Wondering What Became of the Fluoroscopy Safety Rule?

Wondering What Became of the Fluoroscopy Safety Rule?

Texas Fluoroscopic Radiation Safety Update

The Texas Administrative Code Part 289.227 went into effect on May 1, 2013 requiring classroom training for physicians performing Fluoroscopically Guided Interventional (FGI) procedures because of the increased use of fluoroscopy and the resultant radiation injuries. Multiple studies across the United States documented the increase in the utilization of imaging procedures and the resultant increase in population radiation dose from medical radiation exposure.  The growth of imaging studies had spread to independent imaging centers in emergency centers, orthopedics centers, gastrointestinal centers and pain management clinics.

The lack of radiation safety training for non-radiology students in the majority of medical schools and the proliferation of high dose digital radiation producing machines prompted the FDA to recommend radiation safety training for all non-radiology personnel using fluoroscopic equipment. For those educated in radiation safety, it was a vital step for patient protection.  States adopted different regulations for training, but the training and continuing education became the basis for best practice for patient protection.

In Texas in January 2015, enforcement of the rule was abruptly suspended and tabled, leaving the medical imaging community frustrated and concerned.

We have news from the State Bureau of Radiation Control!

Following is a response recently received from Charles “Chuck” Flynn, M.S., H.P., Manager, PSQS Radiation Group of the Texas Department of State Health Services.

In response to a request from the Texas Radiation Advisory Board regarding the subject rule as currently written in Texas Administrative Code, Title 25, Section 289.227 (m)(9)(E), John Hellerstedt, M.D. and Commissioner of the Texas Department of State Health Services, issued a letter dated September 9, 2016.

In the letter, Dr. Hellerstedt states that he has “directed the Department’s Radiation Control Program staff to proceed with a language change in the rule that will modify the currently written requirement to a strong recommendation”, further stating that in the rule “shall” will be replaced by “should”.  Dr. Hellerstedt’s statements conclude with “Department inspectors will continue to encourage radiation safety officers to ensure that technicians and practitioners in their facilities demonstrate competency in this modality as a way to improve patient and staff radiation safety.”  Accordingly, the DSHS Radiation Control Program will proceed to update the currently written rule during the next scheduled opportunity to open the 25 TAC §289.227 rules.

This movement to accommodate the regulation as a best practice for patient radiation safety gives credence to a radiation safety program administered by a radiation safety committee to implement training protocols as a medical credentialing procedure. We will keep you posted as we learn more.  Your comments are welcome!

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