BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                  SB 1237|
          |Office of Senate Floor Analyses   |                         |
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                                 THIRD READING


          Bill No:  SB 1237
          Author:   Padilla (D), et al
          Amended:  4/28/10
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  5-0, 4/21/10
          AYES:  Alquist, Leno, Negrete McLeod, Pavley, Romero
          NO VOTE RECORDED:  Strickland, Aanestad, Cedillo, Cox

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8 


           SUBJECT  :    Radiation control:  health facilities and  
          clinics: records

           SOURCE  :     Consumer Attorneys of California


           DIGEST  :    This bill requires health facilities and clinics  
          that use imaging procedures that involve computed  
          tomography for diagnostic purposes to record the dose of  
          radiation used during the administration of the radiation  
          on the radiology image.

           ANALYSIS  :    Existing law:

          1.Requires the Department of Public Health (DPH) to license  
            persons who receive, possess, or transfer radioactive  
            materials, and devices or equipment utilizing these  
            materials.

          2.Requires DPH to adopt registration and certification  
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            regulations for mammography equipment.

          3.Requires DPH to develop and enforce standards for the  
            education, training, and experience of persons who use  
            radiologic technology on human beings.

          4.Requires DPH, on or before January 1, 2008, to adopt  
            regulations that require personnel and facilities using  
            radiation-producing equipment for medical and dental  
            purposes to maintain and implement medical and dental  
            quality assurance standards that reduce unnecessary  
            exposure to ionizing radiation while ensuring that images  
            are of diagnostic quality.

          5.Requires ionizing radiation machines to be inspected once  
            each year for mammography X-ray units, once every three  
            years for high-priority sources of ionizing radiation,  
            and once every four and one-quarter years for  
            medium-priority sources, as specified.

          6.Requires a facility that operates a mammogram machine to  
            post notices of serious violations in an area that is  
            visible to patients within two working days after receipt  
            of the documents from the department, as specified. 

          This bill, commencing January 1, 2012, requires physicians  
          or other practitioners, facilities, or other entities that  
          furnish diagnostic magnetic resonance imaging, computed  
          tomography, and nuclear medicine services to be accredited  
          by an organization that is approved by the federal Centers  
          for Medicare and Medicaid Services.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes

           SUPPORT :   (Verified  5/18/10)

          Consumer Attorneys of California (source) 
          Breast Cancer Fund
          California Nurses Association
          Consumer Federation of California

           ARGUMENTS IN SUPPORT  :    According to supporters,  
          Californians are at increasing risk of over radiation, and  

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          cites statistics that total exposure to ionizing radiation  
          has nearly doubled over the past two decades, in large part  
          because of increased use of computed tomography scans for  
          medical diagnostic and treatment purposes.  Medical  
          radiation can save lives, but can be deadly if improperly  
          administered, and can increase a person's lifetime risk of  
          developing cancer.  Problems at Cedars-Sinai Medical Center  
          in 2009, in which 206 patients were exposed to overdoses of  
          radiation over an 18-month period, roughly eight times the  
          recommended level of radiation, when a scanner used for  
          brain scans was reconfigured.  Over radiation is difficult  
          to detect if there is no record of the dosage administered,  
          which this bill would ensure.

          The Consumer Attorneys of California (CAC), the sponsor of  
          SB 1237, states that aside from the tragic incidents that  
          occurred at Cedars-Sinai Medical Center, Californians in  
          general are at increasing risk of over radiation that can  
          subsequently increase the risk of cancer.  CAC states that  
          the surge in new technology provides many benefits for  
          diagnosing and treating disease; however, the increasing  
          dependence on it has created new avenues for errors in  
          software and operation, and those mistakes cannot only be  
          difficult to detect, but can become embedded in a treatment  
          plan and repeated over and over with patients.  CAC states  
          that oversight of medical imaging is fragmented and SB 1237  
          is intended to take steps to protect patients, including  
          recording of radiation dosage and adoption of quality  
          assurance programs to prevent errors such as the ones that  
          have been recently reported.

          The Consumer Federation of California (CFC) states that  
          this bill will increase patient safety by deterring  
          one-time over radiation errors, which can cause damage to  
          DNA and increase a person's lifetime risk for cancer,  
          especially for children and youth.  The risk for over  
          radiation is becoming more and more likely, as the National  
          Council on Radiation Protection and Measurements reports  
          that US citizens are being exposed to ionizing radiation at  
          twice the level of two decades ago.  CFC states that  
          one-time instances of over radiation may be difficult to  
          detect without proper documentation of the dosage  
          administered.


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          CTW:nl  5/18/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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