Joint Commission: MRI accidents increase

Feb 14, 2008

The Joint Commission of Oakbrook Terrace, IL, has issued an alert warning that MRI accidents are on the rise, and has urged hospitals and other healthcare facilities to take steps to prevent them.

The U.S. Food and Drug Administration has received nearly 400 reports of MRI-related accidents over the past decade. Over 70% of these were burns, while 10% occurred when metal objects became "missiles" when pulled into the scanner's magnetic field. The Joint Commission alert noted that no accidents occur in the vast majority of the more than 10 million MRI scans performed each year in the U.S.

The increase in accidents is attributed to various factors, including the greater field strength of newer magnets, the increasing number of interventional applications, and more sedated and anesthetized patients.

Heating accidents can arise from improper positioning of a patient during an exam or incorrect settings on the MRI for a particular scan. Implants, such as pacemakers and aneurysm clips, can become dangerous if and when patients are exposed to either static or time-varying magnetic fields. Steel and other metal objects also can become airborne when brought into an MRI room and are drawn into the scanner.

The Joint Commission recommends that healthcare providers take a number of steps to reduce MRI-related injuries; the recommendations can be viewed at the organization's Web site.

Joint Commission MR safety surveys: Moving past the fire extinguisher, August 29, 2007

MR guidelines: Elevating standards of practice and care, May 10, 2007

Did the MRI community learn from the Colombini tragedy? July 28, 2005

MR accident results in child's death, July 31, 2001