Wrong lead put in my Mother's pacemaker

My Mom had a pacemaker put in the Fall of 2016. She has had 4 MRI's since then. She needed another a few months ago and it was denied. She has been in severe back pain and needed the MRI. After months of the different offices saying it is fine they did MRI's in the past she finally got to the bottom of it. The doctor that put in the pacemaker, his office said there was a hiccup and the wrong lead was put in. Someone caught it and that is why it was denied. She has suffered crying every night because of back pain. They sent her for a CT scan that was so painful. They had to put a needle into her spine. She could not twist and had to stay at a 30 degree angle for 24 hours. The pacemaker doctor said that the MRI lead not being compatible didn't do her any harm. He said "taking it out and replacing it could cause her death. Living with back pain would not." How callus. She needed back surgery this morning and was told last night it was denied because she did not have an MRI, this just changed in the past month and would have been covered months ago when they kept denying her and could not explain why. We had to pay for her portion so she could get the surgery today. I am so upset as her daughter. My questions for anyone that can answer are these:

1) Can haveing 1 incompatible lead in a pacemaker that is compatable cause any issues, especially going through MRI's that they thought the device was compatable?

2) she has had extremely eradicat blood pressure since. Can this be associated with this "hic up" or mistake?

3) does anyone know if there have been problems like this and what happened as a result?

 

thank you for any help. I am a concerned daughter.

6 Comments

get another opinion

by Tracey_E - 2017-09-13 10:21:46

Something does not add up here. I think it's time for fresh eyes to take a look and see if they can give you some advice. 

Are you sure the lead was a mistake? There are reasons sometimes it's better to not go with the mri compatible leads. Even with the mri compatible lead, we can't go just anywhere and have an mri. There is a protocol to follow and not every facility is able to do it. Also, there are more and more places that can safely do an mri on a pacer/lead system that is not mri-compatible as long as the whole thing is less than 10 years old and there aren't any old capped off leads. We have had several members safely have mri's with regular pacers/leads. So, whether she has compatible leads or not, if you dig deep enough, you should be able to find a doctor able to do it. Again, it's time for a second opinion. 

All the pacer does is raise the heart rate. It has no direct effect on blood pressure or anything else except making the heart beat faster. Is she on medications that might affect it? Most heart meds drop bp. 

Agree

by The real Patch - 2017-09-13 14:31:19

I agree with TraceyE, this doesn't add up and reading your post I can't help wonder if you are understanding what the medical people are telling you. That's more common than people think.

When I first got a device, I misunderstood most of what doctors were telling me because we spoke different languages. After I educated myself on my heart disease and medical devices I suddenly found that my doctors were much smarter than I first believed.

I assume you are saying one lead is not MRI compatible...if that's the case, so what, big deal. Most large hospitals have a protocol specifically for that and can perform an MRI anyway. I spoke to the head of Radiology at a local hospital and he said he performs an average of 3 MRI's per month on people with a non-MRI device.

But what really caught my attention was the vast number of MRI's your mother has had in a short time. That is an extremely expensive test and should only be conducted on an absolute need basis. Most people never have an MRI in their lifetimes. There are numerous other tests that can be conducted in lieu of an MRI, and far less troublesome for your mother.

If I were going to question doctors about anything in this scenario it would be why so many MRIs

Wrong lead

by KarBear - 2017-09-13 18:34:23

its much more complicated then I guess I explained. Her doctor meant to put a fully MRI compatable pacemaker in. He made a mistake or as he said the lead rep made the mistake and one of the leads was not MRI compatable. I understand that MRI's can be done on non compatable devices. Non of that is the concern. The concern is this, the doctor and the places that did the MRI's did not realize that the device had a lead that was not MRI compatable. They were under the impression it was 100% MRI compatable. Why this is a problem is this: 

1) when a device is not compatable the MRI people want to know and certain locations are approved to go to.

2) the doctor not telling her he made a mistake caused her months of refusal by another doctor to get the MRI. His office did the appropriate work and looked all parts up and realized it was not compatable. Rather then tell her they made a mistake she was given denials and run around with no explanations.

3) she went through A LOT of suffering through a CT scan that required a procedure in the spine. This would not have been a problem if she had an MRI, which she was denied with no explanation.

4) she needs MRI's because she has had colon cancer and back problems that require surgery. Surgery they did not approve because the MRI was not done. The fault of the doctor, not my Mom.

Thank you for your input.

sometimes......

by Bionic Beat - 2017-09-13 20:47:20

I guess its dependant on what you have implanted in you.   Recently had a general surgeon tell me I HAD to have an MRI due to a liver problem.  I called my electrophysiologist and the answer was a definite NO.  My pacemaker was put in last December but I have leads from 2008 that preclude the MRI.  

Its now up to the liver doctor to try and figure it out with just a CAT scan.  he knows whats wrong but not why or how to fix it.  having another CAT scan in Nov to see if its worse.

Bottom line?  without the pacemaker for the last decade, I wouldnt be here at all.

Sometimes, what they do to save you at one point, can have drawbacks in the future.

They bought me ten years of life.....maybe much more.

you make the best decisions at the time, with the knowledge you have, at the time.

Best Wishes,

Bionic Beat

Listen to TraceyE

by Gotrhythm - 2017-09-14 16:33:49

I cannot even imagine how frustrated and scared you must feel, knowing something needs to be done, but feeling caught in an endless Catch-22. You and she have been through a terrible time.

It seems to me that the question is no longer, what has been done, but what can be done? In my experience, there's no payoff in continuing to go to a doctor whose mind is made up about the feasibility of a certain treatment. If you don't think you're getting the treatment you need, move on.

You need a different doctor--maybe several different doctors. Given the complexity of your mother's issues, it might be time to ask for referral to a major medical center where rare or unusual situations are more frequently seen. And also where there is more of a 'can do' attitude.

It might also be time, and I say this very gently, for a frank discussion with your mother and her doctors about what her goals for treatment are.

Ditto - 2nd opinion

by BillH - 2017-09-15 18:49:30

Recent study was released that showed any modern (IIRC after 1990) PM/ICD and leads can be safely MRI'd. But the protocol needed can be a problem and it can be hard to find a hospital to do it.

Likewise the surgery can be approved w/o the MRI, but it might take appeals by the patient/family and doctor. And some times many tries.

Something like this might be better handled by a large teaching hospital where the have the expertise to work around the problems.

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