MRI Risk Accented by Records Delivery Flaw: Study

Washington, DCIt's bad enough that an MRI contrast agent can induce health problems especially for those with weak or compromised kidneys. MRI contrast side effects, for those patients, can lead to incredible suffering and possible death due to Nephrogenic Systemic Fibrosis . However, even discounting the risk often associated with MRI and kidney failure, sometimes a patient can be felled by a simple flaw in the delivery of records.

New research suggests that timely follow-up care is not always forthcoming—even in spite of the availability of advanced, computerized medical-record systems that feature alerts as a way to further guarantee timely response.

Not so, according to the authors of a study appearing late last month in the Archives of Internal Medicine.

"Our findings suggest that an electronic medical record that facilitates transmission and availability of critical imaging results to the health care provider through either automated notification or direct access of primary report does not eliminate the problem of missed test results even when one or more health care providers read the results," write the authors of a study in the Sept. 28 issue of the Archives of Internal Medicine.

According to a news release from the American Medical Association, researchers established alert notifications to let doctors know about abnormal test results at a Department of Veterans Affairs facility. They checked to see whether the doctors followed up with the patients.

Doctors failed to follow up in a timely fashion on nearly 8 percent of the alerts that showed signs of possible problems.

According to the authors, communication breakdowns are blamed in cases when doctors don't follow-up on abnormal test results. In some cases, all the doctors involved in a patient's care don't receive information about a lung mass, for example.

Taking that one step further, the failure on the part of a doctor to identify an issue involving weak, or diseased kidneys prior to administering a gadolinium-based contrasting agent poses a huge risk to the patient for Nephrogenic Systemic Fibrosis (NSF) or Nephrogenic Fibrosing Dermopathy (NFD)—two related conditions characterized by the painful hardening of skin, which impedes movement. NSF and NFD patients have described the rare condition as akin to being entombed in your own body.

The authors of the study are calling for more effective systems to ensure doctors pay better attention to abnormal test results. Taking that recommendation one step further, it's important for doctors to have a thorough working knowledge of a patient's pre-existing deficiencies, such as weak or diseased kidneys, before prescribing a gadolinium-based contrasting agent for MRI. In such cases, kidney dialysis immediately following the MRI is prudent.