State inspections lag for X-rays, other critical medical equipment

State inspections for lasers and half of all registered X-ray machines are overdue due to budget constraints, according to an audit.(Photo: Getty Images/Pixland)

Nearly half of Arizona's registered X-ray machines are overdue for inspection as the state regulatoryagency tasked with handling inspections has struggled with a large backlog and a shortage of experienced inspectors, a state audit found.

The Arizona Auditor General report released this weekfound that 49 percent of the 5,455 registered X-ray facilities in Arizona were overdue for inspection as of June. It found a backlog of inspections at hospitals,doctors offices, chiropractors, dental offices and elsewhere that threatenpublic health and safety by not ensuring machinesare operating correctly.

The Arizona Radiation Regulatory Authority's inspectionslagged even more for certain types of locations, such as doctors' offices or medical clinics,where 70 percent of X-ray machines had not been examined withinthe required three-year time frame.

The Auditor General report saidthat 44 percent of hospitals and therapy centers, considered a high-risk category, had not been inspected within the required two-year period.

In addition to a lack of timely inspections, the audit found the agency did not follow proper steps to certify X-ray technicians. Other duties of the state agency includeregulating businesses and individuals that handle radioactive material, medical lasers,tanning beds andcosmetic lasers. It also monitorsradiation levels at stations outside Palo Verde Nuclear Generating Station.

The report also found examples of other areas that were not inspected in a timely fashion. An ophthalmology office with six lasers for eye treatments had not been inspected since 2004 and a hospital with 93 lasers had not been inspected since 2006.

Aubrey Godwin, executive director of ARRA, said the backlog of inspectionsis largely due to the lack of experienced inspectors. His agency had five inspectors for X-ray equipment as of June, and he said his agency's request for funds to hire more inspectors has been rejected by the Arizona Legislature.

Godwin noted that his agency received federal funding for an inspector who oversees mammography machines, and the audit found inspections on all 160 registered mammography facilities are current.

Godwin said his agency would need one dozen inspectors to meet the recommended staffing levels as outlined by a national organization, the Conference of RadiationControl Program Directors.

He added that his agency has taken other steps to improve workflow for his inspectors, including an electronic filing system designed to cut down on paperwork to allow inspectors more time in the field.

The Auditor General report suggested the agency establish working groups with representatives from the medical community and other stakeholder groups to examine how other states handleinspections, including the possibility of allowing private-sector inspections.

Hospitals, for example, often conducttheir own checks of X-ray machines, lasersand other medical equipment. But Godwin questioned whether a hospital-paidexpert would be willing to issue a critical report and share that information with a public agency.

"We lookedat it (privatizing inspections)in the past and we didn't thinkit was in the public's interest," Godwin said.

The Auditor General report pointed out that the inspection backlog has been a long-standing problem at the state agency, with audits conducted in 1984 and 1995 showing similar results.

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