Today I want to discuss the possibility of your facility being sued for using too much mAs (over radiating/over dosing) the patient with CR or DR general radiography. This sort of takes us back to the first blog I ever posted (January 1st, 2013) where I discussed Creeping Dose. The use of too much mAs is certainly still a reality pretty much everywhere, it’s just that most of the focus has been on CT and not general radiography. But now that CT doses have been gone over with a magnifying glass, we’re next.
There is probably no way a person could prove that the over radiation from one general diagnostic radiology exam was enough to harm a person (and that’s because most likely there wasn’t enough radiation to hurt the patient). What the person would be suing for would be that the imaging department had not adhered to the ARRT Standard of Ethics and ALARA (As Low as Reasonably Achievable).
Number 7 of the ARRT Standards states: “The radiologic technologist uses equipment and accessories, employs techniques and procedures, performs services in accordance with an accepted standard of practice, and demonstrates expertise in minimizing radiation exposure to the patient, self and other members of the healthcare team”.
If a lawsuit ever occurs I believe it will be started by someone in the radiology field, as we really are the only ones who know what technique should be used. A radiographer will just happen to be in the room with a family member or friend and see a ridiculous technique being used. As almost everyone has a phone with them, they’ll take it out and snap a couple of photos or video of the control panel and there’s the proof.
Most likely at this point the hospital would want to settle out of court. Even if they won the case, everyone would know that they over radiated a patient and the only reason they won was that the over radiation just wasn’t that bad. Not the kind of publicity any facility wants any part of, that’s for sure.
It’s so strange how a lawsuit can either “change the world” or be completely ignored. I still remember the day 10+ years ago when one of our radiologist’s walked in with an article from their professional journal in his hand and asked if we knew what this was? “It looks like a journal” we said. “No, it’s the end of IVP’s”, he replied. It turns out that a radiologist had been sued for involuntary manslaughter because a patient had died in his department from a contrast reaction. Although deaths like this had happened well over a hundred times over the years, the apposing council brought in enough radiologist’s who stipulated that the standard of care for kidney stones was a non con CT abdomen. Back then I know there were thousands of IVP’s being done every day of the week in the US, so it really wasn’t the standard of care in most facilities at all. But the radiologist lost that case and the rest is history, at least when it comes to performing IVP’s.
On the other hand, there must be plenty of hospitals that have been sued for incidents involving mismarked films/images, yet almost no one has a 100% marking policy in place.
I’ll end by just writing that using less mAs is always a great thing as long as your image is perfectly diagnostic for your facility.