Health Care Department Operations Manual

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Chapter 4 – Special Circumstances

Article 1 – Health Care

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4.1.4 Foreign Body Examination

  • Policy

    • California Correctional Health Care Services (CCHCS) medical providers shall order a medical imaging foreign body examination when medically necessary.  Medical imaging staff shall use approved protocols corresponding to the anatomical area where the foreign body is suspected to be located.

  • Purpose

    • To provide guidance to both medical and custody staff regarding how medical imaging examinations are to be ordered and performed in the event of a suspected foreign body.

  • Responsibility

    • The Chief Executive Officer, or designee, is responsible for the implementation, monitoring, and evaluation of this policy.

  • Procedure

    • Prior to Examination

      • The ordering medical provider shall create an order in the health record to request a foreign body examination.  The order shall identify the anatomical area where the foreign body is believed to be located, a brief explanation of the item suspected, and circumstances of its insertion/ingestion.

      • CDCR custody officers shall escort the patient to the local Medical Imaging Services department.

    • Performing the Examination

      • All clothing (except shorts) and jewelry shall be removed from the patient.

      • The Radiologic Technologist (RT) shall place the patient onto the x-ray table according to the examination protocol for the suspected anatomical area.

      • The RT shall perform the examination following the examination protocol and mark the examination as a STAT in the Radiology Information System and Picture Archiving Communication System (RIS/PACS).

      • A patient may refuse a medical test (e.g., x-ray for contraband) when ordered or recommended by a medical provider.  The refusal shall be documented in the health record.

      • Custody staff may seek a court order for the patient to comply with the examination if the patient refuses the examination recommended by the medical provider or an examination was not ordered by a medical provider due to the absence of a medical indication for the study.

      • Upon receipt of a copy of the court order for the examination, the CCHCS medical provider will order the requested examination.

      • Refusal to comply with a court-ordered examination will be managed by custody staff.  Medical staff will not perform a radiologic examination without the cooperation of the patient.

    • Examination Interpretation

      • Since the examination is marked as a STAT, the Radiologist shall have a final report available in the RIS/PACS within two business hours (between the hours of 7:00 a.m. and 7:00 p.m. Monday through Friday).

      • In the event that the examination is performed outside of the Radiologist’s business hours or an immediate interpretation is needed, the ordering medical provider shall provide a preliminary interpretation and complete a CDCR 7537, Preliminary Interpretation/Discrepancy Report.

      • The ordering medical provider shall give a preliminary interpretation to the requesting custody staff, especially in cases where the patient has been detained (i.e., confined to a cell, placed in restraints), pending the Radiologist’s interpretation.

      • Any questions concerning the interpretation of the examination prior to the Radiologist’s review must be directed to the reviewing medical provider. (No other staff member is authorized to provide an interpretation of the examination).

  • References

    • California Code of Regulations, Title 15, Division 3, Chapter 2, Subchapter 2, Article 2, Section 3999.210, Refusal of Treatment

    • California Department of Corrections and Rehabilitation, Department Operations Manual, Chapter 5, Article 19, Section 52050.20, Degrees and Types of Searches

    • California Department of Corrections and Rehabilitation, Department Operations Manual, Chapter 5, Article 19, Section 52050.21, X-ray Examination

    • California Department of Corrections and Rehabilitation, Department Operations Manual, Chapter 5, Article 19, Section 52050.22, Forcible Retrieval

    • Health Care Department Operations Manual, Chapter 4, Article 1, Section 4.1.5, Contraband Surveillance Watch

  • Revision History

    • Effective: 08/2015
      Revised: 09/2015