A "near miss" is an unpleasant event that did not result in injury, illness, or damage but had the potential to do so, but for a fortunate break in the chain of events. We present a near-miss case which occurred in the MR suite of a tertiary care hospital. Although the MR is considered a very safe procedure, if MR safety guidelines are not adhered to, adverse and catastrophic events to the extent of patient deaths are known to have occurred.
View Article and Find Full Text PDFInt J Health Sci (Qassim)
July 2008