Description of Event or Problem · 1
A FERROMAGNETIC OBJECT WAS PULLED INTO THE BORE OF THE MAGNET. THE CUSTOMER HAD COMPLETED A SCAN AND WAS PREPARING THE OPERATING ROOM SUITE TO RESUME WITH SURGERY. THE CUSTOMER ROLLED A LAMP POLE BEHIND THE HEAD OF THE OPERATING ROOM TABLE BEFORE THE MAGNET HAD BEEN FULLY RETURNED TO THE MAGNET BAY. THE LAMP WAS PULLED INTO THE BORE OF THE MAGNET. THE MAGNET AND LAMP WERE WELL AWAY FROM THE PT AT THE TIME OF THE INCIDENT AND THERE WERE NO INJURIES TO ANY PERSONNEL OR THE PT. THE CUSTOMER REMOVED THE LAMP FROM THE MAGNET; THERE WAS SOME COSMETIC DAMAGE TO THE FOAM PORTION OF THE COLLISION DETECTION RING AS WELL AS TO THE REAR BORE LINER. NO FURTHER CORRECTIVE ACTION IS REQUIRED AS THERE IS A KNOWN RISK THAT THE INTRODUCTION OF FERROUS OBJECTS INTO THE MR SUITE CAN CAUSE DAMAGE OR INJURY IF THEY ARE PULLED TOWARD THE MAGNET. ALL SUITES ARE EQUIPPED WITH SAFETY LABELS INFORMING ALL VISITORS ARE USERS OF THE HAZARDS INTRINSIC TO THE MR ENVIRONMENT WHICH MUST BE RESPECTED. AS PART OF THE DEVICE TRANSFER TO THE CUSTOMER, TRAINING IS CONDUCTED PRIOR TO SYSTEM TURNOVER. ALSO, THE USER MANUAL CONTAINS INFO ABOUT THE HAZARDS IN ALLOWING FERROMAGNETIC ITEMS TO BE BROUGHT INTO THE MAGNET AND BECOME POTENTIALLY DANGEROUS PROJECTILES.