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Publication Type: Patient Safety Alert
Single or Multiple Incident: Multiple
Date: 10/19/2021 12:00:00 AM
Country: South Korea
This alert addresses the various kinds of hazards including body injuries involving presence of metallic objects in the presence of a magnetic resonance imaging (MRI) machine. The MRI machine attracts metallic objects or causes the malfunction of implantable metallic medical devices in the body. Two cases are described, one of which was fatal when an oxygen tank was pulled into the MRI machine. The alert provides a list of hazardous items and recommendations to prevent injuries during an MRI scan.

Additional Details

Device:
iron sand bag, ventilator, saturation monitor, oxygen tank, IV stand, wheelchair, glasses, hairpin, earrings, dentures, Implantable metallic medical devices, pacemaker, cochlear implant, insulin pump, credit card, phone, key, scissors, cosmetics made with metallic ingredients, clothes with metallic ornaments

Rules / Policies / Procedures
  1. Check for any metallic medical devices implanted inside the patient’s body.
  2. Check the belongings of the patient and healthcare providers.
  3. Access to the MRI room after changing into suitable items for an MRI scan.

Patient safety incidents during the Magnetic Resonance Imaging (MRI) scan