Types and Causes of Radiation Errors

xray3.jpgIndiana medical malpractice cases involving radiation errors are extremely technical and complicated. One reason is because there isn’t just one way in which a radiation error can occur. With new medical technologies, using radioactive rays to diagnose and treat, and a continued paucity of training and oversight, the types and sources of these errors have increased.

The types of errors have been numerous.

• Errors have occurred due to malfunctioning ultrasound machines.
• Radioactive seed therapy has gone wrong because seeds were planted in the wrong location.
• Treatment schedules have not been followed strictly.
• Treatments devised for one patient have been given to another.
• The wrong body parts have been radiated. This has happened because the system was set up incorrectly, or system warnings were ignored. In other cases, therapists have wrongly entered coordinates, or have used a template from a previous treatment cycle to implement a current treatment.
• Dosage errors have been some of the most frequent radiation mistakes. These have occurred because of
• Improper configuration of beam adjusting systems • Failure by medical physicists to perform a chart check • Lack of training of temporary and permanent staff • Faulty dose verification methods
Several factors have combined to generate this crisis in radiation treatment.

• Hospitals have been too quick to rely on computers, even in the case of technologies that are new and need to be tested further.
• Manufacturers have failed to provide foolproof technical safeguards that can prevent the equipment from being used when these have been wrongly set up.
• Federal agencies have failed to regulate the market for these devices.
• Safety protocols that were in place earlier, have become outdated, and are not adequate for new technologies.
• Training of radiation therapists, medical physicists and other technical staff has been inadequate in many states.
• In some cases, unqualified medical physicists have been able to slip through the cracks, and find employment at hospitals.
• Hospitals operate in a culture that encourages hierarchical subservience, where a therapist who notices a wrong dose doesn’t question it, or inform the doctor about it.
• There have been staffing problems, with shortages resulting in overstressed, sleep deprived technicians who are more likely to make errors.
• State and federal regulators have failed to set standards, and define responsibilities.

None of these issues are without remedy, but it will take an overhaul of the radiation technology industry, revision of safety protocols and training processes, as well as greater federal involvement, to set stronger standards and prevent these errors.