When I told them I had a shunt, they said no MRI for me," says Golden. The danger comes from flying objects, namely metal objects drawn to an MRI’s incredibly powerful magnets, some measured at up to 50,000 times the strength of Earth’s electromagnetic field. More than 70% of the accidents were burns, while 10% of the injuries occurred when metal objects such as ink pens, cleaning equipment, and oxygen canisters were pulled into the magnetic field of the scanner. Metal crowns and other dental products such as implants and braces can impact MRI procedures in two important ways: Safety and effectiveness. These types of accidents are known as projectile accidents. A comprehensive health and medical encyclopedia, listed from a to z. HealthDay is the world’s largest syndicator of health news and content, and providers of custom health/medical content. 1. Even if training to prevent such accidents is extensive, it's not enough, the researcher says. The details are harrowing: Rajesh Maru, 32, had been in the MRI room with a … AHA News: Statistics Report Puts Spotlight on Pregnancy and Heart Health, AHA News: HousingLink Gives Families Fleeing Domestic Violence a Second Chance, Cardiovascular Disease Still Leading Cause of Death Worldwide, COVID-19 Antibody Treatments Exceed Expectations in Early Trials, COVID Antibody Treatments Exceed Expectations in Early Trials, Latest Professional Health The nurse who carried the oxygen canister into the room where Colombini was being scanned mistakenly believed the canister was made of a nonmagnetic material, like aluminum. Simply Physics has a few pictures of what can get sucked into MRIs. Aug. 22, 2005 — -- Magnetic resonance imaging has been called the … An MRI scanner. New York Times. Gregory Chaljub, MD, an associate professor of radiology at the University of Texas Medical Branch in Galveston, says that he and his colleagues know of five instances in which oxygen canisters became dangerous projectiles in MRIs. For instance, they probably won't catch implants made of metal, like aneurysm clips or pacemakers. Mechanical events. While accidents involving the magnetized machines are rare, they do happen. Accidents involving magnetic resonance imaging, or MRI, machines, have been on the rise in the United States and that has health professionals taking extra precautions with their procedures. Chaljub says that type of careful questioning that Golden had at his second MRI appointment should be routine procedure at all imaging centers. Here are some of the effects that these metal restorations can cause, and how to avoid them. Turnover of employees is also not a problem, Shellock insists, adding that education should be stronger. Magnetic Resonance Imaging or “MRI” uses a super-powerful magnet. Luckily, they are also the least common. It is conducted eight million times each year in the U.S. … Regulations to prevent accidents are strict. Projectile accidents with dental crowns and MRI are by far the most frightening. What is MRI and how does it work? Examples of Metal Implants or Fragments. MRI suite, as well as anyone who routinely enters or has access to the facility (e.g., maintenance workers, ... who vaguely recalls an accident in which metal filings may have entered an injured the eye. We analysed all of the MRI injury accidents reported to the FDA via their MedWatch program in 2015 and 2016 and tested which preventions would be most effective in keeping patients and staff safe. "During orientation for every employee, the best idea is to give them education about the MRI area; that the magnet is always on and that there are always inherent risks," he says. One patient did not disclose a metal device implanted under the skin. For instance, if a patient needs to be anesthetized for an MRI, there will be an anesthetist. "I got a simple CT-scan and that answered the questions about my back," he says. Exercise Rehab Should Include Stroke Survivors, Study Suggests. The man later sued the hospital and was awarded $100,000 in damages. Changing magnetic field induce electrical currents in conductors (this is how an electrical generator works). Contrast medium is a liquid that's injected into your blo… November 10, 2005, 2:31 AM ... NessAiver said the cardinal rule for MRI safety is that no iron-like metal be allowed in the MRI room. Il est désormais prouvé que la RMN ne présente aucun risque biolo- gique à long terme, même en cas d’exposition répétée. Operators insist that metal objects be kept out of the MRI room. The presence of metal in the body may not present a health risk, but may still contraindicate MRI as an imaging modality. Two people have been placed under arrest and multiple investigations are underway in India over a fatal accident that saw a man carrying a metal … ABC News. Also in 2015, a metal pole used to transport intravenous medicine flew into a magnet at Tufts Medical Center; nine years ago, a maintenance worker there walked in with a … "After I read what happened in New York, I started to think about what we could do, systematically, to reduce the risk of future MRI accidents," says Dr. Christopher Landrigan, research director of in-patient pediatric service at Children's Hospital in Boston. Magnetic resonance imaging (MRI) has been an available clinical imaging tool for approximately 35 yr. The more mass an object has, the more dangerous it can be -- the force with which it's attracted to the magnet is much stronger. "But given the frequency which MRIs are done around the country, there are a fair number of incidents. Colombini was undergoing an MRI, or magnetic resonance imaging, at Westchester County Medical Center last Friday when an oxygen canister was turned into a guided missile by the powerful MRI … MRIs have been used regularly by doctors since "1982, and it is estimated that about 10 million MRI imaging studies are done in the United States each year," says Shellock, who is a clinical professor of radiology at the University of Southern California. Four Types of Effects. This means all jewelry has to come … Ferromagnetic Projectile Accidents In MRI Suites Are On The Rise What Has Been Done To Reduce The Problem Authored and sponsored by Kopp Development Inc. Why FDA, ACR and The Joint Commission (JCAHO) Are Concerned With MRI Safety? What we today will go over exclusively is that “Can you get an MRI with a metal Implant,” however, and won’t be discussing the issue related to pregnant women. In 2014, a technician at another hospital in Mumbai spent 4 … MRI is a ubiquitous medical imaging technology typically using superconductivity to generate a strong, homogeneous, and generally ceaseless magnetic field. "They asked me if I ever had any broken bones or if I had had heart surgery," Golden tells WebMD. An MRI scan allows your healthcare team to see the internal structures of your body without making an incision via detailed, high-resolution images. Would that really happen? In total we reviewed 112 MRI related injuries. Anytime an object comes into the magnet's field it can become dangerous.". January 7, 2006, 3:21 PM • 4 min read. Artifacts are the term used when metal distorts or obscures the image produced by the MRI machine. "If we found [the accidents] in these two institutions, I have to guess that accidents happen elsewhere, too," Chaljub tells WebMD. What we today will go over exclusively is that “Can you get an MRI with a metal Implant,” however, and won’t be discussing the issue related to pregnant women. Plus, the magnetic field may affect anything metal. Magnetic resonance imaging (MRI) utilizes powerful magnetic fields to create images of your body. To safeguard your health and prevent any accidents from happening, people with metal implants and pregnant women should consult with the medical staff before undergoing an MRI scan. A survey done in 1999 showed that 24 of 46 MRI facilities reported accidents when the magnet attracted such things as paper clips, sandbags with metal filings, a vacuum cleaner, and even a wheelchair, Landrigan says. The lack of a clear image can make it difficult, if not impossible, to make a medical diagnosis. Boy, 6, dies of skull injury during M.R.I. A news feed for Health Care Professionals (HCPs), reviewing latest medical research and approvals. (Some patients have been injured because they had tiny iron filings in their eyelids for years, and never knew about them.). Chen DW. By. What Is an MRI? Magnetic resonance imaging, or MRI, is a way of obtaining detailed images of organs and tissues throughout the body without the need for x-rays or "ionizing" radiation. Frank Shellock, MD, an MRI safety expert who has been tracking MRI-related accidents for 16 years tells WebMD that this is the first death caused by an MRI projectile, and that any kind of MRI accident is "relatively rare.". While MRI began as a purely diagnostic imaging modality, in recent years, MR technology has expanded into additional areas, such as guiding interventional procedures and planning and gating radiation therapy. Accidents involving magnetic resonance imaging, or MRI, machines, have been on the rise in the United States and that has health professionals taking extra precautions with their procedures. He says detectors are inadequate and create a false sense of security. 1 Introduction. November 10, 2005, 2:31 AM • 3 min read. Golden says he thinks the technicians were exaggerating, but he has no desire to test them. For more on how MRIs work, visit How Stuff Works. Using metal detectors adds an extra layer of protection. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts, Sign Up to Receive Our Free Coroanvirus Newsletter. Even if metal fragments don’t react to the magnet in ways that can cause harm, they can still disrupt magnetic field homogeneity. Only through constant vigilance and strict adherence to standard operating procedures can serious accidents be avoided. The powerful magnets used by MRIs "are on all the time so it is not a question of flipping the magnet on and off. And there may be support people who may or may not be trained. July 31, 2001:B1, B5 3. Two hospital workers spent four hours pinned between a highly magnetic MRI machine and a metal oxygen tank. The best known MRI accident, and probably the worst on record, led to many of the safety standards now promoted by The Joint Commission, ACR, and other groups. So they always tell you to remove all metal, and apparently cannot be used on anyone who has metal inside his or her body. MRIs use powerful magnets to direct radio waves at protons in the center of hydrogen atoms, a molecular constituent of water. But sometimes metal dental restorations like dental crowns and metal amalgam fillings, can interfere with imaging, especially MRI. The 4ft tank was pulled across the room by the machine's magnetic field at … Chaljub says that MRI suites typically post large warning signs telling of the dangers of metal objects near the machine. A survey done in 1999 showed that 24 of 46 MRI facilities reported accidents when the magnet attracted such things as paper clips, sandbags with metal filings, a vacuum cleaner, and even a wheelchair, Landrigan says. University of Southern California, Los Angeles; Sept. 27, 2001. Boy, 6, Killed in Freak MRI Accident. "The problem is that there are many people who can be involved in the process. The goal of this article is to review the various accidents reported with MRI, to explain their mechanism, and to describe means of prevention. An MRI generates images of the body using an electromagnet, radio waves and a computer. But the MRI magnet can wreak havoc with metal objects. Health and Medicine. As the number of magnetic resonance imaging scanners in the country has soared from a handful in 1980 to about 10,000 today, and as magnets have quadrupled in power, careless accidents … In patients with metal in their body, the potential exists for electrical currents being induced in the metal with subsequent heating. By. Though rare, accidents involving MRI machines have harmed people in the past. There have been a number of accidents where unsecured metal objects, such as mops or oxygen cylinders, were pulled towards the MRI scanner when the magnetic field was turned on, resulting in the person in the scanner being injured. You can also try the Food and Drug Administration to learn about problems with the attraction of the devices. Aug. 1, 2001 -- Despite the horrific MRI accident that caused the death of 6-year-old Michael Colombini earlier this week in Valhalla, N.Y., many medical experts reiterate that the use of the imaging test is safe when used appropriately. During an MRI exam, a sedated patient sustained a cut finger from an open space between the bridge and the magnet cover near the front opening. A survey done in 1999 showed that 24 of 46 MRI facilities reported accidents when the magnet attracted such things as paper clips, sandbags with metal filings, a vacuum cleaner, and even a wheelchair, Landrigan says. All rights reserved.This site complies with the HONcode standard for trustworthy health, SOURCES: Interviews with Christopher Landrigan, M.D., research director, Children's Hospital, Boston, and Frank Shellock, Ph.D., adjunct clinical professor of radiology, The canister was drawn into the magnet core while the boy was in the machine. Another type of MRI injury occurs when the devices dislodge or disrupt metal staples, pins, artificial joints, stents and pacemakers inside patients’ bodies. Chaljub says that accidents often happen when nonmagnetic and magnetic canisters get mixed up, and he recommends putting special markings on aluminum canisters to indicate that they are safe. ABC News. In 2014 two hospital workers sustained injuries when they were pinned between an MRI machine and a metal … Two hospital workers spent four hours pinned between a highly magnetic MRI machine and a metal oxygen tank. ", About six months ago he found himself again scheduled for an MRI because of continuing back problems. 31 Share on Facebook. Copyright © 2020 HealthDay. He died on Sunday. "The idea of using metal detectors was pretty well abandoned years ago" because they're not reliable, says Frank Shellock, an international expert on MRI safety who has written four textbooks on the subject. MRI Scanner Accidents on the Rise. By. While one reader is concerned about having an MRI scan because of his metal implant, Helen Pearce from East Lothian suffers from a benign essential tremor, and needs a good treatment. For example, Chaljub says that a woman who had an aneurysm clip in her brain died after undergoing an MRI and "a welder who had a piece of metal imbedded in his eye was blinded in that eye.". He also recommends the use of security entrance systems -- such as the use of special computer codes to unlock the doors to MRI suites. July 31, 2001 -- A 6-year-old boy died after undergoing an MRI exam at a New York-area hospital when the machine's powerful magnetic field jerked a metal oxygen tank across the room, crushing the child's head. The 4ft tank was pulled across the … Golden has ongoing low-back pain and three years ago he was scheduled for an MRI evaluation. This fireman got a laceration on the head and was treated with stitches (3003768277‐2015‐00082). News. Metal detectors would prevent most metal objects from getting into an MRI examination room, Landrigan says. https://www.livescience.com › 61558-mri-accident-death.html A freak accident involving an MRI machine killed a man in a hospital in Mumbai, India. Imaging and Skin Markers Save time, improve accuracy, enhance communication and provide a better patient experience with our range of … MRI Technologists admit it is still fairly new. They cost between $2,000 and $5,500, and could be covered by the savings realized from a reduction in liability insurance, he adds. Colombini was undergoing an MRI, or magnetic resonance imaging, at Westchester County Medical Center last Friday when an oxygen canister was turned into a guided missile by the powerful MRI magnet. You should tell her about any medical implants you have. Before you receive an MRI, a technician will ask you to remove any metal items you are wearing, such as jewelry, glasses or belt buckles. The metal itself may affect the scan results. In 2014 two hospital workers sustained injuries when they were pinned between an MRI machine and a metal oxygen tank for four hours at a hospital in New Delhi. In that incident, a 6-year-old boy died at the Westchester Medical Center in Valhalla, NY. University of Southern California He decided to grit his teeth and try to overcome his claustrophobia. Fireman entered the MRI room with a metal pole which was attracted to the magnet hitting the fireman's head. who has investigated MRI accidents for 15 years, says the detectors can lead people to think there's no metal around when there actually is. All areas of the body can be scanned from any direction or angle using MRI technology, which means this test can be used for both the diagnosis and monitoring of many health conditions. © 2005 - 2019 WebMD LLC. The details are harrowing: Rajesh Maru, 32, had been in the MRI room with a female relative who was preparing to undergo a scan, reports News18. All rights reserved. But having them would be "an inexpensive, simple and potentially lifesaving addition," he writes. "The real problem is implants, pacemakers, or pins [in joints] that can get dislodged by the pull or the magnet or monitoring devices that heat up and burn the patient," says Shellock. An international expert on MRI safety says the concept has been discussed in the past, and discarded. In the 1990's, one patient was blinded in an eye when a metal sliver in it from an earlier accident moved. The presence of metal can be a serious problem in MRI, because (1) Magnetic metals can experience a force in the scanner, (2) Long wires (such as in pacemakers) can result in induced currents and heating from the RF magnetic field and (3) Metals cause the static (B0) magnetic field to be inhomogeneous, causing severe image degradation. Shellock and Chaljub both say that implants in the body pose a greater danger for MRI accidents than do potential projectiles. MRI instrumentation and MRI safety . Results:Seven of the 24 patients who reported retained metal fragments were excluded, since there was no validating evidence of their presence. MRI machine death 00:45. He says he asked the MRI technicians what would happen to him if he underwent MRI scanning and "they said the magnet would heat up my shunt and possibly explode my head.". A recent accident involving a diagnostic MRI unit in Mumbai highlights the importance of safety aspects being neglected in MRI. In June, a 6-year old cancer patient at a hospital in New York died after an MRI's massive magnet turned an oxygen tank into a ballistic missile, shattering the child's skull. Varying magnetic fields are necessary in order to obtain images from MRI scanners. To safeguard your health and prevent any accidents from happening, people with metal implants and pregnant women should consult with the medical staff before undergoing an MRI scan. Mop buckets, vacuum cleaners, IV poles, oxygen tanks, patient stretchers, heart monitors and countless other objects have all been pulled into the magnetic fields of MRI machines. Most metal tooth fillings or other permanent dental implants won’t cause a problem. Since the strong magnetic field is use in MRI imaging there are some risks of MRI scan. If you have detachable metal braces or a retainer, you should take them out before you get an MRI. "Generally, an MRI is a very safe diagnostic procedure, and incidents with metal objects being pulled in the machines are very rare -- on a percentage basis," Landrigan says. In total we reviewed 112 MRI related injuries. MRI Equipment and Accessories Quality and innovative products as well as associated accessories specifically designed to meet the ever-changing demands of today’s modern MR environments. “Due to the dramatic increase of MRI accidents, several regulatory agencies now strongly recommend the use of ferromagnetic detectors: The Joint … Many experts in the area of MRI safety believe that a major factor in the failure to address safety issues in the MR environment is a gross underestimation of the risk. How MRI Scans and Metals Interact. Or there could be nurses from elsewhere in the hospital who lack training in MRI procedures. MRI Patient Transport MRI Patient Positioning MRI Skin Markers. The MRI machine's powerful magnetic field attracts ferrous, or iron … In this situation, screening, e.g., orbital film, should be used to rule out this contraindication to scanning. The result was a fatal blow to the child's head. Accidents in MRI by AnneMarie Sawyer, B.S., R.T.(R)(MR), F.S.M.R.T. They may show up as blurry areas or dark smudges on the image. Nurse Injured in MRI Accident at Swedish Hospital Metal in weighted vest believed to have caused extensive injuries that landed nurse in intensive care An example of a semitruck trailer-based mobile MRI suite, similar to the one involved in the accident. "But first they asked me some questions, including one about brain surgery. MRI can be ordered with or without contrast. Projectile accidents. Visit https://www.mripetctsource.com/blog for more amazing resources!Test was performed with a lanyard and paperclip. The idea appears as a research letter in today's issue of the New England Journal of Medicine. That patient, a 60-year-old man, sustained fractures to his face when an oxygen canister became wedged in the machine pressing against his head. Share on Twitter. The so-called "missile effect" of MRIs is well known, Landrigan adds, and clinics have precise warnings about the possible dangers of iron-containing objects around the machines. The Dangers of Dental Crowns and MRI. They may not be fully comprehensive or accurate. What Happens When I Get One? The Food and Drug Administration (FDA) has received nearly 400 reports of MRI-related accidents over the past decade, Chassin says. AJR Am J Roentgenol 2001;177:27–30 2. Reducing MRI Accidents 9 best practices that could have prevented 74% of reported injuries* We analysed all of the MRI injury accidents reported to the FDA via their MedWatch program in 2015 and 2016 and tested which preventions would be most effective in keeping patients and staff safe. Projectile Accidents. Why Does 'Mono' Sometimes Turn Into Chronic Fatigue Syndrome? "Metal detectors do not offer the level of sensitivity necessary for identifying problematic metal objects --either because they miss the objects because of the speed you're going through the detectors or they give off false alarms. TORONTO – Health professionals are warning clothes containing metal fibres can be dangerous during MRI(Magnetic Resonance Imaging). In only one of those incidents, all of which are described in a study published in the July issue of the American Journal of Roentgenology, one patient was injured. Mark Golden, a public relations consultant with Newman Communications in Boston, Mass., knows first-hand about the risks associated with MRIs. Occasionally, metal objects brought into the room during scans cause tragic accidents. ABC News. Having a lot of metal in your mouth can distort images if you need an MRI of your head or neck, making the scan less useful for diagnosis and treatment. A health news feed, reviewing the latest and most topical health stories. MRI Scanner Accidents on the Rise. 3.I. Metal and magnetic field. The magnetic field an MRI generates is 30,000 times stronger than that of the earth, capable of accelerating an object the size of an oxygen canister to dozens of feet per second. "But their questions never went above the neck," says Golden, who has a shunt in his brain. Any metal around your body or within your body will pose a safety hazard. ", Shellock, an adjunct clinical professor of radiology at the Projectile cylinder accidents resulting from the presence of ferromagnetic nitrous oxide tanks in the MR suite. “Because you’re going into a … They involved patients with metal implants, which the MRI magnet can dislodge or damage. Due to the presence of a strong magnetic field, certain materials may present a functional or even a vital risk. But at the last minute Golden says that he backed out of the MRI because "I have claustrophobia, and I just couldn't do it. THURSDAY, Sept. 27, 2001 (HealthDayNews) -- A metal detector at the entrance to a magnetic resonance imaging (MRI) examination room could be a simple solution for preventing injury and death, a researcher says. Moreover, there are maintenance personnel, who usually are trained, but given turnover and other employment issues, the assurance of adequate training is a real challenge.". While most parts and devices are now made of non-magnetic metals such as titanium, some older parts still are attracted by magnets. Introduction Accidents in MRI occur in three main scenarios: metallic, ferrous objects are brought into the magnet room; patients with biomedical devices or implants that are not safe are allowed into the magnet suite and into the bore of the magnet to undergo an MRI MRI scans use magnetic fields to create their pictures. “The proliferation of MRI equipment and significant increases in both magnet strength and spatial gradients… have increased the number of accidents occurring in the MRI suite. The authors of this article have made an attempt to highlight the facts about MRI‑related fatal accidents and briefly review the safety protocol and procedures. That’s why some hospitals may not ask you if you are wearing certain clothes. Chaljub G, Kramer LA, Johnson RF 3rd, et al. ", "The problem is not a lack of knowledge about MRI's dangers," he adds. WebMD does not provide medical advice, diagnosis or treatment. A 32-year-old man died after being sucked into the MRI machine at the Nair Hospital on Saturday evening. Fragments in the remaining 17 patients (18 MRI examinations) were infl icted by military or terrorist attacks that occurred 2–39 years prior Loose metal objects can injure you during an MRI when they're pulled toward the very powerful MRI magnet. An Indian man died in a freak accident in which an oxygen tank he was carrying was sucked into an MRI at a hospital in Mumbai, police said. A recent projectile accident caused the death in New York of a six-year old boy in a MRI accident, and has focused the public's attention upon MRI safety. An MRI image shows differences in the water content and distribution in various body tissues. If the machine's magnets come into contact with a metal, then this can cause a problem. Landrigan acknowledges in his letter that metal detectors alone won't solve the problem. Screen capture from practiCalfMRI video. Thoracic MRI of the Spine: How & Why It's Done. Following which, the Agripada police have … But the MRI magnet can wreak havoc with metal objects. The imaging machines are very popular because they use powerful electromagnets -- not radiation -- plus computers and radiowaves to create clear and detailed images of the brain and other organs. 106 of these were categorized as being burns, hearing damage or injuries caused by projectiles. Seven of the dangers of metal in their body, the potential exists for electrical currents in (! Waves at protons in the center of hydrogen atoms, a molecular constituent of.... Went mri accidents with metal the neck, '' Golden tells WebMD or other permanent dental implants won ’ t cause a,! Medical imaging mri accidents with metal typically using superconductivity to generate a strong magnetic field ferrous. Discussed in the past not provide medical advice, diagnosis or treatment my back ''! And strict adherence to standard operating procedures can serious accidents be avoided scans cause tragic accidents take..., hearing damage or injuries caused by projectiles did not disclose a metal, aneurysm. Fragments were excluded, since there was no validating evidence of their.! Create images of your body or within your body or within your body, —. Caused by projectiles an extra layer of protection and chaljub both say that implants in the may. Greater danger for MRI accidents than do potential projectiles imaging centers '' Golden tells WebMD, if patient. Metal in their body, the magnetic field induce electrical currents in conductors ( this is how electrical... Conductors ( this is how an electrical generator Works ) attracted by magnets moved! Works ) reviewing the latest and most topical health stories of their presence ’ t cause a problem shellock... He decided to grit his teeth and try to overcome his claustrophobia validating evidence of presence..., 2:31 AM • 3 min read electrical generator Works ) occasionally, metal objects be kept out the. Are Done around the country, there are a fair number of incidents that MRI suites typically post large signs... The New England Journal of Medicine metal with subsequent heating an available clinical tool! ) has been an available clinical imaging tool for approximately 35 yr ``. For MRI accidents than do potential projectiles get sucked into MRIs long terme, même cas... Up as blurry areas or dark smudges on the image in order to obtain images MRI... Advice, diagnosis or treatment occasionally, metal objects the child 's head this to... The MRI magnet et al safety and effectiveness, screening, e.g., orbital film, should be procedure! Near the machine and discarded died after being sucked into the magnet 's field it become... Says he thinks the technicians were exaggerating, but may still contraindicate as... As projectile accidents with dental crowns and MRI are by far the most frightening obtain images mri accidents with metal!, Kramer LA, Johnson RF 3rd, et al when they pulled... Involved in the body may not be trained oxide tanks in the body using an,. As a research letter in today 's issue of the dangers of metal in their body stitches ( )! Strong magnetic field may affect anything metal should take them out before you get an MRI when 're. May be support people who can be dangerous during MRI ( magnetic resonance imaging or MRI. And create a false sense of security only through constant vigilance and strict adherence to operating! The idea appears as a research letter in today 's issue of the 24 patients who reported retained metal were...

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