Flint water crisis victims may need X-rays for compensation, raising health concerns

Some Flint, Michigan, residents who may have been affected by lead in their water during the 2014 crisis may now be exposed to radiation in an effort to get a share of the $641.25 million water crisis settlement. Anyone exposed to lead at that time can receive a higher settlement if they submit proof of excessive lead levels, through blood or bone tests, or show evidence of injury, according to court documents.

Some attorneys in the case are using portable X-ray devices in an effort to detect excessive levels of lead in claimants' bones, but some health officials and medical experts question whether the use of these machines is unnecessary and poses any unjustifiable risk.

"The risk of the treatment or some test that's medically approved has to be less than the benefit," Dr. Lawrence Reynolds, Flint city health adviser and a pediatrician, said in an interview with ABC News. He said the use of radiation outside of medical necessity is unethical, and that the X-ray devices being used were not designed for this purpose.

"Why would you subject your child or yourself or a pregnant woman to the risk, no matter how small the radiation, if there's no benefit?" Reynolds said.

Claimants can demonstrate proof of injury in one of three ways: an excessive blood level test taken prior to August 2016; medical records demonstrating cognitive impairment or one of several physical conditions; or excessive lead levels in a bone test conducted through April 2021. According to court filings, attorneys from the offices of Levy Konigsberg, LLP and Napoli Shkolnik PLLC are using portable X-ray fluorescence devices to help complainants determine if they meet the excessive lead levels in the bone test option.

Thousands of people have been exposed to lead and other contaminants through the city of Flint's water supply since 2014. Lawsuits were filed against the local government as well as city officials for switching the city's water source to the Flint River, which resulted in sending contaminated water to the homes and businesses of thousands.

The lawsuits were resolved in a settlement that forced the city to pay more than $600 million to affected residents. The court decision stated that residents' concerns about the public health crisis were "ignored" and "downplayed," while solutions were "ignored'' since the crisis first made headlines.

Dr. Mona Hanna-Attisha, the pediatrician who helped expose the Flint water crisis, told the Detroit Free Press that she doesn't recommend the use of these scans for children -- there are between 6,000 to 12,000 children who were affected by the lead poisoning, according to Genesee County officials -- or for pregnant woman.

The newspaper reported that a Flint woman who was 28 weeks pregnant was given a bone scan by the Napoli Shkolnik law firm, but she said was never asked whether she was pregnant. The law firm has not responded to requests for comment on the allegation.

Dr. Brian Choi, professor of medicine and radiology at The George Washington University and co-director of advanced cardiac imaging in the division of cardiology, said, "Children have more rapidly dividing cells so if a child is exposed to a lot of radiation, that's gonna be more problematic than like a 60-year-old being exposed to a lot of radiation."

In February, other attorneys in the case filed a motion to have use of the devices suspended, but the motion was quickly withdrawn after a court hearing.

Attorneys Corey Stern and Hunter J. Shkolnik then wrote a letter to the court defending the safety and validity of the testing devices. Although the devices are typically used on dirt, metal and similar materials, the two attorneys have said that modifications have been made under guidance of experts in the field to ensure that they are suitable for use on humans and that the devices pose no risk of exposure to children or adults.

"We emphasize that under no circumstances would we ever expose our clients or others in the community to risk of harm," the attorneys stated in court filings. "The expert physicians and physicists who have developed and supervised the scanning process have published many studies and analyses that provide assurance that the process is without risk and, as discussed below, have received approvals from Purdue University and Harvard University to utilize the technology on humans."

The letter also said that the medical director overseeing the use of the devices is a renowned expert in pediatric neurotoxicity and that the amount of radiation exposure is the equivalent of nine hours of sun exposure and less than one-thirtieth of that received in a chest X-ray.

However, medical experts like Reynolds remain hesitant, some noting that the device has not been approved by the U.S. Food and Drug Administration.

Choi said that FDA approval is important to ensuring quality and safety for patients.

"The No. 1 thing is that in the medical setting all of the radiation-producing equipment that we expose our patients to has to be FDA-approved because that assures a certain level of reliability and testing to make sure that the dose that patients receive is what you expect it to be," Choi said. "It's very important to make sure that they're getting the appropriate dose necessary to make a proper diagnosis when it comes to radiology images."

Radiation is potentially dangerous because the more that one is exposed, the more likely DNA damage is to occur, which can cause cancer, according to Choi. He said that being exposed to a lot of radiation is a problem, but it's unknown how much of a risk smaller amounts of radiation can be.

Choi said that if the device isn't FDA-approved, radiologists simply wouldn't be permitted to use them.

"Any time a patient is exposed to radiation or a person is exposed to radiation you have to weigh the risks and benefits," Choi said. "If the risk exceeds the benefits, even if there are theoretical risks, what's the good in that?"

In their letter to the court, Stern and Shkolnick asserted that FDA approval is not required for this use of the XRF devices because they are not being used to diagnose, prevent or treat any disease, rather the "sole purpose of the test is to quantify lead exposure for the purpose of settlement."

The law firms of Levy Konigsberg and Napoli Shkolnik have not responded to ABC News' request for comment.