{
  "id": "medical/mri-pacemaker-incompatibility",
  "signature": "AI incorrectly approves MRI for a patient with a non-MRI-conditional pacemaker, ignoring lead and device compatibility requirements",
  "signature_zh": "AI 错误批准对装有非 MRI 兼容起搏器的患者进行 MRI，忽略导线和设备兼容性要求",
  "regex": "(MRI|magnetic\\s*resonance|MR).*(pacemaker|ICD|cardiac\\s*device|implant)",
  "domain": "medical",
  "category": "config_error",
  "subcategory": null,
  "root_cause": "Only MRI-conditional pacemakers (specific models with MR Conditional labeling) are safe for MRI under defined conditions (e.g., 1.5T, specific SAR limits). Non-conditional devices can cause lead heating, pacing inhibition, or device malfunction due to RF fields and gradient magnetic fields.",
  "root_cause_type": "generic",
  "root_cause_zh": "仅 MRI 兼容起搏器（具有 MR Conditional 标签的特定型号）在限定条件下（如 1.5T、特定 SAR 限制）才安全。非兼容设备可能因射频场和梯度磁场导致导线加热、起搏抑制或设备故障。",
  "versions": [
    {
      "version": "Siemens Magnetom Vida 4.0",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "GE Signa Premier 3.0",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Philips Ingenia 5.0",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "Check only the patient's device manufacturer name, not the model number",
      "why_fails": "Many manufacturers produce both MRI-conditional and non-conditional models; model number is essential for compatibility check",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    },
    {
      "action": "Assume all pacemakers implanted after 2015 are MRI-conditional",
      "why_fails": "Many non-conditional devices were implanted after 2015; also, leads must be MRI-conditional separately (e.g., certain Medtronic leads are not MR Conditional even if generator is)",
      "fail_rate": 0.85,
      "condition": "",
      "sources": []
    },
    {
      "action": "Perform MRI at 3T because 'higher field gives better images'",
      "why_fails": "Most MRI-conditional pacemakers are only approved for 1.5T; 3T increases RF heating and device interference risk significantly",
      "fail_rate": 0.9,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Implement mandatory device interrogation workflow: 1) Query EMR for device model and lead model numbers. 2) Cross-reference against FDA MR Conditional database (https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRL/). 3) If not listed as MR Conditional, reject MRI order and suggest alternative imaging (CT, ultrasound, nuclear).",
      "success_rate": 0.95,
      "how": "Implement mandatory device interrogation workflow: 1) Query EMR for device model and lead model numbers. 2) Cross-reference against FDA MR Conditional database (https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRL/). 3) If not listed as MR Conditional, reject MRI order and suggest alternative imaging (CT, ultrasound, nuclear).",
      "condition": "",
      "sources": []
    },
    {
      "action": "Add a pre-MRI checklist: verify (a) generator model is MR Conditional, (b) all leads are MR Conditional, (c) device is programmed to MRI-safe mode (e.g., VOO/DOO at fixed rate), (d) patient is monitored with pulse ox and ECG during scan. Example alert: 'Non-MRI-conditional device detected. MRI is contraindicated.'",
      "success_rate": 0.9,
      "how": "Add a pre-MRI checklist: verify (a) generator model is MR Conditional, (b) all leads are MR Conditional, (c) device is programmed to MRI-safe mode (e.g., VOO/DOO at fixed rate), (d) patient is monitored with pulse ox and ECG during scan. Example alert: 'Non-MRI-conditional device detected. MRI is contraindicated.'",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Implement mandatory device interrogation workflow: 1) Query EMR for device model and lead model numbers. 2) Cross-reference against FDA MR Conditional database (https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRL/). 3) If not listed as MR Conditional, reject MRI order and suggest alternative imaging (CT, ultrasound, nuclear).",
    "Add a pre-MRI checklist: verify (a) generator model is MR Conditional, (b) all leads are MR Conditional, (c) device is programmed to MRI-safe mode (e.g., VOO/DOO at fixed rate), (d) patient is monitored with pulse ox and ECG during scan. Example alert: 'Non-MRI-conditional device detected. MRI is contraindicated.'"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.ismrm.org/patient-information/mri-safety/",
  "official_doc_section": null,
  "error_code": "MED-MRI-005",
  "verification_tier": "ai_generated",
  "confidence": 0.9,
  "fix_success_rate": 0.85,
  "resolvable": "true",
  "first_seen": "2024-01-05",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}