When Invisible Force co-host Toby Gilk first contacted the California Department of Public Health (CDPH) about a near-fatal 2023 MRI accident at Kaiser Permanente's Redwood City Hospital, he expected a state investigation report. What he got, repeatedly, was a report from the U.S. Centers for Medicare & Medicaid Services (CMS).
The latest episode of The Invisible Force podcast follows co-hosts Gilk and John Posh as they pursue what should have been a straightforward public records request. Instead, they stumbled into a bureaucratic maze with no clear exit and some troubling implications for hospital safety oversight in California.
Despite CMS threatening the hospital with expulsion from its reimbursement program, and the California Division of the Occupational Safety and Health Administration (Cal/OSHA) fined it $18,000 for dangerous workplace practices, the podcast team cannot identify a single state enforcement action against Kaiser Foundation Hospital–Redwood City in CDPH's own public enforcement database. The hospital doesn't appear in the database.
When Gilk and Posh pushed harder by submitting a formal citizen petition asking CDPH to create MRI safety rules for licensed hospitals, the agency's denial revealed something: CDPH claims it has no regulatory jurisdiction over MRI safety, because MRI does not use ionizing radiation and therefore falls outside the state's Radiation Control Law and Radiologic Technology Act.
Yet California's own definition of radiologic services includes MRI. And the state actively regulates prenatal ultrasound providers, another non-ionizing modality. When the podcast team asked CDPH to reconcile that contradiction, they received no satisfying answer.
Adding another layer of confusion, CDPH invoked an investigatory-file exemption to withhold certain records, an exemption that requires a "substantial prospect of enforcement," per the agency's policy guidelines. What enforcement that referred to remains unexplained.
The next episode will examine whether hospital accreditation through the Joint Commission was supposed to serve as the safety net that state licensure apparently did not.
Editor's note: Those working in hospital safety, state health regulation, CMS, healthcare policy, or MRI can contribute to this story and The Invisible Force podcast via its Tip Line -- 631-MRI-TIPS (631-674-8477).
Host
Tobias "Toby" Gilk is the founder of Gilk Radiology Consulting. An architect by training, he has spent over 20 years focusing on MRI safety, initially through the architecture and planning of MRI facilities, but growing into the technology, clinical practice, regulation, and economics of MRI safety. Gilk holds both MR Safety Officer (MRSO) and MR Safety Expert (MRSE) certifications from the American Board of Magnetic Resonance Safety (ABMRS). An evaluator of serious reportable events (SRE), he is also a volunteer member of the Technical Expert Panel (TEP) of the National Quality Forum, and co-author of "The Technologist MRI Safety Handbook."
Co-host
John Posh is an MRI educator, safety consultant, and safety auditor with over 35 years of experience in the field of MRI safety and education, working with outpatient facilities, hospitals, and universities. He owns Posh Education in Bethlehem, PA, and currently serves as global director of education and training for Aspect Imaging, chief academic officer-MRI at John Patrick University, and adjunct professor of medical imaging at Rush University.
This episode of "The Invisible Force" is brought to you by AuntMinnie and the AuntMinnie Podcast Network. You can also find it on Apple Podcasts and Spotify. Check out AuntMinnie's full podcast library, including extras, on Apple Podcasts and Spotify.
