DHS 157.63(3)(a)(a) A licensee may not administer to humans a radioactive drug containing more than the following: DHS 157.63(3)(a)1.1. 0.15 kilobecquerel of molybdenum-99 per megabecquerel of technetium-99m (0.15 microcurie of molybdenum-99 per 1 millicurie of technetium 99m). DHS 157.63(3)(a)2.2. 0.02 kilobecquerel of strontium-82 per megabecquerel of rubidium-82 chloride injection (0.02 microcurie of strontium-82 per 1 millicurie of rubidium-82 chloride injection). DHS 157.63(3)(a)3.3. 0.2 kilobecquerel of strontium-85 per megabecquerel of rubidium-82 chloride injection (0.2 microcurie of strontium-85 per 1 millicurie of rubidium-82 chloride injection). DHS 157.63(3)(b)(b) A licensee that prepares radioactive drugs from radionuclide generators shall do all the following: DHS 157.63(3)(b)1.1. If using a molybdenum-99/technetium-99m generator for preparing a technetium-99m radiopharmaceutical, measure the molybdenum-99 concentration in each eluate from a generator to demonstrate compliance with par. (a). DHS 157.63(3)(b)2.2. Measure the concentration of radionuclide contaminant in each eluate or extract, as appropriate for other generator systems. DHS 157.63(3)(b)3.3. If using a strontium-82/rubidium-82 generator for preparing a rubidium-82 radiopharmaceutical shall, before the first patient use of the day, measure the concentration of radionuclides strontium-82 and strontium-85 to demonstrate compliance with par. (a). DHS 157.63(3)(c)(c) A licensee that must measure radionuclide contaminant concentration shall retain a record of each measurement under s. DHS 157.71 (14). DHS 157.63(3)(d)(d) The licensee shall report any measurement that exceeds the limits in par. (a) at the time of generator elution, in accordance with s. DHS 157.72 (4). DHS 157.63(4)(4) Training for uptake, dilution and excretion studies. Except as provided in s. DHS 157.61 (10), a licensee shall require an authorized user of unsealed radioactive material for the uses authorized under sub. (1) to be a physician who meets any of the following requirements: DHS 157.63(4)(a)(a) Is certified by a medical specialty board whose certification process has been recognized by the department, the NRC, or an agreement state. To have its certification process recognized, a specialty board shall require all candidates for certification to do all of the following: DHS 157.63(4)(a)1.1. Complete 60 hours of training and experience in basic radionuclide handling techniques and radiation safety applicable to the medical use of unsealed radioactive material for uptake, dilution, and excretion studies that includes the topics listed in par. (c). DHS 157.63(4)(a)2.2. Pass an examination, administered by diplomates of the specialty board, that assesses knowledge and competence in radiation safety, radionuclide handling, and quality control. DHS 157.63 NoteNote: Specialty boards whose certification processes have been recognized by the department, the NRC or an agreement state will be posted on the NRC’s web site at www.nrc.gov. DHS 157.63(4)(c)(c) Has completed 60 hours of training and experience, including a minimum of 8 hours of classroom and laboratory training, in basic radionuclide handling techniques applicable to the medical use of unsealed radioactive material for uptake, dilution and excretion studies that includes all the following: DHS 157.63(4)(c)2.2. Work experience, under the supervision of an authorized user who meets the requirements in this subsection, sub. (4) or (5), s. DHS 157.61 (10) or 157.64 (4), or equivalent NRC or agreement state requirements, involving all the following: DHS 157.63(4)(c)2.a.a. Ordering, receiving and unpacking radioactive materials safely and performing the related radiation surveys. DHS 157.63(4)(c)2.b.b. Performing quality control procedures on instruments used to determine the activity of dosages and performing checks for proper operation of survey meters. DHS 157.63(4)(c)2.c.c. Calculating, measuring and safely preparing patient or human research subject dosages. DHS 157.63(4)(c)2.d.d. Using administrative controls to prevent a medical event involving the use of unsealed radioactive material. DHS 157.63(4)(c)2.e.e. Using procedures to contain spilled radioactive material safely and using proper decontamination procedures. DHS 157.63(4)(c)2.f.f. Administering dosages of radioactive drugs to patients or human research subjects. DHS 157.63(5)(5) Training for imaging and localization studies. Except as provided in s. DHS 157.61 (10), a licensee shall require an authorized user of unsealed radioactive material for the uses authorized under sub. (2) to be a physician who meets any of the following requirements: DHS 157.63(5)(a)(a) Is certified by a medical special board whose certification process has been recognized by the department, the NRC, or an agreement state. To have its certification process recognized, a specialty board shall require all candidates for certification to do both of the following: DHS 157.63(5)(a)1.1. Complete 700 hours of training and experience in basic radionuclide handling techniques and radiation safety applicable to the medical use of unsealed radioactive material for imaging and localization studies that includes the topics listed in par. (c) 1. and 2. DHS 157.63(5)(a)2.2. Pass an examination, administered by diplomates of the specialty board, which assesses knowledge and competence in radiation safety, radionuclide handling, and quality control. DHS 157.63 NoteNote: Specialty boards whose certification processes have been recognized by the department, the NRC or an agreement state will be posted on the NRC’s web site at www.nrc.gov. DHS 157.63(5)(c)(c) Has completed 700 hours of training and experience, including a minimum of 80 hours of classroom and laboratory training, in basic radionuclide handling techniques applicable to the medical use of unsealed radioactive material for imaging and localization studies that includes, at a minimum, all the following: DHS 157.63(5)(c)2.2. Work experience, under the supervision of an authorized user, who meets the requirements in this subsection, s. DHS 157.61 (10), or subd. 2. g. and s. DHS 157.64 (4), or equivalent NRC or agreement state requirements. An authorized nuclear pharmacist who meets the requirements in s. DHS 157.61 (9) or (10) may provide the supervised work experience under subd. 2. g. Work experience must include all of the following: DHS 157.63(5)(c)2.a.a. Ordering, receiving and unpacking radioactive materials safely and performing the related radiation surveys. DHS 157.63(5)(c)2.b.b. Performing quality control procedures on instruments used to determine the activity of dosages and performing checks for proper operation of survey meters. DHS 157.63(5)(c)2.c.c. Calculating, measuring and safely preparing patient or human research subject dosages. DHS 157.63(5)(c)2.d.d. Using administrative controls to prevent a medical event involving the use of unsealed radioactive material. DHS 157.63(5)(c)2.e.e. Using procedures to safely contain spilled radioactive material and using proper decontamination procedures. DHS 157.63(5)(c)2.f.f. Administering dosages of radioactive drugs to patients or human research subjects. DHS 157.63(5)(c)2.g.g. Eluting generator systems appropriate for preparation of radioactive drugs for imaging and localization studies, measuring and testing the eluate for radionuclidic purity, and processing the eluate with reagent kits to prepare labeled radioactive drugs. DHS 157.63 NoteNote: Eluting generator systems are a family of radioactive material devices used to extract useful radioactive materials by passing sterile fluid through a column of the parent material. The resulting mixture of fluid and radioactive material, known as the eluate, is used in the diagnostic procedures. These generators are used to produce Tc-99m, Ga-67 or Rb-82.
DHS 157.63(6)(a)(a) Unsealed radioactive material for uptake, dilution, and excretion studies for which a written directive is not required. As required by sub. (4) (c) 3., the licensee shall require an authorized user of unsealed radioactive material for the uses authorized under sub. (1) to have obtained written attestation that the individual has successfully completed the requirements of sub. (4) (c) and is able to independently fulfill the radiation safety-related duties as an authorized user for the medical uses authorized under sub. (1). The attestation must be obtained from either of the following: DHS 157.63(6)(a)2.2. A residency program director who affirms in writing that the attestation represents the consensus of the residency program faculty where at least one faculty member is an authorized user who meets the requirements sub. (4) or (5), s. DHS 157.61 (10), s. DHS 157.64 (4), or equivalent NRC or agreement state requirements, and concurs with the attestation provided by the residency program director. The residency training program must be approved by the Residency Review Committee of the Accreditation Council for Graduate Medical Education or the Royal College of Physicians and Surgeons of Canada or the Council on Postdoctoral Training of the American Osteopathic Association and must include training and experience specified in sub. (4) (c). DHS 157.63(6)(b)(b) Unsealed radioactive material for imaging and localization studies for which a written directive is not required. As required by sub. (5) (c) 3., the licensee shall require an authorized user of unsealed radioactive material for uses under sub. (2) to have written attestation that the individual has successfully completed the requirements in sub. (5) (c) and is able to independently fulfill the radiation safety-related duties as an authorized user for the medical uses authorized under subs. (1) and (2). The attestation must be obtained from either of the following: DHS 157.63(6)(b)2.2. A residency program director who affirms in writing that the attestation represents the consensus of the residency program faculty where at least one faculty member is an authorized user who meets the requirements sub. (5), s. DHS 157.61 (10), ss. DHS 157.64 (4) and 157.63 (5) (c) 2. g., or equivalent NRC or agreement state requirements, and concurs with the attestation provided by the residency program director. The residency training program must be approved by the Residency Review Committee of the Accreditation Council for Graduate Medical Education or the Royal College of Physicians and Surgeons of Canada or the Council on Postdoctoral Training of the American Osteopathic Association and must include training and experience specified in sub. (5) (c). DHS 157.63 HistoryHistory: CR 01-108: cr. Register July 2002 No. 559, eff. — see Note at the start of the chapter; correction in (2) (a) made under s. 13.93 (2m) (b) 7., Stats., Register July 2002 No. 559; CR 06-021: r. and recr. (1) (b), (2) (b), (3) to (5), cr. (6) Register October 2006 No. 610, eff. 11-1-06; CR 09-062: renum. (1) (a) and (2) (a) to be (1) (a) (intro.) and (2) (a) (intro.) and am., cr. (1) (a) 1., 2., (2) (a) 1. and 2., am. (1) (b) (intro.), (2) (b) (intro.), (3) (a) 1. to 3., (4) (c) 2. (intro.), (5) (a) 1., (c) 2. (intro.), (6) (a) and (b) Register April 2010 No. 652, eff. 5-1-10; CR 16-078: am. (2) (b) 3., (4) (c) 2. Register January 2018 No. 745, eff. 2-1-18; CR 22-015: r. and recr. (3) (b) 1., cr. (3) (b) 3., (d), am. (4) (intro.), (a) (intro.), (b), (c) 2. (intro.), cr. (4) (c) 3., am. (5) (intro.), (a) (intro.), (b), (c) 2., cr. (5) (c) 3., r. and recr. (6) Register June 2023 No. 810, eff. 7-1-23. DHS 157.64DHS 157.64 Unsealed radioactive material — written directive required. DHS 157.64(1)(1) Use of unsealed radioactive material for which a written directive is required. A licensee may use any unsealed radioactive material identified in s. DHS 157.64 (4) (b) 2. g., prepared for medical use, and for which a written directive is required that is any of the following: DHS 157.64(1)(b)(b) Excluding production of PET radionuclides, is prepared by any of the following: DHS 157.64(1)(b)3.3. An individual under the supervision of either an authorized nuclear pharmacist or physician who is an authorized user as specified in s. DHS 157.61 (3). DHS 157.64(1)(c)(c) Obtained from an NRC or agreement state licensee for use in research under an investigational new drug application accepted by FDA. DHS 157.64(1)(d)(d) Prepared by the licensee for use under an investigational new drug protocol accepted by FDA. DHS 157.64(2)(2) Safety instruction. In addition to the requirements of subch. X, a licensee shall do all the following: DHS 157.64(2)(a)(a) Provide radiation safety instruction, initially and at least annually, to personnel caring for patients or human research subjects who have received therapy with a drug containing radioactive material and cannot be released under s. DHS 157.62 (8). The instruction shall be commensurate with the duties of the personnel and include all the following: DHS 157.64(2)(a)5.5. Notification of the radiation safety officer or his or her designee and the authorized user if the patient or the human research subject dies or has a medical emergency. DHS 157.64(3)(a)1.1. Quarter the patient or the human research subject in one of the following: DHS 157.64(3)(a)1.b.b. A room, with a bathroom, with another person who also has received therapy with a radioactive drug containing radioactive material and who cannot be released under s. DHS 157.62 (8). DHS 157.64(3)(a)2.2. Visibly post a “Radioactive Materials” sign on the door of a patient’s or the human research subject’s room and note on the door or in the patient’s or human research subject’s chart where and how long visitors may stay in the patient’s or the human research subject’s room. DHS 157.64(3)(a)3.3. Either monitor material and items removed from the patient’s or the human research subject’s room to determine that their radioactivity cannot be distinguished from the natural background radiation level with a radiation detection survey instrument set on its most sensitive scale and with no interposed shielding or handle such material and items as radioactive waste. DHS 157.64(3)(b)(b) A licensee shall notify the radiation safety officer or his or her designee and the authorized user as soon as possible if the patient or human research subject has a medical emergency and immediately if the patient dies.
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