Figure 7 Figure 5
There are several potential legal risk
involved with using digital equipment,
but the one that is by far the most pertinent and important involves post collimation (shuttering). As an example,
refer to Figure 9. This is a lateral C-spine
image which was then post collimated
too tightly, leaving the anterior mandible cut off, but left the marker on (this is
how it is known it was post collimated).
Months later, there was a tumor located
in the mandible and the patient required
major reconstructive surgery. Afterwards,
the patient’s attorney requested all of the
radiographs and realized that if the mandible had not been post collimated, the
tumor would have been discovered half
a year earlier and the patient’s mandible
could have been saved. Sadly, stories like
this are common in our industry. This
makes hospitals at risk to lose millions
of dollars on one single case. Since all
these lawsuits were settled out of court,
it is impossible to know how often this
has already occurred around the country.
Legally, the radiologist’s responsibility
is to read all of the anatomy that is radiated and ends up on the Image Receptor (IR). This means if a chest x-ray is
not collimated well and gall stones can
be seen and the radiologist misses the
Figure 9 • Lateral C-spine.
The legal risk that is by far the most pertinent and
important involves post collimation (shuttering).
Figure 6 Figure 8
chart could be put together for them.
Two years later, CHOMP received three
Siemens DR rooms and over the next year
technique charts were developed for them
as well. It then became apparent that the
techniques were almost identical, so universal DR Cesium charts were created.
Since the facility also had Gadolinium
based detectors (the corded Canon mod-
els), separate charts were developed for
them as they needed 50% more mAs than
the Cesium based detectors. These charts
are very large and can be viewed at digit-
alradiographysolutions.com (click on “All
Charts”). All of the previously described
charts are also there.