[HN Gopher] Phones containing magnets inhibit implantable cardio...
       ___________________________________________________________________
        
       Phones containing magnets inhibit implantable cardioverter
       defibrillators
        
       Author : Tomte
       Score  : 88 points
       Date   : 2021-08-23 11:21 UTC (11 hours ago)
        
 (HTM) web link (bhrs.com)
 (TXT) w3m dump (bhrs.com)
        
       | gorkish wrote:
       | Question for phone repair folks: On teardown photos, it seems
       | like the iPhone magnets are accessible after dealing with a few
       | layers of adhesive. Is it possible and if so, how difficult is it
       | to remove the ring of magnets?
        
       | mensetmanusman wrote:
       | This might create a niche market for mu metal iPhone cases.
        
       | amrcnimgrnt wrote:
       | The problem appears to me to be a design problem of the implanted
       | devices, not the iPhone.
       | 
       | Unless I'm mistaken this is what's happening:
       | 
       | 1. ICDs want/need to communicate with the outside (at least one
       | way).
       | 
       | 2.However, this is not trivial since a human body is a bag of
       | salt water. Therefore low frequencies are needed.
       | 
       | 3. Low frequencies are very difficult at the necessary length
       | scales with electric fields, so they used the magnetic field
       | instead.
       | 
       | So far, so good. But then they assumed that the person would
       | never be next to a magnet? That's a design flaw on their end, not
       | the iPhone's. There's magnets, and low moving large currents,
       | everywhere!
       | 
       | The should have implemented a primitive type of port knocking.
        
         | bdcravens wrote:
         | The entire medical devices industry tackles this issue just
         | fine (for example, I have a percussion vest for respiratory
         | therapy that uses strong magnets, and there's no shortage of
         | warnings).
        
         | KineticLensman wrote:
         | > Unless I'm mistaken this is what's happening:
         | 
         | The actual problem is that EM fields blind the device so that
         | they can't sense the cardiac arrhythmias they are designed to
         | fix, this rendering them useless.
         | 
         | > ICDs want/need to communicate with the outside (at least one
         | way).
         | 
         | My St Jude Ellipse ICD communicates bidirectionally (control
         | inputs in, telemetry out).
        
           | amrcnimgrnt wrote:
           | I'll leave it to you, a user, that strong EM fields also
           | blind the devices. The signals the ICD is trying to measure
           | are very weak. I can imagine that strong 50/60Hz surge
           | currents really screw things up, especially in single
           | conductor power distribution situations (UK ring circuits,
           | rural farms, etc).
           | 
           | That being said, the article (TL/DR) appears to focus on
           | "static" magnetic fields. The near field charging feature of
           | the iPhone barely makes mention.
           | 
           | I think the "disable ICD" being a simple magnetized reed
           | switch for an implantable medical device is a bit silly. At
           | least tap a code into that reed switch a little!
        
       | argvargc wrote:
       | The heart itself is kind of an electromagnetic device - are there
       | any studies on the health implications in healthy people of
       | having powerful magnets placed next to it?
        
         | joezydeco wrote:
         | Decades of MRI research and clinical use have probably proven
         | this to be safe.
        
           | argvargc wrote:
           | Where are the boundaries though? Are they established?
           | 
           | There must be a point at which a magnet of power n causes a
           | negative effect that increases along with n, time, and
           | exponentially with proximity?
        
             | shadowgovt wrote:
             | As far as we can tell... Yes, such a magnet exists. But it
             | costs the power of a small city to maintain its field, and
             | the patient would experience all kinds of strange effects,
             | including levitating in it as it induced magnetic forces
             | across their water molecules...
             | 
             | (Seriously though, there are research magnets powerful
             | enough to levitate plastic that people have jammed their
             | hands into with no ill effects. It seems that across a wide
             | range of intensities at least, the human body just does not
             | care. This is, perhaps, surprising given how much
             | electrochemical activity is necessary for continued
             | homeostasis, but it appears to be observationally true).
        
               | argvargc wrote:
               | Wow, thank you.
               | 
               | In a brief search, I found this strange and interesting
               | article from 1983, regarding experiments conducted at
               | Lawrence Berkeley Laboratory of the University of
               | California:
               | 
               | https://www.nytimes.com/1983/02/22/science/do-enormous-
               | magne...
               | 
               | TL;DR - there were detectable effects on heart function,
               | eye function and possibly sense of direction. The effects
               | were deemed safe at the levels studied.
               | 
               | Here is the study the article appears to be about (on
               | page 86, as numbered in the scan):
               | 
               | https://inis.iaea.org/collection/NCLCollectionStore/_Publ
               | ic/...
               | 
               | Going by its closing remarks, it appears this was an
               | active field of research at the time.
        
               | lvncelot wrote:
               | There actually have been experiments with levitating
               | animals[1] via a very strong magnetic field - they've
               | been fine afterwards.
               | 
               | [1]
               | https://www.ru.nl/hfml/research/levitation/diamagnetic-
               | levit...
        
               | argvargc wrote:
               | Well worth the click, the article (1997) starts with a
               | great explainer, and has photos.
               | 
               | Deserves its own post.
        
               | tgv wrote:
               | I know of an 11T MRI (in Paris, IIRC) which knocks people
               | unconscious when they move too fast. Apparently, the
               | field across your skull inhibits (some) spike
               | propagation. Doesn't require that much power.
        
               | xondono wrote:
               | It's not unique to MRIs, but it's one of the niche
               | applications where this happens.
               | 
               | Working in certain environments (IIRC >2T) requires
               | special training, that include things like "slow
               | walking", since moving too fast would induce currents in
               | the brain that could knock you out.
               | 
               | For a product that I worked in we had to find a cheap way
               | to create a 2T static field for validation, the
               | complications of each of the possibilities were amazing.
        
         | nabla9 wrote:
         | No effects has been found. It's considered pseudoscience.
         | 
         | https://en.wikipedia.org/wiki/Magnet_therapy
        
       | KineticLensman wrote:
       | UK ICD-user here. So three weeks ago I had a severe ventricular
       | fibrillation episode - I fell unconscious, had bystander
       | defibrillation, air ambulance to hospital and two days later had
       | an ICD fitted just below my left collar bone and was out of
       | hospital the next day.
       | 
       | I use an iPhone 12Pro. The advice I was given was don't hold any
       | phone closer than six inches away from the device- so holding it
       | to my right ear is fine. Mag fields right next to the device can
       | stop it sensing or in rare circumstances can cause a factory
       | reset.
       | 
       | The biggest EM hazards in my house are the induction hobs on my
       | cooker - these are worse than the phone. On full power I have to
       | keep at least 60cm away from them or they will blind / alarm the
       | ICD. So I am more concerned about them than the phone.
       | 
       | [Edit] Other hazards are drills held close to my chest and even
       | the capes used by hair-dressers that have magnetic clasps to stay
       | shut. Standing right next to the speakers at a concert is also
       | not-advised.
        
         | philjohn wrote:
         | Hope you're doing better now after the ICD! My 81 year old
         | father had one fitted a few months ago and it's been pretty
         | much life changing (once he was allowed out of the hospital,
         | they managed to nick his lung, which was a whole big thing).
         | 
         | Was going to say induction hobs - that's a huge one, especially
         | as gas is eventually phased out and they become the defacto hob
         | type.
         | 
         | NHS recommendation[1] is, as you said, 6 inches for most mobile
         | phones, but no special callout for the 12.
         | 
         | Apple goes further[2] and says 12 inches when wirelessly
         | charging, which also makes sense.
         | 
         | [1] https://www.nhs.uk/conditions/pacemaker-
         | implantation/recover... [2] https://support.apple.com/en-
         | gb/HT211900
        
           | KineticLensman wrote:
           | > Hope you're doing better now after the ICD!
           | 
           | Thank you! I'm just 60 and was (I believed) in good health.
           | My VF episode was a glitch in my heart's conduction cycle,
           | and the various tests I received show that my heart is
           | physically healthy. So I feel 'perfectly okay' apart the
           | almost dying thing. My biggest health issue now is the
           | cracked risks from the superbly enthusiastic CPR I received,
           | but the pain from coughing and moving awkwardly is a small
           | price to pay.
        
       | stevespang wrote:
       | Lawyers will be upset you published this - - now they cannot make
       | money sueing a REALLY deep pocket.
        
       | culturestate wrote:
       | For what it's worth, the FDA published a similar warning[1]
       | earlier this year. I'm a little surprised the proliferation of
       | random accessories (phone cases, headphones, etc) with strong-ish
       | neodymium magnets over the last few years hadn't already raised
       | an alarm.
       | 
       | 1. https://www.fda.gov/radiation-emitting-products/cell-
       | phones/...
        
         | oneplane wrote:
         | Especially since magnets are used so widely in so many products
         | you'd think that even some sort of
         | test/certification/measurement that would happen anyway (RFI?)
         | would also note that there is a strong field present. This
         | stuff gets measured all the time, also for equipment that is to
         | be used in aerospace and hospitals... the whole concept of
         | devices interfering with each other isn't new. But apparently
         | it's still overlooked when it's about consumer electronics as
         | if those couldn't possible interfere/cause interference.
        
           | xondono wrote:
           | > This stuff gets measured all the time, also for equipment
           | that is to be used in aerospace and hospitals...
           | 
           | They only measure _dynamic_ magnetic fields (i.e.
           | electromagnetic fields). There are essentially no regulatory
           | limits in static fields, since they don 't really interfere
           | with RF signals.
           | 
           | In fact, is amazingly easy to purchase neodymium magnets of a
           | size _that should not be_ that easily available, which
           | explains the hilarious safety videos like this one[1]
           | 
           | [1] https://www.youtube.com/watch?v=0t8yDnyOaQ8
        
             | oneplane wrote:
             | Now that I read that, it seems obvious that static fields
             | and RF wouldn't interact like that... Thanks!
             | 
             | The video is very well done (for a semi-pro it seems?),
             | it's one of those things where people (including me) might
             | think "oh yeah magnets, I know about those" but you
             | actually don't, or at last not at the scale that you might
             | need.
             | 
             | That reminds me of this LPL video about Gallium:
             | https://www.youtube.com/watch?v=jeghGhVdt9s where you might
             | think: oh yeah, metals, those are sturdy blocks that you
             | need to weld or saw.
        
           | jaywalk wrote:
           | In this case, the magnet isn't really _interfering_ with the
           | ICD in the strictest sense of the word, because ICDs are
           | deliberately designed to be disabled by magnets.
        
       | oever wrote:
       | Great opportunity for a killer app.
        
         | Maxburn wrote:
         | Unexpected humor is the best.
        
       | TheCapn wrote:
       | I don't know the entire story, but my wife is a cardiac ICU nurse
       | and says magnets are part of the normal procedures for dealing
       | with ICDs. They'll slap a magnet on the chest of an ICD patient
       | to inhibit the device if it malfunctions.
       | 
       | All I'm saying from that is while a lot of comments around here
       | are calling it design flaws, I'm pretty sure to a certain extent
       | its a design _decision_. If you have a patient on the stretcher
       | and you need to disable that thing _now_ then a magnet seems like
       | a perfectly reasonable  & safe thing to use. Requiring
       | specialized devices that might not be available at all times
       | seems like the design flaw. Asking patients with specific health
       | needs to avoid certain activities/devices is not a huge stretch.
        
       | analog31 wrote:
       | In addition to heart implants, cochlear implants are an issue
       | too. Not only that but the electronics for controlling the
       | implant require an iPhone app.
        
       | Forge36 wrote:
       | Place phone in pants pocket not shirt pocket. I wonder if this is
       | a new phenomena with wireless charging or if other phones could
       | have caused problems and were never tested.
        
         | codetrotter wrote:
         | > Place phone in pants pocket not shirt pocket.
         | 
         | I keep my phone in my pocket but I think some people may be
         | hesitant to keep their phone in the pocket for concerns about
         | radiation from the phone in proximity to their testicles.
         | 
         | And there may be something to it. In particular if you keep
         | your phone in your pocket while using hands free and having
         | conversations on the phone. https://www.webmd.com/infertility-
         | and-reproduction/news/2008...
        
           | Retric wrote:
           | "2.5 centimeters away for 1 hour" that hardly equivalent to
           | real world use and likely due to temperature not radiation.
        
         | chimen wrote:
         | People browse the internet laying on their back. I am placing
         | that phone on my chest quite often while doing so
        
           | meowster wrote:
           | When I take a nap and set the alarm on my phone to vibrate
           | only instead of ringing, I place the phone on my chest so
           | that it wakes me up. Because of this post on HN, if I ever
           | get an ICD, I now know better. I wonder how many people don't
           | know.
        
             | ssully wrote:
             | When you get an ICD, they explain all of this to you. Even
             | before the recent warning about iPhone 12's, they explained
             | how the device interacts with magnets and to avoid them.
        
         | sandworm101 wrote:
         | Patient in hospital. In bed. On back. Phone sits of chest while
         | they sleep. Device stops. Alarms. Flashing lights. Nurses
         | running. This is a necessary PSA.
        
           | jaywalk wrote:
           | A patient in a hospital bed isn't of any real concern with
           | this. There will be no alarms or nurses running if the device
           | is disabled, only if the patient's heart stops. And their
           | heart would have stopped either way, because the ICD isn't
           | keeping their heart running. It's there in case it stops, and
           | if they're in a hospital bed there will be people around
           | ready to attend to them if their heart stops.
        
       | FriedPickles wrote:
       | It's a PSA: if you have an implanted defibrillator, don't keep
       | iPhone 12 in a shirt pocket. No need for any more drama than
       | that. Reminds me of antennagate, to which Jobs responded: "Don't
       | hold it that way."
        
         | philjohn wrote:
         | Or 12 inches away if wirelessly charging - so if you charge
         | your phone on your nightstand that may cause an issue if super
         | close to you.
        
         | Wowfunhappy wrote:
         | Idk, with my life on the line I wouldn't buy an iPhone 12 at
         | all. Sure, I don't _usually_ keep my phone in my shirt pocket,
         | but it's a fairly natural thing to do in some circumstances,
         | what if I forget?
        
           | agent327 wrote:
           | Nah, that wouldn't happen more than once.
        
             | multiplegeorges wrote:
             | That's a wildly flippant response this issue.
             | 
             | "ah, you'll be fine" seriously?
             | 
             | Think of the likely user who has a pacemaker. They are
             | probably a man, he's probably in his 60s, 70s, or 80s. He's
             | likely not all that familiar with the intricacies of modern
             | phones. His kids probably convinced him to get a phone so
             | he could stay in touch more easily. That's the audience
             | we're talking about here.
             | 
             | It'll happen a lot and while it's happening the lifesaving
             | device is fully disabled. That's a big deal.
        
               | btown wrote:
               | The user could also fall asleep and the phone could end
               | up resting on the chest area - and they may never even
               | know that's something to look out for!
        
               | kemayo wrote:
               | The joke was "it will only happen once, because it will
               | kill you".
               | 
               | (Which is inaccurate, of course, since it sounds from the
               | article like disabling a pacemaker in this way will only
               | open up an _opportunity_ for your heart to fail.)
        
               | panzagl wrote:
               | 90% of my upvote usage on HN is balancing out people who
               | have no sense of humor.
        
               | agent327 wrote:
               | It's appreciated! :-)
        
         | ekianjo wrote:
         | > Reminds me of antennagate
         | 
         | So a problem of phone calls disconnecting reminds you of phones
         | causing cardiac problems with people using pacemakers?
        
         | okdjnfweonfe wrote:
         | "if you have an implanted defibrillator, don't keep iPhone 12
         | in a shirt pocket. [or you might die [vastly sooner than the
         | average person]]"
         | 
         | Kinda worth making some drama about it, no?
        
           | droopyEyelids wrote:
           | How much drama do we make about other magnets?
        
             | webmobdev wrote:
             | What other strong magnets do you keep in your pocket or
             | come into contact with regularly, that can interfere with
             | an implanted medical device that can cause an organ
             | failure?
        
               | pc86 wrote:
               | Nobody is forcing anyone to keep any particular magnet
               | anywhere. Plenty of people, including successful tech and
               | non-tech people, do just fine without smartphones. iOS is
               | not a requisite for a fulfilling life.
               | 
               | Note it, inform people about it, mitigate the effects
               | where possible and research ways to eliminate the issue
               | entirely. But it's not exactly an emergency by any
               | reasonable definition and the pearl-clutching "drama" is
               | a bit much.
        
             | bdcravens wrote:
             | Little, because devices that have strong magnets do a good
             | job of disclosing the fact.
        
           | oneplane wrote:
           | Is it? Sometimes all you can do is inform. People will still
           | ignore it and do it anyway and die earlier (tobacco,
           | alcohol).
        
           | jjoonathan wrote:
           | Yeah, it's definitely worth the drama, but personally I'm
           | more scandalized that biomedical engineers still use
           | unmodulated magnetic fields to switch implanted
           | defibrillators than I am scandalized by the fact that the
           | iPhone emits a magnetic field. iPhones aren't the only thing
           | that emits a magnetic field. Not by a long shot. Not by
           | accident, not by intent. I'm sure being able to use a magnet
           | to switch these implants is handy, but putting inductive
           | transceivers on every EMT's toolbelt and in every operating
           | room isn't a physics challenge or an engineering challenge,
           | not with the amount of money in the medical world. It's an
           | implementation challenge, yes, but it's one that should have
           | happened 20 years ago. Due to the severity of their work the
           | medical community is used to always getting its way, but in
           | this case they're the ones who need to shape up.
        
             | DaiPlusPlus wrote:
             | Why not a subdermal physical switch that could be actuated
             | through the skin? Like a push-button toggle or slider-
             | switch?
        
               | da_chicken wrote:
               | Probably because people roll over in their sleep and like
               | to carry laundry or groceries by holding the bag to their
               | chest.
        
             | matthewdgreen wrote:
             | The minute you require the presence of a non-standard tool
             | for emergency medical attention that could impact an ICD,
             | you've guaranteed that it will not be present in some
             | cases. It's very likely that such a decision will have a
             | body count.
        
               | xxpor wrote:
               | But the current situation likely has a body count as
               | well.
        
               | mikeyouse wrote:
               | For the last xx years of ICDs, ~nobody with ICDs carried
               | magnets in their pockets. So the body count of the
               | 'current situation' is likely 0. Now that phones are
               | ubiquitous and some are including magnets powerful enough
               | to interfere, there's a new issue.
        
             | animatedb wrote:
             | The magnet is usually used as a mitigator to turn off the
             | device in case the device is doing something wrong like
             | producing pulses too fast. There is typically RF
             | communication that can communicate to the device and can
             | often be used to turn the magnet detection off, which means
             | that the device will not quit working when a magnet is
             | detected.
        
         | tener wrote:
         | A warning is good thing, but the drama is less welcome. Blaming
         | Apple is absurd too: the defibrillators have built-in kill
         | switch that responds to strong magnetic fields. At the time
         | where this was designed it was concluded that it is very
         | unlikely for such strong magnetic fields to occur in real life.
         | Well, that assumption is wrong these days.
         | 
         | It is a responsibility of the designers of the medical devices
         | to assure they are safe. Furthermore they naturally have to be
         | replaced every few years, so it isn't even hard to phase out
         | the outdated design in a coordinated fashion. But I guess this
         | costs money and it is cheaper to blame others.
        
           | webmobdev wrote:
           | Seems to me like both the cell phone maker and the medical
           | device maker want to pass the blame to each other. That said,
           | medical devices should get more leeway here - they already
           | come with warnings, just like medicines too (e.g. don't take
           | with alcohol). When a device is implanted the doctors and the
           | manufacturer pass on the warnings to the patient. However,
           | they obviously can't pass on warnings about future tech that
           | they didn't predict would exist and interfere with their
           | device. In such cases, since Apple's new tech is the one
           | causing the issues, I feel Apple (and other phone
           | manufacturers) need to be more proactive and should publicise
           | and caution the public that their mobile phone may interfere
           | with implanted medical devices.
        
           | animatedb wrote:
           | The magnet is usually used as a mitigator to turn off the
           | device in case the device is doing something wrong like
           | producing pulses too fast. There is typically RF
           | communication that can communicate to the device and can
           | often be used to turn the magnet detection off, which means
           | that the device will not quit working when a magnet is
           | detected. This was used in the past for electric trains or
           | other large magnets such as in factories.
        
           | treesknees wrote:
           | Pacemakers need to be replaced every 5-15 years as the
           | battery wears out [1]. It's not like a visit to the dentist
           | either, it's a major surgery. I also think you underestimate
           | how rapidly a medical device company can make a dramatic
           | change to the design, have it tested and approved, and
           | distributed inside everyday people. Yes it's "coordinated"
           | but the timeline is extremely long compared to how often the
           | phone market is being pumped full of magnets.
           | 
           | For what it's worth I think it's still up to the user to be
           | safe and know what they can and cannot have up against their
           | chest. But to say that the medical community can just be
           | "agile" about this is to really misunderstand how those
           | devices are certified and designed.
           | 
           | [1] https://www.hopkinsmedicine.org/health/conditions-and-
           | diseas...
        
             | maj0rhn wrote:
             | And ICD is not a pacemaker. An ICD costs about $30K. When
             | its battery wears out, the battery is replaced, not the
             | ICD. So there will be no replacements of already-implanted
             | ICDs because of this problem.
             | 
             | Also, it is a big deal to redesign an implanted medical
             | device, as it should be. These are not tongue depressors.
             | ICDs are the most tightly regulated device the FDA reviews.
        
             | tener wrote:
             | Nowhere in my comment did I suggest a timeline for the
             | design change to happen. Yes, it will take years, but it
             | cannot happen at all if the device manufacturers keep
             | blaming others for their poor designs.
        
             | cstross wrote:
             | > It's not like a visit to the dentist either, it's a major
             | surgery.
             | 
             | My father had a pacemaker, and for long enough to receive a
             | battery swap. The battery for that particular model was
             | implanted under his shoulder blade; the swap-out was
             | performed under local anaesthetic.
             | 
             | The original implantation was a bit more complex from a
             | surgical perspective, requiring keyhole surgery and an
             | angioplasty to run the wire around his heart as well as to
             | implant the battery and controller. But the point is: these
             | devices can be installed and expected to perform for
             | decades, so the engineering design is of necessity highly
             | conservative and has long-term maintenance in mind. It's
             | also safety-critical: if the device malfunctions, people
             | can die.
             | 
             | PS: a pacemaker is not an implanted defibrillator. (Also,
             | my father died in 2017, so what I'm describing is probably
             | a decade or two behind the state of the art.)
        
           | maj0rhn wrote:
           | Blaming Apple is not absurd. The interaction between magnets
           | near the chest and cardiac rhythm devices has been well known
           | since at least the 1980s. Even I can remember a published
           | case report of a person carrying a stereo speaker, and a
           | magnet in the speaker deactivated his ICD.
           | 
           | If Apple were two guys in a garage, you could forgive them.
           | But a trillion dollar company... not so much.
        
         | bdcravens wrote:
         | Apple did more than just utter a sentence. Everyone who owned
         | one of the phones was entitled to a free bumper case, and Apple
         | eventually settled a class-action suit, agreeing to pay
         | $15/user.
        
       | nycbenf wrote:
       | ICD patient and avid cell phone user here. They tell us magnets
       | will disable the device. This is by design, they include a hall
       | effect sensor to allow medical personnel to disable the devices.
       | They aren't exactly specific about how big a magnet and how close
       | it has to be.
       | 
       | My device sends data to a base station which reports back and is
       | also interrogated every 6 months by a electrophysiologist and
       | they can see if and when it has been disabled.
       | 
       | Mine has been disabled twice so far, once by using the Boston
       | Scientific interrogation device to turn it off, and once by a
       | surgeon taping a magnet to my chest!
        
       | dcroley wrote:
       | I guess those $10 magnetically attached name tags are bad too
       | then.
        
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       (page generated 2021-08-23 23:03 UTC)