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The “full disclosure for the patient” concept that has animated the push for breast density notification laws is spilling into other areas of imaging. A bill speeding through the New Jersey Legislature would require that patients be notified of chest X-ray abnormalities. Doctors have concerns.

Assemblyman John Burzichelli, D-Paulsboro, introduced bill A4227 in tribute to sister-in-law Claudia Burzichelli. He calls it Claudia’s Law. Claudia, who founded the Center for Effective School Practices at Rutgers University, died June 7 at age 54 from lung cancer. The assemblyman said she had seen a doctor about a persistent cough. A chest X-ray showed an abnormality but no one told her, he said.

Two years later, he said, another chest X-ray showed that the abnormality had become late-stage lung cancer. He thinks Claudia would have had a better chance at beating the cancer if it had been caught and treated earlier.

John Burzichelli told the South Jersey Times newspaper of Woodbury:

I had people approach me about this in similar situations with lungs. It’s just human error. It’s not by malicious design. The idea is to give patients as much information as possible.

The medical community has reservations about requiring notification after some tests but not others. “We absolutely commend the assemblyman for encouraging more education for patients,” said Mishael Azam, chief lobbyist for the Medical Society of New Jersey, “but it does raise some concerns about the piecemeal nature of legislation.” Azam said preliminary and inconclusive reports of abnormalities could needlessly alarm patients. “Individual test notices will be sent with no discussion or context.”

She was quoted by the Courier-Post newspaper of Cherry Hill, New Jersey.

Burzichelli said he was open to tweaking the bill. “We don’t want to alarm people,” he said, “just give them as much information as possible so that they can make the decision to pursue further actions.”

Radiologist Christopher Gribbin, MD, a trustee of the medical society, said, “We certainly support the intent of the bill,” but added, “I am a little surprised the bill went through so quickly.”

The state Assembly passed the bill unanimously. Senate President Stephen Sweeney, D-West Deptord, planned to sponsor it in the Senate.

The bill requires that patients be told: “Your chest X-ray shows an abnormality that may be associated with a risk factor for various illnesses. This information about the result of your chest X-ray is given to you to raise your awareness. Use this information to talk to your health care provider about any risks for illness that pertain to your personal medical history. At that time, ask your health care provider if more screening tests might be useful, based on your risk. A report of your results was sent to your physician.”

Related CME seminar (up to 42.5 AMA PRA Category 1 credits™): UCSF Radiology Review: COMPREHENSIVE IMAGING


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