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Caring for the Critically Ill Patient
June 25, 2008

Electromagnetic Interference From Radio Frequency Identification Inducing Potentially Hazardous Incidents in Critical Care Medical Equipment

Author Affiliations

Author Affiliations: Spatial Information Laboratory, Institute of Environmental Studies, VU University, Amsterdam, the Netherlands (Mr van der Togt and Dr Beinat); Department of Intensive Care and Mobile Intensive Care Unit (Drs van Lieshout and Binnekade), Department of Clinical Epidemiology, Biostatistics and Bioinformatics (Dr Binnekade), and Department of Quality Assurance and Innovation (Dr Bakker), Academic Medical Centre, University of Amsterdam, Amsterdam; TNO Netherlands Organization for Applied Scientific Research, Leiden, the Netherlands (Mr Hensbroek); and Faculty of Sciences, University of Salzburg, Salzburg, Austria (Dr Beinat).

JAMA. 2008;299(24):2884-2890. doi:10.1001/jama.299.24.2884

Context Health care applications of autoidentification technologies, such as radio frequency identification (RFID), have been proposed to improve patient safety and also the tracking and tracing of medical equipment. However, electromagnetic interference (EMI) by RFID on medical devices has never been reported.

Objective To assess and classify incidents of EMI by RFID on critical care equipment.

Design and Setting Without a patient being connected, EMI by 2 RFID systems (active 125 kHz and passive 868 MHz) was assessed under controlled conditions during May 2006, in the proximity of 41 medical devices (in 17 categories, 22 different manufacturers) at the Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands. Assessment took place according to an international test protocol. Incidents of EMI were classified according to a critical care adverse events scale as hazardous, significant, or light.

Results In 123 EMI tests (3 per medical device), RFID induced 34 EMI incidents: 22 were classified as hazardous, 2 as significant, and 10 as light. The passive 868-MHz RFID signal induced a higher number of incidents (26 incidents in 41 EMI tests; 63%) compared with the active 125-kHz RFID signal (8 incidents in 41 EMI tests; 20%); difference 44% (95% confidence interval, 27%-53%; P < .001). The passive 868-MHz RFID signal induced EMI in 26 medical devices, including 8 that were also affected by the active 125-kHz RFID signal (26 in 41 devices; 63%). The median distance between the RFID reader and the medical device in all EMI incidents was 30 cm (range, 0.1-600 cm).

Conclusions In a controlled nonclinical setting, RFID induced potentially hazardous incidents in medical devices. Implementation of RFID in the critical care environment should require on-site EMI tests and updates of international standards.