Letter confirms VA accepts specific violations, fine

A letter dated April 8 from an official at the Department of Veterans Affairs confirmed the Philadelphia VA Medical Center accepts the specific violations that became public in 2008. The letter was addressed to the Nuclear Regulatory Commission and confirmed that the VA will pay a fine to the NRC.

“I understand the need for all of our facilities using radioactive materials to focus on a safety culture,” wrote Veterans Affairs Under Secretary for Health Robert Petzel.

On March 17, the NRC proposed a fine of $227,500 for the VA after a reported 97 botched brachytherapy procedures, wherein radioactive seeds are implanted near cancerous tissue. Gary Kao, then an associate professor of radiology at the School of Medicine, was on contract with the VA at the time and performed the procedures between 2002 and 2007.

According to NRC spokeswoman Viktoria Mitlyng, the VA has already paid the proposed fine.

However, Petzel also wrote that the NRC’s inspection report did reject a “proposal to retract medical events based on an activity metric,” and that he plans to “pursue approval for use of such a metric.”

Mitlyng said the metric refers to a definition of a “medical event” reportable to the NRC. “If the amount of radioactive material in a patient is 20 percent more or less than the prescribed dose, it’s a medical event,” she said, adding that most of the medical community uses this definition.

Mitlyng explained that a “blue ribbon panel” held by the VA determined that a more sensible way to define a medical event would be to measure the amount of radioactive activity in a patient. However, Mitlyng maintained that a 20-percent discrepancy between the dosage prescribed and the dosage given signifies a “deficiency.”

“If you’re going to use nuclear material, you have to use it correctly,” she said. She also said there are avenues to change the contested definition, but “even if the metric changes, it won’t be applied retroactively,” adding that “hopefully [the Department of Veterans Affairs] will take the lessons they learned and apply them elsewhere.”

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