HOSPITAL AUTHORITY OF HALL COUNTY vs ADAMS (GA., 1964): SLIP-AND-
FALL-LEAVING THE PATIENT UNATTENDED
After taking a series of radiographs, the x-ray technologist left the patient, who was
medicated and suffering from nausea, unattended on the x-ray table. Hearing
groans as he reentered the room, the x-ray technologist assumed that the patient
was in the bathroom vomiting. In fact, the patient was lying on the floor beside the x-
ray table. The patient, experiencing a wave of nausea in the x-ray technologist's
absence, had attempted to get off the table and walk to the bathroom by himself.
But, because of the medication, he had lost his balance and suffered a fall and
subsequent injury. The court ruled in the patient's favor. It held that the radiographer
should have anticipated that a nauseous patient might try to use the bathroom and,
that since the medication affected movement and coordination, the patient might
suffer injury if allowed to move unassisted.
a. Before subjecting a female patient of child-bearing age to x-rays, the patient
should be asked if she is or could be pregnant. Non-emergency studies should be
postponed if there is any doubt, at all. In emergency situations, the risks versus the
benefits should be evaluated. The literature indicates that doses as low as ten Rads
administered at critical stages may cause embryonic abnormalities in rats and mice.
While such doses do not seem to contribute to congenital malformation, intrauterine
growth retardation, or fetal death in human embryos, they could cause mutagenic or
carcinogenic effects.15 Most diagnostic procedures performed on a potentially pregnant
woman involve a dose of 0.3 to 1.0 rad. But the patient should be spared that risk,
however minimal, and the anxiety over possible effects of exposure in the early stages
of pregnancy when fetal development is most critical.
b. Pregnancy is one area that demonstrates the great importance of taking an
accurate history. The x-ray technologist must make the appropriate inquiries of the
patient. (From a legal standpoint, it is the primary physician who is implicated, not the
radiologist, if a proper history is not taken.) The physician must find out about the
patient's status with regard to pregnancy through proper testing and examination. The
radiologist must ensure that if radiation is required, the study is monitored so that the
fetus is exposed to the minimum dose possible.