Re: NRC PROPOSES $6,000 FINE AGAINST ST. JOSEPH MERCY HOSPITAL INMICHIGAN FOR OVEREXPOSURE TO A MEMBER OF THE PUBLIC

[John Jacobus <crispy_bird@YAHOO.COM>]

Sandy,

Good points.  In fact the licensee can allow a member of the public to receive up to 500 mrem (5 mSv) under 10 CFR 20.1301(c) for care of a patient who cannot be released under 10 CFR 35.75.  The fact that the licensee allowed the patient's family member received a higher dose withoug taking appropirate actions is the issue. 

Like you I did not see anything that said that the patient was dying and needed more than appropriate care.  It is unclear why the patient's urine was being collected, but the fact that the collection bag was not shieled from the patient's daughter is another indication the licensee was not taking actions to reduce exposure.

 

As a side note, medical treatment for dying patients is sometimes accessed by use of the Karnofsky Performance Scale.  See http://www.cancerbacup.org.uk/questions/specific/general/karnofsky-scale.htm

Usually, patients being treated for ablation therapy are about 70 to 80%.  They are "slow," but can take care of themselves while in isolation.  It is really hard to tell how bad this patient was.  We had refused to a treat patient due to very poor prognosis and wide spread cancer.

Sandy Perle <sandyfl@EARTHLINK.NET> wrote:

. . .
Let me also agree that the dose to the relative was not putting the individual at risk.
In fact, they could have received much more radiation, and still not have been
harmed. But that isn't the issue, and, the NRC and any other regulatory agency,
would have handled this situation the same way. There are regulations. Part 35
covers this specifically, and more liberally when it comes to public dose limits. If the
family were to be treated as a member of the general public, Part 20, they would
have exceeded the 0.100 rem annual dose limit, and not the 0.500 rem limit.
. . .

Compassion is also not a causative agent for simply violating the regulations. I also
believe that many are interpretating what this case was all about. I've read where the
patient was dying, and the family had to be there. I'm not sure that is the case. If the
patient was in fact dying, I'm not sure what the purpose of the administration was
even ordered. In any event, the patient could have always gone home, and, let the
family get the dose they wanted to accept. But as long as the patient was
administered a dose in their facility, under a license issued by the NRC, they have an
obligation to follow the letter of the law. Interpretative regulations can never be
allowed, where they become interactive, following what you want and ignoring what
you don't agree with. That can never be allowed to occur. Compassion ,,, discretion ..
in the end, I believe that is exactly what we see here. $6,000 to me is a lot of
compassion and discret! ion.

-- John
John Jacobus, MS
Certified Health Physicist
e-mail:  crispy_bird@yahoo.com

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