California RT gives deposition in CT overdose case

By Donna Domino, AuntMinnie.com staff writer

December 10, 2009 -- The California radiologic technologist accused of operating the CT scanner that delivered a massive radiation overdose to a 23-month-old boy in 2008 testified last week that she only pushed the CT scan button a few times, and she doesn't understand how the toddler received 151 scans in a single imaging session.

Raven Knickerbocker, who is accused of subjecting Jacoby Roth to more than an hour of continuous scanning, said she only pressed the scan button "two to four times," according to the Roth family's attorney, Don Stockett, who questioned her during a December 4 deposition in preparation for a civil trial in a lawsuit filed by the boy's parents.

Knickerbocker testified during the deposition that she performed two scout scans and then tried to start the examination, but the machine did one rotation before it stopped and displayed a fault code, said Stockett, whose practice is based in Folsom, CA. She asserted the scanning procedure lasted only about 20 minutes.

Jacoby Roth several hours after receiving 151 CT scans in a 68-minute period. Photo courtesy of Roth family attorney Don Stockett.
In January 2008, the boy was taken to the emergency room at Mad River Community Hospital in Arcata, a small town 290 miles north of San Francisco, after he fell out of bed and could hardly move his head.

The ER doctor ordered x-rays and CT scans to check for damage to the child's cervical spine. The boy was taken to the scanning room, where Knickerbocker performed CT scans at C-spine levels C1 through C4 in the same section of the midmaxillary sinuses, midclivus, and posterior fossa. Over the next 68 minutes, the toddler was exposed to 151 scans.

Within a few hours, the child developed a bright red ring around his head from the massive radiation overdose. Photographs of the left side of the boy's face show a clear line extending from the infraorbital ridge backward through the ear and nape of the neck; a similar line extends from the infraorbital ridge through the ear on the right side.

In off-the-record comments, one state official called it the worst case of radiation overdose of a child in the U.S.

Dave Laumann, the head technologist at Mad River at the time, told the state agency that he had stopped in to check on Knickerbocker, saw she was having problems, and suggested that she reboot the scanner. But Knickerbocker testified last week that she asked for help, but no one ever came. The boy's parents have also said no one entered the room during the lengthy scanning session.

"Somebody's not telling the truth," observed Stockett during a phone interview with AuntMinnie.com.

Bruce Fleck, the hospital's former radiology manager, testified during the state hearing that Knickerbocker subsequently gave many explanations for the incident, such as the boy's parents distracted her, the scanning table wouldn't move incrementally, and the boy's father was leaning on the table. Knickerbocker could not provide a "valid explanation" of why she took 151 images of the same location, Fleck said. "I think it was just a rogue act of insanity," he told a stunned court in September.

Knickerbocker, who was fired shortly after the incident, is contesting the state's revocation of her license. Stockett has filed a lawsuit against the hospital and Knickerbocker, claiming negligence and medical battery.

The boy's blood sample was sent for analysis to Dr. David Lloyd, a DNA specialist and principal investigator of the Molecular Design Group of the School of Biochemistry and Immunology at Trinity College in Dublin, Ireland. Lloyd's analysis of the child's lymphocytes found he sustained substantial chromosomal damage, Stockett said.

Dr. Fred Mettler, a radiation injury specialist at the radiology department of the University of New Mexico in Albuquerque, estimates the boy received the following radiation doses: 5.3 Gy to the brain and salivary glands, 7.3 Gy to the skin, and 1.54 Gy to the lenses of both eyes, according to Stockett. The child will probably develop cataracts within three to eights years, Mettler concluded.

A trial in the civil lawsuit is expected to begin in February in Eureka.

By Donna Domino
AuntMinnie.com contributing writer
December 10, 2009

California technologist faces testimony in CT overdose case, September 18, 2009

California hospital fined $25,000 for pediatric CT radiation overdose, March 24, 2009

Parents sue California hospital over CT radiation dose, November 20, 2008

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Last Updated np 12/9/2009 4:46:14 PM