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Case 4

A 2-year-old boy fell from the sofa, landing head first on the floor at home. He was admitted immediately to the Accident and Emergency Department of a local hospital. After primary medical care had been given, the medical officer (MO) requested 3 views for skull X-ray (occipital-frontal, lateral and Towne's projections). His grandma and domestic helper accompanied him to the A&E X-ray room. There were two radiographers on duty at that time and they required someone to hold the baby during the X-ray exposure, because the baby was too anxious and kept crying. The radiographer explained to the two caregivers about the hazards involved and the reasons for holding the baby. He also asked them who would hold the baby. The grandma refused at once, saying that she did not want to have any X-ray exposure even if she would be given a lead apron for protection. She also turned to the domestic helper, saying that it was she, who 'made' the baby fall down, so she should be the one to hold the baby. However, the domestic helper was an Indonesian who spoke neither Chinese nor English. The radiographer tried to use simple English and body language to ask for her last menstruation period (LMP), but failed, as she could not understand. The radiographer would not let the domestic helper hold the baby if her LMP was not known, but the grandma insisted on allowing her do so. After about 15 minutes of negotiation, the grandma asked the radiographer to see if her grandson's injuries were severe or not, and if it was okay that the X-ray films were not taken. The radiographers refused to give any comments on that, explaining that it was not their duty to do so. The radiographers suggested that she return to the MO for consultation about these questions. The grandma and child did not come back to the X-ray room again.

The nest day, the patient relations officer (PRO) received a complaint from the family. They complained that the two radiographers had breached their duty, because they were not willing to answer the questions raised by the grandma about the severity of the baby's injuries and whether the X-ray films could be omitted. Also, the family were not satisfied as the radiographers had prevented the domestic helper from holding the baby, even though the grandma wanted her to do so, which resulted in postponement of the examination. They also said that the baby still kept crying all the time since then and it may probably be due to some internal injuries that were not diagnosed.