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RAD 2321
Basic Patient Care

    LEGAL ISSUES FOR
    RADIOGRAPHERS

              Lesson 1

           A Case Study


     University of Arkansas for Medical Sciences
      Division of Radiologic Imaging Sciences
   At the completion of this course, the student
    will be able to:
    ◩ Explain legal terms, principles, doctrines and laws
      specific to the radiologic sciences according to the
      American Registry of Radiologic Technologists
    ◩ Outline the conditions necessary for a valid
      malpractice claim.
    ◩ Describe institutional and professional liability
      protection typically available to the radiographer
      according to the American Registry of Radiologic
      Technologists
   You will need to read the following sections
    in your Patient Care textbook
    ◩ Chapter 2, pages
        50-51   on   Professionalism
        52-54   on   Practice Standards
        58-63   on   Ethical Judgments and Conflicts
        65-71   on   Legal Considerations
    ◩ Appendix A, pages
      382-394 on Radiography Practice Standards
   You will also need to read the “Standards of
    Ethics” section on the ARRT website found at
    www.ARRT.org
It’s early morning on a
                                            rural road in southern
                                            Arkansas. Two vehicles
                                            collide. One driver is
                                            unharmed, the other is
                                            penned in his vehicle for
                                            half an hour until a rescue
                                            unit can extract him.
ww.swtimes.com/PhotoGallery/Galleries/Kaia/15.html
When he got to the ER, the physician was with
  another patient. The charge nurse ordered his x-
  rays.
I am sure that you know when a patient complains of
  neck pain following an accident, it’s a good idea to
  take a radiographic look at the spine for possible
  fracture. A fractured vertebra that is undiagnosed
  has the potential for causing damage to the spinal
  cord.
   X-RAY!
Lateral
                                                                                                  cervical
                                                                                                    spine

http://www.emergencycare.co.nz/courses/default.asp


        Immobilization
           in place
                                                     Weist P., Roth P. Fundamentals of Emergency Radiology 1996
C5???                           C1

C6???
                               C2
                               C3

C7???                          C4




        Weist P., Roth P. Fundamentals of Emergency Radiology 1996
Sagittal section MRI


Weist P., Roth P. Fundamentals of Emergency Radiology 1996
The area not visualized on the first
lateral projection had major damage –
  it just couldn’t be seen. When the
 cervical collar was removed, the neck
was no longer stabilized. The unstable
spine changed position as the patient
  moved, damaged the spinal cord at
     the site of injury, and a major
        paralytic event occurred.

 On the previous slide you can see a
 typical lower cervical spine injury –
one vertebra displaced over another,
       called subluxation.
Look at the facts of the case and form an
opinion based on the reading assignment in
  your text and on the ARRT website.




                              Yes
                               No
   What would be the basis of the case?

   Where would you place the blame for the
    patient’s injury?

   What justification or compensation do you
    feel the patient deserves?

   Is the patient the plaintiff or defendant?
   What responsibility does the radiographer
    hold?

   What could have been done differently to
    prevent this injury?

   Do you feel the patient is owed any
    compensation?

   Is the radiographer/facility the plaintiff or
    defendant?

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LSTE 7310_DUA #3

  • 1. RAD 2321 Basic Patient Care LEGAL ISSUES FOR RADIOGRAPHERS Lesson 1 A Case Study
 University of Arkansas for Medical Sciences Division of Radiologic Imaging Sciences
  • 2.  At the completion of this course, the student will be able to: ◩ Explain legal terms, principles, doctrines and laws specific to the radiologic sciences according to the American Registry of Radiologic Technologists ◩ Outline the conditions necessary for a valid malpractice claim. ◩ Describe institutional and professional liability protection typically available to the radiographer according to the American Registry of Radiologic Technologists
  • 3.  You will need to read the following sections in your Patient Care textbook ◩ Chapter 2, pages  50-51 on Professionalism  52-54 on Practice Standards  58-63 on Ethical Judgments and Conflicts  65-71 on Legal Considerations ◩ Appendix A, pages  382-394 on Radiography Practice Standards  You will also need to read the “Standards of Ethics” section on the ARRT website found at www.ARRT.org
  • 4. It’s early morning on a rural road in southern Arkansas. Two vehicles collide. One driver is unharmed, the other is penned in his vehicle for half an hour until a rescue unit can extract him. ww.swtimes.com/PhotoGallery/Galleries/Kaia/15.html
  • 5.
  • 6. When he got to the ER, the physician was with another patient. The charge nurse ordered his x- rays. I am sure that you know when a patient complains of neck pain following an accident, it’s a good idea to take a radiographic look at the spine for possible fracture. A fractured vertebra that is undiagnosed has the potential for causing damage to the spinal cord. X-RAY!
  • 7. Lateral cervical spine http://www.emergencycare.co.nz/courses/default.asp Immobilization in place Weist P., Roth P. Fundamentals of Emergency Radiology 1996
  • 8. C5??? C1 C6??? C2 C3 C7??? C4 Weist P., Roth P. Fundamentals of Emergency Radiology 1996
  • 9.
  • 10.
  • 11. Sagittal section MRI Weist P., Roth P. Fundamentals of Emergency Radiology 1996
  • 12. The area not visualized on the first lateral projection had major damage – it just couldn’t be seen. When the cervical collar was removed, the neck was no longer stabilized. The unstable spine changed position as the patient moved, damaged the spinal cord at the site of injury, and a major paralytic event occurred. On the previous slide you can see a typical lower cervical spine injury – one vertebra displaced over another, called subluxation.
  • 13. Look at the facts of the case and form an opinion based on the reading assignment in your text and on the ARRT website. Yes No
  • 14.  What would be the basis of the case?  Where would you place the blame for the patient’s injury?  What justification or compensation do you feel the patient deserves?  Is the patient the plaintiff or defendant?
  • 15.  What responsibility does the radiographer hold?  What could have been done differently to prevent this injury?  Do you feel the patient is owed any compensation?  Is the radiographer/facility the plaintiff or defendant?

Hinweis der Redaktion

  1. This portion of Basic Patient Care discusses legal issues that are pertinent to the profession of radiologic technology. Lesson one is a case study. At the end of the lesson you will be asked to give an opinion about the case and submit your thoughts to course faculty via the Submit Assignments tool in the Library. You will have a deadline to meet for the assignment – you will find it on the Calendar.
  2. It’s early morning on a rural road in southern Arkansas. Two vehicles collide. One driver is unharmed, the other is penned in his vehicle for half an hour until a rescue unit can extract him.
  3. After being extracted from his vehicle, the man was taken by ambulance to a local hospital. He had several minor injuries, but his major complaint was neck pain.
  4. When he got to the ER, the physician was with another patient. The charge nurse ordered his x-rays. It is not uncommon for nurses to order radiographs in the emergency room when a physician is not immediately at hand. And I am sure that you know when a patient complains of neck pain following an accident, it’s a good idea to take a radiographic look at the spine for possible fracture. A fractured vertebra that is undiagnosed has the potential for causing damage to the spinal cord.
  5. When the spine has been injured, in this case the cervical spine, the immobilization device that was put in position at the the crash site is left on the patient until the first radiographs are made. The picture on the left shows the patient lying on a spinal board, with both the head and the neck firmly immobilized. The first image made is a side view of the spine, called a lateral. The physician will review the radiograph for signs of vertebral fracture or displacement. If damage is not evident, the physician will instruct the radiographer to remove the immobilization devices and proceed with the remainder of the radiographic examination. The stabilization devices are never to be removed until the spine is radiographically checked for damage and cleared for removal by the physician.
  6. When the radiographs were available for viewing, the radiographer noticed that the lower portion of the cervical spine was not well demonstrated. You will learn that when doing cervical spine trauma radiography, all of the vertebrae must be demonstrated. You should be able to see on the image on the slide that only 4 of 7 cervical vertebra are clearly visible. Notice that only a part of C5 is seen, and C6 & 7 are not visible at all.
  7. When the radiographer presented the physician with the radiographs for review, she said nothing about the lower portion of the spine being inadequately visualized. The physician wanted to see the spine better, and the conversation probably went something like this: Physician: I need a better look at the lateral, can you do anything differently? Radiographer: I can get a better view if he can sit up or stand up. Physician: He doesn’t seem to have any other injuries that would prevent him from moving into the upright position, so go ahead.
  8. The radiographer returned to the radiology department, had the patient stand up, and obtained a much better lateral radiograph. She was, in fact, able to show all 7 cervical vertebrae this time.
  9. But twenty minutes later a once mobile patient was paralyzed from the neck down, for life. So what happened here? The area not visualized on the first lateral projection had major damage – it just couldn’t be seen. When the cervical collar was removed, the neck was no longer stabilized. The unstable spine changed position as the patient moved, damaged the spinal cord at the site of injury, and a major paralytic event occurred On the slide you can see a typical lower cervical spine injury – one vertebra displaced over another, called subluxation. And if you think this lateral cervical looks different from the earlier image, you’re right. This image was obtained using a modality called magnetic resonance imaging, or MRI for short. The original image was done via conventional methods of radiography.
  10. Well, does the patient in this case study need an attorney? Answer these questions: If yes, what would be the basis of his case, and, where would you place the blame for the patient’s injury? If you don’t think he has a case, justify your answer. Please combine this assignment with the assignment in Lesson 3C. Submit your opinions to me by the deadline posted on the Calendar, and use the Submit Assignments tool in the course Library to send your opinions to me.
  11. Well, does the patient in this case study need an attorney? Answer these questions: If yes, what would be the basis of his case, and, where would you place the blame for the patient’s injury? If you don’t think he has a case, justify your answer. Please combine this assignment with the assignment in Lesson 3C. Submit your opinions to me by the deadline posted on the Calendar, and use the Submit Assignments tool in the course Library to send your opinions to me.
  12. Well, does the patient in this case study need an attorney? Answer these questions: If yes, what would be the basis of his case, and, where would you place the blame for the patient’s injury? If you don’t think he has a case, justify your answer. Please combine this assignment with the assignment in Lesson 3C. Submit your opinions to me by the deadline posted on the Calendar, and use the Submit Assignments tool in the course Library to send your opinions to me.