Information Notice 2003-22, Heightened Awareness for Patients Containing Detectable Amounts of Radiation from Medical Administrations
| ML033390164 | |
| Person / Time | |
|---|---|
| Issue date: | 12/09/2003 |
| From: | Chris Miller Office of Nuclear Material Safety and Safeguards |
| To: | |
| Darden T, Howe D, Henderson P | |
| References | |
| IN-03-022 | |
| Download: ML033390164 (8) | |
UNITED STATES
NUCLEAR REGULATORY COMMISSION
OFFICE OF NUCLEAR MATERIAL SAFETY AND SAFEGUARDS
WASHINGTON, D.C. 20555-0001 December 9, 2003 NRC INFORMATION NOTICE 2003-22: HEIGHTENED AWARENESS FOR PATIENTS
CONTAINING DETECTABLE AMOUNTS OF
RADIATION FROM MEDICAL ADMINISTRATIONS
Addressees
All medical licensees and NRC Master Materials License medical use permittees.
Purpose
The U.S. Nuclear Regulatory Commission (NRC) is issuing this Information Notice (IN) to alert
addressees of an event where a radiation detector, installed as part of heightened homeland
security measures, alarmed when a recently released radiopharmaceutical patient passed by it.
In reviewing this notice, licensees are also reminded to emphasize to those patients still
containing detectable amounts of radiation from medical administrations and released with
written instructions in accordance with 10 CFR 35.75, the importance of following those
instructions. This is essential for maintaining doses to other individuals as low as is reasonable
achievable and, presently, to reduce the occurrence of patients triggering with radiation
monitors, installed at public locations for increasing public security in the United States.
It is expected that recipients will review this information for applicability to their licensed
operations and consider actions, as appropriate, to avoid similar problems. However, suggestions contained in this IN are not new NRC requirements; therefore, no specific action
nor written response is required.
Description of Circumstances
On March 20, 2003, a bus traveling from New York to Atlantic City set off a radiation alarm in a
tunnel, as it passed by a radiation detector. When the State Police pulled over the bus, it was
discovered that one of the passengers had received a 370 Megabecquerel (10 millicurie) dose
of iodine-131 earlier that day from a medical procedure. Although the medical licensee
provided the patient with written safety instructions, which included not using public
transportation for 2 days, the patient failed to follow the instructions. This resulted in the
activation of the radiation detector in the tunnel. Subsequent discussions with the patients
physician indicated that the patients actions in taking the trip would have no safety significance
to the members of the public on or near the bus. However, the event resulted in unnecessary
concern and inconvenience to the patient and members of the public, as well as to law
enforcement authorities and other public officials.
Discussion:
Heightened security measures are now in effect throughout the United States. These include, but are not limited to, installation of radiation surveillance equipment at critical infrastructures
and mass congregation events. Therefore, types of incidents such as the one described within
this IN are likely to increase for released patients that still contain detectable amounts of
radiation from medical administrations of radiopharmaceuticals and brachytherapy sources.
These incidents may not be limited to those patients who are required to be provided written
instructions, when released in accordance with 10 CFR 35.75, but could also include patients
administered diagnostic dosages or low-level therapeutic dosages of radiopharmaceuticals. In
the example above, if the patient had been administered less than 259 Megabecquerel
(7 millicurie) of iodine-131, NRC regulations would not have required that the licensee provide
the patient with written instructions, but the patient might still have set off a radiation detection
alarm.
When licensees are required to provide written directions to patients released in accordance
with 10 CFR 35.75, the licensees are expected to, among other things, review with authorized
users the expectation that written instructions provided to patients will be followed. Accordingly, authorized users are expected to evaluate the patients capability to follow recommended
written instructions before release, to determine if release at that time is advisable, and stress
the importance to the patient of following the written instructions.
In view of the event described and its potential for becoming more common, licensees should
consider the following voluntary actions for all patients who still contain detectable amounts of
radiation after receiving diagnostic or therapeutic quantities of radiopharmaceuticals or
brachytherapy implants:
1. Released patients who are administered diagnostic or therapeutic quantities of
radiopharmaceuticals or brachytherapy implants should be aware that their
treatment may have additional implications, because of heightened security
measures. Accordingly, provide all patients that still contain delectable amounts
of radiation with an appropriate explanation about the potential of alarming
radiation monitoring equipment.
2. To assist the patient and avoid unnecessary concern by law enforcement
authorities and other public officials, consider providing the patient with the
licensees business card and written information for law enforcement use, stating
that the radiation received by the patient poses no danger to the public and that
it is allowed by NRC medical use regulations. This IN requires no specific action nor written response. If you have any questions about the
information in this notice, please contact one of the technical contacts listed below or the
appropriate regional office.
/RA/
Charles L. Miller, Director
Division of Industrial and
Medical Nuclear Safety
Office of Nuclear Material Safety
and Safeguards
Technical Contacts: Teresa Darden, Region I Pamela J. Henderson, Region I
610-337-5245 610-337-6952 E-mail: thd@nrc.gov E-mail: pjh1@nrc.gov
Donna-Beth Howe, Ph.D., NMSS
301-415-7848 E-mail: dbh@nrc.gov
Attachments:
1. List of Recently Issued NRC Information Notices
2. List of Recently Issued NMSS Information Notices This IN requires no specific action nor written response. If you have any questions about the
information in this notice, please contact one of the technical contacts listed below or the
appropriate regional office.
/RA/
Charles L. Miller, Director
Division of Industrial and
Medical Nuclear Safety
Office of Nuclear Material Safety
and Safeguards
Technical Contacts: Teresa Darden, Region I Pamela J. Henderson, Region I
610-337-5245 610-337-6952 E-mail: thd@nrc.gov E-mail: pjh1@nrc.gov
Donna-Beth Howe, Ph.D., NMSS
301-415-7848 E-mail: dbh@nrc.gov
Attachments:
1. List of Recently Issued NRC Information Notices
2. List of Recently Issued NMSS Information Notices
ADAMS Accession#:
Document Name: G:\IMNS\Cabrera\IN-R1 Inst. to Patients.wpd
- See previous concurrence or e-mail
OFFICE: DNMS/R-I MSIB MSIB NMSS MSIB IMNS
NAME: PHenderson* ICabrera* Ekraus(fax)* RTorres* TEssig* CMiller
DATE: 8 /19/03 8 /19/03 8/25/03 8/ 29 /03 9 / 2 /03 12/4/03 OFFICIAL RECORD COPY
Attachment 1 LIST OF RECENTLY ISSUED
NRC INFORMATION NOTICES
_____________________________________________________________________________________
Information Date of
Notice No. Subject Issuance Issued to
_____________________________________________________________________________________
2003-21 High-Dose-Rate-Remote- Pending All medical licensees.
Afterloader Equipment Failure
2003-20 Derating Whiting Cranes 10/22/2003 All holders of operating licenses
Purchased Before 1980 for nuclear power reactors, except those who have
permanently ceased operations
and have certified that fuel has
been permanently removed from
the reactor vessel; applicable
decommissioning reactors, fuel
facilities, and independent spent
fuel storage installations.
2003-19 Unanalyzed Condition of 10/06/2003 All holders of operating licenses
Reactor Coolant Pump Seal or construction permits for
Leakoff Line During Postulated pressurized water reactors
Fire Scenarios or Station (PWRs).
Blackout
2003-18 General Electric Type SBM 09/26/2003 All holders of operating licenses
Control Switches With for nuclear power reactors, Defective Cam Followers except those who have
permanently ceased operations
and have certified that fuel has
been permanently removed from
the reactor vessel.
2003-17 Reduced Service Life of 09/29/2003 All holders of operating licenses
Automatic Switch Company for nuclear power reactors.
(ASCO) Solenoid Valves With
Buna-N Material
2003-16 Icing Conditions Between 10/06/2003 All 10 CFR Part 72 licensees and
Bottom of Dry Storage System certificate holders.
and Storage Pad
Note: NRC generic communications may be received in electronic format shortly after they are
issued by subscribing to the NRC listserver as follows:
To subscribe send an e-mail to <listproc@nrc.gov >, no subject, and the following
command in the message portion:
subscribe gc-nrr firstname lastname
______________________________________________________________________________________
OL = Operating License
CP = Construction Permit
Attachment 2 LIST OF RECENTLY ISSUED
NMSS INFORMATION NOTICES
_____________________________________________________________________________________
Information Date of
Notice No. Subject Issuance Issued to
_____________________________________________________________________________________
2003-21 High-Dose-Rate-Remote- Pending All medical licensees.
Afterloader Equipment Failure
2003-20 Derating Whiting Cranes 10/22/2003 All holders of operating licenses
Purchased Before 1980 for nuclear power reactors, except those who have
permanently ceased operations
and have certified that fuel has
been permanently removed from
the reactor vessel; applicable
decommissioning reactors, fuel
facilities, and independent spent
fuel storage installations.
2003-16 Icing Conditions Between 10/06/2003 All 10 CFR Part 72 licensees and
Bottom of Dry Storage System certificate holders.
and Storage Pad
2003-12 Problems Involved in 08/22/2003 All holders of 10 CFR Parts 32, Monitoring Dose to the Hands 33, and 35 licenses.
Resulting from the Handling of
Radiopharmaceuticals
2003-10 Criticality Monitoring System 08/04/2003 All U.S. Nuclear Regulatory
Degradation at BWX Commission (NRC) licensees
Technologies, Inc., Nuclear authorized to possess a critical
Products Division, Lynchburg, mass of special nuclear material.
2003-09 Source Positioning Errors and 07/16/2003 All medical licensees.
System Malfunctions During
Administration of Intravascular
Brachtherapy
Note: NRC generic communications may be received in electronic format shortly after they are issued by
subscribing to the NRC listserver as follows:
To subscribe send an e-mail to <listproc@nrc.gov >, no subject, and the following command in the
message portion:
subscribe gc-nrr firstname lastname
______________________________________________________________________________________
OL = Operating License
CP = Construction Permit