Re: Breast-cancer patient gets radiation overdose -Reply

[Kathleen Kaufman <KKAUFMAN@dhs.co.la.ca.us>]

The American College of Radiology has written Standards of Practice for
linear accelerators. They state that the medical physicist should review
the patient's records at least once a week. That doesn't mean that the
physicist would actually observe a treatment. Unless the unit provides a
record (record & verify) of the treatment (it's my understanding that
some newer units do this), I suspect that the physicist wouldn't have
been able to find this error (it appears that the tech hadn't entered the
use of a wedge into the treatment plan) by looking @ patient charts. If I
needed rad therapy I'd ask if they used a dose verification system on the
first treatment.

kkaufman@dhs.co.la.ca.us
>>> Al Tschaeche <antatnsu@pacbell.net> 12/08/98 12:24pm >>>
Sandy Perle wrote:
> It will be interesting to
> determine whether or not the physicist was actually performing the
> verification, or having a subordinate perform the reviews, and simply
> signing the forms, as if he/she had performed it. 

See my other transmittal on this subject.  I know of no checking by the
physicist, who lived in a city about 260 miles from the city where my
wife received the treatment, of the settings after he had made them on
the first day.  My wife, at the time, told me only the technician was
present during each day's treatment.  Are there standards that require
checking settings, or checking the physicist's calculations that set the
dose and how the dose is delivered (e.g. aiming of the accelerator,
patient placement, etc.)  Al Tschaeche antatnsu@pacbell.net
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