First reported 15 Dec 2015•Latest report 14 Mar 2025
Definition
What this concern includes
Includes failures of controls specifically dedicated to the safe administration of intravascular or iodinated contrast media, including formal prescribing, risk-sensitive dose selection, allergy or contraindication screening, responsible-clinician identification and emergency safeguards linked to contrast administration.
Not included
Excludes general medication-prescribing or medication-administration failures where contrast media are not materially involved.
Excludes generic imaging-access, scan-quality, interpretation or reporting failures that do not concern the safety of contrast administration.
Excludes management of adverse reactions after contrast administration when no failure in a dedicated pre-administration or administration safety control is identified.
Excludes unrelated procedures involving contrast entering an anatomical structure unless the assertion concerns the safety of administering intravascular contrast media.
Reports
3
Distinct published reports
Individual concerns
7
A report can raise multiple concerns
Date range
2015–2025
First to latest report issue date
Stated actions
10
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Barking, Havering and Redbridge University Hospitals NHS Trust1
Department of Health and Social Care1
Medicines and Healthcare products Regulatory Agency1
Queen's Hospital, Romford1
Royal College of Radiologists1
University Hospitals Birmingham NHS Foundation Trust1
University Hospitals of Northamptonshire NHS Group1
NHS trust2
Healthcare site1
Health professional body1
Medicines and medical devices regulator1
Ministerial department1
NHS provider group1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Northamptonshire
Concerns raised1
Lack of pre-injection identification of potential allergy to iodinated contrast agents
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Develop and publish guidance on administering iodinated contrast media and gadolinium through the established working party.
Stated by Royal College of RadiologistsStated in progressThe respondent said that this action was in progress when they made their response on 15 December 2025.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
No reliable standardised test can currently predict contrast reactions in patients without prior adverse symptoms.
Stated by University Hospitals of Northamptonshire NHS GroupDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
Routine allergy testing is not viable because services lack capacity and testing could delay diagnostic and cancer-treatment pathways.
Stated by University Hospitals of Northamptonshire NHS GroupUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Position
Routine pre-exposure allergy testing for iodinated contrast medium is not considered necessary because reactions are rare and testing could delay urgent CT scans.
Stated by Royal College of RadiologistsNo action considered necessaryThe respondent said that no further action was needed.
East London
Concerns raised4
Failure to identify a responsible clinician for contrast administration
Administration of contrast media without a formal prescription
Lack of careful consideration of contrast medium dose
Lack of prescribing safeguards for patients at higher risk of contrast induced acute kidney injury
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.8
Action
Record radiologist contrast-authorisation decisions on request forms or the RIS, including decisions for patients with eGFR below 30.
Stated by Barking, Havering and Redbridge University Hospitals NHS TrustStated completedThe respondent said that this action was complete when they made their response on 21 December 2020.
Action
Obtain approval for radiographer PGDs and update the internal protocol to permit contrast injection on a radiologist’s prescription for eGFR 30–45.
Stated by Barking, Havering and Redbridge University Hospitals NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 21 December 2020.
Action
Require an ED clinician’s prescription for intravenous contrast for specified direct-access scans, recording it in the notes and RIS as an interim measure.
Stated by Barking, Havering and Redbridge University Hospitals NHS TrustStated plannedThe respondent said that this action was planned when they made their response on 21 December 2020.
Action
Create a prescription sheet within the PGD for patients with eGFR below 30 or risk factors outside the PGD.
Stated by Barking, Havering and Redbridge University Hospitals NHS TrustStated plannedThe respondent said that this action was planned when they made their response on 21 December 2020.
Action
Specify contrast dosing at 1 ml/kg up to a 100 ml maximum.
Stated by Barking, Havering and Redbridge University Hospitals NHS TrustStated completedThe respondent said that this action was complete when they made their response on 21 December 2020.
Action
Provide medical scales for all scanners to support the specified contrast dosing.
Stated by Barking, Havering and Redbridge University Hospitals NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 21 December 2020.
Action
Communicate to radiologists the requirement for personalised assessment of patients receiving intravenous contrast with eGFR below 30 and multiple risk factors.
Stated by Barking, Havering and Redbridge University Hospitals NHS TrustStated completedThe respondent said that this action was complete when they made their response on 21 December 2020.
Action
Introduce a radiology request form containing safeguards for abnormal renal function, contrast indication and patient discussion.
Stated by Barking, Havering and Redbridge University Hospitals NHS TrustStated plannedThe respondent said that this action was planned when they made their response on 21 December 2020.
Birmingham and Solihull
Concerns raised2
Administration of hypertonic Omnipaque through central lines
Frequent administration of Omnipaque doses exceeding manufacturer guidelines
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Reviewed intravenous contrast administration protocols against manufacturer guidance and relevant literature.
Stated by University Hospitals Birmingham NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 15 December 2015.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
The administered contrast dose was within accepted ranges, was not an overdose, and toxicity was unlikely to have caused the death.
Stated by University Hospitals Birmingham NHS Foundation TrustDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
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Includes failures of controls specifically dedicated to the safe administration of intravascular or iodinated contrast media, including formal prescribing, risk-sensitive dose selection, allergy or contraindication screening, responsible-clinician identification and emergency safeguards linked to contrast administration.
