I heard on the news here in Atlanta last week, a Doc at Piedmont Hospital radiated the wrong side of a patients mouth... 13 treatments!
The poor woman now has no functioning salivary glands.
She sued and was awarded $250.000. Not enough.
The Doctors lawyer told the jury; "no one knows for sure that the radiation caused her dry mouth problems." WTH is wrong with these people.

Question everything folks.

We had one person here who went in for a radiation treatment and the patient before her was a no show - she was irradiated for prostate cancer that day (oops!). They never advanced the program to hers.

I used to always check the computer monitor in the treatment room to make sure that my name was on the treatment plan.

Considering that many treatment centers run people through like cattle and some operate 12/hrs a day, I am surprised that more mistakes like these don't happen (or maybe they are just not reported).

If I was her I would file a complaint through the MEDWATCH system on a Form 3500 with the FDA for patient injury - that is definitely a reportable event. http://www.fda.gov/medwatch/

In fact anytime you receive unnecessary radiation or x-rays or studies that have to be repeated (because they blew the exam or "lost" your image files, they are all considered patient injuries.
This above doesn't apply to MRI, PET (but not PET/CT)or Ultrasound as these don't introduce gamma or ionizing radiation into the body. Dental and chest x-rays are a small amount of radiation. When you start getting into CT scans, one is equal to 3 years of normal background radiation exposure.

Just FYI, In addition to being a care giver, I happen to be a nuclear medicine technologist and current radiation safety officer at the community hospital where I work. We use the ALARA principle ("As low as reasonably achievable" when it comes to any radiation for our patients or employees.)
PET (positron emission tomography) also gives off ionizing radiation (2- 511 KEv gamma rays). So, that should be included in your list of exams too. Good advice to be prudent when ever undergoing any procedure involving radiation. Your Radiation therapist should be using positive Identification procedures for each and every treatment.(PS Dental xrays give off alot of radiation also. Gary, may I suggest changing your statement to "Dental and chest x-rays are a smallER amount of radiation"? For dental, be sure they cover you with a lead apron. )

Mary how is Rick doing? He's right at the midpoint. Responding well I hope.

Here's a reference to different radiation levels from different devices (PET isn't listed, nor is dental) http://www.radiologyinfo.org/en/pdf/x-ray_safety.pdf

PET scans safety:
PET scanning is non-invasive, but it does involve exposure to ionizing radiation. The total dose of radiation is small, however, usually around 7 mSv. This can be compared to 2.2 mSv average annual background radiation in the UK, 0.02 mSv for a chest X-Ray, up to 8 mSv for a CT scan of the chest, 2-6 mSv per annum for aircrew, and 7.8 mSv per annum background exposure in Cornwall (Data from UK National Radiological Protection Board).

Because the half-life of 18F is about two hours, the prepared doses decay significantly during the working day. If the FDG is delivered to the scanning suite in the morning, the specific activity falls during the day, and a relatively larger volume of radiopharmaceutical must be injected in later patients to deliver the same radioactive dose.

Here's a link to dental x-ray safety for those interested - the amount of radiation is pretty small. I personally think that the lead aprons were mandated by some risk management attorney to the ADA. It's really a joke. Especially after you've had 60-80 cGy of ionizing radiation under a LINAC (How come they don't give you a lead apron there !?!?!). But if you're paranoid - go for it. I support paranoia in all its forms;-) They should give flight crews lead aprons. They get more radiation being at high altitude. At least they banned smoking on most flights now...

By the way those big LINACS, the ones using klystron tubes (20MeV) can put out nuetrons as well as ionizing radiation. I think that most H&N cases are treated on a 6 MeV machine because of the depth and beam geometry.

http://hps.org/hpspublications/articles/dentaldoses.html

It does help to be in the business. I was treated on a LINAC from a company I used to work for (in the development group - Siemens Medical Labs) and my therapist was training at the company during the same I was working there. She's moved on to bigger and better things - She runs the Gamma Knife now at UCSFCCC. She shared with me, one time, that it's really hard on them to have otherwise healthy people come and have the living crap kicked out of them by the radiation and watching the deterioration. I visit her every now and then to encourage her that the stuff really works sometimes. So bring your therapist some chocolate chip cookies!

I'm in the radiology business doing mainly PACS but an occasional mammography, MRI, CT and lots of ultrasound systems(I am very familiar with ALARA - It has to be in the user manual as part of the labeling mandated by the FDA) FDA 510K Pre-Market Notification (PMN).

In California the Sherman Act regulates x-ray installations as well as the FDA, including non-medical uses.

HI Gary,
Thanks for asking about Rick! He is doing better since this Monday when he had a PEG tube inserted.(I think reading about how much it has helped many of you gave him the encouragement to go for it!) IT was a really quick procedure and we even used it the same day. He also had a visit from a very nice home health nurse to show us how to use it...Wow! It was great care! And they arranged to have a case of Jevity deliivered right to our house. Awesome!

He had been losing weight and was so dehydrated the Dr. said he may have to be hospitalized. Eating hurts his mouth alot...he was even thinning out his Ensure with ice water...So far he hasn't dropped any more weight. Tomorrow is chemo day along with the radiation, and we will see how it goes.

LAst week he took the radiation therapists and chemo nurses some Esther Price Chocolates!....I know they need a little encouragement every so often, also. He isn't usually Mr. Sunshine if you know what I mean!

BTW, Our PACS is in the process of being installed!!!! I get so excited I can't stand it. It is probably one of the most significant changes I will have been involved with in my career (which began in 1975)....Some of the referring docs are already viewing x-ray over the internet..and they love it! (Did you happen to attend the AHRA last week?)

Mary,
Danny Boy put together an ultra high calory drink that many have used successfully and if you do a little digging with the search engine you can probably find it. He was also a big proponent of Jevity.

As you probably know, it will go downhill from here until about three weeks post Tx. We are here here to help you.

Dehydration can cause a lot of problems, from feeling like sh*t to renal failure (because of the toxicity of the chemo). He can be rehydrated on an outpatient basis in the infusion clinic where he is getting his chemo - ask about that. The chemo actually functions better when it is flushed from the system.

So Mary who is the manufacturer of your PACS system? I have obtained 510(k) clearance for most of them.

I am usually very busy with last minute FDA filings by companies exhibiting at the trade shows so I rarely get to go to them. It's mainly marketing people there anyway and they make for good regulatory contacts and don't generate any additional revenue streams for me.

My last sentence made no sense at all - I meant to say that marketing people DON'T make for good regulatory contacts since most of them thrive on deception. Regulatory (and closely related brother Quality Assurance) is about science and the truth.