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Radio tag signals can play havoc with hospital devices
- 21:00 24 June 2008 by Ewen Callaway
The wireless scanners than let cars speed through tolls and subway commuters pass through turnstiles could have disastrous consequences in hospitals, according to a team of Dutch researchers.
Electronic interference from so called radiofrequency identification (RFID) tag readers can switch off ventilators, reset intravenous drips, and reprogram pacemakers, they claim.
As RFID and other wireless technologies stream into medicine, the chances of accidental malfunction rise. The US Food and Drug Administration has documented at least one such incident, involving an implanted brain stimulator that caused a minor physical tremor in response to a wireless signal.
'No ban'
However, the Dutch researchers and other experts believe more testing and better engineering - rather than a ban or moratorium - will make for safer hospital wards.
"Don't put on a frenetic ban on RFID systems," says Erik Jan van Lieshout, a critical care physician at the University of Amsterdam who led the study. "That would be as stupid as instituting systems without testing them."
He and his colleagues previously found that cell phones could interfere with hospital equipment, and wanted to test how RFID technology might also affect medical devices.
RFID tags, which communicate with a receiver via radio waves, have become increasingly common in hospitals. They can track medications, spot surgical sponges left inside patients, and even identify patients themselves.
Serious malfunctions
Yet, despite this influx, doctors know little about how the electromagnetic fields used for communication affect the internal workings of life-saving medical devices, from dialysis units to pacemakers. "To our astonishment, it wasn't tested," van Lieshout says.
His team tested two RFID systems and dozens of medical devices, none of which were connected to patients. The researchers tested devices within meters of an RFID reader broadcasting a radio signal to nearby tag. The strength of the radio signal, though high, was not unrealistic.
If the signal caused a device to break down, the researchers moved the device away until the interference stopped. If the initial test turned up negative, van Lieshout's team inched the device closer.
In 123 tests of 41 different pieces of equipment, the devices malfunctioned 34 times - 22 of the glitches were deemed serious enough to affect patients. For instance, eight of nine syringe pumps, which trickle medicine to patients, failed completely when exposed to an RFID field, anywhere between a centimetre and a meter away from a transmitter.
Older is safer
"If they shut off, that would be extremely dangerous. In critical care people depend on those devices," van Lieshout says.
Few types of devices showed absolutely no interference, but the further away the source, the lower the chances for an incident. Older equipment also tended to be less susceptible, van Lieshout notes.
For a full breakdown of the results, read the full report here.
Despite these concerns, van Lieshout says RFID and other wireless technologies have the potential to reduce medical errors and make hospital an easier place to work. "We hate wires, when the patient is hooked on machine with wires it gives a lot of trouble," he says.
Donald Berwick, a medical researcher and president of the non-profit Institute for Healthcare Improvement, in Cambridge, Massachusetts, agrees. "I think it's really neat case showing the double edge of technology," he says. "Every technology brings with it good news and bad news"
Interference guidelines
But Berwick also agrees that a ban is not the way to go. He suggests that hospitals ought to screen for potential mishaps, while manufacturers should re-engineer devices to withstand radio waves.
Last year the FDA, which regulates device manufacturers, issued a set of draft guidelines that identified RFID technology as a potential safety concern. Its policy would recommend, but not require, that manufacturers design their devices to minimise interference.
A representative for the FDA says it has received no injury reports due to RFID interference with a medical device. However the agency says it is working with manufacturers to develop standards and has tested some devices, such as implantable pacemakers, itself.
Manufacturers and regulators must ensure that medical devices and RFID can coexist, Berwick says. "I'd love to see them take this seriously."
Journal reference: Journal of the American Medical Association (vol 299, p 2884)
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EPCglobal Inc.™ Hardware Certification Program EPCglobal Press Release.MET Laboratories, Inc has partnered with EPCglobal Inc,™ a joint venture of EAN International and the Uniform Code Council, Inc. ® (UCC®), to develop and manage the EPCglobal Hardware Certification Program (HCP) and the Global Performance Test Center Accreditation Program. Global Performance Test Center Accreditation Program is a program through which qualified facilities can be assessed and approved for RFID performance testing. MET performs the facilities assessment. Workgroups have been formed to develop the specific criteria for this program. EPCglobal Inc. Software Certification Program Approved RFID Testing Center (ARTC) Program The ARTC program provides the opportunity for regional test centers to offer a broad range of testing and certification services based on EPCglobal RFID standards. Accredited ARTCs will offer RFID testing based on EPCglobal specifications for UHF, HF and other (such as sensor technology) as they become available. This program is offered in partnership with AT4Wireless and is endorsed by EPCglobal. Learn more. 2)DASH7 Alliance MET has an exclusive, three year agreement with the DASH7 Alliance to test products for DASH7 certification. DASH7 is the first successful attempt to organize active RFID technologies into a strong, global standard. Highlights of DASH7 include:
MET hosted the first ever DASH7 Alliance Interoperability Testing Event at MET's Union City Laboratory during April 6 - 8, 2010. Read the DASH7 press release. | ||||||||||
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