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RE: saftey of being in the proximity of someone on RAI therapy
There is an intereseting statement about instructions
given to patients receiving radioactive material upon
release from medical care:
"NRC does not intend to enforce patient compliance
with the instructions nor is it the licensee.s
responsibility to do so."
See page U-6 in NUREG 1556, Vol 9 "Program-Specific
Guidance About Medical Use Licenses" at
http://www.nrc.gov/reading-rm/doc-collections/nuregs/staff/sr1556/v9/
--- "Stankewitsch, Brian T."
<BRIAN.T.STANKEWITSCH@saic.com> wrote:
>
> I may be talking out of turn here, (I got my lawyer
> credentials from a
> Cracker Jack box...) but isn't the assumption that
> the consumer is liable
> from a compliance standpoint inasmuch as the
> provider recommends certain
> actions, "for the safety of the patient and the
> public". Take f'rinstance
> the statement on the back of the can of paint that
> says "Use of this product
> in a manner other than that for which it was
> intended is a violation of
> applicable laws". (Talk about vague enough to cover
> any and all potential
> violations!) Usually the litigious entity goes after
> the deep pockets (not
> the patient) (at least in California), though. I
> imagine enforcement toward
> the patient would be weak.
>
> Brian Stankewitsch
> SAIC Radiation Safety
> 16701 West Bernardo Drive
> San Diego, Ca 92127
> 858-826-5734
>
>
> -----Original Message-----
> From: owner-radsafe@list.Vanderbilt.Edu
> [mailto:owner-radsafe@list.Vanderbilt.Edu] On Behalf
> Of John Jacobus
> Sent: Friday, August 20, 2004 5:57 AM
> To: Neil, David M; daleboyce@charter.net; Philip
> Egidi; kb1ipd@hotmail.com;
> owner-radsafe@list.Vanderbilt.Edu;
> radsafe@list.Vanderbilt.Edu;
> crispy_bird@yahoo.com
> Subject: RE: saftey of being in the proximity of
> someone on RAI therapy
>
> I do hope that the authorities have been things to
> do.
> What is generally done in the waste shipment is set
> aside and allowed to decay. Of course, I am
> assuming
> that the landfill people have determined
> spectroscopically that the waste in medical in
> nature,
> e.g., I-131 or Tc-99m.
>
> From what I understand, this is what most states are
> pushing the landfill operators to do. I am not sure
> about Colorado.
>
> --- "Neil, David M" <neildm@id.doe.gov> wrote:
>
> > Giving out records would not necessarily be how
> they
> > trace it. If the material is in a trash bag with
> a
> > get well card to Aunt Hildegarde that has her
> > address, the presumptive conclusion would be that
> > she disposed of it.
> >
> > Dave Neil
> >
> > -----Original Message-----
> > From: daleboyce@charter.net
> > [mailto:daleboyce@charter.net]
> > Sent: Thursday, August 19, 2004 2:30 PM
> > To: Philip Egidi; kb1ipd@HOTMAIL.COM;
> > owner-radsafe@list.vanderbilt.edu;
> > radsafe@list.vanderbilt.edu; crispy_bird@YAHOO.COM
> > Subject: Re: saftey of being in the proximity of
> > someone on RAI therapy
> >
> >
> > Phil,
> >
> > If the suits show up with a bill, I think the
> > lawsuit against the hospital
> > for giving out confidential medical records would
> > more than cover it! ;)
> >
> > Dale
> > daleboyce@charter.net
> >
> >
> > ----- Original Message -----
> > From: "Philip Egidi" <phil.egidi@state.co.us>
> > To: <kb1ipd@HOTMAIL.COM>;
> > <owner-radsafe@list.Vanderbilt.Edu>;
> > <radsafe@list.Vanderbilt.Edu>;
> > <crispy_bird@YAHOO.COM>
> > Sent: Thursday, August 19, 2004 12:52 PM
> > Subject: Re: saftey of being in the proximity of
> > someone on RAI therapy
> >
> >
> > > And PLEASE have your friend follow the
> > instructions given (hopefully) by
> > > the doctor/clinic/hospital as to disposal of
> > wastes that may contain the
> > > I-131 after she is released from patient care.
> Do
> > NOT just throw paper
> > > towels or anything that may contain body fluid
> > (feces, urine, sweat,
> > > vomit, etc), in the trash - it may set off
> alarms
> > at the local landfill.
> > > Your friendly state regulator (or less friendly
> > hazmat response team)
> > > may end up dumping the load looking for the
> > offending trash in order to
> > > deal with it appropriately/ If the responders
> can
> > trace the radioactive
> > > trash back to your friend, she may get a visit
> > from the suits, and
> > > perhaps a bill for the effort.
> > >
> > > Thanks,
> > > Phil Egidi
> > > Colorado
> > >
> > > >>> John Jacobus <crispy_bird@YAHOO.COM>
> 08/19/04
> > 07:42 AM >>>
> > > Steve,
> > > Your friend is being treated with I-131 to
> ablate
> > any
> > > remaining thyroid tissue. I-123 is an imaging
> > agent,
> > > which was probably used during a diagnostic scan
> > to
> > > assess her the extent of the cancerous thyroid
> and
> > > uptake of iodine.
> > >
> > > Because she no longer has a functioning thyroid,
> > > various hormonal and physiological problems will
> > > develop. Eventually, she will be put on a
> > synthetic
> > > hormone that will have to be adjusted over time.
>
> > Too
> > > little, and the patient is lethargic. Too much,
> > and
> > > the patient is too hyper. I assume they have
> not
> > > started her on replacement therapy because the
> > want to
> > > ensure that all of the cancerous thyroid tissue
> > has
> > > been destroyed.
> > >
> > > Your friends sinus problem may be a side effect
> of
> > the
> > > removal of the thyroid, or a totally unrelated
> > effect.
> > >
> > > There are a number of Web sites dealing with
> > thyroid
> > > cancer try
> > >
> >
> http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=43
> > > and
> > >
> >
>
http://cancernet.nci.nih.gov/cancertopics/types/thyroid/
> > >
> > > With regard to at home care, the precautions she
> > is
> > > asked to take are to ensure that exposures to
> the
> > > public and family members as the I-131 decays.
> > She
> > > should have been given a date as to when she no
> > longer
> > > needs to follow these precautions.
> > >
> > > The precautions you discussed with probably
> > provide
> > > minimal protect to you. Potassium iodine would
> > > protect your thyroid from uptake of radioiodine.
> > > However, patients do not excrete significant
> > amounts
> > > of iodine. It is bound to the remanant throid
> > tissue;
> > > proper hand washing and sanitary activities,
> e.g.,
> > > using separate eating utensils, precludes the
> > spread
> > > of contamination.
> > >
> > > The use of a leaded apron will provide no
> benefits
>
=== message truncated ===
=====
+++++++++++++++++++
"Everyone is ignorant, only on different subjects."
Will Rogers
-- John
John Jacobus, MS
Certified Health Physicist
e-mail: crispy_bird@yahoo.com
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