NRC bars Penn Med oncologist

The United States Nuclear Regulatory Commission rarely issues orders against individuals, but the commission felt that the case of Gary Kao was a unique circumstance.

The NRC issued an order on Feb. 23 barring Kao, a School of Medicine radiation oncologist, from administering medical treatment using NRC-regulated nuclear material unless he undergoes training and meets other requirements specified by the agency, according to an NRC statement.

If Kao were to return to NRC-regulated activities, the commission would need “reasonable assurance that he’s not going to repeat the same mistakes and that his treatments are going to be performed safely for the public,” NRC spokeswoman Viktoria Mitlyng said.

The order comes after the discovery in May 2008 that Kao misplaced radioactive seeds in 91 of 116 brachytherapy procedures since 2002 at the Philadelphia Veterans Affairs Medical Center.

Kao subsequently took administrative leave and the NRC fined the VA $227,500 in March, 2010.

The procedure, a prostate cancer treatment that involves implanting iodine seeds in the prostate to battle the cancer, may have also been performed improperly at the Hospital of the University of Pennsylvania in a separate incident, according to a report the hospital issued to the NRC on Feb. 25, 2010.

The NRC is currently inspecting the actions at HUP, Mitlyng said.

The VA has paid the fine in its entirety and has suspended its brachytherapy programs at several of its facilities, including the one at the Philadelphia VA Hospital.

Despite these two separate cases of errors being reported with the procedure, brachytherapy is relatively safe and only 5 to 10 “medical events” are reported per year to the NRC, Mitlyng said.

“This is an established and safe treatment method that has been used for a long time,” Mitlyng said.

“The case of Dr. Kao is unprecedented” due to his “huge rate of error,” she continued.

For this reason, the NRC took what Mitlyng called a “very unusual action” in issuing an order against Kao as an individual physician.

Kao no longer has any clinical responsibilities. He is doing research involving DNA repair, HUP spokeswoman Susan Phillips wrote in an e-mail.

Phillips said Kao is not teaching any classes at the Medical School and is complying with the NRC order in not using NRC-licensed materials in his research.

Medical School radiation oncologists were not available for comment due to ongoing litigation. Kao is the defendant in a pending civil lawsuit being filed by several of his patients.

The suit was also filed against HUP, even though Kao conducted the procedures at the VA Hospital.

“Often in those cases, people sue every entity,” Phillips said. “It’s a legal strategy.”

Kao’s lawyer, Jack Gruenstein, was not willing to comment on the NRC’s decision or the pending litigation.

The civil case is currently sitting and no action has been taken since Dec. 6, 2010, according to court documents. Phillips also would not comment on the case, but said there “is nothing going on now.”

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