# AI incorrectly approves MRI for a patient with a non-MRI-conditional pacemaker, ignoring lead and device compatibility

- **ID:** `medical/pacemaker-mri-safety-check-failure`
- **Domain:** medical
- **Category:** config_error
- **Error Code:** `PM-MRI-INCOMPAT-ERR`
- **Verification:** ai_generated
- **Fix Rate:** 82%

## Root Cause

Only MRI-conditional pacemakers (e.g., Medtronic SureScan, Abbott Tendril) are safe for MRI; older or non-conditional devices can cause lead heating, dislodgement, or device reset. AI fails to check device model and lead compatibility against the MR conditional database.

## Version Compatibility

| Version | Status | Introduced | Deprecated |
|---------|--------|------------|------------|
| Medtronic Advisa DR v2.0 | active | — | — |
| Abbott Accent MRI v1.5 | active | — | — |
| Boston Scientific Ingevity v3.0 | active | — | — |

## Workarounds

1. **Query the manufacturer's MRI conditional database (e.g., Medtronic MRI SureScan website) using device serial number and lead model; if incompatible, reschedule MRI with alternative imaging (CT or ultrasound)** (82% success)
   ```
   Query the manufacturer's MRI conditional database (e.g., Medtronic MRI SureScan website) using device serial number and lead model; if incompatible, reschedule MRI with alternative imaging (CT or ultrasound)
   ```
2. **Implement a pre-MRI checklist in EHR that automatically checks device model against a curated list of conditional devices and leads; flag any mismatch** (85% success)
   ```
   Implement a pre-MRI checklist in EHR that automatically checks device model against a curated list of conditional devices and leads; flag any mismatch
   ```
3. **If device is non-conditional but MRI is medically necessary, consult cardiology to reprogram device to MRI-safe mode (e.g., pacing threshold increase, rate response off) and have a technician monitor during scan** (78% success)
   ```
   If device is non-conditional but MRI is medically necessary, consult cardiology to reprogram device to MRI-safe mode (e.g., pacing threshold increase, rate response off) and have a technician monitor during scan
   ```

## Dead Ends

- **** — Many devices implanted after 2010 are still non-conditional; only specific models with MRI-safe labeling are compatible; leads also need to be conditional (70% fail)
- **** — Even if generator is conditional, older leads (e.g., Medtronic CapSureFix) may not be MRI-safe; lead heating can occur at the tip (65% fail)
- **** — Generic registries may be outdated or incomplete; manufacturer database is authoritative and includes firmware versions (55% fail)