California leads radiation dose regulation efforts

Because of all the attention currently focused on radiation dose, a California imaging bill addressing radiation exposure has the potential to spread like wildfire to other states. California is a state that doesn’t wait for others to address a problem, so it’s possible similar bills could pop up around the country. The bill has passed the California senate and is now in the California Assembly Appropriations Committee with a hearing set for Aug. 4. Sen. Alex Padilla (D-Pacoima) is lead sponsor of the bill.

The bill, SB 1237, would require hospitals and clinics to record radiation dose of CT scans. The bill would also require CT services to be accredited by an organization approved by CMS and calls for facilities to report any overdose to the patient, treating physician, and California Department of Public Health.

“Right now the likelihood of the bill becoming law appears good because the senator has been effective in working with stakeholders to address their concerns and in conveying the need for the legislation to his colleagues in the senate and assembly,” said Padilla’s press office.

Sen. Padilla introduced the bill in reaction to the incident at Cedars-Sinai Medical Center in which 260 patients were exposed to high radiation doses.

However, recording radiation dose is a tricky business, as Diagnostic Imaging has previously reported.

The process isn’t as cut and dried as writing down a number, said Bob Achermann, executive director of the California Radiological Society.

Different machines record dose differently. Some use dose length product and some use CT dose index. The bill has been amended to require that if its machine(s) can do so, a facility must record the dose. If not, it’s not required.

“I think we got the original intent of the bill down to something manageable,” he said.

The California Radiological Society opposes the last set of amendments because it would require reporting any repeat CT exams.

“If a patient moved in a scanner, or something just went wrong, that kind of repeat examination is not a significant event. It’s just the practice of medicine,” Achermann said.

The California Hospital Association also opposes the bill unless amended because its proposed standards seek to address a very complex area where the proposed treatment can vary according to the condition of the patient, the association said.

The bill is supported by the American GI Forum (a Congressionally chartered Hispanic veterans and civil rights organization), the Children’s Advocacy Institute, the Breast Cancer Fund, the American Association of Retired Persons, California Nurses Association, the Consumer Federation of California, Congress of California Seniors, and the Consumer Attorneys of California, according to Padilla’s office.

The legislation has received bipartisan support throughout the legislative process and to date has not received any “no” votes.