Forgotten electrical accidents and the birth of shockproof X-ray systems

OBJECTIVES To commemorate victims of electrical accidents that occurred in the first decades of radiology and relate these accidents to the evolution of the X-ray apparatus. METHODS Digitised newspapers, scientific journals, books and reports of legal procedures were searched for electrical accidents involving X-ray systems. Information on the historical systems was retrieved from the scientific literature and brochures from manufacturers. RESULTS We found 51 fatal and 62 non-fatal but serious electrical accidents. Most of them occurred between 1920 and 1940 and involved transformers that provided output currents well above the threshold for the induction of ventricular fibrillation. The accidents led to recommendations and regulations to improve safety for operators and patients, and spurred manufacturers to technical developments that culminated in fully electrically shockproof systems by 1935. CONCLUSIONS Although largely forgotten, the development of the shockproof X-ray systems we take for granted today lasted about 4 decades and was associated with considerable human suffering. The complete solution of the problem is a success story of engineering realised by contributions from all parties involved. MAIN MESSAGES • The development of electrically shockproof X-ray systems took about 4 decades (1895-1935). • Between 1896 and 1920 electrical shocks from X-ray systems were common, but their consequences limited. • After 1920, transformers killed by delivering currents above the ventricular fibrillation threshold. • Inductors, static generators and high-frequency coils were generally low-current systems and safe. • We found 51 fatal and 62 serious non-fatal electrical accidents, most occurring from 1920 to 1940.