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.
LeifCarrotson · 9h ago
> "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.
daft_pink · 8h ago
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.
josephcsible · 9h ago
> 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.
jpgvm · 9h ago
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.
Doxin · 1h ago
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.
paulryanrogers · 9h ago
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?
al_borland · 9h ago
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.
xboxnolifes · 9h ago
> 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.
solid_fuel · 5h ago
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.
WillAdams · 9h ago
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:
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.
jpgvm · 9h ago
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.
its-summertime · 2h ago
That size of building is relatively normal for a non-hospital MRI facility.
ahartmetz · 1h ago
"Open MRI" - how appropriate. Too open MRI even.
JdeBP · 2h ago
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.
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.
zigzag312 · 2h ago
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.
jleyank · 10h ago
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…
kylecazar · 9h ago
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."
atmavatar · 4h ago
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.
arp242 · 3h ago
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.
mhdhn · 2h ago
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.
zigzag312 · 2h ago
> she was getting an MRI on her knee and asked her husband to come in to help her get up afterwards
duxup · 9h ago
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.
blitzar · 1h ago
Caution! This coffee is hot. Avoid pouring on crotch area.
mrlonglong · 1h ago
First class candidate for the Darwin Awards.
bobajeff · 9h ago
Good to know the Final Destination series was not exaggerating on the hazards of MRIs.
> 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.
jmclnx · 9h ago
>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.
Granted that probably does not matter, but to me, for profit generally means cut costs, even safety costs to maximize profits.
Mistletoe · 10h ago
> She said he was wearing a 20lb (9kg) chain with a lock that he used for weight training.
Um, ok.
odyssey7 · 9h ago
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.
andy99 · 9h ago
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".
odyssey7 · 9h ago
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.
jpgvm · 9h ago
> 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.
andy99 · 9h ago
> 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.
ta20240528 · 2h ago
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.
odyssey7 · 2h ago
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 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.
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.
I thought these days, most MRIs did have an emergency quench button.
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.
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.
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.
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).
Only good for removal of any metal-adorn victims and unintended metallic objects ...
https://maps.app.goo.gl/6ssyJfjVn1fUGaG2A
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.
I don't understand how such a dangerous machine can end up in a place that looks like that.
* 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.)
https://en.wikipedia.org/wiki/WNYW#News_operation Fox 5 NY seems that it used to notably be a trailblazer
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.
Also, twenty pound necklace?
"She said he was wearing a 20lb (9kg) chain with a lock that he used for weight training."
> 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.
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.
No comments yet
> 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.
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.
Um, ok.
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.
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.
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.
They shouldn't have been, it's a major failure of access control.
Astonishing.
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.