Unsecured Nuclear Materials Put All at Risk

by DR. JAMES “JIM” BLAIR, COL RET, ARMY AMEDD September 25, 2012

It is almost surreal how the world has become a place with so little accountability and so much apathy among those who have a moral responsibility to care for a trusting public. Welcome to Superman's Bizarro World of the 21st century.

This summer I spent the better part of a week on Capitol Hill with Congressional members and their staff expressing continuing concern over two profound gaps in the nation's Public Health and Healthcare sector. Fortified with recent OIG and GAO reports and copies of my recent books on Public Health and Healthcare all-hazards readiness (UNREADY: To Err is Human, 2010 and DEADLY NEGLECT: Apathy and Denial vs. Act of God, 2011), and a series of questions designed to assess the level of concern members had for the all-hazards preparedness within  facilities housing our exploding ageing populations (my next book).

A recent DHHS OIG report was an industry-wide condemnation of any reasonable level of preparedness in Nursing Homes to either "shelter-in-place or evacuate" their vulnerable patients. With 10,000 elders joining the Medicare ranks each day, the increasing numbers of under-65 disabled populations swelling those numbers and the fastest growing population elder cohort "85+",  the nation faces a near-term "perfect storm" in meeting the need for safe and secure environments of care for elders.

There is little need to go into threats posed by the lack of security of "Medical and Research Radioactive Use Materials (MRRUM)" in active use, or in storage across the nation. GAO-12-925, September, 2012 tells the story in great detail. One would have to be on MARS not to know the facts since the professional and popular press keeps telling the ugly truth about these dangers.

I braced myself for the deluge of calls from professional/popular media, asking "Why four out of five Hospitals, Blood Banks and University-based Healthcare Research organizations fail to secure what the Defense Science Board characterizes as the greatest immediate nuclear threat from terrorists, MRRUM, low hanging fruit, half of the dreaded "Dirty Bomb"?

In one of the most egregious examples of dereliction of duty in the medical arena, these organizations are not required by law to secure these materials, and due to an apparent priority for profit over security, they cannot afford the expense of $10,000 a year over 3-5 years to maintain such a system.

These organizations are not alone in their unfulfilled obligations to the public; a web of contributing entities is on this slippery slope of denial, they include:

  • The CFO does not consider it a good ROI bet. They may feel that there is an acceptable level of risk in this area, which we wholeheartedly reject,
  • Their insurance carriers do not require it,
  • Capital lending institutions (Federal and Private) do not require it,
  • Congressional oversight Committees and Sub-Committees do not see the need to burden the industry with more costs (beyond the increase in K Street spending they need to get re-elected),
  • Department of Homeland Security and FEMA do not require it for grant eligibility, even though they would be the ones to Respond and Recover from a Dirty Bomb attack) ,
  • Department of Health and Human Services and CDC do not see this as a priority issue, even though it would overwhelm them for hundreds of square miles,
  • It is not seen as a predicate for Accreditation or Certification at the CMS or State Health Departments,
  • You can be listed as one of the "Decade's Best Hospital in the Nation" without securing your radioactive materials,
  • You can be listed as one of the "100 Best Hospitals for This or That" without securing your dangerous medical use radialogical materials,
  • You may be selected as one of the "best places to work in healthcare" without securing your medical use radioactive materials,
  • External Evaluation mechanisms will provide you with "deeming status" - taxpayer reimbursement for care without a secure site for your active use or stored radio-logical materials,
  • If you carefully read the Nuclear Regulatory Commission's Guidance (NRC) there is no legal requirement to comply,
  • Even the coveted Baldrige Selection does not require compliance
  • Oakridge y-12 folks gave us a clean bill of health,
  • Where is OSHA? Where is EPA?

Given all the reasons you don't have to take responsibility, it seems the only reason to secure this material would be because it is the right thing to do to prevent a huge and unnecessary loss of life.

Go Figure.

James “Jim” Blair, Col Ret, Army AMEDD , DPA, MHA, FACHE, FABCHS, CAS, is president and CEO of the Center for HealthCare Emergency Readiness. This article was adapted from excerpts from Blair's book, Unready: To Err is Human: The Other Neglected Side of Hospital Safety and Security, which was published in June. He is also a career-retired army colonel with 28 years of active service. Among his private sector experiences, he served as VP of Hospital Corporation of America, Middle East Limited and as an independent consultant to Joint Commission International.

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