Freak MRI Accident Shakes Bay Area Hospital: Nurse Injured, Safety Concerns Exposed
REDWOOD CITY, Calif. – A routine MRI scan turned into a harrowing incident at a Bay Area hospital, causing injury to a nurse and revealing serious safety failures. The incident occurred at Kaiser Permanente’s Redwood City Medical Center, and the shocking photos obtained by KTVU capture the terrifying moment.
Inside the MRI center, an imaging technician was startled by screams coming from another room. He rushed to find a nurse pinned between the hospital bed and the MRI machine, suffering from crushing injuries. According to a Cal/OSHA investigation, the bed had been pulled uncontrollably into the machine’s magnetic force.
The incident highlighted the dangerous potential of MRI machines, with MRI safety advocates citing projectiles, burns, and implanted devices as common causes of injuries and even deaths. In this particular case, the nurse, Ainah Cervantes, underwent surgery to treat a severe laceration and had to have two embedded screws removed. Miraculously, the patient who fell from the bed onto the floor escaped unharmed.
What is most concerning about this incident is that it occurred in February, but the investigation was not completed until several months later. MRI expert Tobias Gilk revealed that accidents involving MRI machines are on the rise, correlating with the growing number of scans and exams. Disturbingly, Gilk estimated that thousands of incidents go unreported each year, highlighting the need for greater awareness and safety measures.
The investigation conducted by the California Department of Public Health found that Kaiser Redwood City had failed to provide radiologic services in a safe manner. According to regulators, the systemic failures at the facility included leaving the nurse and patient care technician unsupervised without proper screening. No one, not even the patient, was screened for potential risks. To make matters worse, the door to the magnetic room was left open, and the safety alarm system failed to sound.
Dr. Emanuel Kanal, a radiologist at the University of Pittsburgh, emphasized the importance of safety training in MRI centers. Drawing parallels with aviation safety, he highlighted the need for standardization, certification, and recertification for MRI personnel to ensure they are adequately prepared and informed to prevent such incidents.
The investigation into Kaiser’s MRI safety policy revealed several breaches that contributed to the accident. The policy clearly states that employees should not enter the magnet area without proper screening, and metal objects such as gurneys should not be taken into the MRI room. Additionally, the door to the MRI room should be kept closed at all times. However, records from the incident investigation showed that some employees never received the required safety training, and the facility failed to conduct annual tests of the door alarm as recommended.
The Department of Public Health concluded that the many safety failures…created a culture of unsafe practices at Kaiser Redwood City. While Kaiser Permanente expressed their commitment to understanding why such accidents occur and implementing changes to prevent them in the future, sources alleged that this was not the only incident at the hospital. A photo provided to KTVU shows a medical equipment cart stuck to the MRI scanner, likely from a previous incident in March 2015.
MRI safety experts underscored the need for increased oversight and mandatory safety requirements to protect patients from potential risks. Restricting access to the MRI site and implementing strict controls can help prevent accidents and minimize exposures.
As MRI centers continue to play a crucial role in medical diagnostics, it is imperative that safety education and best practices are prioritized. By addressing the systemic failures and implementing stricter safety protocols, hospitals can decrease the occurrence of such incidents and safeguard both patients and healthcare professionals.
