John Kenward MRCVS, a director of Maidstone practice Pet Emergency Treatment Services, has been given a conditional discharge for allowing an employee to X-ray her own foot after a horse stamped on it.
Maidstone Magistrates heard that the employee, a 25 year-old vet and equine intern, was afraid the foot was broken and she might be unable to do that evening's on-call duty.
As a result, she rang Mr Kenward. As they were both concerned she could be held up in hospital A&E, Mr Kenward suggested she use the in-house X-ray kit. He gave her the settings to use and she carried out the test, which showed no break so she continued to work as normal.
Another director, who acts as Radiation Protection Supervisor, later noticed a human image on the digital processor. This led him to notify other practice board members of his intention to interview staff about the suspected breach of site radiation safety policy. He was immediately told by Mr Kenward not to discipline the vet intern as he had suggested that she use the X-ray.
As a result the Health and Safety Executive was contacted and an investigation confirmed a breach of radiation regulations.
Although the vet intern, from Maidstone, was the only person present during the X-ray exposure, she did not wear a personal dosemeter during the procedure.
However, HSE told the court that Mr Kenward was fully aware that the rules of the practice clearly stated nobody should be placed within the beam of the X-ray machine.
Mr Kenward was ordered to pay £1,296 in costs after admitting a breach of the Health and Safety at Work etc Act 1974.
After the hearing, HSE inspector Rob Hassell said: "Any vet practice using ionising radiation for medical exposures must ensure that the X-ray equipment is properly maintained and that the requirements of the Ionising Radiations Regulations are complied with. The view of HSE and the Department of Health is that it is highly unlikely that all these conditions can be met by a veterinary practice.
"It follows therefore that X-rays must not be taken of human beings at practices. We are aware that the X-raying of people may not be unique to this particular practice so I hope others will take note that HSE is prepared to prosecute if such breaches come to light."
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There are several issues here. Firstly despite what any of you may think or do in your work place, you are not allowed to x-ray people. Even if you are vets who are 'qualified regarding the use of x-rays'. To do this you need to be a radiographer who has completed an appropriate degree in radiography. Secondly, vet's practices are not licenced to administer ionising radiation to people. Thirdly anyone x-raying people has to comply with the IR(MER) regulations and the IRR regulations, whereas the former do not apply to veterinary practice. This is where the article is incorrect - it should mention that veterinary use of ionising radiation does not come under the IR(ME)R regs.
Lastly in order to x-ray a person a request has to be made by an appropriately qualified referrer, ie a doctor or other suitably qualified medical professional. This does not include vets.
It is frankly disappointing to see the number of responses here from vets who don't seem to think there is anything wrong with x-raying a person. It is even more worrying that they all have access to x-ray machines. If you cannot see any difference between x-raying a person and x-raying, say, a dog, then please do the following. Look in your favourite journal and see how many articles there are regarding radiation protection of the patient in veterinary medicine. How many vets are interested in reducing the radiation dose to their patients? Now do the same for human radiography. You will see that the difference in culture is immense.
Australia following the UK with +++ red tape/regs etc. Our radiographic equipment has to be checked by EPA regularly. Only vets supposed to take views but if one is holding the animal (even anaesthetised), one would need a third hand to press the button !
I have been radiographing my hands (osteoarthritis) every couple years (& feet a couple of times when I thought I broke a toe) for years !
First diagnosed after a cat bite over 2nd phalanx first finger L hand almost 20 years ago. When a radiograph of my finger was taken at RPA hospital, Sydney, NSW, the staff didn't even provide me with a thyroid collar while they all ran behind a screen !! So much for OH&S !!
Sounds petty to dob someone in for taking a radiograph of themselves.
Dexter, you've hit the nail on the head.....every practice in this country shouldn't be registered to use x-rays. FULLSTOP. Clearly no-one can meet ALL the specified conditions anyway..so the only way to satisfy them conditions is to stop using x-rays right. Only prob is there is no real alternative and so really it comes down to common sense ..... minimizing unintended exposure as far as is possible. I strongly feel in this case the failure to differentiate between "intended and un-intended" exposure actually led to the prosecution. Vets are qualified regarding the use of x-rays and so it would appear common sense is now fast becoming an "endangered" notion.
Hands up anyone who hasn't done this!! Perhaps I'm too near retirement as well, but I do find the endless procession of people with clipboards ticking boxes (on missions that, to my amusement, they continually assure me are not box ticking exercises) a little tedious. Especially when many, it would appear, lack the knowledge, experience or even the common sense to tell me how to do my job! For such a person, having brought a prosecution, to come out with the statement that "Any vet practice using ionising radiation for medical exposures must ensure that the X-ray equipment is properly maintained and that the requirements of the Ionising Radiations Regulations are complied with. The view of HSE and the Department of Health is that it is highly unlikely that all these conditions can be met by a veterinary practice." beggars belief in that those very conditions in the statement all need to be met before the practice could have and use an Xray machine in the first place!
When I told my own medical human GP, she was incredulous and asked why we couldn't X-ray ourselves.
To the person who asked why the person didn't delete her X-ray - you can't from digital systems, unlike the more common X-ray film technique (where more exposures may be needed to get the right one) of throwing in the bin after viewing. Hmm.
One wonders at this world and it brings to mind the police finding it much more efficient to prosecute for minor but recordable traffic offences than root out the more complicated and dangerous ones.
"The view of HSE and the Department of Health is that it is highly unlikely that all these conditions can be met by a veterinary practice"....obviously the Radiation Protection Supervisor aka Diector has himself managed to meet all the conditions for him to take others to task. Secondly that rule applies where "unintended exposure" is the premise...i.e to protect staff and clients not being x-rayed. In this case exposure was intended and consented to. Question is "did she over expose?" What a shame when your own colleague cannot even sort issues with you inhouse. Vets are becoming an endangered species lol....
You can understand the temptation ,on one wants to hang around A&E for 3-4 hours with the drunks, junkies, domestic punch ups, teenage over doser's and ladies of the night. Can't help thinking there are some underlying machiavellian politics underway in that practice, someone in a hurry to see the back of someone else ?.
In one of the presentations on last year's BSAVA it was recommended to use a wooden spoon to flatten the abdomen when taking lateral x rays for suspected fb. This helps a lot to identify linear fbs and intussusceptions. I have done that regularly, wearing appropriate protective apron and dosimeter. Is this now "illegal" or dodgy practice???
Just dropping in to this chat now the theme that comes across in the comments is that everyone is depressed and waiting to retire. What a sad profession we are. Can't we fight back a bit?
Of course if she had deleted the xray afterwards.......
I trust that some personal experience of the local A&E Department was arranged for the Radiation Protection Supervisor following the court case.
Publishing Editor: Arlo Guthrie
Clinical Editor: Alasdair Hotston Moore MA VetMB CertSAC CertVR CertSAS FRCVS
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