2010 MRI Safety Update: Codes & Standards. Who Is This Guy? Full Disclosure

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1 2010 MRI Safety Update: Codes & Standards Tobias Gilk, M.Arch President & MRI Safety Dir. Mednovus, Inc. Special Consultant RAD-Planning 1 Who Is This Guy? ACR MR Safety Committee VA / ASHE Design Standards Author (x 100 s) Expert on MR Accidents 2 Full Disclosure President & Stockholder Mednovus, Inc. Consultant RAD-Planning 2010 AHRA Annual Meeting Page 1 of 17 Sponsored by Mednovus & RAD-Planning 3

2 Forward Thank you to Emanuel Kanal, MD RAD-Planning / Junk Architects Working Session Feedback Forms 4 Why am I here? Good Question... MRI is 10,000% safe... There are no accidents... Status quo is perfect... 5 MRI is 10,000% safe... There are no accidents... Status quo is perfect AHRA Annual Meeting Page 2 of 17 Sponsored by Mednovus & RAD-Planning 6

3 Status quo is perfect FDA MRI accident reports 310% increase 7 MRI Safety Today 8 Major MR-Environment Safety Concerns Time-Varying RF / Magnetic Fields Static Magnetic Fields Cryogens 2010 AHRA Annual Meeting Page 3 of 17 Sponsored by Mednovus & RAD-Planning 9

4 Cryogen Safety Entrapment / Asphyxiation Catastrophic Failure 10 Cryogen Safety 11 Cryogen Safety 2010 AHRA Annual Meeting Page 4 of 17 Sponsored by Mednovus & RAD-Planning 12

5 Cryogen Safety 13 Major MR-Environment Safety Concerns Time-Varying RF / Magnetic Fields Static Magnetic Fields Cryogens 14 Static Magnetic Field Always On Interfere With Implants / Devices Translational (Missile) Effect Rotational (Torque) Effect 2010 AHRA Annual Meeting Page 5 of 17 Sponsored by Mednovus & RAD-Planning 15

6 Projectiles / Missiles Cause $100,000 s of Damage Injure Patients and Staff Result in Days / Weeks of Downtime Still Occur Regularly Recent Events Oxygen Cylinder vs. Physician s Arm Wheelchair vs. Technologist Flat-Panel Monitor vs. Face Rolling Cart vs. Vendor Apps Specialist MR Fan Unit KILLS Service Engineer 2010 AHRA Annual Meeting Page 6 of 17 Sponsored by Mednovus & RAD-Planning 18

7 MRI Projectile Cost $43, The Stakes 20 Why We re All Here 2010 AHRA Annual Meeting Page 7 of 17 Sponsored by Mednovus & RAD-Planning 21

8 Westchester Medical Center What Was The Result? $2,900,000 Which works out to 9.7 per U.S. MRI patient last year 23 Who Has Requirements, Today, To Prevent This? NO NO 4 NO 2010 AHRA Annual Meeting Page 8 of 17 Sponsored by Mednovus & RAD-Planning 24

9 Who Has Requirements, Today, To Prevent This? NOBODY! 25 But That Couldn t Happen Here Two RT s On Duty Piped-In Oxygen Unsecured Control Room Unsafe Materials Kept Outside Room Nurse Responded To Call For Help 26 But We re Licensed & Accredited... ACR Snubs Own MR Safety Committee Radiology State License = Ionizing JCAHO Worried About Fire Extinguisher No Federal Requirements No Payor Requirements 2010 AHRA Annual Meeting Page 9 of 17 Sponsored by Mednovus & RAD-Planning 27

10 But Our Vendor NOT Design = 29 Bringing It Home: What You Can Do At Your Facility AHRA Annual Meeting Page 10 of 17 Sponsored by Mednovus & RAD-Planning 30

11 Codes & Licenses 2010 Guidelines NY State Certification (CA to follow?) Guidelines Introduces MRI Safety Standards Awaiting Joint Commission (JCAHO) Rolling-Out To States Guidelines 2010 AHRA Annual Meeting Page 11 of 17 Sponsored by Mednovus & RAD-Planning 33

12 2010 Guidelines Design con/iguration of the MRI suite (1) Suites for MRI equipment shall be planned to conform to the four- zone screening and access control protocols identi>ied in the American College of Radiology s Guidance Document for Safe MR Practices. (2) The layout shall include provisions for the following functions: (a) Patient interviews and clinical screening (b) Physical screening and changing areas (as indicated) (c) Siting of ferromagnetic detection systems (d) Access control (e) Accommodation of site- speci>ic clinical and operational requirements 34 Designer Certification?!? New York Requires Designer Certification of MRI Safety California Reviewing Similar Measure 35 Accreditation Radiology Accreditation (ACR) CMS Advanced Imaging (welcome TJC) 2010 AHRA Annual Meeting Page 12 of 17 Sponsored by Mednovus & RAD-Planning 36

13 ACR 37 JCAHO E.C. Standard 38 JCAHO E.C. Standard 2010 AHRA Annual Meeting Page 13 of 17 Sponsored by Mednovus & RAD-Planning 39

14 New York Times, Ionizing Radiation & CMS Accreditation Preventing Accidents? Basic Safety Standards Needed Radiology Safety Must Include MRI 40 4 Things To Check At Home 4-Zones Physical Access Controls Line-of-Sight Situational Awareness Ferromagnetic Screening 41 4-Zones 2010 AHRA Annual Meeting Page 14 of 17 Sponsored by Mednovus & RAD-Planning 42

15 Access Controls 43 Line-of-Sight BLIND SPOT Toby s Blueprint Barn 44 Ferromagnetic Screening 2010 AHRA Annual Meeting Page 15 of 17 Sponsored by Mednovus & RAD-Planning 45

16 Ferromagnetic Screening 46 Summary MR accidents are increasing, dramatically. Accident / interruption costs are huge! New standards demand expertise, that YOU can provide. MR Safety = Enlightened Self-Interest 47 Questions? Tobias Gilk Tobias.Gilk@Mednovus.com TGilk@RAD-Planning.com 2010 AHRA Annual Meeting Page 16 of 17 Sponsored by Mednovus & RAD-Planning 48

17 THANK YOU! Tobias Gilk, M.Arch President & MRI Safety Dir. Mednovus, Inc. Special Consultant RAD-Planning AHRA Annual Meeting Page 17 of 17 Sponsored by Mednovus & RAD-Planning