Woman Dies During MRI Scan Due to Medical Negligence

In early February 2025, a tragic incident occurred in Eluru, Andhra Pradesh, where a 61-year-old woman named Nallaguchu Rama Tulasamma lost her life during an MRI scan at a private diagnostic center. This heartbreaking event has sparked concerns about medical safety protocols, particularly in cases involving patients with implanted medical devices such as pacemakers.

Background of the Patient

Rama Tulasamma, a resident of Prati Kolla Lanka village in Eluru Rural mandal, had been struggling with kidney-related ailments and was undergoing regular dialysis. Two years before this incident, she had undergone a pacemaker implantation due to heart complications.

A few days before her tragic death, she had been experiencing dizziness, which led her doctors to recommend an MRI scan to assess any underlying neurological issues. Given her medical history, any diagnostic procedure required extra precautions to ensure her safety.

The MRI Procedure and What Went Wrong

On the day of the incident, Tulasamma was accompanied by her husband, Koteswara Rao, to the diagnostic center for the MRI scan. Before the procedure, he reportedly informed the medical staff about her pacemaker and her ongoing dialysis treatments. Despite this crucial information, the MRI scan was carried out without proper assessment of the risks.

As the scan commenced, Tulasamma started showing signs of distress. She appeared to be in pain, had convulsions, and struggled visibly inside the machine. Seeing her discomfort, Rao tried to alert the technician, but his concerns were allegedly dismissed. The technician reportedly instructed him to hold her still, emphasizing that movement could interfere with the scan.

By the time the procedure ended and medical staff finally attended to her, she had already lost consciousness. She was later declared dead, leaving her family in shock and grief.

Allegations of Negligence

Following the tragic incident, Tulasamma’s husband accused the diagnostic center of medical negligence. He claimed that despite informing the staff about her pacemaker, they went ahead with the MRI, failing to follow necessary safety protocols. The family has since filed a formal complaint against the diagnostic center, demanding justice for what they believe was a preventable death.

This case has raised serious questions about whether the diagnostic center had adequately trained personnel and proper procedures in place to assess high-risk patients. The absence of a qualified radiologist or technician with expertise in handling complex cases like Tulasamma’s has come under scrutiny.

Medical Investigation and Findings

Authorities launched an investigation into the circumstances surrounding the incident. Preliminary findings revealed multiple lapses at the diagnostic center, including:

• Lack of Qualified Personnel: There was no radiologist present, and the technicians lacked adequate training to handle high-risk patients.
• Negligence in Patient Assessment: The medical staff did not conduct a thorough evaluation of Tulasamma’s medical history before proceeding with the scan.
• Failure to Follow MRI Safety Guidelines: The risks associated with conducting an MRI on a patient with a pacemaker were overlooked, resulting in a fatal outcome.

The inquiry has also raised concerns about the lack of regulation and oversight in private diagnostic centers, highlighting the urgent need for stricter enforcement of medical safety protocols.

Why MRI Scans Are Dangerous for Pacemaker Patients

Magnetic Resonance Imaging (MRI) is a widely used diagnostic tool that provides detailed images of internal organs and tissues. However, it poses serious risks for patients with implanted medical devices like pacemakers.

1. Interference with Pacemaker Function: The strong magnetic fields of an MRI machine can disrupt pacemaker function, leading to irregular heart rhythms or complete failure of the device.
2. Heating and Tissue Damage: The electromagnetic energy can cause the pacemaker or its leads to overheat, potentially burning surrounding tissues.
3. Metallic Pull Effect: Pacemakers contain metal components, and exposure to the MRI’s magnetic field can lead to unintended movement or mechanical malfunction.

For these reasons, MRI scans for pacemaker patients should only be performed in highly controlled environments where the pacemaker’s compatibility with MRI is verified, and appropriate precautions are taken.

Preventing Future Tragedies

Tulasamma’s case underscores the urgent need for medical facilities to follow stringent protocols to prevent such tragedies. Some crucial measures that must be implemented include:

• Thorough Pre-Scan Evaluations: Patients with pacemakers should undergo detailed medical reviews before being scheduled for MRI scans.
• Advanced Training for Medical Staff: Technicians and radiologists must be well-trained in assessing high-risk patients and handling emergency situations.
• Strict Regulatory Oversight: Government health agencies must enforce stricter regulations to ensure diagnostic centers comply with safety standards.
• Patient Awareness: Patients and their families should be educated about the risks associated with MRI scans and the importance of disclosing their complete medical history.

The tragic death of Nallaguchu Rama Tulasamma highlights a critical failure in medical safety protocols. Had proper precautions been taken, this loss could have been prevented. This case serves as a wake-up call for healthcare authorities to enforce stricter regulations and ensure that medical facilities prioritize patient safety above all else.

The incident has sparked widespread outrage, and the hope is that it will lead to meaningful changes in the healthcare system, preventing similar tragedies in the future.