1. Provide the title of your story or series and the names of the journalists involved.
Series title: The X-Ray Factor: States' uneven rules put patients at risk Reporter: Caroline Stetler Graphics & Multimedia: Lynne Perri, Lauren Orsini, Meera Pal, Jacob Fenton. Fact-checking: Mia Steinle (Although Lynne Perri is the primary contact and her information is listed first, please use "Caroline Stetler & Investigative Reporting Workshop" as listing for the order on an award certificate.)
2. List date(s) this work was published or aired.
29-Sep-10
3. Provide a brief synopsis of the story or stories, including any significant findings.
A review of state laws and regulations by the Investigative Reporting Workshop found that 12 states and the District of Columbia do not require medical X-ray operators to be credentialed or to meet specific competency standards. Of the 38 states that do license or accredit technologists, requirements vary greatly – from a mere 12 hours of operator training to a two-year accredited radiography program. The Workshop's survey also found that some states do not conduct routine inspections of medical imaging machines. The lack of standardization increases a patient's risk of misdiagnosis and excess exposure to radiation, at a time when regulators struggle to keep up with new types of imaging equipment.
Description of the Multimedia Elements: 1. Interactive U.S. map links to database detailing how each state regulates, or fails to regulate, X-ray technicians and the machines they operate. 2. Video: A behind-the-scenes look at how a CT scanner works and what patients should expect. 3. Video interviews: National Institutes of Health radiology chiefs on why patients receive too little or too much radiation during diagnostic imaging exams and the need for better dose tracking. 4. Video interview: NIH radiologic technologist talks about daily measures hospitals can take to ensure CT scanners work properly before patients arrive.
4. Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
The Investigative Reporting Workshop reviewed state and federal regulations, collected machine inspection data and searched the web for organizations and experts involved in X-ray technician training and machine inspections. The Workshop filed two FOIA requests with the Illinois Emergency Management Agency. The Workshop initially requested documentation of the fines issued to organizations that allowed unaccredited individuals to perform X-rays. The Workshop then requested the complete files for the most egregious offenders, who paid the maximum $10,000 fine. As a result, the Workshop learned the state of Illinois fined more than 120 unqualified individuals and the facilities that allowed them to perform diagnostic exams from 2004 to 2009. Two portable X-ray service providers were fined for sending unaccredited individuals to Chicago-area nursing homes. The information was crucial in that it confirmed the Workshop_s survey results: There is no guarantee every person operating X-ray machines is qualified to do so, especially in non-hospital settings.
5. Explain types of human sources used.
More than 100 interviews conducted by phone and email: state regulators, radiologic technologists, radiologists, health physicists, patients, and officials representing radiation and X-ray safety organizations, the Food & Drug Administration, National Institutes of Health, Centers for Medicare & Medicaid, The Joint Commission and state medical associations.
6. Results (if any).
As the FDA takes steps to reduce unnecessary radiation from medical imaging, the Workshop provided the definitive guide on states' regulation of X-ray machines and technicians. State officials were anxious to review the Workshop's report to learn how their regulations stacked up and areas for improvement.
7. Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
N/A
8. Advice to other journalists planning a similar story or project.
During the planning stages, brainstorm how to make a data-heavy, technical story resonate with readers. Seek out personal stories and incorporate multimedia elements to make the information accessible.