Definitely not by trusting people to decide/judge by themselves I hope?
The policy should be no one but the patient and staff is allowed in, the prep for the patient prior to procedure (both in advance and immediately prior) should cover them, and staff should be adequately trained.
There should be no need to evaluate random other people because they simply should not be allowed in at all.
Not sure why it would have to be a massive cost? Wouldn’t even need to be a room, a door like metal detector used normal security settings with its sensitivity turned up.
Now make it medical grade and it costs an insane amount.
i.e. we can't fix a dysfunction in X because of dysfunction in Y.
There is (at least according to one episode of _Grey's Anatomy_) a big scary red button to shut down the machine in an emergency, resulting in expensive to restore operation:
https://www.reddit.com/r/explainlikeimfive/comments/m9algh/e...
According to the above post, it's a venting of the liquid helium, which requires ~$25,000 to replace).
I'm not sure: "apologies, it was too expensive to turn it off, better luck next time" is a valid justification nor is it a solution.
We’re talking about a human life here. Fuck the balance and vent immediately!
There is some consideration for other patients who may die due to not getting an MRI in the meantime
They gonna to get an MRI while the guys corpse is stuck to the machine?
Again, it isn't an instant-off button.
Only good for removal of any metal-adorn victims and unintended metallic objects ...
The dude suffocated. You don't need anything near "instant" to prevent that.
Edit: Since apparently some people need reminding, per the article he had time to say goodbye to his wife before he lost consciousness, this wasn't some liveleak skull splat type thing.
The chain apparently caused him to be hurled across the room. We don't know how he died, but given the inverse square law, the possibilities are quite grisly.
He was wearing a twenty pound necklace. In a magnetic field that strong? His throat was crushed, likely instantly.
Do you have a source for that? The BBC just says "a medical episode" of which he died later.
Multiple heart attacks.
That I can well believe!
I am willing to bet a lot of money he was going into that room no matter how many times he was told not to or how many signs were posted. Some people have an extreme contempt for authority and will stubbornly ignore direction. Sometimes,bad things happen to them.
We didn't evolve to have the warning mechanisms for modern life.
Tell a person there's a tarantula or a cobra in the next room and not a second will go by without them being deeply aware of this information.
Tell them it's a 3 tesla magnetic field and they'll run in carrying a piece of sheet metal and a pocket full of ball bearings.
This doesn't track to me. People have been irrationally afraid of things since the dawn of time, based purely on hearsay (see religion). And surely even the simplest of language serves to warn about unseen dangers.
Entering the MRI room myself I was very familiar with the dangers of bringing metal inside, to the point where I would second guess myself and my own body. "What if my leg bone actually has metal in it for some reason?!"
There are people who flock towards information about technology (probably almost everyone here as well as many in their social circles) and there are people who run from information about technology.
I know people who if you tried to explain an MRI to them, would become visibly uncomfortable and search for any way to change the topic.
>I know people who if you tried to explain an $X to them, would become visibly uncomfortable and search for any way to change the topic.
Expected behavior. Explanations of complex topics are to be rejected if explainer does not have sufficient authority to make behaver hold-still-and-listen.
I know such folk, too, and this is among the thing about people which annoys me to no end. If a MRI tech tried to explain the shit to one such acquaintance, they would try to change the subject like you say. OTOH, if the doctor in charge tries the same, the listener will instead have to zone out. But zoning out is a more expensive operation, as any zooner knows. (Which is why they hold doctors, lawyers, and other semi-priests in high reverence, up to pushing kids to take up these rather joyless professions to the exclusion of all sense.)
Peeps here equally well-behaved other way round tho. C-f "mal" = 0. Geez I really needed to witness the absolute by-the-book Freudian slip that can be found at 1:55 of one of the probably infinite interview cuts, then have MRI safety explained to me by hacker noosers on their Monday morning.
> "What if my leg bone actually has metal in it for some reason?!"
I have a titanium plate in my head, so it's not magnetic.
When the MRI tech asked if I had any metal in me, I said I had titanium on my skull.
She asked if I was sure it was titanium.
I knew it was, but I was nervous, so I said, "I think so."
She half-joked, "Well, if it's not, we'll find out real quick."
It was titanium.
But they never really double-checked or anything.
Part of me thinks that because of my age, she could tell it wasn't iron or anything dangerous.
But another part of me feels like she honestly didn't care that much and meant it when she said we'd find out fast.
Wouldn’t your head have started to get pulled towards it as you approached, so maybe you could stop approaching once you felt something weird going on in your head?
Both can be true. We learn to fear and respect modern technology because of training and reinforcement that might occur as part of learning.
Consider the “Things I Won’t Work With” column. There is a healthy degree of respect for various compounds that’s learned with experience. This is similar to the way that (properly trained) electricians work with electricity, and nuclear plant techs work around radioactive material.
I think people are just not aware of how bad it is. People might think it's "fork in microwave" oopsie bad, not "fire at the gas station" fatal bad.
> "What if my leg bone actually has metal in it for some reason?!"
I had that constant thought for the 15 minutes of my knee MRI (except s/leg bone/body/). Most discombobulating.
There's lots of ways we could have metal in our body. A hip replacement, a forgotten piercing, old tooth fillings, maybe you accidentally swallowed some piece of metal.
If MRI scanners are this deadly, everybody should be really thoroughly screened and scanned to be allowed into the room. And even into the room next to it. How can the door of that room open while the machine is still turned on? (Edit: apparently the magnets in these machines usually can't be turned off, which changes the question to: how was he allowed to enter the room at all?)
But wearing such a heavy chain while accompanying your spouse to an MRI scan, is also not the best move.
> There's lots of ways we could have metal in our body. A hip replacement, a forgotten piercing, old tooth fillings, maybe you accidentally swallowed some piece of metal
One of the reasons they ask what you do for work is because if you're doing some sort of job that involves working with metal (e.x. cutting pipes, welding, etc) there are extra precautions to take.
Indeed. The hospital will pay a lot of money. Metal detectors are insanely cheap, there's no reason why there shouldn't be one before reaching the door as a default cautionary measure.
Depending on how or where they are installed, they risk being pointless. Every human has mental on them and it’s mostly safe (in shoes, bra, zips, buckles, access swipe card). Little bits of jewellery are fine. Surgically implanted metal is mostly fine.
Having an alarm that goes off for a staff member’s bra 200x a day leads to normalisation of hearing the alarm, and the unsafe things gets missed.
Im an MR tech.
Of course you don't want to ignore that alarm 200 times a day. That's why I'd rather just ban everything with metal. All of these things have non-metal alternatives that you could easily enforce in such a specialized setting. Why wouldn't you, if it can save lives?
That's a very easy fix. Just make the volume proportional to the amount of metal detected.
And the 10+ a day with a knee joint or a hip joint replacement?
And then what if they also have a pacemaker or aneurysm clip?
An unsafe clip is tiny, and it will kill them. You can’t depend on a metal detector.
Technology might help, but people following process is what safety depends on.
If staff follow the rules the MR suite is very safe.
https://mrisafety.com/
The walls are usually made from mu-metal. This is a metal mixture that blocks/attenuates magnetic energy.
Spinning rust hard drives are also made with mu-metal as well.
Wait till you learn about Peripheral Nerve Stimulation effects:
https://www.robarts.ca/scholl_group/research/peripheral_nerv...
Hehe, in my case I used to have a metal filling that was removed, but I was still worried about a missing piece of it or something.
Apparently it's not an issue, even if you do have them.
My first MRI I confirmed I have no metal on my body to the technician, but by the time I was inside I suddenly remembered I have metal fillings. I was so stressed by the time the machine turned on, but yeah no problems at all
The machine was already on by the time you were in it. The magnet does not get turned off.
True, but the RF coils do get turned on & off. Heating of non-magnetic metal from the radio waves used for scanning is another concern, not just magnetic force.
We don't have a sense for detecting 3 Tesla magnets because they don't happen in nature. People can see a tarantula, and, depending on the snake, hear it as well.
But you need to seriously piss off the tarantula for it to engage in a fight with an opponent our size. Most of them are sweet and just want to get on with their tiny lives. They are well aware we are not food. Poisonous snakes, on the other hand, tend to be much less chill. Much like wasps, they seem to enjoy causing pain and suffering.
Tarantulas covers A LOT of spiders (around 1100 different species). You still have to at least be a bit careful around them since they have urticating hairs.
> Poisonous snakes, on the other hand, tend to be much less chill. Much like wasps, they seem to enjoy causing pain and suffering.
Eh, I don't know about that. For example, sea snakes, despite being incredibly venomous, are actually pretty timid creatures.
Also:
https://www.britannica.com/story/whats-the-difference-betwee...
Wasps aren't sadists.
Agreed, most wasps are super chill if you're not a jackass to 'em. Watching 'em lick up some sugar water is pretty neat in my experience, what with the way they clean their little legs.
My mom would actually feed wasps by pouring sweet syrup or the like in her palm and letting them land and drink it from there. She never got stung.
Maybe if you instead phrased it as "there's a magnetic field in there that will shear anything magnetic straight through your body if you're holding it on the wrong side of you" that might help folk get the picture a bit better? I mean sheesh, I've got a B.S. in Computer Engineering and a 3 Tesla magnetic field doesn't mean much to me either
Just a sensitive metal detector around the doorway where you enter the MRI room. It sounds like this guy would have had the metal detector blaring before he even crossed the threshold.
As would staff shoes, bra, jewellery, access card, ring etc etc.
"There's a huge evil magnet that will tear you apart if you have any metal on you" sounds much easier to grasp and less likely to lose the listener's attention. Then, when you have them listening: "It can grab you from outside the room and hurl you into the machine where the evil magnet lives! Any metal, be it coins, necklaces, pins in your bones, belt buckles, bra wiring, dog tags. Anything can be the end of you, be damn sure you don't have any metal on you."
Oh, wait, you still want them willing to go near the machine? That complicates things a bit ;)
Fear of heights is ingrained, fear of snakes is learned. We can definitely do better to educate people on the fear of magnets, I figure it’s not a priority since we’re not going to encounter many MRI machines in the wild.
How difficult would it be to install metal detectors to give an alarm to people who enter. I have had a few MRIs and they did seem too trusting that I properly remembered to remove anything magnetic.
Fear of snakes is also biological. Look up the cat cucumber videos.
For some species that makes a lot of sense, but humans do not react the same way to cucumbers.
I'm going by; https://www.youtube.com/watch?v=3L4lxusff1c "The Surprising Reason Babies Are NOT Afraid of Snakes | Secret Science"
Similarly: https://www.fox5ny.com/news/courtney-edwards-piedmont-airlin...
Intellectually, you can think that "If a jet can move a plane, it can move me through space", but you never experience a fan even close to that in real life.
To be fair, most people aren't going to know what they means. If anything it's going to sound more like "only 3 huh? That doesn't sound very dangerous." Only 3 miles per hour isn't very fast. Only 3 degrees outside is cold, but it probably won't kill you.
30,000 gauss sounds a lot scarier.
Not to mention that "gauss" sounds deadlier than "tesla" to begin with. Talking about choosing the right units.
Cars are quite deadly though.
Same for 2°C of global warming…
Obligatory xkcd: https://xkcd.com/3106/
https://en.wikipedia.org/wiki/Darwin_Awards
The other side is also true though, "man gets killed by cobra venom" isn't sensational international news because it's an intuitive rational thing we expect to happen. A man getting killed by an MRI machine doesn't fit into our intuition so it gets much more interest than a snake bite.
Honestly yeah, why do you need your "workout chain" while taking your wife to a medical exam?
Sounds like Darwin Awards material
I'd make sure to look into life insurance and abuse complains.
And yet, Koreans are afraid of fans.
The current generations aren’t. It stopped being a thing a decade back.
„In the description of the fundraiser, which had raised more than $3,300 by Monday morning, Bodden said her mother and the technician “tried for several minutes to release him” before calling the authorities.“ https://www.independent.co.uk/news/world/americas/mri-machin...
Is there information on why they didn’t quench?
They teach anyone operating MRI or even sitting by - in the first instruction lesson - that if life is at danger in relation to the magnet, you quench (=release the helium to stop the magnet).
Misleading title.
>he was wearing a 20lb (9kg) chain with a lock that he used for weight training.
That is not what any reasonable person would call a "necklace." Yes, metal and MRIs don't mix well, but normal jewellery won't be able to generate enough force to kill you. It might actually be more dangerous due to inducted currents heating the thing up and giving you burns.
Google Street view of the facility:
https://maps.app.goo.gl/6ssyJfjVn1fUGaG2A
I was wondering "why would the street view be relevant?"
Turns out, it's pretty relevant to the situation - especially how the unauthorized access was possible.
This wasn't your typical hospital MRI. This is basically your local tanning salon that somehow acquired an MRI machine.
If it weren't so dangerous, I'd love to pop along to my local tanning salon and get an MRI scan. I've always been quite interested to see an MRI of my brain. Alas, I'm stuck with waiting for some kind of medical testing to need some test subjects to scan, or a university student needing someone to learn to use an MRI on. Or I guess have a head injury serious enough to need an MRI, but that's less desirable
In Poland you can get one without doctors referal (for CT you need one because of ionizing radiation exposure), it cost between 100-200$ in normal, reputable hospital (not one like from the street view).
Nice to be on a country where these facilities are not overwhelmed
Other way around, you are paying money to go to the head of the line, while the people with medical issues get it for free - but have to wait.
Which I wouldn’t assume based on an HN post.
Sadly that's a little too far for me to pop over for a day
It isn't dangerous as long as you follow the safety protocol. This guy was very unlucky as he was wearing a weight training device made of metal, not just a watch or earring.
That's mostly true, but we're still finding new and interesting ways MRIs can kill people. E.g., non-magnetic metals are often safe, bit there was that guy who had his brain cooked as a spinal implant was the wrong length and focused the RF energy into his head. The additional protocol we developed is that objects can be certified safe for specific MRIs but not for all of them (and that being certified safe for a bigger machine doesn't say anything about safety in the presence of smaller machines).
Yes, they're pretty safe nowadays, but there's a lot of energy that gets dumped into a human body during an MRI, and I'd bet my last nickel that we haven't found every way that can cause problems.
I would prefer to have a trained professional operating my MRI scanner as opposed to someone who read the manual for 10 mins
I've seen many people make 3D prints of their own brain.
Once, I heard a story where some company was trying to get MRI test participants, and if you agreed they offered to print your brain for you as one of the perks.
Turns out, they gave everyone the same brain, like they would just always use the same file when 3D printing it. Probably had a box of pre-printed ones in the back. Dishonest, but I guess how would you ever find out?
There are providers that cater to the "I just want to know" market: https://prenuvo.com/
You can volunteer for a study. Check for flyers at your hospital asking for volunteers. (Especially psychiatric institutions - they love brain MRIs for their research.)
Yeah, hopefully someone will want to do a study on autism, adhd, trans women or all of the above
I wasn't going to click that link but now I have and honestly - that is mildly terrifying.
I don't understand how such a dangerous machine can end up in a place that looks like that.
That size of building is relatively normal for a non-hospital MRI facility.
What we are learning is that "non hospital" medical facilities suck.
I can tell you that I don't trust you as a doctor unless you are physically located in a hospital, preferably the larger the better.
If I have an appendicitis on the way to my normal procedure, I want to be within less than 100M of an emergency room already.
Small scale/small time medical offices were a mistake and I'll never change my mind.
That just doesn't make sense to me. If I'm going for a regular checkup or a non-surgical appointment, there's absolutely no reason that I need my doctor's office to be within a hospital complex. Sure, I could have an emergency on the way to my non-emergency appointment, but I could also have an emergency on the way to the grocery store or the gym or the park, and I don't demand that those facilities also be built within a hospital.
Agreed. It's also for patient convenience. More than once I was at a small medical office and was told that the doctor had prescribed a certain diagnostic test for which the facility didn't have the equipment for. So I make an appointment at a real hospital, and then make a follow-up appointment at the small medical office for reviewing the results. It's tiring.
You would have to do that anyway. Just because you are physically located in the hospital for your checkup does not mean there is magically some availability for this procedure.
They would schedule you, and you come back.
> What we are learning is that "non hospital" medical facilities suck.
That's really not true, just because you have one bad example does not mean they all are. In general the non-hospital facilities just do one thing, and they do it very very well.
> I can tell you that I don't trust you as a doctor unless you are physically located in a hospital, preferably the larger the better.
That's terrible!! Really. Putting the doctor in a hospital makes him a hospital employee usually, you are asking for the end of private practice for Doctors, you are asking for the end of personal relationships with doctors.
I wonder if you could take a walk around that building and see a compass needle move.
I have only been to MRI in hospitals but it looks shady as fuck
"Open MRI" - how appropriate. Too open MRI even.
> According to the US Food and Drug Administration, MRI machines have magnetic fields that will attract magnetic objects of all sizes
Good thing they sourced that fact, I never would have guessed.
Most people don't understand the danger of MRI, myself included. I trust the people and follow their directions but I can't really visualize what it would be like to get caught with metal in a MRI magnetic field.
For quoting the article : « According to the US Food and Drug Administration, MRI machines have magnetic fields that will attract magnetic objects of all sizes - keys, mobile phones and even oxygen tanks - which "may cause damage to the scanner or injury to the patient or medical professionals if those objects become projectiles". » the choice of words from both the bbc and the FDA don't really convey the risks.
Anyway there are very surprising issues in what is described : why did the wife needed her husband's help to get help although it is the role of the technicians ? Why was the husband in a place where he was able to hear his wife and not being prepped for MRI ? Why was it possible for him to enter ? And why wasn't the technician able to stop him entering ?
I got to take apart an MRI-safe(ish¹) video projector recently. Turns out it was just a regular DLP projector in an RF shielding box, but all the screws and components on the outside (anything that could be removed) were either plastic, non-magnetic stainless steel, or aluminum. They even converted the stock remote control to be powered with a cable instead of a AA battery (most batteries have steel cases).
They replaced the lens with a very long throw one so the projector could be located far away and bolted to the wall. It still had some steel components inside, but the manual made it very clear you were not supposed to open the case while in the same room with the magnet. No other manual I've read has warnings that trying to change a light bulb could kill you.
¹it was designed to be used within the same room as the MRI, but not to go into the magnet bore itself. You were supposed to securely mount it at a distance where the field strength was less than 100 gauss. Since it still contained steel, there were still warnings all over that "this device may become a projectile" if you got too close to the magnet. Installation must have been a bit nerve wracking!
>Installation must have been a bit nerve wracking!
They almost certainly just selected a drywall anchor based on the rating advertised on the package and sent it without any more thought, their ass was covered.
Big picture people who take a step back think about what they're doing don't tend to find themselves installing projectors in hospitals, or if they do they aren't there very long.
Likely true. For all the warnings the thing had about "securing" it, it did not have very many mount points or threaded holes to do so, just some rubber feet. Probably was just sat on a shelf and tied off with a nylon strap. I suppose you aren't going to casually walk past the magnet with a bulky projector like this as you would do with a screwdriver you forgot in your pocket.
> Big picture people who take a step back think about what they're doing don't tend to find themselves installing projectors in hospitals, or if they do they aren't there very long.
They're installed for fMRI research, to show stimuli to study participants.
https://www.youtube.com/watch?v=EJJ9oqmkItI
I love this old GE training video around the time of MRI's introduction to the medical market. Even the oldest machines could show some significant power back then.
Watching the scale attached to a pipe wrench pulling some significant weight on a wrench will help show the forces that a 20 pound chain would have made...
(Oh, and stay for the 'old custodian' tale in the intro of this one...)
When that dude got to throw the wrench at the MRI, you know he was having his best day at work ever. I wouldn't be able to be on camera because of giggling.
The flying wrenches remind me of the Gravity gun i Half-Life 2 :D
> Why was it possible for him to enter?
This is probably the main one. I could completely understand wanting the assistance of a loved one for mundane things like standing up.
Although to your “not prepped for MRI” point, it is kind of wild that someone with a 20 lbs chain around their neck would be allowed even on the same floor as a MRI machine. Although last time I saw one in person, the door to the room did have some pretty blunt warning text in large print.
Last time I went to an MRI, there was a prep room before the MRI machine. There was a stern and visible warning to remove anything metallic from your body before going through the second door. I am fully aware if the pins on my leg were affected, the machine would gladly remove them from my, most likely along with the bone and the leg they are attached to.
A lot of fatal accidents are like that - a series of small mistakes nobody notices, each individually harmless, followed by THAT ONE BIG MISTAKE that ends up killing someone (or a lot of people).
That huge chain though.
People with 10kg chains around their neck might not be the kind of people that you can tell no to.
Mr. T seems like he'd be quite reasonable if you were discussing medical safety procedures.
His chain is gold though and not magnetic =)
That's because Mr. T respects MRI safety.
Mr. T pities the fool who would walk around with an iron chain.
"you need to take off the chain"
"nah man, gotta hit my 5k steps wearing 20lb for my fitness goal"
"ok, well just don't go in the room"
"sure"
The kind of interaction that many people will pretty much forget having within the hour.
You would think a simple metal detector to go through before the lock on the MRI room door unlocks would be a requirement.
I guess maybe the MRI machine might interfere with metal detecting?
Nope, metal detectors are fairly typical for MRI access. They just generally aren’t set up as an engineering control like you suggest.
I'm not sure what "engineering control" means. Just put it in front of the door to the MRI room. Alarm goes off, you do not get to enter, it should be as simple as that.
An engineering control is how your microwave works—if the door isn’t physically closed, it can’t run. The way many (most?) hospitals currently operate is called an administrative control—analogous to a sign on the microwave door telling people not to run the microwave with the door open or open the door when the microwave is on.
But MRI machines can't be turned on and shut off that easily. As someone here explained, it takes up to 15 minutes for the magnet in an MRI to "shut down", and costs $50,000 each time.
Why not just control access to the room behind a metal detector? It would be really simple, but effective. I don't think any MRI should be allowed to operate without this basic level of protection.
Sure, an engineering control for MRI room access would be implemented differently--that's just the canonical example that people are familiar with. One possible implementation for MRI access is the airlock method, where the inner access door would only be allowed to unlock with the outer door locked and no metal detected in the space between (also the outer door would be prohibited from unlocking when the inner door is unlocked, except for some kind of inner emergency override that might also be tied to the emergency quench).
Literally no one disagrees with you on this, and most (if not all) hospital administrators will say they already do it the way you suggest. I'm pointing out that the actual implementations I'm aware of are often ineffective because they use administrative rather than engineering controls, and this is a critical distinction people need to be more aware of when interacting with dangerous systems. Managers, at least in my experience, tend to wildly overestimate compliance rates with administrative controls, even ignoring any possibility of deliberate noncompliance.
People should try a magnet fishing magnet.
A fist-sized powerful magnet that's next to impossible to straight-up pull out of ANYTHING. You need to slide it carefully and NOT let your fingers get in between it and anything else.
Now imagine a magnet that's infinitely more powerful than that.
A good N52 neodymium magnet can be 1.5 tesla- MRIs are usually 1.5 tesla. The pull force is around the same too- a steel object will experience say 20g, and 100 lb fishing magnets are not hard to find.
The difference is the size. Even a large magnet only hits that 20g force over an inch or two. An MRI pulls at that force over a full foot or more; equivalent to dropping the object from 20'+. Worse, the MRI starts pulling at 5 or 10 feet away. Objects can experience a tremendous amount of uncontrolled acceleration in fractions of a second.
It's not like a black hole- unless you are trapped under something very large, the crushing force is substantial but not incredible. In fact inside the tube the gradient is actually smaller than the entrance of the tube- you are pulled in strongly, but once inside the tube you are pressed against the wall somewhat less forcefully. Instead it's like an invisible waterfall, and any metal will be swept away in it, fast enough to put holes in you.
Not sure about medicine, but at least in research, most MRI fields are 3T and up.
This was not the sort of "paint the room" liveleak tier accident that a hell of a lot of people seem to want to assume it was.
Per the article, the chain was stupid heavy because it was gym/weight training stuff, he was tossed and pinned to the machine where he suffocated, he died at the hospital.
No, he died the next day, following multiple heart attacks.
I entered an MRI room once when my wife was getting ready to be scanned. I had a metal Cross pen in my shirt pocket. Although I was 10 feet back, the pen flew out of my pocket, across the room, and stuck to the magnet. It was scary.
That's crazy... Did they bill you for the cost of shutting down the MRI and refilling the helium?
Depending on the mass they may have been able to remove it manually. A colleague used to use paperclips to study the field lines, and those had very little force.
They probably left it until the next maintenance cycle. Nobody wants the downtime.
Or sent the tech in with a plastic putty knife to scrap it to somewhere he could get a hand on it and rip it out of there.
Even after adding MRI levels of force a 1oz pen is still gonna be something that you can pick up.
Wouldn't that cause heavy distortion in the image though?
I know very little about MRIs, but it seems likely that they could recalibrate the machine and effectively adjust for something small.
Not removing it sounds dangerous though.
Shim it with some more pens?
It would come off ok, this happens from time to time, but that facility needs to lift its game.
Peripheral staff (nurses, anaesthetic techs etc) visiting are the usual source of these accidents.
The problem is that normal MRI math tries its damnedest to avoid actually solving the right equations. Instead, with a flat enough field, you can assume linearity and just FFT the thing. They'll physically place bits of metal and magnets at various places on the big magnet to calibrate and better adjust the field to being approximately linear. A hunk of metal bigger than a shim sounds like it would mess with that.
Such MRI accidents are like falls of airplanes: extremely rare relative to the thousands (millions) of successful attempts.
By the way, a much larger responsibility for CT/MRI centers remains a patient's allergic reaction to the contrast medium infused intravenously.
Y’know, sometimes people saying you can’t do certain things isn’t them just being an asshole. Physics and biology really doesn’t care what people think…
I've been in a Zone II area waiting before and was surprised how easy it would be for an unauthorized person to get close to a 6T machine. The only thing preventing access was a plastic stop sign.
The machine itself should be able to detect that something anomalous is happening to the magnetic field as it is doing work on the metal item and immediately cut power.
Nobody should be able to get into that room that isn't supposed to be there.
Also, twenty pound necklace?
"She said he was wearing a 20lb (9kg) chain with a lock that he used for weight training."
In addition to that:
> She said she had called him into the room after she had a scan on Wednesday.
Part of me wonders why the wife felt empowered to invite her husband, who she knew was wearing a giant metal necklace, into the MRI room after her scan. The hospital would have been very clear with her about the dangers of wearing any metal in the room even when the scanner was not running especially because it's common for women to wear jewelry containing various metals and alloys.
Presumably, the husband would have been part of those conversations as well, and thus, should have refrained from joining her in the room anyway, so he isn't completely absolved of responsibility.
It seems there's plenty of blame to go around.
Just force of habit. Being around such forceful magnets is not a daily occurrence so you don't really think about this sort of thing (for both the wife and husband). I can totally see how something like this happens.
I once bought a can of coke and put it in my backpack, then I forgot about it. At the airport a few hours later I went through security and didn't think about it at all. No idea why my bag was selected for a manual check. Until he pulled out the soda can. Big (but harmless) do'h moment. People's brains and memories are just wonky like that sometimes; most people have a few "I'm an idiot" anecdotes like that. Even with training by the way: which is why checklists exists for safety critical stuff. "They have been warned about MRI dangers" is pretty meaningless.
The failure is 100% on the facility for not properly controlling access to the MRI room, and people can just walk in apparently(?) And no, a sign or some briefing doesn't cut it.
This is also a risk for absent-minded staff by the way: I don't think I'm the only person who has walked in the wrong room by accident. Or just a small confusion about whether the MRI is operational. Things like that.
> The hospital would have been very clear with her about the dangers of wearing any metal in the room even when the scanner was not running especially because it's common for women to wear jewelry containing various metals and alloys.
It was not in a hospital: https://news.ycombinator.com/item?id=44630969
I just got an MRI. No warning about dangers of having any metal in the room was mentioned verbally. Was asked if I had any metal in my body, not told why. I just said no to that question. That was it.
You say "hospital" but this was basically an amateur run MRI salon as far as I can tell.
> she was getting an MRI on her knee and asked her husband to come in to help her get up afterwards
The people getting MRIs are sicker than the general population so the facility should have people available to help getting people up after being scanned.
Most people included myself don't realize the risks of a MRI
A dude wearing a 9kg necklace is not usually someone the average MRI tech can prevent from going anywhere if stern words won't do.
A normal necklace wouldn't cause such an accident no? This was a heavy workout chain, a bizarre item to wear when going to a hospital
Feels like a midlife crises gone awry.
More likely to end up with a burn mark in the shape of the necklace.
s/Man wearing metallic necklace dies after being sucked into MRI machine/Man wearing 20lb chain on neck dies after being sucked into MRI machine
Maybe if we reverted back to the original Nuclear Magnetic Resonance name, people would understand it could be a bit more dangerous that just an image when we are not careful.
Entering the room without permission and wearing a 20lb weight training chain ... I look forward to my next visit where they ask me if I've got some weight training equipment on me.
Caution! This coffee is hot. Avoid pouring on crotch area.
Do yourself a favour and actually read about that incident.
I have read about it and still can't see how mcdonalds lost.
McDonald's was negligent. The coffee was hot enough to cause immediate lasting damage, having it that hot didn't benefit any party involved, reducing the temperature would have fixed the problem, been as simple as turning a knob, and increased customer satisfaction, and they knew about the dangers and repeatedly chose to do literally nothing about it.
If you tweak elements of the case then you can imagine the restaurant winning. As it stands, it's not surprising McDonald's lost.
And they apparently didn't even learn all that much: literally this week, but with hot chocolate and an 8-year old: https://www.cornwalllive.com/news/cornwall-news/young-girl-s...
Maybe this time they won't go on a PR campaign against the victim (it's also the UK where you only get real damages, so they probably won't care enough, no million pound lawsuits here even if it was as serious as the original case, which it isn't).
There's definitely a balance between hot drink being hot and absolutely scalding, especially when you know you're going to be handing it into a vehicle from a window. And it's not an especially onerous thing to turn the temperature down, and as you say, no one likes getting 98 degree paper cup of lava that you can't even sip for 10 minutes. They say they did control the temperature, so maybe it's indeed all on the customers, but I do know I have been given some really hot hot drinks in paper cups that seem excessive.
> knew about the dangers and repeatedly chose to do literally nothing about it
The dangers of... hot coffee? Yeah, everyone knows that. That's exactly why they shouldn't have lost to the extent that they did.
It's tragic for the person involved obviously; I get why emotionally the court would feel sympathy for the victim. But objectively speaking its pretty ridiculous for the legal system to be awarding punitive damages for companies exposing people to normal, reasonable risks that everyone encounters as part of everyday life. It creates a culture where businesses have to treat grown adults like children for fear of huge fines if something goes wrong.
At worst McDonald's was probably like 10% responsible for the incident but they got treated like they were 100,000% responsible.
(The jury actually did find the woman was partially responsible, it was the judge that decided on the absurd damages amount. It later got reduced and settled out of court so all in all I think the system ultimately worked okay despite the judge's ridiculous initial decision.)
Edit: I misread, it was actually the jury that made the initial ridiculous punitive damages ruling, the judge was the one who reduced it later before it got settled out of court for an undisclosed (possibly still ridiculously high) amount.
> The dangers of... hot coffee?
I don't expect hot coffee to put me in the hospital needing skin grafts.
> At worst McDonald's was probably like 10% responsible
80%, according to the jury.
> The jury actually did find the woman was partially responsible
Correct, which was factored into the award of actual damages, reducing the $200,000 in damages to a $160,000 award, since it was in a comparative negligence jurisdiction.
> it was the judge that decided on the absurd damages amount. It later got reduced and settled out of court
No, it was the jury that returned the original $2.7 million punitive damage award, which the judge reduced to $480,000, for a total actual+punitive award of $640k in the trial judgement.
The parties did settle out of court while an appeal of the trial judgement was pending.
I see, so it was the jury that was responsible for the ridiculous ruling, not the judge. My mistake, I misread. Definitely seems like there were some systemic or possibly cultural issues at play here.
> I see, so it was the jury that was responsible for the ridiculous ruling, not the judge
No, a jury verdict that is not reflected in the trial judgement is not a ruling at all.
There was some rush-to-publish reporting of the jury verdict prior to the ruling which is the source of the whole popular perception of the case, because the misunderstanding of the case has deliberately magnified ao it can be weaponized by people wanting to limit perfectly warranted recovery from actually-at-fault corporatiojs by spinning false tales of out-of-control judgements.
That's a fair criticism of the media headlines, but the final ruling of $480,000 just in punitive damages ($1M inflation-adjusted) is still pretty ridiculous given, again, that handling too-hot-to-immediately-drink beverages is a normal, reasonable risk that almost everyone encounters as part of everyday life. We could quibble about about the compensatory damages (80% McDonald's fault seems too high to me, but it's also probably not 0%), but I feel that certainly there should be no punitive damages for such things.
> That's a fair criticism of the media headlines, but the final ruling of $480,000 just in punitive damages ($1M inflation-adjusted) is still pretty ridiculous
Given subsequent McDonald's incidents of the same type, it was clearly inadequate to serve the function of punitive damages, that is, to be sufficient to dissuade the willful tortfeasor from repeating the same willful tort. (It’s quite likely that the original $2.7 million award would also have been.)
> handling too-hot-to-immediately-drink beverages is a normal, reasonable risk that almost everyone encounters as part of everyday life.
That's not an argument that the punitive damage award was ridiculous, that's an argument that the jury assessment of comparative negligence that figured into the actual damage award was wrong. Punitive damages are not even in theory about the degree of care that the injured party should have applied, that's the comparative negligence part of actual damages.
Not just negligent, chronically negligent to the point that a court hit the "fuck you fix it" button (punitive damages). They had all the chances in the world to turn down the heat, use better cups, etc, etc, after any one of the prior accidents. They didn't, they just kept paying the settlements and the lawsuits, until someone got hurt so badly that the court said enough is enough.
It's a textbook perfect example of how punitive damages are supposed to work.
Coffee is supposed to be hot! McDonalds now serves tepid dishwater instead of coffee.
I like to post this whenever the danger MRI magnetic field strength comes into question: https://www.youtube.com/watch?v=6BBx8BwLhqg
A plot line literally out of a Final Destination movie (the newest one). MRI machines are scary!
It comes to something when Fox News is more informative with background information about signage and safety protocols, and reporting about a technician's warning not to enter, than BBC News is.
* https://fox5ny.com/news/long-island-mri-freak-accident
(Many U.S.A. news services do a better job than BBC News does on U.S.A. stories. But this is the BBC being beaten by Fox, specificially.)
That's a Fox Affiliate (a broadcast station in the Fox broadcast network) local news source. The much denigrated Fox News is a cable TV station rated for only for Entertainment that purports to be for News and has done much to confuse the boundaries between the two in the US skirting truth-in-advertising and truth-in-news laws/regulations/common decency for the seeming sake of far right propaganda. (I believe the British equivalent is The Sun if it was allowed its own 24 hour TV channel because despite showing "news-like things" "everyone" knows it is only for Entertainment purposes only, why else would they include celebrity gossip.)
Many of the Fox Affiliates are still best-in-class local news. (Though it varies from city to city.) The Fox News cable channel lowered the bar on what Americans think news is supposed to be to historic low levels.
The U.K. equivalent is GB News. Its reality is worse than your hypothetical. (-:
But the level of Foxness that I was alluding to was not that of GB News, but rather more that of Reach PLC; which isn't Murdoch-owned, but which runs a whole network of purportedly regional news outlets which turn out to be just localized skins applied to a big syndicated empire, and which BBC News often does better than locally.
Yeah in the US system thanks to some old competition requirements the Affiliate Network gets most of the name recognition and provides most of the prime time entertainment content (a few other content blocks), but the stations under that network have their own owners that can be more or less damaging, especially in news content, and more or less "invisible" in that maybe you only see their name in the fine print at the end of credits or copyright statements.
One other notorious example is Sinclair Broadcasting [1]. Sinclair-owned stations include all of the major Affiliate Networks in the US and some of the minor ones, but are known for how much they farm politically-biased news content across their platforms, including trying to pass off editorial content as news content.
(ETA: Which is to say that yeah a FOX affiliate gets entertainment programming from what is left of Rupert Murdoch's empire, but could be getting news content from all sorts of places from home-grown proper local journalism to content farms from their real owners.)
[1] A humorous rant on it: https://www.youtube.com/watch?v=GvtNyOzGogc
There are multiple different Fox News services under similar names
https://en.wikipedia.org/wiki/WNYW#News_operation Fox 5 NY seems that it used to notably be a trailblazer
That's reporting by the local affiliate, not the Fox News.
"The man entered a room at Nassau Open MRI in Westbury, on New York's Long Island, without permission as the MRI machine was running..."
People think they can do anything they want nowadays.
A tragic anecdote has shaken France recently, when an unsupervised 6-year old entered a NICU, took a premature baby and dropped her on the floor. She died of her injuries a few hours later.
The same questions are being asked: how come anyone can enter a NICU? How could the parents let an unsupervised child roam the hospital? How come no one intervened? The worst part is that other parents had complained about the unsupervised child the day before.
Failures all along... that's often how accidents happen.
I wish there was a solid way to balance the weight of a tragedy (sans the kneejerk human emotional reaction) against the proposed solution.
Freak accidents will always happen, and if mitigation is simple and cheap, we should do it. But as soon as we get into the territory of "NICU doors need to be locked with keycard access" (causing every doctor and nurse to do a badge scan 40-50 times a day) then I think it's ok to have 1 infant death every 50 years globally because of it.
My rule of thumb for any big organization (like a hospital) is that nothing changes until there's a body to explain away.
Yeah, sometimes enough fractional close calls add up (usually to a big lawsuit) and policy changes without and death, but don't bet on it.
But, on the other end of the spectrum, having all sorts of absurd policy and procedure because someone might die so incredibly rarely we can't quantify it is terrible too.
There are so many dangers in the world that society would grind to a halt if we tried to proactively prevent all of them.
People have always thought they could do anything. If you think this is crazy you should see some of the stuff people have been doing with cars and motorcycles for the last 5 decades.
While wearing "a 20lb (9kg) chain with a lock that he used for weight training."
It's literally like reading a guide "How to kill yourself with an MRI machine" and following it step by step
Dude, exactly what I was thinking. Even if the staff weren’t telling me to remove it I would instinctively do the math:
big fat metal chain + big fat powerful magnet = disaster.
In fact, whenever I hear MRI I instantly think dental fillings. You’d think the patients and their handlers would instinctively think about all the metal they carry. How could big fat metal chain on neck not come to mind?
Step 1: Affix excessively large metallic decapitation device.
Step 2: Lock metallic decapitation device in place.
I don't get it how in the world someone can just enter the room when the device is on. Trusting people to read signs and follow the rules is borderline insane. A simple lock mechanism could spare life here.
>> I don't get it how in the world someone can just enter the room when the device is on.
The magnet is always on. His wife was in the room. Unless you're previously aware of the dangers of an MRI machine it looks like any other exam room with some equipment in it. It's up to the staff to inform and keep people out and enforce that. IMHO he should not have even been in the outer room wearing a chain like that.
This article[1] has a good overview of safety procedures already in use at other facilities:
> Melonie Longacre, VP of Operations at Northwell Health, explained MRI safety protocols, emphasizing the importance of multizone procedures to ensure safety around the powerful magnet.
> "Zone I is just for awareness that there’s an MRI in the vicinity, Zone II is the patient screening zone where they get screened. Zone III is the post-screening zone, and Zone IV is the actual magnet room," she said. "It’s important to be educated and safe."
It's unclear if Nassau Open MRI (where this incident took place) had similar safety protocols. I'm guessing not.
[1]: https://www.fox5ny.com/news/long-island-mri-freak-accident
Somebody told me that they knew of a case where a hospital porter tried to take a shortcut through the MRI room with a metal gas cylinder. Apparently it made quite a hole in the wall.
So like, why aren't there metal detectors on the doors going into these rooms?
Warning signs, eyeballs, reading, and common sense are sufficient most of the time.
Clearly not. Feels like you'd want a metal detector tied to a door lock.
"Most of the time" is not good enough.
Door should only open if no metals detected.
Why though? Why are we going to force society to spend hundreds of millions of dollars in equipment, wasted time and personal costs, to avoid a one in a million possibility that someone not caring about clear warning signs gets injured?
Interesting that he didn't feel gradual increase of pull force while he was approaching the MRI machine.
I guess cubic growth (?) changes from mild to dangerous so quickly when walking towards a MRI machine that once you realize what happening it's already too late.
> Interesting that he didn't feel gradual increase of pull force while he was approaching the MRI machine.
There isn't a gradual increase in pull when magnets are involved. My wife used to work for a company whose product involved powerful magnets. For a while they produced a demo kit in which a magnet would hold a large ball-bearing levitated against gravity. That thing was lethal. If the ball-bearing approached the magnet too closely it instantly became a dangerously fast finger-crushing hammer.
Magnetic force works quite like gravity (depends on r^2). When you drop something it immediately starts going.
I think it's inverse-square, and as you get closer, the acceleration increases quadratically, so your speed increases faster (possibly cubic?)
>> I think it's inverse-square
No, for "a magnet" it's an inverse cube law. I've often wondered if the force holding a nucleus together is really magnetism. No, physicists you don't need to correct me, I know how off the wall that sounds ;-)
For nuclear forces it's actually the strong force binding the nucleus (electromagnetic force is far, far, far too weak to do this) but you can theoretically unify the weak force and the electromagnetic force into the electroweak force : https://en.m.wikipedia.org/wiki/Electroweak_interaction
Ah, yes, I was assuming it was essentially like any other electromagnetic force, but apparently it being a dipole messes with things and it's inverse cube. TIL
Lots of "why don't they..." comments here.
This is international news, which means that this kind of event is extremely rare. People are often pretty dumb, and magnetic metal is common, so that means that the existing precautions are very effective. There's probably room for improvement, but there isn't some blisteringly obvious thing that's been overlooked that would save many lives.
Can’t the magnetic field be turned off? Big red button?
That was a brutal story that raises way too many questions. So many that it tires the brain.
Tragedy all around. Feel bad for that lady.
Final Destination Bloodlines?
Good to know the Final Destination series was not exaggerating on the hazards of MRIs.
I came here to say the same thing.
Wasn't this the guy who entered the MRI room without authorisation?
Metal detector + gate that denies entry if it detects metals?
It's stupid, but I read the headline and can't help but hear the Terminator theme in my head.
The incident with the child seems worse:
> In 2001, a six-year-old boy died of a fractured skull at a New York City medical centre while undergoing an MRI exam after its powerful magnetic force propelled an oxygen tank across the room.
There shouldn't exist any metals in the room (that are not the machine itself), period. The smallest metallic object can fly off like a bullet. Everything and everyone that enters the room should be required to be scanned with a handheld metal detector.
The real story here is that breakaway connectors exist and yet are still not used.
While the MRI angle makes it "newsworthy," there are many ways in which a chain might be caught and cause injury if it does not disconnect at a lower energy level than the minimum amount of injury the wearer is willing to accept.
its straight out of a scene from Final Dedtination [0] (currently in the theaters), I guess this guy never saw that recent film lol
[0] https://youtu.be/9fUB-nDZT8Q?si=ENx3IP27TVRlioKP
First class candidate for the Darwin Awards.
It's awful to say, but sometimes it's interesting to see natural selection at work.
most necklaces are metallic are they not?
There's also hippie stuff with hemp twine and wooden beads, plus candy necklaces.
>without permission
How is that possible ? I would think at the very least the door would be locked.
From quick searches I believe it is a for profit company.
https://opennpi.com/provider/1851878409
Granted that probably does not matter, but to me, for profit generally means cut costs, even safety costs to maximize profits.
> She said he was wearing a 20lb (9kg) chain with a lock that he used for weight training.
Um, ok.
This is a sad episode, but you can see it in the language quoted from the wife's victim, that she already has an eye in some lawsuit to get money out of this.
"It was also not the first time that the employee had seen her husband's weight that he used for training, she said."
"She claimed an employee and her husband previously "had a conversation about it before: 'Oh that's a big chain'"."
"I'm saying, 'Could you turn off the machine?" she said. "Call 911. Do something. Turn this damn thing off!'"
This is really so sad, reminds me some facts about ancient Roman history and how everyone kept trying to sue somebody else for some easy money.
Why does the magnet always pull rather than push?
why doesn't the MRI machine do magnetic field checks to make sure there isn't some anomalous metal anywhere near it - and do near instant shut down if so?
It can't shut down fast. You can only shut it down by boiling away the liquid helium, and all the energy of the magnet turn into heat to boil it.
It's a slow process. There is an enormous amount of energy in that magnet which has to go somewhere.
Because shutting down and restarting it is a >$10,000 event.
Related:
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/d...
It’s wild that the bottleneck keeping us from buying more MRI machines, achieving economies of scale for a no-radiation way of viewing soft tissues in high resolution, is supposedly the specialized technicians, and here we had a technician who couldn’t manage to turn it off in time when something went wrong, and apparently didn’t keep metal objects out of the room. (We use metal detectors any time you walk into a sporting event, why not an MRI room?)
I expect this story to be promoted by people who benefit from sales of x-ray / CT machines though. MRIs and all of their promise for public health could continue to be set back.
You can't turn it off, it's a static magnet with hundreds of amps flowing in a closed loop in a giant superconducting coil. The usual comparison is that a charged magnet has the same kinetic energy as a loaded 747 coming in to land. To "turn it off" you can bring it above superconducting temp, dissipate all that power as heat, and boil off thousands of liters of helium (fun fact, they usually have ducts to outside for this so everyone doesn't suffocate during a quench). Which might have happened in this case due to physical damage to the magnet, but is not as easy as flicking a switch and having it be "off".
> The usual comparison is that a charged magnet has the same kinetic energy as a loaded 747 coming in to land.
That sounds like it a bit of an overstatement. 200 tonnes of 747 at 250kph is nearly 500 MJ. Even the biggest, baddest high-tesla MRIs are maybe 10MJ. Which is still a 67-tonne M1 Abrams at 40 mph, so it's not like it's an unimpressive amount of energy!
Sure, a tank can stop from 40mph in not much time due to a very big braking system (https://youtu.be/f5XUQ2beGfM?t=85), but also a tank at 40mph will utterly demolish an MRI suite, patient and all if it drives into it.
A magnet yanking a chain around your neck isn't going to slowly suffocate you either. It's going to instantly crush your trachea and maybe your spinal chord, like a drop from a hanging.
The facts as reported in the article indicate that he was able to say goodbye before being suffocated. I wouldn't call that "instantly crush your trachea and maybe your spinal chord".
Okay, this sounds more serious than I thought. But then, why was someone able to walk into that room with metal around their neck if it was clearly so life-threatening?
Anyway, I’m complaining as someone who personally has turned down recommended medical procedures after checking radiation cancer risk numbers and realizing the radiation risk was being downplayed. When I saw the numbers, to me the cancer risk wasn’t worth it, so I went without a solution to my health problem. Had an MRI been an option, I would have more likely said yes.
> But then, why was someone able to walk into that room with metal around their neck if it was clearly so life-threatening?
Take a look at the Google Street View link someone posted. It's pretty clear this facility -shouldn't- have been able to acquire an MRI machine in the first place.
It also elucidates how such an accident could happen, i.e they clearly don't have the trained staff and protocols necessary given the danger of an MRI machine. It's very likely the poor gentleman didn't understand the immense danger the machine poses.
They are expensive and rare for a reason IMO. Yes it would be great to have more of them but the best place for more of them is within proper hospitals and leveraging economies of scale to share technicians across a fleet of them in a well run facility.
Can you explain why your assertions are clear from the Google Street View? They don't seem to follow for me.
> But then, why was someone able to walk into that room with metal around their neck if it was clearly so life-threatening?
They shouldn't have been, it's a major failure of access control.
You got the MRI magnet dissipation-time completely wrong, but it hasn't influenced your opinion on the radiation risk in other similarly sophisticated equipment that could save your life?
Astonishing.
A hasty incorrect assumption that I revised on new information is obviously not the same as hard data on radiation doses and cancer implications considered over weeks.
The “could save my life” odds were not very clear and the risk of cancer for that radiation dose had been long ago quantified by scientists, though without considering the immunosuppressants I was taking at the time that elevate cancer risks, making those rates more of a best-case scenario than something to count on. Above all else, the number known to the healthcare facility was the dollar amount to bill to my insurance, with the facility receiving nothing but money in exchange for taking those risks with patients’ lives.
For reference, in exchange for 10 mSv of radiation, a moderate dosage for a CT scan, the cancer risk for a young adult is something like 1/1000 over the course of their life. This means that out of every 1000 young adults who receive a 10 mSv CT scan, 1 would go on to get cancer they otherwise would not have gotten, assuming those 1000 aren’t already at higher risk of dying sooner (this assumption is important to weigh but is not straightforward). Those odds sound low, but if there was a revolver with 1000 chambers and one bullet, would you play Russian roulette with that if your life wasn’t on the line? The risk of cancer for the same radiation dose is much higher for children.
A technically clear answer to this is to use MRIs wherever practical, and to make MRIs more practical as much as we can. Why accept 10 mSv of radiation when you could just do an MRI instead? We should be making MRIs more and more practical. I’m concerned about the potential fear-mongering over times like this one when the facility fails to perform an MRI safely, where the impression people get could be that MRIs are dangerous, when the hazard was really the facility doing a bad job. By contrast, a perfectly performed CT scan will deliver a known radiation dose to the patient every time.
> The usual comparison is that a charged magnet has the same kinetic energy as a loaded 747 coming in to land
So once you divide by the "lying to people allegedly for their own good and trading away credibility in the process" factor what does that come out to? A semi truck at highway speeds? Those can stop in under 10sec.
If you get hit by a semi truck at highway speeds it could stop one second later and you'd still be in pretty rough shape.
It isn't a binary like that with the MRI though. If it stops strangling you in 10sec you're great, 15 you're fine, 20 you need to be woken back up.
Edit: Per the article that you have all supposedly read, he wasn't instantly incapacitated. He was pinned onto/into the machine with enough weight on him that he suffocated over seconds and ultimately died at the hospital. This would have been a "close call" with an E-stop (which they likely had, just wasn't hit soon enough).
That necklace would have been stuck to the magnet with a force around 3,000 pounds.
Strangulation is one thing, but his throat was crushed; there’s no way around it. That’s not survivable no matter how quickly you’re released.
I don't know, I imagine getting suddenly jerked across the room by your neck is not a slow and gentle strangulation event. In addition, as I understand it, currents can be induced in metal objects causing them to heat up. So no, I'm not sure that 15 seconds of violent burning strangulation of an elderly individual is fine. It's not clear this fellow died from strangulation.