Good news, my son and I had a long chat last Saturday. Not-so-good news, we had it in the local emergency room.
Still, it could have been worse. After a few hours of fluids and pain meds, he wasn’t feeling quite so awful, and I drove him home again.
Blood work told us that his major systems were working. And a scan showed that his brain wasn’t missing any pieces. So, basically, good news.
Even so, I could have done without the stress. So, I’m sure, could my son.
And I’m very glad that (almost) a week has gone by without a similar incident.
“I Told You I Was Sick”
It’s been decades since I’ve heard that someone “enjoys poor health,” so maybe that phrase has dropped out of my dialect of English.
Malingering, however, is still a thing. And that’s not what’s been happening. I’m as sure of that as I can be about anything.
A key factor for enjoying poor health is that the ersatz invalid must not, in fact, be experiencing poor health. Particularly not the sort that comes with near-crippling and intermittent pain.
Imaging Tech: X-Rays and the Fabulous Foot-O-Scope
(An image from my brain scans in 2018.)
Medical diagnostic tech has come a long way since my youth, but we still can’t tap into another person’s sensory inputs. Which, from a ‘privacy’ perspective may be a good thing, and I’m wandering off-topic.
Even so, we had impressive tech in my ‘good old days.’
My childhood memories include standing on a shoe-fitting fluoroscope.
Maybe finding shoes that fit was easier with Pedoscope, Foot-O-Scope and the X-ray Shoe Fitter — which, name notwithstanding, didn’t actually fit a customer’s shoes. Someone in the shoe store used that ‘length and width’ gadget. Turns out it’s called a Brannock Device.
Anyway, shoe-fitting fluoroscopes may or may not have helped folks find shoes that fit. Either way, we started learning about ionizing radiation’s health issues in the late 1940s.1
My guess is that folks working in shoe stores were far more at risk than all but their most fanatic shoe fanciers. But the perceived risk and reward balance tipped away from retail X-ray machines, so now shoe store fluoroscopes are museum pieces.
On the other hand, medical X-ray imaging is still with us.
My routine dental exams, for example, often include getting X-ray images.
I see that as a reasonable benefit/risk tradeoff. Partly because today’s dental X-ray gadgets get results with far less energy. Greater efficiency and safer: what’s not to like?
Death During Diagnosis: MRI Scanners and Flying Oxygen Tanks
Some other medical imaging tech — like MRI, that’s magnetic resonance imaging in technospeak — uses no ionizing radiation.
Maybe someday we’ll learn that an MRI’s radio waves and intense magnetic fields can hurt us. By themselves, that is.
What’s certain is that airborne oxygen tanks are occasionally lethal.
Back in 2001, Michael Colombini, a six-year-old boy, survived an operation that removed a benign brain tumor.
Then folks at a hospital put him in their MRI scanner. After that, they turned it on. A metal oxygen tank was in the room.
It shot into the MRI scanner’s ‘donut hole.’
Where it collided with the boy’s head. He died a couple days later.2
Another Death by MRI and Oxygen Tank
(From Subrata Dhar, via The Indian Express, used w/o permission.)
(January, 2018: a short flight, swift death, and many questions.)
About 17 years after M. Colombini survived surgery, but not a diagnostic scan, a man died after being pulled into an MRI scanner.
Rajesh Maru had been holding an oxygen tank. That much is certain.
I gather that he’d been with a 65-year-old woman, Laxmi Solanki, and other relatives. The 65-year-old had been in the hospital’s MICU, Medical Intensive Care Unit. Then she was taken to the hospital’s MRI room. Pretty much everyone seems to agree on this.
L. Solanki needed oxygen, which may explain the oxygen cylinder R. Maru was holding. The family says a hospital staffer told R. Maru to bring the cylinder, and assured him that the MRI magnet was inactive. The staffer says he didn’t. Understandably, perhaps.
What happened next could have been much worse.
Wrong Place, Wrong Time, Wrong Equipment
L. Solanki was on a conventional hospital “trolley,” one of those steel things we call gurneys. That’s what I call them, anyway.
Instead of transferring L. Solanki to a non-magnetic MRI gurney at a safe distance, hospital staff brought her and the metal gurney into “Zone III:” where the MRI’s magnetic field can cause trouble. That’s what R. Maru’s family says. Hospital staff tell another version.
In any case, R. Maru stepped too close to “Zone IV,” near the MRI.
R. Maru might have lived, if his fingers hadn’t been around the oxygen cylinder’s nozzle.
But they were. So when the MRI’s (active) magnetic field grabbed the metal cylinder, R. Maru went with it.
His upper body lodged in the MRI’s ‘donut hole.’
The oxygen cylinder’s nob snapped.
I don’t know whether it held oxygen gas at high pressure, or liquid oxygen.
I’ve read that Rajesh Maru died from a pneumothorax: lung collapse.3
Whether a blast of gas and/or liquid oxygen overloaded his body and killed him, or he died from blunt force injuries, the result’s the same. He’s dead.
But, again, it could have been worse.
Laxmi Solanki’s gurney was dangerously close to the MRI scanner, but didn’t get pulled in. Civic authorities and hospital higher-ups acknowledged that something went horribly wrong and eventually settled on who should have known better.
Risk, Minnesota’s Powerball Jackpot and Weighing the Odds
(From Pennsylvania Patient Safety Authority, via NLM/HIH, used w/o permission.)
(PPSRS MRI safety events by zone, January 1, 2009 through December 31, 2017.)
There are lessons to be learned from those accidents, and one of them isn’t that MRI technology is bad. It’s dangerous, if we don’t pay attention. But that’s been true of every tech, from camp fires to the printing press and arc welders.
I strongly suspect that we learn more from a myriad non-fatal “screening events,” than we do from the handful of incidents where someone died after an MRI scan.
“Handful” may be overstating it.
Doctors at the University of Aberdeen did the first clinically useful MRI scan in 1980.
In 2001, a flying oxygen tank killed a patient. In 2018, another flying oxygen tank killed a patient’s relative. That’s two too many deaths.
But that’s one death out of roughly 95,000,000 MRI scans in 2018. I haven’t found estimates for the number of MRI scans in 2001.
Assuming consistent conditions worldwide, that means I had about a 1/95,000,000 chance of not surviving my MRI scan, back in 2018. The odds of my winning Minnesota’s Powerball jackpot would be even worse: 1/292,201,338.4 And that’s almost another topic.
I’ve seen scary headlines and angsty op-eds about the dangers of MRI scans.
But, although a handful of people were scanned and then died, I only found three cases where folks had demonstrated a cause-effect connection.
Three Deaths, Maybe More, and Boston’s Phenomenal Flying Gurney
In 1992, someone died after “an undisclosed cerebral aneurysm clip” tore open an artery.
Then there were the two deaths I’ve mentioned, plus apparently “several” folks with pacemakers who died after an MRI scan.
Maybe the pacemakers moved or glitched after the scan. Or maybe the patients died after the scans, but from whatever condition warranted the MRI procedure. I don’t know, and couldn’t find details.
Getting back to my experience in 2018. Although the odds of my dying during an MRI scan were slightly better than winning Minnesota’s Powerball jackpot, I don’t think I was taking a crazy risk.
That said, an MRI scan for someone with a pacemaker that was implanted before 2011 might be too risky.
Not that I have a pacemaker. I do, however, have two artificial hip joints: which I mentioned to hospital staff before that 2018 MRI. They said they knew about them, and that the things would be okay. As it turns out, they were right.
I see an ‘up’ side in our growing files on MRI accidents, or “safety events,” as Pennsylvania’s PPSRS calls them. The more data medicos and technicians have, the more opportunities we have for developing better safety and training procedures.
But, every once in a while, someone goofs.
Like the time in 2016, when folks at Boston’s Brigham and Women’s Hospital wheeled a patient into their MRI room. On your standard metal gurney.
Then the gurney and patient started moving toward the MRI. Without anyone pulling it.
They promptly lifted the patient and stayed out of the way as the gurney took off, colliding with the scanner.
My hat’s off to folks at BWH. They acknowledged that something went wrong, found ways to reduce the odds of it happening again, and published what they learned.5
Life, Health and Making Sense
Sooner or later, I will die. (Catechism of the Catholic Church, 1007 (p. 262))
But death isn’t permanent, which can be good news or bad news — depending on what I’ve done and whether or not I accept God’s love and mercy in my particular judgment. (Catechism, 991, 997, 1021-1029, 1033-1037, 1042-1050 (pp. 258, 260, 266–268, 272–274)
Since life always leads to death, and I’m looking forward to eternal life with God, shouldn’t I denounce health care, medicine and particularly newfangled contraptions like MRI scanners?
Basically, no. Although making good health my highest goal would be a bad idea.
Top priority is where God belongs. Putting anyone or anything else there — money, family, power, pleasure, anything — is idolatry. And it’s a bad idea. (Catechism, 2112-2113 (pp. 512-513))
But life and health are important. They’re “precious gifts” from God. How I act matters. Getting and staying healthy is a good idea. Within reason. Being sick is okay. Painkillers are okay. Helping others get or stay healthy is okay. (Catechism, 1506-1510, 2279, 2288-2289, 2292 (pp. 377–378, 550–552))
So if my son or someone else in the family needs medical attention, I’ll probably worry.
But I won’t wonder if it’s a “visitation from God,” or brood over whether or not blood tests are blasphemous.
I’ve talked that, and vaguely-related topics, before:
- “Sunshine, Holy Water and a Trip to the Emergency Room”
(April 11, 2021) - “A Winter Weather Advisory, Forecasts and Making Sense”
(January 13, 2021) - “COVID-19, Cells, Viruses and mRNA Vaccines”
(December 5, 2020) - “Happy Death?!”
(April 26, 2020) - “Sickness, Death, God, Love and Questions”
(February 23, 2019)
2 Science, technology and an MRI scan gone wrong:
- Wikipedia
- “Boy Killed In Freak MRI Accident”
AP, via CBS News (July 31, 2001)
- Wikipedia
- “Story of an extraordinary death: How MRI machines work, and can (in rare cases) kill”
Tabassum Barnagarwala, The Indian Express (February 7, 2018) - “Fatal MRI machine accident brings arrests, investigations”
AFP, via CBS News (January 30, 2018)
- Wikipedia
- Figuring the Odds
Minnesota Lottery - “Magnetic Resonance Imaging (MRI) and its global impact in healthcare”
M. Lakrimi; International Cryogenic Engineering Conference and International Cryogenic Materials Conference, Oxford (UK) (September 2018)
5 Safety and a non-lethal MRI accident:
- Wikipedia
- “Five Questions with Allen Kachalia, MD, JD”
News, Betsy Lehman Center for Patient Safety (April 13, 2017) - “Pediatric Magnetic Resonance Research and the Minimal-Risk Standard”
Matthias H. Schmidt, Jennifer Marshall, Jocelyn Downie, Michael R. Hadskis; IRB: Ethics & Human Research; The Hastings Center (February 19, 2016) - “Safety Of Mris In Patients With Pacemakers And Defibrillators”
Methodist Debakey Cardiovascular Journal (July-September 2013) - “MRI in Patients With Pacemakers”
Overview and Procedural Management
Dr. med. Henning Bovenschulte, Dr. med. Klaus Schlüter-Brust, Prof. Dr. med. Thomas Liebig, Prof. Dr. med. Erland Erdmann, Prof. Dr. med. Peer Eysel, PD Dr. med. Carsten Zobel; Deutsches Ärzteblatt International (April 2012) via NCBI/NLM/HIH - “Safety in the MR Environment: MR Screening Practices”
Pennsylvania Patient Safety Advisory, Pennsylvania Patient Safety Authority (March 2009)
Praying for your son, as well as for you and your family.
God bless.
🙂 Thank you. It’s been an – interesting – week.