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RE: hospital contamination incident



Despite Mr. Lipton's, posting the vulnerability is not limited to hospital situations, but any facility licensed for radioactive material. But then again, I don't believe this hospitals action reflects as poorly on medical facilities as he believes.  A poor reflection is when a patient has to come back for a second medical scan two days later because the initial diagnostic administration was supposed to be Tc-99m sestamibi and was Tc-99m MDP instead.  The patient complains to anyone who will listen (coworkers, family, friends, etc.) about the foul up in the procedure that means he needs to get a second day off from work.  But at the same time he won't mention the associated radiation dose, largely because the physician has correctly pointed out that there is no real health effect as a result from getting double dosed from this material.
 
This gets us back to how the whole thing is viewed by the regulator.  The NRC is genuinely progressing towards the performance based perspective of, 'Whats the real hazard here?'  Forgetting procedures or performing the procedure poorly should not result in an automatic violation even though it could be cited.  There doesn't have to be a regulatory response for every mistake.  Accidents happen, move on.  The genuine question that needs to be answered is 'what is the safety impact?'   20,000 dpm of Tc-99m or even I-131 is not going to impact anyone adversely so why get bent out of shape as a result?  On the other hand if a poorly packaged Mo-99/Tc-99m generator falls off the back of the delivery truck and gets broken open on the outbound lanes at 4 o'clock on a Friday, there's a genuine safety impact, and not from the radiation.  Make the citation and send the bill to the responsible licensee for associated response costs.  Lets regulate according to consequence and less on perception.
 
The thoughts expressed are mine, mine, all mine....
I'm with the government, I'm here to help
Daren Perrero
perrero@idns.state.il.us
 
-----Original Message-----
From: BLHamrick@AOL.COM [mailto:BLHamrick@AOL.COM]
Sent: Friday, December 27, 2002 10:29 PM
To: pottert@erols.com; radsafe@list.vanderbilt.edu
Subject: Re: hospital contamination incident

In a message dated 12/27/2002 7:57:17 PM Pacific Standard Time, pottert@erols.com writes:

.  It seems that the NRC is focusing on one tree and ignoring the
forest.  The real issue is not whether the nuclear medicine tech changed
her gloves before handling the package.


In my mind, the real issue is what were the consequences?  How significant was the contamination?  It's difficult to determine if this was even a reportable event.

Barbara