Beware of radiation overdose

First of all, this is not meant to scare you. This is simply to make you aware. Through the use of radiation, imaging techniques have greatly helped diagnostic medicine in saving lives. Through radiotherapy, cancer patients have gotten a new lease in life. But let’s face it. Despite its benefits, radiation especially ionizing radiation has its share of risks. Radiation can affect the cells, tissues and organs to cause cell damage and death that may be irreversible.

In a previous post, I have cited recent studies which lament lack of regulations of the use of imaging techniques, especially computer tomography (CT) scans.

This lack of proper regulations has led to several tragic accidents, that is, radiation overdoses. I describe these cases below.

Radiation overdose through CT scan

In October 2009, the New York Times reported two cases in California.

Case 1: This involved the well-known Cedars-Sinai Medical Center in Los Angeles. The hospital reported that it is possible that as many as 206 patients (median age 70 years) who underwent a CT brain perfusion scans were exposed to radiation up to 8 times more than the normal dose. The patients were suspected to have had a stroke and this type of diagnostic procedure can determine the presence of blood flow problems in the brain. Upon discovering the mistake, the hospital immediately alerted the health authorities. The US FDA then in turn alerted other clinics using this type of CT procedure.

Case 2: This case is so tragic because it involved a 2 ½-year-old boy evaluated at Mad River Community Hospital in Arcata. The child was subjected to over an hour of CT scan, a procedure which should normally take a few minutes. The hospital did not report the incident to the health authorities. The most difficult part of such cases is the fact that the damage, which may range from cataract to cancer, will only come out in years or even decades. And this kid still has whole life before him.

According to USCF researchers who evaluated CT scan safety:

“…Our results highlight the need for greater standardization because this is a medical safety issue.”7

Radiotherapy overdose

Radiation is used as therapy for many conditions, including cancer. Unfortunately, overdoses in radiotherapy also happen. Last month, the New York Times published a report about cases of radiation therapy that proved more fatal than the diseases they are supposed to cure.

Case 1: One case was 43-year old Sparks who was treated for tongue cancer. Unfortunately, due to computer error, the linear accelerator blasted high-energy radiation to his brain and neck for 3 consecutive days.

Case 2: In another case, a 32-year old breast cancer patient was subjected to radiation 3 times the prescribe dose – for 27 days. The accelerator used had a missing filter which the operators never noticed. The radiation overdose burned a hole into her chest. The report continued to explain that while the latest in radiation technology helps to diagnose tumors more swiftly and precisely, it has also become so complex that there is a lot of room for error that includes “software flaws, faulty programming, poor safety procedures or inadequate staffing and training.” Furthermore, there is no regulatory agency overseeing the use of medical radiation and there are no guidelines about reporting accidents and medical errors involving radiation. A search of records showed that some hospitals never report radiation-related errors. Some errors go on for months, up to a year being discovered, thus affecting a large number of patients.

Health experts are calling for more regulations about radiation use in medicine whether as a diagnostic or as a therapeutic tool.

To be fair, some hospitals are trying to do the right thing by informing patients of the risks, and reporting errors.

In the case of Cedars Sinai, they reported the cases and admitted that their flawed procedures might be responsible for the overdoses. However, its chief executive, Thomas M. Priselac, said the manufacturer could help to prevent future errors by improving its internal settings and by installing more safeguards.

The Henry Ford Health System issued a statement to inform their patients of potential risks. Furthermore, the recommend patients to ask questions before a CT scan that would include:

• 1. Why do I need this exam?
• 2. How will having this exam improve my health care?
• 3. Are there alternatives that do not use radiation which are equally as good?
• 4. Is my child receiving a “kid-size” radiation dose? (for pediatric exams)