[ RadSafe ] RE: Medical Radiological Technician Oversight

[Paul Lavely]

John,

I missed the intentional part.

>What mechanisims are in place to prevent Medical Radiological Techs 
>from intentionally or unintentionally overexposing their patients to 
>X-rays?

I looked only to the issue of unnecessary exposures. My experience 
was the rad tech who took 7 sequential x-rays of my 2 year old son 
that "didn't come our right." At that point, I intervened and said 
that no more x-rays would be taken until the problem was determined 
and addressed. In this case it was movement. The tech refused to 
allow me (or anyone else) to be in the room with the child while the 
x-ray was taken. The kid was hurt, scared, and in a place (and alone) 
that he had never been before. I knew that my dose would be in the 1 
to 2 mrem range, but it took the hospital's head of radiology 
involvement to get that permission. Additionally the struggle and 
delay did not help.

However, you are clearly correct - why. There was a popular fiction 
book (maybe by Cook) that had a HMO provider killing off selected 
patients with a BIG rad source in a ridiculously small shield under a 
special hospital bed.  Perhaps questions such as this (or irrational 
fears) are spawned by the fiction around us on TV, in movies, and in 
print.

It seems that hospitals offer a variety of "potentially undetectable 
lethal weapon(s)." A person could choose from pain med overdose, 
equipment failure, insulin dosing, succinylcholine, administration of 
a med a person with an extreme allergic (they are noted on the 
charts). and the list goes on. Would they be found out? Perhaps and 
perhaps not. The death of a very sick patient of apparent natureal 
causes would no necessitate calling in Quincy or CSI. However, why 
would someone do these things and why would they select radiation as 
their weapon?

I have had a couple of aspiring writers ask me about the use of 
radiation as a poison and I have told them about time, distance, 
shielding, and access to the material. A "dirty bomb" story sounds 
good; however, it is far from practical. For most people large 
amounts of radiation or radioactive materials is hard to get' but, 
your ACE hardware store can provide a variety of poisons.

By the way, a California legislator is proposing a law that would 
require tracking of patient medical exposures and that MDs consider 
the history in making a decision as to tests.

Paul

>I cannot imagine why a technologist would overdose a
>patient.  Do you have a reason?  Are looking to sue
>someone?
>
>--- A <ab19283 at excite.com> wrote:
>
>>
>>  Of all the millions of radiological procedures
>>  performed by the many thousands of (possibly
>>  uncertified) technicians, is no one concerned that
>>  foul play is not occurring?
>>
>>  Imagine for a moment that one tech decided not to be
>>  upstanding and trustworthy, for whatever reason...
>>
>>  They could easily overdose a patient and suffer
>>  absolutely no risk of being caught or exposed.  If
>>  they are careful to keep the dose under a certain
>>  level, there would be no immediate evidence.  The
>>  harm would come many months or even years later, and
>>  even then, there would be no way to link the harm to
>>  them.  Most patients are woefully unaware of how
>>  many exposures (and of what duration) any radiologic
>>  procedure requires.  I understand that exposure
>>  records are not kept and that patient dosimetry is
>>  not required.  It is also likely that a technician
>>  see the same patient over their lifetime.  The
>>  opportunity for abuse is tremendous.
>>
>>  The lack of oversight of someone with a potentially
>>  undetectable lethal weapon is utterly appauling.
>>
>>  Arthur
>>
>>
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>
>
>+++++++++++++++++++
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>never shrinks back to its original proportion." -- Oliver Wendell 
>Holmes, Jr.
>
>-- John
>John Jacobus, MS
>Certified Health Physicist
>e-mail:  crispy_bird at yahoo.com
>
>
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-- 


****
Paul Lavely
Radiation Safety Officer
Environment, Health & Safety
UC Berkeley, Berkeley, CA 94720-1150
Tel: (510) 643-7976
Fax: (510) 643-9495