Tag Archives: radiation

Data: Hospital performs ‘combination’ CT scans at 10 times national rate

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Lisa Chedekel, of the Connecticut Health Investigative Team, used Hospital Compare data from the Centers for Medicare & Medicaid Services to find that patients at the University of Connecticut’s John Dempsey Hospital are getting “combination” CT scans much more that the national average.

ct-scan

Photo by Akira Ohgaki via Flickr

Combination scans mean that patients get two scans which, of course, subjects them to more radiation than a regular scan.

For chest scans, a patient’s radiation exposure from a double scan is 700 times higher than from a simple chest X-ray. For abdominal scans, the radiation dose is comparable to that of approximately 400 chest X-rays.

Nationally, the rate of patients getting a combination scan is 5 percent for chest scans and 19 percent for abdominal scans. At Dempsey, 48 percent of patients receiving chest scans had combination scans. For abdominal scans, it was more than 72 percent.

The hospital’s chief of radiology said he was “absolutely staggered” by the high rates but that “his own internal review last year had flagged a high incidence of the multiple scans – a trend that the hospital is now addressing.”

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X-ray regulation, inspections a patchwork

Andrew Van Dam

About Andrew Van Dam

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.

The Investigative Reporting Workshop’s Caroline Stetler explains what she calls “the patchwork regulation of technicians who perform imaging exams,” and the risks that come with it.

In short, there’s no national standard for training or performance of such technicians, 12 states don’t have any requirements at all, and standards in the other 38 vary wildly. As the medical imaging industry continues to flourish, and Americans’ exposure to radiation increases, regulations have failed to keep pace. Likewise, imaging equipment has proliferated, but inspection rules have not. Only mammography machines are subject to federally mandated annual inspections, though the Joint Commission and other organizations will begin accrediting imaging centers in 2012.

The story package also includes an excellent, interactive state-by-state breakdown of licensing numbers and variations, as well as a number of related videos.

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Schwarzenegger signs CT radiation tracking bill into law

Scans at LA hospital spewed 8x normal radiation

Andrew Van Dam

About Andrew Van Dam

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.

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.

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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.

Massive levels of uranium found in Indian children

Andrew Van Dam

About Andrew Van Dam

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.

Writing in The Observer, Gethin Chamberlain looks into a rash of deformities and disabilities that have appeared among youth in India’s Punjab region and appear to be linked to high levels of uranium exposure. radioactiveChamberlain finds nearby coal-fired power plants to be the most likely source (coal ash can contain high levels of radioactive material) and reports the Indian government appears to be denying that there is a problem.

Staff at the clinics say they were visited and threatened with closure if they spoke out. The South African scientist whose curiosity exposed the scandal says she has been warned by the authorities that she may not be allowed back into the country.