Remediation of the MRI Room

Orange Imaging Center at 230 S. Main St. Orange CA.

 

The remediation of a Magnetic Resonance Imaging (MRI) room within a medical clinic was one of the most unique projects that Skalsky & Associates completed.  In this particular case (Radnet Management Inc. v. David W. Clayton, et al.  LA Sup.Crt BC-334531), a plumbing leak had resulted in the episodic flooding the floor in the MRI examination room. 

 

The MRI room was completely (ceiling, wall, and floors) shielded with copper sheathing.  Once the water from the plumbing leak penetrated the copper sheathing and entered the plywood subflooring, it could no longer escape by evaporation and provided ample moisture for mold growth.  The flooring of the MRI room consisted of floor tile (12x12) and mastic on top of the copper sheathing and a plywood subfloor covering the concrete slab.  No asbestos was dectcted in samples of the floor tile or the mastic. 

 

The most prevalent fungi detected (in decreasing order) were  Aspergillus versicolor, Eurotium herbariorum, Acremonium fusidiodes, Acremonium strictum, and  Scopulariopsis brumptii.  These fungi can produce mycotoxins and be causative agents in Organic Dust Toxic Syndrome or Hypersensitivity Pneumonitis. 

 

The flooring of the MRI Room was not only colonized by fungi but also by Gram Negative Bacilli and mites. The outer membrane of gram negative bacteria contains a family of toxic lipopolysaccharide molecules that are collectively referred to as endotoxin.  Endotoxin is encountered in the environment as part of the whole bacterial cell or as membrane fragments of those cells.  Endotoxin and the allergens produced by mites are potent, biologically active agents that are particularly problematic for asthmatics

 

Medical Office - Temporary Entrance - MRI Room

 

 

 

 

 

 

Medical Offices stay open during Remediation of the MRI Room

 

In order to avoid disturbing other medical businesses located in the 230 South Main office building and to maintain the flow of patients into the Radnet Medical Imaging center, a separate entrance for the remediation of the MRI room was constructed on the exterior of the building.

In addition, temporary containment walls were constructed on the interior of the imaging center to allow patient reception, patient waiting, bookkeeping, and radiology to continue to function throughout the remediation of the MRI room.

Patients were received and processed normally with the exception that imaging occurred via a portable MRI machine located in the parking lot. Radiologists were able to maintain their offices and interpret MRI images throughout the remediation.

 

No white suited workers were visible to the public – either from the street or from the building's offices.

 

Liquid Helium Creates Some Complications

 

At the time of remediation, liquid helium was still present in the MRI machine and the compressor sustaining the liquid helium was still running. The presence of 1700 liters of liquid helium in an enclosed space system and the potential for accidental release was a significant cause of concern. The hoses and connections running from the MRI to the compressor in the mechanical room were secured so that they could not be inadvertently punctured.

 

During remediation an oxygen meter with alarm set at 19.5% was present and running at all times. Emergency Exits were planned so that the containment could easily be breached if a release of helium occurred. A Self-Contained Breathing Apparatus was maintained outside of containment for potential rescue use.

 

During remediation, numbered grids were established so that materials could be removed, investigated and then bagged/stored sequentially. Labels were attached to each bag so that the materials removed could be maintained as evidence until the litigation was settled. The containment was cleared as specified by viable (DG18,MEA) and non-vialble (AOC) air testing, by non-viable surface testing (tape) for fungi and by dust sampling for Endotoxin and mite allergens.