Radiation gets exposed

A rash of reports highlighting patient exposure to excessive radiation has radiology providers, equipment manufacturers and regulators scrambling to address safety and protocol concerns even as they acknowledge uncertainty over how best to prevent such mishaps in the future.

The recent problems surfaced late last year when four hospitals—909-bed Cedars-Sinai Medical Center, Los Angeles; 457-bed Glendale (Calif.) Adventist Medical Center; 417-bed Providence St. Joseph Medical Center, Burbank, Calif.; and 806-bed Huntsville (Ala.) Hospital—told Food and Drug Administration officials that hundreds of patients who underwent CT perfusion brain scans at their facilities to diagnose stroke were exposed to several times more radiation than they should have received. Those reports were followed by a January news report of patients who received too much radiation from linear accelerators during cancer treatment at two New York hospitals.

“We believe the incidents in California, Huntsville and now in New York were systemic problems,” said Christine Lung, vice president of government relations and public policy for the American Society of Radiologic Technologists. “Equipment is often brought into a clinical site and installed, and technologists are expected to use it immediately,” added Lung, who believes some of the dosage problems can be addressed through greater training and more defined protocols.

To that end, a number of agencies are moving forward with attempts to address the problems. But in an e-mail, an FDA spokeswoman acknowledged that the agency’s investigation into causes of the CT-perfusion radiation overdoses is ongoing and that officials had yet to reach any conclusions or determine a course of action.

The House Energy and Commerce Committee is poised to hold a hearing on imaging-related radiation exposure on Feb. 10, and last week the American Society for Radiation Oncology released a six-point patient-safety plan aimed at preventing radiology medical errors.

In addition to those efforts, the CMS in late January also announced steps that could have a mitigating effect on radiation dose errors. The agency designated the American College of Radiology, Intersocietal Accreditation Commission and Joint Commission as the three accrediting bodies for free-standing imaging facilities. The action fulfills a 2008 law requiring the CMS to establish an accreditation prerequisite for Medicare imaging provider by Jan. 1, 2012.

The CMS requirement, however, does not affect hospital-based imaging centers.

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