$34m MRI machine too small for some patients

BY JOEL JULIEN
The wrong-sized Magnetic Resonance Imaging (MRI) machine, valued $34 million, has been installed at the Scarborough General Hospital.

As a result of this, dozens of patients who are unable to fit into the MRI machine’s tunnel now have to be flown to private health institutions in Trinidad to get their MRI scans done at taxpayers’ expense.

It costs approximately $4,000 to do a routine MRI scan.

Those MRI scans are said to be done at the Alexandra MRI Ltd, located on Alexandra Street in St Clair, Trinidad.

Alexandra MRI Ltd has the first and only open MRI unit in the Caribbean—the Philips Panorama High Field Open (HFO) machine.

The Panorama HFO offers an alternative to the tunnel-like MRI units.

The only MRI machine at a public health institution in this country that can accommodate “obese” patients is at the Couva Children’s Hospital which remains closed.

An MRI scan is a non-invasive scan that sees inside the human body. It uses magnetic fields and pulses of radio wave frequency to take pictures of tissues, ligaments, arteries, joints and structures.

Cabinet granted approval for the purchase of an MRI machine for the Scarborough hospital costing $34 million, according to the 13th report of the Joint Select Committee (JSC) on Ministries, Statutory Authorities and State Enterprises (Group 2).

A Magnetom Avanto MRI machine from Siemens was commissioned at the hospital last year.

However, when trial runs were being done last August, it was realised that the machine was the wrong size to accommodate “many people in Tobago.”

George Bryce, the project site manager at the hospital, wrote Patrick Caesar at the National Insurance Property Development Company Limited (Nipdec) on the issue on August 19.

“The Magnetom Avanto (MRI machine) installed at the MRI/Cath Lab facility at the Scarborough General Hospital is a 60 c.m. bore while the documents pg 35 employers requirement calls for a 70 c.m. bore machine,” Bryce wrote.

“At one of our many trial runs this morning (9.30 am August 2015), a male test patient (330 lbs weight) was unable to be processed. This was minus body coils. Think about a female patient,” he wrote.

“I wish to point out that there are many people in Tobago with body weights well in excess of 330 lbs. This machine therefore will not be able to handle these obese persons.”

“Please treat this advisory with the utmost dispatch,” he wrote.

Bryce then referred to the document provided by Siemens about the Magnetom Avanto machine.

“The Siemens document claims ‘For claustrophobic patients, Magnetom Avanto enables feet first exams for nearly all MRI procedures. For obese patents, it supports up to 250 k.g. (550 lbs), without table movement restrictions,” Bryce wrote.

The letter was copied to the head of department at Nipdec, Vyas Ramphalie; Nipdec’s project manager, Damien Leach; Yunfei Zhang, the contractor’s representative at China Railway Construction Caribbean Company Ltd (CRCCCL); David Jaikissoon, the managing director of Biomedical Technologies Ltd; Ronald Koylass, the project manger at the Ministry of Health; and Dr Rohit Doon, the adviser of Health Promotion, Communications and Public Health at the Ministry of Health.

Biomedical Technologies responds

On August 20, Jaikissoon replied to Bryce’s letter.

Biomedical Technologies Ltd is listed as a “cooperation partner” in this country on the Siemens’ Web site.

“We acknowledge receipt of a copy of your letter to Mr P Caesar concerning the Magnetom Avanto 1.5T MRI unit installed at the Scarborough Hospital.

“In this regard please see that attached published equipment specifications by Siemens which were submitted with the tender documents indicating that the unit supplied has a 90 c.m. bore which meets the tender requirements,” Jaikissoon said.

The document provided by Jaikissoon stated the Magnetom Avanto’s “magnet parameters” include a “Magnet bore diameter of 90 c.m.”

The document explained that the “magnet bore diameter” was “without shim coils, gradient coil, RF (radiofrequency) body coil” and that the “inner diameter” was actually 60 c.m.

The “inner diameter” is “inclusive of the shim coils, gradient coil and RF body coil,” the document stated.

According to Siemens’ website the “bore size of the Magnetom Avanto is 60 c.m.”

Bryce: No comment

The Sunday Guardian contacted Bryce last week on the situation but he said he had no comment to make.

More info

On May 22 last year the Magnetom Verio was delivered at the Couva Children’s Hospital.

The Magnetom Verio is the only MRI machine in a public health facility in this country with a 70 c.m. bore, the size that the Scarborough General Hospital requested.

The Magnetom Verio is said to be the first Three Tesla Magnetic Resonance Imaging (3T MRI) in the Caribbean and one of only 300 operational in the world.

The Children’s Hospital, however, remains closed.

Health Minister Terrence Deyalsingh said on Friday that the Couva hospital will be officially handed over to the Government on May 30.(Trinidad Guardian)

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