title: Intrathecal Pump Exposure to Electromagnetic Interference: A Report of Device Interrogation following Multiple ECT Sessions.
abstract: BACKGROUND
  Intrathecal drug delivery systems represent an increasingly common treatment modality for patients with a variety of conditions, including chronic pain and spasticity. Pumps rely on electronic programming to properly control and administer highly concentrated medications. Electromagnetic interference (EMI) is a known exposure that may cause a potential patient safety issue stemming from direct patient injury, pump damage, or changes to pump operation or flow rate.
  
  
  OBJECTIVE
  The objective of our case report was to describe an approach to evaluating a patient with a pump prior to and following exposure to EMI from electroconvulsive therapy (ECT), as well as to document findings from device interrogations associated with this event.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Academic university-based pain management center.
  
  
  RESULTS
  We present the case of a patient with an intrathecal pump who underwent multiple exposures to EMI in the form of 42 ECT sessions. Interrogation of the intrathecal drug delivery system revealed no safety issues following ECT sessions. At no time were error messages, unintentional changes in event logs, unintentional changes in pump settings, or evidence of pump stall or over-infusion noted.
  
  
  CONCLUSIONS
  Communication with multiple entities (patient, family, consulting physicians, and device manufacturer) and maintaining vigilance through device interrogation both before and after EMI exposure are appropriate safeguards to mitigate the risk and detect potential adverse events of EMI with intrathecal drug delivery systems. Given the infrequent reports of device exposure to ECT, best practices may be derived from experience with EMI exposure from magnetic resonance imaging (MRI). Although routine EMI exposure to intrathecal drug delivery systems should be avoided, we describe one patient with repeated exposure to ECT without apparent complication.
authors.affiliation: Department of Anesthesiology, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Bicket
authors.affiliation: Department of Anesthesiology, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA.
authors.forename: George M
authors.initials: GM
authors.lastname: Hanna
mesh_terms: D000328:Adult; D016503:Drug Delivery Systems; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D055590:Electromagnetic Phenomena; D060733:Electromagnetic Radiation; D006801:Humans; D015918:Infusion Pumps, Implantable; D008297:Male; D059408:Pain Management