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RE: safety of being in the proximity of someone on RAI therapy
Group,
I have heard reports of States presenting a bill to hospitals when they have
traced waste from a patient released properly under the state equivalent of
10 CFR 35.75. I have never heard of them trying to collect from a private
individual. But it makes no sense to present a bill to a hospital when no
regulation or law was violated and no sense to dig it up if it is I-131 that
will in effect be in a place frequented only by people that work there and
will in a month or three decay away.
I recently asked a state regulator if they would dig up I-131 if they could
ID it and it had ended up their legally. He said they would probably direct
the operator to bury it deeply or remotely and leave it. But he also said
if they traced it to a hospital, and it had gotten there because of loss of
control they probably would dig it up, return it to the hospital and give
them a bill.
While I applaud the first response I think it would make a lot more sense to
leave the stuff in the land fill and fine the licensee if they had lost
control and that was why it had gotten into the land fill.
Any opinions in this e-mail are solely those of the author, and are not
represented as those of the VA Eastern Colorado HCS, the Dept. of Veterans
Affairs, or the US Government.
Peter G. Vernig, Radiation Safety Officer, VA Eastern Colorado Health Care
System, 1055 Clermont St. Denver, CO 80220, peter.vernig@med.va.gov, Phone=
303.399.8020 x2447; Fax = 303.393.5026, alternate fax, 303.393.5248
"...whatever is true, whatever is noble, whatever is lovely, whatever is
admirable, if anything is found to be excellent or praiseworthy, let your
mind dwell on these things."
Paul of Tarsus
-----Original Message-----
From: John Jacobus [mailto:crispy_bird@YAHOO.COM]
Sent: Friday, August 20, 2004 9:47 AM
To: Stankewitsch, Brian T.; radsafe@list.vanderbilt.edu
Subject: 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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