A Chicago surgery center was fined $2,000 for letting unlicensed operating room nurses operate C-arms.

The Illinois Emergency Management Agency imposed the civil penalties against Rush SurgiCenter, which also included $500 fines for the 2 OR nurses who activated a C-arm at a physician's direction. According to Illinois law, only professionals licensed under the state's Medical Practice Act, such as chiropractors, dentists, podiatrists, veterinarians or certified radiologic technologists, are permitted to operate radiologic equipment.

Officials at Rush SurgiCenter say they'll now make X-ray technologists available for fluoroscopy procedures.

The fines were the result of an investigation launched by the agency in December 2011, after receiving a written complaint from Jeffrey Pecoraro, who was then working as a registered nurse at Rush, according to Donald Agnew, chief of the Illinois Emergency Management Agency's electronic products section. Mr. Pecoraro, who was fired by Rush in December and has since relocated to the Seattle area, alleged in his complaint that he had witnessed 2 registered nurses operating the fluoroscope on 2 separate occasions.

The head of the agency's technologist accreditation program and 2 inspectors subsequently made unannounced site visits to Rush in December, but were unable to substantiate that any violations had occurred, says Mr. Agnew. Additional interviews with staff members and the facility's administrator, however, revealed that the nurses had in fact operated the C-arm, he says.

According to Mr. Agnew, Rush did not share the exact circumstances that led to nurses operating the fluoroscope, but "it appears they just got caught in a staffing bind," and didn't have a radiographer or other properly licensed professional available at the time of the violations. The center has since corrected that staffing issue, making radiologic technologists available for procedures that require using a C-arm, says Mr. Agnew.

Attempts to contact Barbara Ramsey, MSN, RN, CASC, Rush SurgiCenter administrator, were unsuccessful. But Ms. Ramsey told the Chicago Tribune that a Rush physician had twice instructed a nurse to push a button to activate one of the facility's 2 fluoroscopes. In both cases, she says, a doctor was present and adjusted the settings, and no patients were harmed.

Mark McGraw