d. Enforcement Procedures. There are no enforcement procedures in the Title
21 regulation, BUT the Joint Commission on the Accreditation of Hospital Organizations
(JCAHO) will not accredit a hospital without a quality assurance program. (Would you
like to be x-rayed in a nonaccredited hospital?) Consequently, no Army hospital wants
to be without such a program.
e. Information and Consultation Services. If none of the hospital personnel is
qualified to propose the type of equipment to be bought, to prepare the aims of the
program, or to identify problem areas, an outside consultation service can be contracted
to do those things. It will probably be a civilian agency that will send a representative to
confer with the practitioner and/or the committee and help make the decisions.
f. Other Responsible Agencies.
(1) Health and Human Services (HHS) is a top government agency that
deals with problems concerning the general public.
(2) The Food and Drug Administration (FDA) is a subagency of HHS and
deals with problems concerning food, drugs, and other products. This includes control
MILITARY REGULATIONS: TECHNICAL BULLETIN MEDICAL 521
a. The Inspector General (IG) appoints a team for periodic inspections using
Technical Bulletin (TB) Medical (MED) 521 for guidelines (see figure 2-1).
b. If a radiology department does not comply with the requirements of TB MED
521, the IG files a formal written complaint to the commanding general. All complaints
must be answered in writing stating that the unsatisfactory conditions have been
corrected. Then, the IG will probably return in thirty days to see if the department is up
c. While the TB MED 521 outlines the how, where, and who of ionizing radiation
for the military, a consultation service may be hired occasionally. This is done to be
sure of compliance with any changes in Title 21 CFR because the TB incorporates the
Federal regulations into its bulletin.