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[Fwd: RE: Nuclear Medicine Patients and Homeland Security]



IN 2003-22 implies that the licensee is accountable, to some degree, for

the patient's compliance with the applicable instructions.  Quoting: 

"...When licensees are required to provide written instructions to

patients released in accordance with 10 CFR 35.75, the licensees are

expected to, among other things, review with authorized users the

expectation that written instructions provided to patients will be

followed...."  Although this is currently an "expectation" rather than a

requirement, my advice to medical licensees is to make every effort to

comply.  



The opinions expressed are strictly mine.

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

Curies forever



[The following is posted with the author's permission.]



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

From: "Williamson, Matthew/Medical Physics" <willim01@MSKCC.ORG>

Subject: RE: Nuclear Medicine Patients and Homeland Security

To: William V Lipton <liptonw@DTEENERGY.COM>



Bill,



I'm not sure if it's under the NRC's purview to enforce/inspect the ptn,

but rather the licensee's actions.  In my opinion, the NRC can refer

back to the licensee for their instructions, and that's it.  The ptn has

not entered into agreement with the NRC.





Matt 



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

From: owner-radsafe@list.Vanderbilt.Edu

[mailto:owner-radsafe@list.Vanderbilt.Edu] On Behalf Of William V Lipton

Sent: Friday, January 02, 2004 7:28 AM

To: Carol Marcus

Cc: John Jacobus; Radsafe@list.Vanderbilt.Edu

Subject: Re: Nuclear Medicine Patients and Homeland Security





The purpose of the 10 CFR 35.75 instructions is to keep the dose to

other individuals ALARA.  Let me quote:  "... A licensee shall provide

the released individual, or the individual's parent or guardian, with

instructions, including written instructions, on actions recommended to

maintain doses to other individuals as low as is reasonably

achievable..."



Hence, it is NOT acceptable for the patient to disregard the

instructions, even if the dose to another person stays below 500 mrem,

if the patient's actions cause dose greater than ALARA.  This IS a NRC

issue.



The opinions expressed are strictly mine.

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

Curies forever.



Bill Lipton

liptonw@dteenergy.com





Carol Marcus wrote:



>

> Dear Radsafers:

>

> ... The physician must make a judgement as to the probability that the



> patient will follow instructions that will prevent a member of the 

> public from receiving >500 mrem.  That doesn't mean that the patient 

> has to do exactly what he/she is told---he/she must keep the dose 

> below the 500 mrem.

>

> ...



> Ciao, Carol

>

> Carol S. Marcus, Ph.D., M.D.

> <csmarcus@ucla.edu>



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