[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index]
Re: Cremation of Prostate Implant Pts -Reply
>X-Authentication-Warning: isnet.is.bgsm.edu: [152.11.173.7] didn't use HELO
> protocol
>X-Sender: deguzman@bgsm.edu
>Date: Sun, 26 Jul 1998 12:25:37 -0400
>Reply-To: Medical Physics Mailing List <MEDPHYS@LISTS.WAYNE.EDU>
>Sender: Medical Physics Listserver <medphys@cwis-20.wayne.edu>
>From: deguzman@BGSM.EDU
>Subject: Re: Cremation of Prostate Implant Pts -Reply
>To: MEDPHYS@LISTS.WAYNE.EDU
>
>At 03:34 PM 7/15/98 -0400, you wrote:
>>Actually, I have run into this, only with I-125 implanted in a kidney.
>> I got the call on a Saturday that a kidney patient had died. I gave
>>the nursing home the usual spiel about not disturbing the kidney
>>during embalming and burying the seeds with the patient. They called
>>back 5 minutes later to say that the family wanted to embalm and
>>cremate. Many phone calls followed. I convinced the funeral home to
>>hold the body until I could have some firm answers. The Radiation
>>Oncologist would not harvest the kidney, the pathology department for
>>some legal reason I don't remember could not harvest the kidney, and
>>besides, I'd have to put it in a jar in radioactive waste storage for
>>more than a year.
>>
>>Eventually I got to the NRC and they referred me to NCRP 37 because
>>they had no rules to cover such an event. I pointed out to them that
>>Chapter 7 (Cremation) deals mostly with the upper limit on how much
>>radiation a crematorium can handle in a year, and that one cremation
>>was not going to put them over the limit. They agreed and said go
>>ahead. I called the funeral home, everyone breathed a sigh of
>>relief, and I wondered why I didn't become a plumber like my mother
>>wanted.
>>
>>I note that NCRP 37 does recommend (with a "shall") that the
>>transplanted organ be removed prior to cremation (but not burial)
>>under the supervision of a Radiation Safety Officer. If the
>>undertaker does this it would be a charge to the family as part of
>>his/her services. If the Radiation Oncologist or other related
>>physician does this perhaps there is a CPT code whereby it can be
>>charged as part of the therapy. But for the Radiation Safety
>>Officer, well, it's all in a day's work.
>>
>Folks,
>I just wanted to follow up my original post with the results of what
>happened to me here (in NC). Since I got replies on the list-server which
>all said something different (and since my RSO was out of town) I ended up
>calling our State Regulators. (Are any of you guys out there??) They
>basically said I needed to get the prostate (ie. the seeds) out of the body
>before cremation. I had to get the body shipped back from the funneral home
>to our morgue and had a pathologist remove the prostate the next morning. I
>was there during the procedure to survey things. It was kind of scary
>watching this guy using such sharp instruments around the 100 or so I-125
>seeds (although I told him to take very wide margins). I ended up with a
>piece of tissue the size of a football !!! and the corpse was still hot!.
>We were poking around and cutting things out for quite a while until we
>recovered all of the seeds. It was a rather nasty procedure. (and this was
>all before I had breakfast that morning). This brings up a number of things
>which we are now trying to address, such as:
>***Costs to the patient and his family (shipping body around, autopsy, etc)
>***Legal responsibilty for the seeds (Does the body come back to the
>implanters?)
>***Dangers of cutting open a seed while trying to remove the prostate
>***Storage of all these tissue samples
>***Religious problems with performing autopsies ?
>***Others???
>
>I think individual hospitals need to prepare some type of policy for dealing
>with this sort of thing because I have a feeling it is going to be happening
>more and more. (Another patient we recently implanted is on a respirator
>and probably won't last "10-half-lives"). Just something else to think
>about in your busy day....
>
>Have a good one.
>
>Al
> \\\|///
> \\ - - //
> ( @ @ )
>******************oOOo*(_)*oOOo*********************************************
>* Allan F. deGuzman, Ph.D., DABR * E-mail: deguzman@bgsm.edu *
>* Assistant Professor * Phone: 910-716-4981 *
>* Dept of Radiation Oncology * FAX: 910-716-5972 *
>* Bowman Gray School of Medicine * *
>* Winston Salem, NC 27157 * *
>
>* *
>* http://www.rad.bgsm.edu/radmain/htmls/faculty/deguzm_a.html *
>* *
>******************************0ooo******************************************
> oooO ( )
> ( ) ) /
> \ ( (_/
> \_)
>
> *****
>Frequently Asked Questions (FAQ) for Medphys at:
>http://www.mindspring.com/~sherouse/MPFAQ/
>
>Archives of recent Medphys postings at:
>http://www.escribe.com/medicine/medphys/
>
Chris Alston
alstonc@odrge.odr.georgetown.edu
I am not here a representative of my employer.
************************************************************************
The RADSAFE Frequently Asked Questions list, archives and subscription
information can be accessed at http://www.ehs.uiuc.edu/~rad/radsafe.html