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Some clients of a Hilton Head Island medical imaging company say they received full-body CT scans from Cancer Check America without a doctor's referral. Company officials dispute the claims.
South Carolina requires medical-imaging equipment to be used under direction and supervision of a licensed practitioner and by prescription.
Health officials say the regulations are intended to protect patients from unnecessary exposure to radiation.
Cancer Check America sales manager David Haddad said the company rented an office at 460 William Hilton Parkway from Atlantic Radiology Associates of Savannah. Atlantic Radiology operates Advanced Imaging, which performed scans for Cancer Check America after being prescribed by Dr. Paul Long, Haddad said.
Long, whose office is next door to Advanced Imaging, acknowledged prescribing the scans.
Long is licensed and in good standing with the state medical board, according to online records.
S.C. public health officials inspected the Cancer Check America site earlier this week after learning of the company's link to a similar operation in Colorado that ran afoul of regulators there. A S.C. Department of Health and Environmental Control spokesman, citing an on-going investigation, said Wednesday he could not comment on the inspection.
Long on Wednesday said he reviewed "every chart and wrote a script for every patient" Cancer Check scanned. He offered to show documentation, but would not say when.
"We have a total history on patients, who have to sign (a form) saying they know they're being exposed to radiation," he said.
A Cancer Check America brochure states that its patients must be between the ages of 35 and 72, be under 6-foot-4, weigh less than 300 pounds, have no stents or pacemakers, and never have had bypass surgery.
However, four people interviewed by The Island Packet say they were scanned without consultation or referral from a physician beforehand. Two said they met with Long after the scan was performed to discuss results.
Hilton Head resident Fred Holtzman, 64, said he, his wife and brother-in-law were scanned last month after receiving promotional materials from a Cancer Check American representative at the Hilton Head Island farmers market. Holtzman said he filled out a form providing medical history but did not consult with a physician before the scan. He said he met afterward with Long about his results.
David Miller, an investment banker from New Mexico visiting Hilton Head, said he paid $1,300 for a full-body scan and never met with a physician.
Jacqui Wilkins, 44, of Hilton Head, said she received no prescription for the scan. Wilkins said she met with Long afterwards to discuss her results.
All three say they were pleased with the service and satisfied by the results. Holtzman and Wilkins contacted the Packet after reading an article about the company's operation on Hilton Head. Miller's name and number were provided by Holtzman.
Another person, who asked that his name not be used for this story, said he and his wife also received full-body scans without a doctor's referral. He said the results indicated he had a high-level of calcium deposits in his coronary arteries and was at significant risk for heart attack and coronary disease. A follow-up stress test and heart catheterization by a cardiologist, however, indicated no problems, he said.
Colorado imaging company Heart Check America closed after regulators determined that only about 5 percent of its clientele had been referred by doctors and that it was being supervised by a doctor whose license had lapsed, according to Colorado health department records.
Haddad said he oversaw sales of Heart Check America's Denver operation, and a Cancer Check America brochure states services include information of "other Heart Check America services."
A Colorado health official said exposure to the controlled radiation from Heart Check America scanning equipment should have been better justified medically and that images produced by the clinic were not sufficient for a diagnosis.
South Carolina also requires that patients be exposed to the minimum amount of radiation required to produce images of good diagnostic quality.
"First, there has been no published study in a peer-reviewed medical journal that has found benefit to doing routine CT scans on healthy individuals," wrote Dr. Carl Canzanelli of Okatie in a letter to the editor published April 12 in the Packet. He added, "It is not medically appropriate to recommend (scans) usage for screening asymptomatic persons."
CT scans expose the body to more radiation than conventional X-rays. Repetitive exposure can reach worrisome levels, Canzanelli wrote. Long and others say the scans save lives by detecting cancer in the earliest, curable stages. He also argues technology advances make exposure to harmful radiation negligible.
Holtzman, Miller and Wilkins defended Long. Holtzman said his previous first wife died in 2007 of cancer.
"She had a stage-four diagnosis and (was) given one to three months to live. She lived 10 weeks. ... There was no indication she had cancer until it was too late," he said. "She was a vibrant and healthy 62-year-old woman. If this had been available then, my wife could have lived."
Though scans for both he and his second wife revealed a clean bill of health, Holtzman said they were both happy to have received "peace of mind."
Miller also was found to be in good health and said he chose a full-body scan because "if you wait until you're symptomatic, you're going to go into a box more likely."
"Medical technology exists for me to protect myself at will. It's a freedom we enjoy as Americans," he said. "I'd rather have more (radiation) going through my system based on my decision to monitor my health rather than not and waiting until I'm symptomatic and go into a box and become another statistic."
Long Wednesday said scans will be provided for about 15 people who pre-paid for future services through Cancer Check America.