Episode 7 of The Invisible Force podcast on the AuntMinnie Podcast Network focuses on the potential gray area of imaging equipment maintenance and service that follows buying, installing, and operating a used MRI scanner -- as it relates to the fatal MRI accident at Nassau OpenMRI in July 2025.
Hosts and MRI safety experts Tobias "Toby" Gilk and John Posh have begun examining the supporting cast of litigants in the Keith McAllister case.
While the original equipment manufacturer (OEM), Siemens, originally produced the 1.5-tesla MRI scanner involved in this accident, they didn't sell the scanner or the semi-trailer that housed it to Nassau OpenMRI, according to Gilk, who noted that the equipment was obtained through a used equipment reseller or agent.
Very little information has been publicly disclosed about the most important details of the McAllister Nassau OpenMRI case, according to Gilk and Posh, who were compelled to open their own, independent investigation. For Episode 7, they have been able to cast light on a few details by way of an adverse event report filed at the U.S. Food and Drug Administration (FDA).
"Siemens contends in their FDA adverse event report that they had nothing to do with the installation of the MRI inside that trailer," Gilk explained.
Little is also known as to where litigation stands. However, Gilk and Posh go on to cite a legal precedent from another fatal MRI accident (the Michael Colombini case, also in New York) in which an OEM was named as the defendant.
Protective precedent
The outcome of the Colombini case was that a manufacturer could not be held legally liable for the actions of people attending to a patient's MRI exam -- it's a hugely protective legal precedent, noted Gilk.
"That's vitally important to us," he said. "In the state of New York, MRI manufacturers aren't legally liable for the actions of MRI providers when somebody gets killed because of a magnetically attracted object."
What about other U.S. states? Listen now to get more perspective.
One of the mysteries that persists in the more recent McAllister case is the scanner quench button in the trailer -- the intricacies of how it may (or may not) have been wired to the MRI system or could have malfunctioned at the time of the man's entrapment.
Using Google Street View images, Posh speculated that the MRI trailer in the accident was introduced at Nassau OpenMRI between August 2019, when an older trailer appears in Street View images, and December 2021, when a new trailer appears.
The uniqueness of the scanner unit and exam environment raises the question of whether the quench button was nothing more than a dummy button, according to Gilk and Posh, who said it appears there were a lot of other hands that this MRI scanner and trailer passed through prior to July 2025.
Tangled web of responsibility
"Even if it was true that the quench button failed to work on that fateful day in July of 2025, as discussed in the first half of the show, there were several companies who had some sort of responsibility for that quench button, its installation, its functionality, over the life of that trailer," Posh said, adding that for many Siemens quench buttons, there are regular preventative maintenance checks and testing under a service contract with the MRI OEM.
It was an InterMed service engineer who ran from another outpatient imaging center to Nassau OpenMRI when the people at the Nassau location were not able to get the magnet to quench, Gilk noted.
"We don't yet know if the quench button was verified as functional when Nassau OpenMRI took possession of the trailer, or if InterMed conducted the same scheduled maintenance checks of the quench button that Siemens would have done," Posh continued.
A quench button would have to be integrated into the construction of the building or, in the case of the magnet at Nassau OpenMRI, fabricated into the construction and design of the semi-trailer, according to Posh. If it was improperly wired back to the MRI scanner in the construction of the trailer by the company that built it out, then it's still not going to work, Gilk added.
Testing a quench button can be costly, according to Posh, who noted that certain parts of the system can't be tested without a significant cost of $50,000 or more. He added that in stories in which quench buttons haven't worked, the failure tracked back to the wiring of the quench button circuit, not a failure of a part inside the MRI scanner itself as was implied in the McAllister case.
"We're left questioning the function of the quench button, which does have a regular testing regime and built-in fail-safes," Gilk added. "Or we're left with what truly sounds like a one-in-a-million long shot, that the part that triggers the quench from inside the MRI scanner failed to work when the button was pushed."
Another big question? What if the quench button wasn't even triggered?
Listen to Episode 7 now.
Catch up on Episode 6.
Editor's note: The imaging community and other listeners have been invited to contribute to the investigation through The Invisible Force Tip Line -- 631-MRI-TIPS (631-674-8477).
Host
Tobias "Toby" Gilk is the founder of Gilk Radiology Consulting. An architect by training, he has spent over 20 years focusing on MRI safety, initially through the architecture and planning of MRI facilities, but growing into the technology, clinical practice, regulation, and economics of MRI safety. Gilk holds both MR Safety Officer (MRSO) and MR Safety Expert (MRSE) certifications from the American Board of Magnetic Resonance Safety (ABMRS). An evaluator of serious reportable events (SRE), he is also a volunteer member of the Technical Expert Panel (TEP) of the National Quality Forum, and co-author of "The Technologist MRI Safety Handbook."
Co-host
John Posh is an MRI educator, safety consultant, and safety auditor with over 35 years of experience in the field of MRI safety and education, working with outpatient facilities, hospitals, and universities. He owns Posh Education in Bethlehem, PA, and currently serves as global director of education and training for Aspect Imaging, chief academic officer-MRI at John Patrick University, and adjunct professor of medical imaging at Rush University.
This episode of "The Invisible Force" is brought to you by AuntMinnie and the AuntMinnie Podcast Network. You can also find it on Apple Podcasts and Spotify. Check out AuntMinnie's full podcast library, including extras, on Apple Podcasts and Spotify.
