RE: Civil Penalty for Medical Violation

["Vernig, Peter G." <Peter.Vernig@med.va.gov>]

Group and Dr. Marcus,

I share some of Dr. Marcus' concerns, not quite as vigorously.

But did I miss something in the revised Part 35?  While I found it VERY FAR
FROM PERFECT, most changes seemed to me, to at least be in the right
direction.

	Some improvements:

ALARA is taken out, as is the Quality Management Program [for non-medical
types a program for therapy and almost all uses of I-131that requires a lot
of paper work and annual reviews] well mostly the written program and
reviews are omitted most of the paper remains.  NRC no longer tells us what
meters we must have or how to calibrate them.  The ten half life rule is
also dispensed with.  [Don't worry we still have to survey at background
before releasing.]

	One thing IMO that was not fixed:	

A doctor qualified as an authorized user of the lowest category [ophthalmic
use of Sr-90] having as little as 24 hours of training can be appointed as
RSO while a professional HP either needs a board certification or 200 hours
of specified training and one year of medical HP experience. 

	Something that could lead to a lot of confusion:

The general training experience scheme which says board certification by an
approved [by NRC] board that requires the stated amount of training and
experience to sit the exam.  I expect it to be a problem, as boards staffed
by volunteers [CHP & NRRPT] may find it difficult or cumbersome to change
their eligibility requirements and seek approval from the NRC.  The
mechanics of getting that approval are of course not included in the
regulation.

I share your disappointment with the NUREG 1556 guidance documents.  They
have mostly the same rules [and recommendations] as recommendations that we
have seen for years and years.  I have read the decon action level sections
in several very carefully.  Alas I haven't read even the medical one
carefully in detail, although I have reviewed most of it.  I would tend to
ascribe it more to bureaucratic inertia and one hand not knowing what the
other was up to with possibly some foot dragging thrown in.

Which brings up a point.  This also speaks perhaps to your comment regarding
the "secret" regulations of license conditions. 

Guidance documents ARE NOT REGULATION unless we let them be!  You do not
have to accept NRC guidance when it doesn't make sense.  I contested 4 fix
it "suggestions" the last time I submitted a license application.  The best
example was the dosimetry guidance; Monthly badges for all exposed to photon
radiation and monthly rings for anybody handling photon emitting isotopes
[PERIOD] no qualifiers of any kind.  Taken to the extreme everybody would
have badges because of background and virtually everybody would need rings,
if you start looking at what NORM is around.  [That bizarre guidance existed
in several Reg Guides but I did not see it in the NUREG on medical use.]  I
prevailed in all four of my objections, the license reviewer did not even
try a second time s/he simply issued the license based on my filing without
comment.

It is extremely valuable to have good guidance documents such as ANSI 13.12
to provide support when you decide that you do not want to accept NRC
guidance.

And one trick or tip.  Do not hesitate to copy a model procedure and change
just a few words or even just one ["and" to "or"] to make it easier to live
with.  The use of mounds of material which may inhibit close examination can
work the other way also !-}>

Any opinions expressed are mine alone and do not necessarily represent those
of the Denver VA Medical Center, The Department of Veterans Affairs, or the
U.S. Government.

Peter G. Vernig                
Radiation Safety Officer, VA Medical Center, 1055 Clermont St. Denver, CO
80220, ATTN; RSO MS 115
303-399-8020 ext. 2447, peter.vernig@med.va.gov [alternate
vernig.peter@forum.va.gov] Fax 303-393-5026 [8 - 4:30 MT service] Alternate
Fax 303-377-5686

"...whatever is true, whatever is noble, whatever is right,, whatever is
pure, whatever is lovely, whatever is admirable, if anything is found to be
excellent or praiseworthy, let your mind dwell on these things."    Paul

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