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RE: NRC Proposed Fine and Severity Level 1 Violation



As a former RN, I had to deal with patients leaving the hospital every once

in a while.  In the state of Alabama where I practiced, a patient had the

right to leave the hospital against the advice of his/her medical doctor at

any time during a hospital stay.  It was called leaving AMA or against

medical advice.  The doctor of record (the admitting doctor) usually tried

to talk the patient out of leaving and would, in most cases, tell the

patient that if he/she left against his advice, he, the doctor, would no

longer be obligated to treat the patient.  Additionally, the patient had to

sign a form saying that they were leaving against the advice of their health

care professional and the hospital and that he/she would not pursue legal

action against the hospital if something happened to the patient.



Although I have not practiced nursing for twenty years, I doubt the rules

have changed very much.  A hospital can not hold a person against his/her

will, except for mental cases where there is a court order.  In the case of

mental patients, the nurse could keep the patient in the hospital (by way of

calling hospital security) but could not force the patient to take his/her

medicine.  Giving a patient medication against his/her will was considered

assault.



Tena A. Graben, CQA

United States Enrichment Corporation

Nuclear Safety and Quality

Independent Assessments Group





-----Original Message-----

From: William V Lipton [mailto:liptonw@DTEENERGY.COM]

Sent: Thursday, May 15, 2003 1:34 PM

To: Flood, John

Cc: Knapp, Steven J.; 'radsafe@list.vanderbilt.edu'

Subject: Re: NRC Proposed Fine and Severity Level 1 Violation





I don't know.  The RSO should make sure it's someone else's decision.  The

policy should limit the RSO's responsibility to reporting the violation to

management and requesting their actions to regain compliance.



The opinions expressed are strictly mine.

It's not about dose, it's about trust.

Curies forever.



Bill Lipton

liptonw@dteenergy.com



"Flood, John" wrote:



> > 1.  If not already in place, develop a written policy statement

regarding

> > nuclear medicine patients who cannot be released under 10 CFR 35.75.

>

> Perhaps I'm being a bit naïve here, but does the hospital have the legal

> authority to compel a patient to stay?  If the patient chooses to go home

or

> to hospice care, can the hospital prevent this?  Would this be imprisoning

a

> person for medical reasons?

>

> Bob Flood

> Nevada Test Site







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