Cabell Huntington Hospital in Huntington, W. Va. has been issued a notice of claim alleging that the hospital’s radiology department overexposed CT angiography patients to radiation by as much as eight times—1.5 to 4.5 Gy—between 2009 and 2010.

The notice, submitted by the law firm of Hill, Peterson, Carper, Bee & Deitzler in Charleston, W. Va., requires the hospital to respond within 30 days (either by mediation or a call for clarification) or face a malpractice suit. In part because the hospital has not provided estimates of the number of affected patients, the Hill and partners firm continues to investigate the hospital’s actions, representing 25 to 30 patients who received well over the recommended radiation dose for CT angiograms (CTA) of the head and neck.

“As many as hundreds or even thousands of patients could be involved, we really don’t know,” Aaron Harrah, JD, an attorney on the case, told Health Imaging News.

“What’s really unfathomable is that the FDA had just warned this and other hospitals about the dangers of these exams,” Harrah said. Photos taken by The New York Times showed patients with what look like bands of baldness circling the forehead.

The firm alleges that negligence is at fault in the cases, which they say has increased the patients’ risk of cancer and elicited memory problems, headaches, nausea and incarnadined skin, as well as causing ‘emotional distress.’ The firm also indicated it may be investigating the hospital’s cover-up of the cases.

The patients were imaged with contrast-enhanced CTA at Cabell Huntington between Oct. 9, 2009 and Nov. 23, 2010 for trauma injuries, stroke and other procedures. In addition to unspecified monetary recompense, the patients’ attorneys are pursuing medical monitoring—a court-appointed committee that would include physicians and advise patients on continued follow-ups to the exposure, while also guaranteeing that the hospital provided all necessary coverage.

Also representing the patients and working with Hill and partners is Owen, Patterson & Owen, a law firm based in Valencia, Calif., which is currently representing patients who claim to have experienced similar overexposure to radiation at Cedars-Sinai Hospital and two other Los Angeles-area hospitals.

Harrah argues that this case is especially significant because the studies were head and neck exams, therefore concentrating the radiation doses in those vital areas. If mediation fails and the case proceeds to trial, Harrah indicated the process could last between two and four years. “The ball is in the hospital’s court,” he said.