2.9HDRunitmalfunction-RadiationProtectionofPatients.pptVIP

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2.9HDRunitmalfunction-RadiationProtectionofPatients.ppt

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2.9HDRunitmalfunction-RadiationProtectionofPatients.ppt

Prevention of accidental exposure in radiotherapy Module title Part No...., Module No....Lesson No IAEA Prevention of accidental exposure in radiotherapy Module 2.9: HDR unit malfunction (USA) HDR remote afterloader A small and mobile source housing installed in shielded treatment room Remote control console Source is 192Ir, with apparent activity of 4.3 Ci (160 GBq) Source is attached to a wire can be extended under remote control through one or more catheters in succession into the patient A second wire with a dummy source used first to verify the pathway through the catheter and to verify positions etc… Background 16 Nov. 1992: Elderly patient being treated for anal carcinoma at Indiana Regional Cancer Center (IRCC) The patient was scheduled for 3 treatments of 6 Gy each Omnitron 2000 HDR unit Five catheters were placed into the target volume What happened? The dummy source was introduced without any problems With the HDR source Four channels went well Upon attempting to direct the source into the fifth catheter, the control console reported an error After several attempts, the treatment was abandoned What happened? Termination of the treatment The staff entered the treatment room disconnected the HDR unit from the implanted catheters removed the patient What happened? An area radiation alarm indicated high radiation levels, but was ignored Both sound and sign alarm The staff reported that the alarm “often malfunctioned” and were used to ignore it What happened? A survey meter was available but was not used to confirm or rule out the area alarm’s signal The HDR console reported that the source was “safe” The patient was transported back to her nursing home The accident The hospital staff did not recognize that the source had broken loose from the guide wire, and had remained inside the catheter The catheters remained in the patient, with the HDR source, as the patient was transported back to the nursing home 20 Nov. 1992 (4 days later) - the catheter contai