Sat, 16 Sep 2000

Hospitals asked to check radiology devices

JAKARTA (JP): The Nuclear Energy Control Agency (Bapeten) asked hospitals on Friday to service and organize their equipment used in nuclear medicine treatments following a number of incidents in the country.

"We will start organizing and checking on hospitals in Jakarta as well as hospitals outside of Java. There are a total of 25 hospitals in the country already equipped with nuclear medicine- related devices," agency director M. Ridwan told The Jakarta Post.

"A lack of knowledge among medical technicians operating these devices and poor maintenance had led to accidents in treating patients."

Ridwan cited a case in May 1998 when a breast cancer patient died following Linear Accelerator therapy.

"She was supposed to receive radiation for five to nine minutes, but she received too much and the radiation affected other cells in her body. The patient died due to excess therapy," he said, declining to name the hospital where the treatment took place.

In February of this year, an accident occurred when a patient with cancer of the reproductive system was receiving brachytherapy and suffered from complications, Ridwan said.

"Fortunately, they were able to save her and the damage was checked. It turned out later that the (medical) device was outdated," he said.

The agency and the Ministry of Health and Social Welfare signed an agreement last week on the supervision of medical equipment used in nuclear medicine treatments.

"Hopefully, by the end of this year we will have checked the 25 hospitals in 13 cities (with this equipment)," Ridwan said.

The hospitals are located in Jakarta; Bandung in West Java; Semarang and Surakarta in Central Java; Yogyakarta, Surabaya and Malang in East Java; Medan in North Sumatra; Padang in West Sumatra; Palembang in South Sumatra; Makassar in South Sulawesi; Manado in North Sulawesi; and Denpasar in Bali.

Stern action was promised against those hospitals found not properly maintaining and using the equipment.

Those found negligent will be charged under Article 43 of Law No. 10/1997 on nuclear energy, which carries a maximum sentence of two years in jail or a Rp 100 million fine, Ridwan said.

He cited Persahabatan Hospital in Rawamangun, East Jakarta, which once was found to be performing brachytherapy without a proper permit.

"Now they are going through the process of securing a permit to perform the therapy," he said.

Also, some nuclear medicine-related devices are calibrated every four years, when ideally they should be checked at least once a year, he said. He added that calibrating the equipment was relatively inexpensive, costing Rp 250,000 ($US28.70) per point.

Among the hospitals regarded as having the safest and best maintained equipment for nuclear medicine treatments and radiology therapy are Dharmais Cancer Hospital, Pertamina Hospital, Cipto Mangunkusumo General Hospital (RSCM) and Gatot Subroto Army Hospital, all in Jakarta.

This year, radiation therapy has helped save the lives of some 500,000 cancer patients in the country, Ridwan said.

"Medical technicians also have to upgrade their skills. It is a shame if we purchase a device and do not know how to operate it properly. Doctors also have to be honest with their patients about the radiation therapy and its side effects," he said.

According to the agency, the latest data shows Costa Rica and Spain are ranked as the countries with the highest number of fatalities as a result of radiation therapy.

"At least 13 people have died in Costa Rica and 11 in Spain.

"In Indonesia, most of the cases are not reported because people are still ignorant or afraid to come forward. The cases are usually settled between doctors and patients," Ridwan said.

The head of finance at RSCM, Ihramsyah, said his hospital conducted regular checks of its nuclear medicine-related devices. "We do not want to risk the lives of people, do we." (edt)