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Re: NRC PROPOSES $6,000 FINE AGAINST ST. JOSEPH MERCY HOSPITALINMICHIGAN FOR OVEREXPOSURE TO A MEMBER OF THE PUBLIC
I suggest that you read the full Notice of Violation. It's available from the
NRC web site, under "significant enforcement actions." The administered
activity was 285 mCi of I-131. The NOV quotes dose rates of 10 mrem/hr in an
emergency exit stairway and 17 mrem/hr outside the ground floor window of the
patient's room. It would be a worthwhile class exercise to estimate dose rates
around the patient, assuming that 30% of the I-131 is retained in the thyroid
and assuming a point source.
To estimate the dose to the patient, I recommend reviewing NCRP Report No. 70,
"Nuclear Medicine - Factors Influencing the Choice and Use of Radionuclides in
Diagnosis and Therapy."
The opinions expressed are strictly mine.
It's not about dose, it's about trust.
Curies forever.
Bill Lipton
liptonw@dteenergy.com
Peter Sandgren wrote:
> This brings up a question that students in my basic rad monitoring classes
> often ask: what kind of dose does a patient typically receive from some of
> these nuclear medicine treatments? It appears that this patient had a
> significant amount of the isotope in his/her body. I'd love to have some
> figures from the educated radsafe community. Anyone who can enlighten me
> on the range of dose that a patient could receive from a procedure with
> which they're familiar will be in my debt. Reply to me off line, if you
> prefer. Thanks!
> sincerely,
> Peter Sandgren
> Training Division
> GIS Operations
> Connecticut Office of Emergency Management
> "Most people are about as happy as they make up their minds to be." --
> Abraham Lincoln
> The French writer Colette once said, "What a wonderful life I've had. I
> only wish I had realized it sooner."
>
> On Wednesday, May 14, 2003 7:53 AM, Sandy Perle
> [SMTP:sandyfl@EARTHLINK.NET] wrote:
> > 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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