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Re: NRC PROPOSES $6,000 FINE AGAINST ST. JOSEPH MERCY HOSP
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Subject: NRC PROPOSES $6,000 FINE AGAINST ST. JOSEPH MERCY HOSPITAL
Author: sandyfl (sandyfl@EARTHLINK.NET) at Internet
Date: 5/14/03 7:52 AM
The Nuclear Regulatory Commission staff has proposed a $6,000 fine
against St. Joseph Mercy Health System in Ann Arbor, Michigan, for a
radiation exposure in excess of NRC limits for a member of the
public. The excessive radiation exposure involved a family member who
had prolonged contact with a patient receiving a nuclear medicine
treatment in July of last year.
A patient at St. Joseph Mercy Hospital received a therapeutic dose of
radioactive iodine-131 on July 1 of last year. The patient s
condition subsequently worsened , and she died on July 7. There is no
indication that her death was associated with the iodine-131
treatment.
Members of the patient s family who visited during the treatment
period of July 1 to 7 were in prolonged, close contact with the
patient.
The hospital staff provided shielding around the patient to reduce
radiation levels and counseled family members on the need to minimize
their time and proximity to the patient. Family members, who wanted
to maintain close contact with the patient, disregarded the radiation
safety instructions provided by the staff.
One family member, who spent the longest period of time in close
contact with the patient, received a total dose of 3,000 to 15,000
millirem (A millirem is a standard measure of radiation dose), which
exceeds the NRC limit of 100 millirem per year. Other members of the
family may have received significantly lower doses.
The NRC conducted a special inspection to review the circumstances
and causes regarding exposures to members of the public which
exceeded the NRC limits, as well as the hospital s corrective
actions. Although the NRC determined that radiation exposures within
the reported range would not cause any significant health effects,
the NRC inspectors found violations of NRC requirements to limit
radiation doses to members of the public, and promptly identify and
implement corrective actions.
In the letter to the hospital, NRC Region III Regional Administrator
James Dyer states, The NRC staff understands that the case involved
unusual circumstances and that you did not want to appear
uncompassionate toward the patient or her family. However, the
hospital could have taken more proactive steps to determine the
visitors doses more accurately and to limit their exposure, he says.
The letter also notes that the hospital has taken appropriate
corrective actions to prevent recurrence of violations.
The hospital has until June 6 to either pay the fine or to protest
it. If the fine is protested and subsequently imposed by the NRC
staff, the company may request a hearing.
The letter notifying St. Joseph Mercy Hospital of the proposed fine
has been posted to the NRC web site at: http://www.nrc.gov/reading-
rm/doc-collections/enforcement/actions/.
-------------------------------------------------
Sandy Perle
Director, Technical
ICN Worldwide Dosimetry Service
ICN Plaza, 3300 Hyland Avenue
Costa Mesa, CA 92626
Tel:(714) 545-0100 / (800) 548-5100 Extension 2306
Fax:(714) 668-3149
E-Mail: sandyfl@earthlink.net
E-Mail: sperle@icnpharm.com
Personal Website: http://sandy-travels.com/
ICN Worldwide Dosimetry Website: http://www.dosimetry.com/
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The 'official' NOV can be found at
<http://www.nrc.gov/reading-rm/doc-collections/enforcement/actions/mat
erials/ea02248.html>
The NRC felt the licensee could have taken implemented more effective
dose reduction techniques. Agreed. The NRC then provides 4 examples
of dose reduction techniques that the licensee could have easily
implemented.
'1) explaining to the daughter that staying an arm's length from the
patient would significantly reduce the exposure (radiation levels at
one meter were approximately one-tenth those at the bedside); (2)
using additional shielding, including shielding the catheter bag; (3)
minimizing the daughter's time at the bedside; and (4) providing a
digital dosimeter for the daughter to self-monitor her exposure, which
you had available. Therefore, the NRC has determined that your staff's
performance was deficient such that enforcement action is warranted.'
My concern here is that the NRC has now giving guidance in writing for
monitoring a member of the public. Hmm, a hospital's performance is
deficient if they have EDs and don't give them to members of the
public visiting radioactive patients.
Keep conjecture and 'what ifs' off the docket. Now it's a
referencable deficiency. The NRC is defining the std of care for
ALARA and members of the public.
Matt Williamson
my opinions only
PS: ever here of a nuke overexposing a worker or a member of the
public and ONLY getting a $6,000 fine?