Medical radiation boom sparks concern
Health care workers have discovered that new technology is bringing new risks when it comes to medical radiation. The latest computer-driven devices are able to deliver high doses of radiation quickly and with a precision not seen in the past. But, even though the new equipment is very successful in diagnosing and treating disease, state-of-the-art, high-tech radiation equipment brings a host of new areas in which mistakes can happen, says The New York Times article, “As Technology Surges, Radiation Safeguards Lag.”
Mistakes difficult to detect
The article states that new machines have “created new avenues for error in software and operation, and those mistakes can be more difficult to detect. As a result, a single error that becomes embedded in a treatment plan can be repeated in multiple radiation sessions.” Perpetuating a radiation error can be devastating to the patient receiving treatment and safety procedures must evolve and improve right along with the advances in radiation delivery systems, reports The Times.
Machine malfunctions
Starting with the manufacturers of radiation equipment right down to the health care workers, there are numerous areas for improvement in this arena. Manufacturers have been known to sell their machines before they were certain that they were performing properly. Software glitches and bugs have caused problems that could have been fixed if more testing of the products had been done prior to marketing the machines.
Manufacturers vie for their market share by selling products with the latest technological advances, often with only a superficial examination by the government and without enough thorough testing. Then hospitals purchase the new technology “to lure patients and treat them more quickly." "Radiation-generating machines," says the article, "are so ubiquitous that used ones are even sold on eBay™.”
Hospital negligence
Hospitals eager to use the new equipment to help patients sometimes lack “the necessary financial support to operate the sophisticated devices safely,” and instruction in using the machines is sometimes lacking, opening up opportunities for errors. Trying to stay within budgets, some hospitals have acquired brand new technology like sophisticated radiation equipment, but have not hired the number of experienced, knowledgeable employees needed to oversee the equipment and make sure safeguards are in place.
The Times article reports that one patient received 38 overdoses of radiation because the new radiation machine was unfamiliar to the hospital and health care workers, and miscalculations were made even while training instructors were on site to monitor the procedure.
Radiation safety
Medical physicists—health care workers that work as a multidisciplinary team and either order, use or evaluate new equipment and monitor safety in radiotherapy treatments—believe that a radiation oncology crisis exists. At a 2007 conference, a group of medical physicists reported that safety protocols were not keeping up with radiation technology and that obsolete safety protocols leave “physicists and radiation oncologists without a clear strategy for maintaining the quality and safety of treatment.”
Government apathy
The New York Times states that government regulators are slow to respond to reports of radiation errors or accidents caused by faulty machines or operator errors. According to The Times, radiation accidents are constantly underreported, and “a patchwork of laws to protect patients from harm are weak or unevenly applied, creating an environment where the new technology has outpaced its oversight, where hospitals that violate safety rules, injure patients and fail to report mistakes often face little or no punishment.”
CT overdose
It’s not just oncology radiation that is being administered improperly; CT scans are also being examined for errors in dosage. For example, a huge error occurred last year when more than 300 patients from four different hospitals were given too much radiation by powerful CT scans used to detect strokes, according to The Times.
“The overdoses were first discovered at Cedars-Sinai Medical Center, a major Los Angeles hospital, where 260 patients received up to eight times as much radiation as intended,” and the errors in dosage continued for 18 months and were detected only after patients started losing their hair.
Licensing medical physicists
Even though medical physicists play a crucial role in keeping radiation patients safe, there are at least 16 states that don't require licensing or registration, says the article. “States can be either very tough or very lax,” said Dr. Paul E. Wallner, a director of the American Board of Radiology when interviewed by The Times. And except for mammographies, eight states permit technologists with no credentials or education requirements in radiation therapy to treat patients with medical imaging.
Robert Pizzutiello, a medical physicist who practices in New York, is part of a growing movement to license every medical physicist. The way things stand now, Pizzutiello tells The Times “You could drive a truck in the morning and operate an X-ray in the afternoon.”
