BILL ANALYSIS
SB 1237
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Date of Hearing: August 4, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
SB 1237 (Padilla) - As Amended: June 23, 2010
Policy Committee: Health Vote:19-0
Business & Professions 11-0
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill establishes several requirements for health facility
documentation and communication related to the dosage levels of
radiation used in computed tomography (CT) X-ray and therapeutic
X-ray. Specifically, this bill:
1)Requires a range of health facilities including hospitals and
clinics to, effective January 1, 2012, record the dose of
radiation used to administer CT X-rays for diagnostic
purposes. Requires documentation to conform to specific data
features and according to standardized definitions.
2)Requires health facilities to provide written notice to the
California Department of Public Health, the patient, and the
treating physician under specified circumstances related to CT
X-ray or therapeutic X-ray, including when the imaging is
administered to the wrong patient or in the wrong dosage.
FISCAL EFFECT
No direct fiscal impact to the California Department of Public
Health to continue oversight of radiology professionals.
COMMENTS
1)Rationale . This bill is sponsored by the Consumer Attorneys of
California in response to recent publicity about CT brain
perfusion scans being administered at eight times the maximum
recommended dose in the course of diagnosing strokes at
Cedars-Sinai Medical Center in Los Angeles. These radiation
overexposures continued for 18 months undetected. According
SB 1237
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to the author and sponsor, this bill adopts a regulatory
approach that is currently used in the Medicare program. A
uniform approach will reduce the fragmentation and variability
found with current oversight approaches.
2)Background . CT is an imaging method that generates a
three-dimensional image of the inside of an object from a
series of two-dimensional x-ray images. The technology is used
to supplement x-rays and other diagnostic imaging. In February
of 2008 Cedars-Sinai Medical Center started a new approach to
diagnosing stroke with CT scans. The new approach required
overriding the default levels of the CT scan equipment. There
was a misunderstanding about the setting readjustment that led
to radiation overexposure for more than 200 patients. Once the
issue was identified, the FDA released national warnings about
excess radiation during CT scans and encouraged CT facilities
to review their protocols confirm control panel settings
corresponded reasonably to the doses normally associated with
respective protocols.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081