Tag Archives: los angeles times

Scans at LA hospital spewed 8x normal radiation

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On Oct. 8, the FDA issued an alert recommending hospitals review CT scan radiation levels after dangerous doses were detected at an unnamed hospital. The Los Angeles Times‘ Alan Zarembo took over from there, finding that serious radiation overdoses at Los Angeles’ Cedars-Sinai hospital had prompted the warning.

Zarembo followed up with a series of stories on the radiation and its aftermath:

CT
Heading into the CT scanner, photo by grewlike via Flickr.

Cedars-Sinai investigated for significant radiation overdoses of 206 patients

Zarembo leads with a summary of what exactly went down at Cedars-Sinai:

More than 200 patients at Cedars-Sinai Medical Center were inappropriately exposed to high doses of radiation from CT brain scans used to diagnose strokes, hospital officials told The Times on Friday.

About 40% of the patients lost patches of hair as a result of the overdoses, a hospital spokesman said.

Even so, the overdoses went undetected for 18 months as patients received eight times the dose normally delivered in the procedure, raising questions about why it took Cedars-Sinai so long to notice that something was wrong.

Class action filed for Cedars radiation patients

Zarembo checks with experts who say the class-action suit filed on behalf of victims has little chance of success because it’s difficult to prove damages, especially since they may not develop for years.

Cedars-Sinai head expresses regret for radiation overdoses

A quick-hit story in which the hospital details exactly what they’ve done to ensure it doesn’t happen again.

4 patients say Cedars-Sinai did not tell them they had received a radiation overdose

Zarembo tracked down patients who said that, while they were contacted by the hospital concerning hair loss, they weren’t informed of radiation overdose or potential cancer risk.

Hospital error leads to radiation overdoses

Zarembo writes that the problem has been traced to a CT scanner reset in early 2008.

Cedars-Sinai radiation overdoses went unseen at several points

In one of the most remarkable moments, Zarembo writes that, before every single scan, technicians were shown a screen indicating, among many other things, the unusually high radiation level. The error was in plain sight the entire time.

Beginning in February 2008, each time a patient at Cedars-Sinai Medical Center received a CT brain perfusion scan– a state-of-the-art procedure used to diagnose strokes – the dose displayed would have been eight times higher than normal. No standard medical imaging procedure would use so much radiation, which one expert said is on par with the levels used to blast tumors.

Somebody should have noticed. But nobody did – everybody trusted the machines.

Related

The New York Times‘ Walt Bogdanich added a broader perspective on the story, adding an additional case and subtly weaving it into the debate about the dangers of medical screening.

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

War injuries advance treatment of brain injuries

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In a three-part package published this month, the Los Angeles Times‘ Melissa Healy explains recent advances in the diagnosis and treatment of traumatic brain injury, with special focus on the United States armed forces.

  • Treating traumatic brain injuries: Anecdotes from an Army National Guard medic and an equipment officer show how much lives can be changed by traumatic brain injury, an ailment that doesn’t even show up on CT scans or MRIs, and how a simple accurate diagnosis can provide patients with hope and understanding.
  • War injury leads to advances at home: Healy writes that while combat veterans with traumatic brain injury are receiving the lion’s share of the attention, they’re just the tip of the iceberg. The “silent epidemic” has hit about 2 percent of the civilian population as well, which totals up to about 11 million since the wars in Iraq and Afghanistan began.
  • Treating brain injuries on the sports field and battlefield: Finally, after tackling diagnosis and prevalence, Healy moves on to treatment. She walks through every step, from prevention to diagnosis to treatment, examining the latest in medical science along the way. It’s the longest piece in the package, and the best to start with if you’re looking for a better technical understanding of traumatic brain injury.

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Health journo goes it alone without insurance

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Freelance health writer and AHCJ founding member Duncan Moore has gained national attention recently for his Los Angeles Times piece explaining his decision to go without health insurance at age 53. Moore quit his job and used a COBRA policy to tide him over until he found a new job. Then the economy tanked, newspapers retrenched, that new job never materialized, his 18 months of COBRA ran out and Moore was forced to ask some tough questions. The answer he found to his first question, “what insurance actually buys,” led him to rethink the entire system about which he’d been reporting for years.

After a quick self-assessment, Moore found he had a clean family history, good habits and almost no pre-existing conditions. That started him thinking.

So what does a guy like me need with health insurance? I’m the best risk in town, I thought to myself. Why shouldn’t I self-insure? In other words, why couldn’t I accept full responsibility for my own health expenses?

Moore writes that he’s ready to accept a certain amount of self-rationing when it comes to everyday care, and that, even if something catastrophic happens, he’ll likely be no worse off than he’d have been if he was insured, because “there are no guarantees that the insurance company would pay, that it wouldn’t try to weasel out of the obligation.”

Moore also made an appearance on Dr. Nancy Snyderman’s show on MSNBC on Tuesday to discuss his decision.

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Calif. nurse rehab program full of holes

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ProPublica’s Tracy Weber and Charles Ornstein follow up their investigation of California’s nursing oversight with a story about the failures of the state’s nurse rehab program (Los Angeles Times version; ProPublica version). The embattled California Board of Registered Nursing has touted the program as a safe haven where otherwise good nurses can free themselves of bad habits, but Weber and Ornstein have discovered that nurses often don’t complete the program, and sometimes continue bad behavior unabated despite the voluntary, confidential program’s required drug tests and treatment.

The team has reinforced its data-driven story with well-chosen anecdotes and observations. Program proponents argue that Weber and Ornstein are focusing on a few failures and ignoring the more numerous success stories, but the reporters show that the failures are due, at least in part, to flaws in the program. Even nurses designated as a “public risk” often aren’t investigated until more than year after earning that dubious distinction.

The reporters’ sum up the problem thus: “At the moment, the main person responsible for protecting the public from a drug-addicted nurse in California is the drug-addicted nurse. It’s a risky honor system.”

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Schwarzenegger replaces nursing board members following ProPublica, LA Times investigation

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Late Monday, Calif. Gov. Arnold Schwarzenegger replaced nearly everyone on the state’s Board of Registered Nursing, “citing the unacceptable length of time it takes to discipline nurses accused of egregious misconduct.” The move came a day after a ProPublica and Los Angeles Times investigation into the board’s activity was published.

He fired three of six sitting board members — including President Susanne Phillips — in one-paragraph letters curtly thanking them for their service. Another member resigned Sunday. Late Monday, his administration released a list of replacements.

Charles Ornstein and Tracy Weber of ProPublica and Maloy Moore of the Los Angeles Times joined forces to review every case between 2002 and 2008 in which a nurse faced disciplinary action — more than 2000 of them — and found that, on average, California’s Board of Registered Nursing took more than three years to take action on such cases. Many took far longer and have not yet been acted upon at all. In other large states, the reporters write, such cases are usually dealt with in less than a year.

The reporting team adds depth to their investigative work with a compelling series of anecdotes, told from the perspective of patients, administrators and even the wayward nurses themselves. They also dissect the system, finding few safeguards other than the tardy board review process, and work to discover all the factors contributing to the delays.

In reaction to the story, leaders of the California Board of Registered Nurses sent a note of encouragement to its staff on Monday that points to some recent accomplishments.

Over at Off the Charts, the American Journal of Nursing blog, AJN editor-in-chief emeritus Diana J. Mason, R.N., Ph.D., weighs in on the investigation and an earlier study of recidivism among disciplined nurses. Mason suggests that the National Council of State Boards for Nursing could “work with the state boards to publicly report on a state-by-state basis a quality metric of length of time between complaints and board action.”

Update

Calif. Nursing Board executive officer resigns: On Tuesday, the longtime executive officer of the embattled California Board of Registered Nursing resigned. Ornstein and Weber report that “Terry had been the appointed executive officer for nearly 16 years and had been on the staff of the board for 25.”

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.