Originally Published MPMN
ENGINEERING SOLUTIONS: MDEA
CT Marker Device Ensures That Scans Are Done Right
Identifying the right-hand side of a CT image using the Accu-Right removes the risk of operator error for image orientation.
Imagine that you must undergo brain surgery to remove a dangerous tumor or treat a cerebral hemorrhage, but the surgeon confuses right from left and performs the operation on the wrong side of your brain. Precisely this eventuality inspired Kevin Mackey, doctor, radiologist, and president of Accu-Right Correct Side Solutions LLC
(Los Angeles; www.correctside.com
), to invent a device that minimizes the potential for such catastrophic errors.
“The Accu-Right CT marker device was created to correctly designate the right side of a patient in CT images,” Mackey remarks. “Currently, labeling the right and left side of an image depends on the technologist pushing the correct patient-position button on the CT console when performing a procedure. The CT scanner does not know if the patient is facing head first or feet first on the table, which determines which side of the gantry is assigned right or left. If the wrong button is pushed, the images are forever mislabeled.” While scans are not often mislabeled, errors occur frequently enough—with potentially disastrous consequences for the patient and the certainty of malpractice lawsuits—to warrant concern. The Accu-Right device, according to Mackey, is a sure-fire way to correctly label CT scans of the head, brain, face, orbits, sinuses, temporal bone, neck, and cervical spine.
Worn like a pair of eyeglasses that conform to the face in one direction only to ensure correct positioning, the device is equipped on the right-hand side with a 3-D ‘R’ rod, which is imaged in cross section by the CT scanner to indicate the right side of the body. If the image is flopped or reversed, the ‘R’ label always remains in the same position relative to the body.
Accu-Right developed the device with the assistance of HLB
), which designed the three-piece device; ProAction Products
(Van Nuys, CA; www.proactionproducts.com
), which designed the injection molds and produced the eyeglass frame and piece connecting the frame to the marker bar; and VIP Rubber and Plastic Products Inc.
(La Habra, CA; www.viprubber.com
), which produced the 3-D ‘R’ marker rod.
Andrew Macey, HLB’s COO and executive vice president, recalls that joint brainstorming sessions took place with Accu-Right’s Mackey, the result of which was a device that resembles a pair of glasses. “The product had to be foolproof,” notes Macey, “meaning that the designers thought through every possible way to put the device on the wrong way.” The result was the incorporation of a bump on the bridge of the nosepiece, ensuring that the device could only be worn right-side up. “The product had to be inexpensive, easily disposable, and designed for one-time use by a single patient.”
After HLB had created CAD drawings, ProAction Products’ engineering department jumped into the mix to assist in modifying the CAD design. Through multiple iterations, the company produced a set of preproduction models that enhanced the device’s functionality. ProAction also assisted in making minor changes to the initial “final model,” optimizing the injection-molded product.
“The only component we needed to produce for the device was a plastic extrusion die [for the ‘R’ marker rod],” states Dean Gillespie, president of VIP Rubber and Plastic Products. However, the hollow-shaped part in the original specification could not be manufactured to meet the application’s control and tolerance demands. “So we converted it to a solid shape, and it worked great because we were able to maintain critical tolerances.” VIP also chose a material for the part with a high specific gravity. A heavier material, according to Gillespie, worked better than a lighter material. Mackey adds, “the device’s marker had to be dense enough to show up in a CT image but not too dense to cause artifacts.”
The Accu-Right CT marker device removes the element of human error from the process of labeling CT images, concludes Mackey. After examining the device, he says, the CEO of a teaching medical center remarked, “The only potential error is if the CT tech were to omit using the device.”
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