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Tests in Product Development
       - Cases of Medical Devices
Raimo Sepponen, prof.
    Aalto University
Electronics Department
Tests in Medical Device development
• Tests required by Medical Device Directive
• Tests by the quality control and international
  standards
• How to test functional safety?
• Special but important problem area:
  Electomagnetic Compatiblity (EMC)
Mechanical Failure: Falling head of a
      radiation therapy unit




These devices are not related to the case – shown only for demonstration!!
Electromechanical Failure: Unexpected
   movement of C-arc of mammography device




    These devices are not related to the case – shown only for demonstration!!


Reason: Opening of electromechanical brakes during drop of mains voltage
Increasing risks of poor EMC




                    FDA + Evaluation Engineer
Evaluation Engineer
Rapidly changing electromagnetic environment – basis of
   standards are old already when the are published




                                              FDA
Wireless communication is a major noise source




                                      FDA
Failing Apnea Alarm
                                         Apnea alarm with poor
                                         RF filtering detects
                                         modulated field and assumes
       FM Transmitter                    that baby is breathing




                        Field modulated by
                            movements
                             coupled to
                            sensor mat



Mother moving in kitchen
Walkie-talkies and cellphones interfere with medical equipment

Many types of hospital equipment are susceptible to RF radiation from hand-
portable mobile radio transmitters – diagnostic equipment such as ECGs, EEGs,
pulse oximeters and other physiological monitoring equipment; and therapeutic
equipment such as infusion pumps, ventilators and defibrillators. Physiological
monitoring equipment is very sensitive – hence very susceptible.

Example: The type of modulation employed by the mobile transmitter can be
significant. For example, an external pacemaker withstood a GSM signal
(modulated at 217Hz) at 30V/m field strength, but TETRA modulation (17Hz)
caused interference at 3V/m.




                                                                      www.emcuk.co.uk
Fibreglass ambulance roof causes death of patient
Medical technicians taking a heart-attack victim to the hospital in 1992 attached her to a
monitor/defibrillator. Unfortunately, the heart machine shut down every time the
technicians turned on their radio transmitter to ask for advice, and as a result the woman
died.

Analysis showed that the monitor unit had been exposed to exceptionally high fields
because the ambulance roof had been changed from metal to fibreglass (to let in more
daylight) and also fitted with a long-range radio antenna. The reduced shielding from the
vehicle roof combined with the strong radiated signal proved to be too much for the
monitor/defibrillator.

Ambulances in the U.K. are typically fitted with radio transmitters with 100W of
transmitted power (ERP), and the resulting field strengths near the roof, where the
medical equipment is often installed, can exceed 70V/m in a vehicle with a metal roof.

Compare this with the 3V/m and 10V/m RF field susceptibility tests required by the
medical devices safety standard EN 60601-1-2. Equipment for fitting in ambulances and
similar environments must be able to function correctly despite such strong RF fields, so
they need to have greater immunity
                                                                         www.emcuk.co.uk
Static Elecricity
• Example: A fluid dispenser often
  malfunctioned when nursing staff entered the
  room
• Reason: Static electric discharges in clothing
  due to interactions of clothes and items in
  pockets
Static discharges generated by metal/dielectric contacts –
                       Electric field




                                        D.C.Smith: EOS/ESD Symposium 99-329
Coins in plastic bag – Magnetic field




                          D.C.Smith: EOS/ESD Symposium 99-329
Hazards due to user errors
• Example: Magnetic Resonance Imaging – burn
  injury
Burn injuries during MRI
                                      L              R
                                          loop           loop




                                  U

                                           C     Cair
                                            skin      Cskin


                                          R
                                              skin    R skin




Radiology 1996; 200:572-575
Testing for Functional Safety
• Know the environment where the product is
  used
• The environment is changing continuously
• Collect user experiences – not only from your
  own products
• Try to develop non-standard tests which
  reveals the unexpected malfunctions
Message
  Tests according to
  standards do not ensure
  functional safety

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Tests in product development

  • 1. Tests in Product Development - Cases of Medical Devices Raimo Sepponen, prof. Aalto University Electronics Department
  • 2. Tests in Medical Device development • Tests required by Medical Device Directive • Tests by the quality control and international standards • How to test functional safety? • Special but important problem area: Electomagnetic Compatiblity (EMC)
  • 3. Mechanical Failure: Falling head of a radiation therapy unit These devices are not related to the case – shown only for demonstration!!
  • 4. Electromechanical Failure: Unexpected movement of C-arc of mammography device These devices are not related to the case – shown only for demonstration!! Reason: Opening of electromechanical brakes during drop of mains voltage
  • 5. Increasing risks of poor EMC FDA + Evaluation Engineer
  • 7. Rapidly changing electromagnetic environment – basis of standards are old already when the are published FDA
  • 8. Wireless communication is a major noise source FDA
  • 9. Failing Apnea Alarm Apnea alarm with poor RF filtering detects modulated field and assumes FM Transmitter that baby is breathing Field modulated by movements coupled to sensor mat Mother moving in kitchen
  • 10. Walkie-talkies and cellphones interfere with medical equipment Many types of hospital equipment are susceptible to RF radiation from hand- portable mobile radio transmitters – diagnostic equipment such as ECGs, EEGs, pulse oximeters and other physiological monitoring equipment; and therapeutic equipment such as infusion pumps, ventilators and defibrillators. Physiological monitoring equipment is very sensitive – hence very susceptible. Example: The type of modulation employed by the mobile transmitter can be significant. For example, an external pacemaker withstood a GSM signal (modulated at 217Hz) at 30V/m field strength, but TETRA modulation (17Hz) caused interference at 3V/m. www.emcuk.co.uk
  • 11. Fibreglass ambulance roof causes death of patient Medical technicians taking a heart-attack victim to the hospital in 1992 attached her to a monitor/defibrillator. Unfortunately, the heart machine shut down every time the technicians turned on their radio transmitter to ask for advice, and as a result the woman died. Analysis showed that the monitor unit had been exposed to exceptionally high fields because the ambulance roof had been changed from metal to fibreglass (to let in more daylight) and also fitted with a long-range radio antenna. The reduced shielding from the vehicle roof combined with the strong radiated signal proved to be too much for the monitor/defibrillator. Ambulances in the U.K. are typically fitted with radio transmitters with 100W of transmitted power (ERP), and the resulting field strengths near the roof, where the medical equipment is often installed, can exceed 70V/m in a vehicle with a metal roof. Compare this with the 3V/m and 10V/m RF field susceptibility tests required by the medical devices safety standard EN 60601-1-2. Equipment for fitting in ambulances and similar environments must be able to function correctly despite such strong RF fields, so they need to have greater immunity www.emcuk.co.uk
  • 12. Static Elecricity • Example: A fluid dispenser often malfunctioned when nursing staff entered the room • Reason: Static electric discharges in clothing due to interactions of clothes and items in pockets
  • 13. Static discharges generated by metal/dielectric contacts – Electric field D.C.Smith: EOS/ESD Symposium 99-329
  • 14. Coins in plastic bag – Magnetic field D.C.Smith: EOS/ESD Symposium 99-329
  • 15. Hazards due to user errors • Example: Magnetic Resonance Imaging – burn injury
  • 16. Burn injuries during MRI L R loop loop U C Cair skin Cskin R skin R skin Radiology 1996; 200:572-575
  • 17. Testing for Functional Safety • Know the environment where the product is used • The environment is changing continuously • Collect user experiences – not only from your own products • Try to develop non-standard tests which reveals the unexpected malfunctions
  • 18. Message Tests according to standards do not ensure functional safety