Radiation Overdoses and Brain Scans

The U.S. Food and Drug Administration has widened its investigation into radiation overdoses that patients have received from a type of brain scan, suggesting that the problem may be a nationwide issue.

The FDA announced in January of 2010 that it was reviewing whether radiation overdoses occurred at Providence St. Joseph Medical Center in Burbank and a hospital in Alabama.

Providence St. Joseph is one of three hospitals in Los Angeles being investigated for problems with CT brain perfusion scans, a procedure used most often to diagnose strokes.

The scanners at the other two hospitals were made by General Electric; the scanner at Providence St. Joseph was made by Toshiba. It was orginally postulated that there was a manufacturing issue.

“Given the fact that we are dealing with two manufacturers and multiple institutions, we wouldn’t be surprised” to find problems elsewhere, said Dr. Jeffrey Shuren, acting director of the FDA’s Center for Devices and Radiological Health.

A spokesperson for the L.A. County Department of Public Health, said 34 patients appear to have received excessive radiation at Providence St. Joseph over a 20-month period ending in October.

The first radiation overdoses were discovered at Cedars-Sinai Medical Center in August of 2009, which led investigators to make inspections of all 11 hospitals and facilities in L.A. County that offer the scans. Cedars-Sinai discovered that it had accidentally exposed more than 200 patients to eight times the normal radiation for the procedure. The overdoses went undetected for 18 months, even as many patients lost hair as a result.

At the other LA County hospital, Glendale Adventist Medical Center, 10 patients received up to four times the normal level of radiation over a 10 month period.

At both Cedars-Sinai and Glendale Adventist, the overdoses began after the hospitals had reprogrammed their machines to use a new protocol — a set of computerized instructions — to control the scans.

In Alabama, Becky Coudert, a 59-year-old teacher, received a CT brain perfusion scan Sept. 8, 2009 at Huntsville Hospital. Within weeks, she had a bald strip around her head above the ears. Reports are that she had received several times the appropriate radiation dose. Hunstville Hospital has now notified 60 patients that they may have received overdoses of radiation.

The FDA estimates that 150,000 CT brain perfusion scans are performed each year in the United States.

The procedure is known to use more radiation than most other CT scans. It lasts 45 seconds as the patient is injected with an iodine solution and a rapid series of X-rays are taken to create a detailed picture of blood flow in the brain.

The FDA is still investigating whether the overdoses resulted from human error, problems with the machines or a combination. If you or a family received an overdose of radiation, you should speak to a lawyer with experience in radiation overdose.