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RE: NRC PROPOSES $6,000 FINE AGAINST ST. JOSEPH MERCY HOSPITAL IN MICHIGAN FOR OVEREXPOSURE TO A MEMBER OF THE PUBLIC
My understanding is that the NRC does not determine how much control is to be placed on the patient. It is the licensees responsibility of ensure that public exposures do not exceed 100 mrem/y (1 mSv/y) or 500 mrem/y (5 mSv/y) to a caretaker. In this case, the licensee did not meets its obligation to reduce exposures to the public.
With regard to a patient terminating treatment, I would believe that all the licensee is required to do is instruct the patient on reducing exposures to the public. Once the patient leaves the facility, the licensee has no control over their actions. HOWEVER, I suspecting that it is not unreasonable for a facility to refuse to treat a patient who they suspect will not (1) complete the course of treatment, and (2) follow directions associated with that treatment. I can honestly say I have not heard of a situation where the patient has left during a treatment. I can imagine a situation where an Alzheimer's patient may require treatment, but sedation and montoring could be used to control their actions.
"Knapp, Steven J." <Steven.Knapp@MED.VA.GOV> wrote:
I am not a lawyer, but I surmise patients have the right to terminate their medical treatment and go home at any time unless they pose imminent danger to the public. If a patient goes home, the situation is not monitored. Where is the consistency in mitigating the radiation risk when the patient is hospitalized versus being at home? This appears to be a regulatory problem, not a health risk problem. The NRC consultant stated the radiation health risk to family members was insignificant.
The questions still remains, how much control over the patient and family is required before the NRC determines the control is adequate? Would the NRC have a similar conclusion if an RSO completed the procedures listed in the NRC letter to St. Joseph Mercy Hospital and a noncompliant and informed family member exceeded the radiation dose limit?
It is obvious the RSO could have done things to lessen the opportunity for the NRC to find fault, but even if he did, would that have been enough?
. . .
-- John
John Jacobus, MS
Certified Health Physicist
e-mail: crispy_bird@yahoo.com
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