VA lowers estimate of patients affected by brachytherapy mistakes

Officials from the U.S. Department of Veterans Affairs (VA) last week said that fewer patients than originally estimated were affected by alleged errors during brachytherapy treatments at a Philadelphia VA facility. At the same time, VA officials also apologized for the treatment mistakes.

The VA in June 2008 shut down the brachytherapy program at the Philadelphia Veterans Affairs Medical Center (VAMC) after the discovery of treatment errors involving the incorrect placement of iodine-125 seeds. The problems were revealed by the New York Times in a front-page article on June 21, 2009, that received national media attention.

Because the problems involved radioactive brachytherapy sources, the U.S. Nuclear Regulatory Commission (NRC) has been investigating the incidents, and the agency held a four-hour hearing on December 17 to gather information on further enforcement action. The NRC has already cited the Philadelphia VAMC for eight apparent violations of its regulations.

After stating for 18 months that 97 veterans had received incorrect doses of radiation when undergoing prostate brachytherapy treatment between February 2002 and June 2008, the Veterans Health Administration revised its count, reducing the number to 19 patients, according to coverage of the NRC meeting published in the Philadelphia Inquirer.

The VA's original standard was based on estimates of radiation dose delivered to the prostate. The new methodology adopted by the VA involves examining where brachytherapy seeds are placed in and around the prostate. Using the new assessment criteria, which VA representatives said was developed by a blue ribbon panel of medical experts, the VA reduced its count of the number of affected patients by more than 500%, according to the Philadelphia Inquirer.

The newspaper reported that Steven A. Reynolds, director of nuclear materials safety for NRC's region III, which led the agency's investigation, expressed concern about the change. He told the VA that it was troubling that the agency developed new criteria after 19 months and numerous onsite inspections and delays.

The NRC demanded written testimony by January 15, 2010, to back up the VA's rationale for limiting sanctions against it. It said it would issue violations and any penalties four to six weeks following this deadline.

In all, 31 veterans or their wives have filed claims totaling $58 million against the VA, according to records obtained in November by the Philadelphia Inquirer through a Freedom of Information Act request.

By Cynthia E. Keen staff writer
December 21, 2009

Related Reading

NRC report cites Philadelphia VA, November 19, 2009

6 more botched prostate brachytherapy cases at Philly VA, August 18, 2009

Congress eyes safety of VA prostate brachytherapy: Part 2, August 10, 2009

Congress eyes safety of VA prostate brachytherapy: Part 1, August 6, 2009

NY Times story claims treatment errors at VA brachytherapy unit, June 23, 2009

Copyright © 2009

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