1. What is the decision or change (e.g., clinical topic, practice guideline, system design, delivery of care) you are facing or struggling with where a summary of the evidence would be helpful?

I am an in house Radiological Service Engineer repairing and maintaining some of our older linear accelerator systems such as the Varian EX and other systems.

My main issue is the disregard for patient safety and system integrity when a present failure is impacting our system or there is a imminent system failure risk that our physics department and/or the doctors take the prerogative to ignore at their discretion even though engineering has the knowledge and experience to make a better informed decision. There are physics policies in place to disregard engineering’s recommendations to shut down the system to facilitate repairs for crucial issues.

This issue is putting the patient and therapists at high risk as well as our infrastructure and reputation of our establishment.

2. Why are you struggling with this issue?

I have discussed this matter with the department manager, physics and RSO as well as the obstruction of responsible maintenance by our doctor(s). My objection to this policy and subsequent urgent repair requests/recommendations have put my career at risk and know I am about to be let go.

3. What do you want to see changed? How will you know that your issue is improving or has been addressed?

Engineering should have equal prerogative to put the system in an immediate "down" status at Engineering's discretion if there is a present or significant imminent safety risk for the patient either due to mechanical such as loose or falling parts or inaccuracy, dosimentric cal issues, patient positioning or stability issues for example.

4. When do you need the evidence report?

Wed, 07/15/2026

5. What will you do with the evidence report?

Your evidence report will allow me to professionally approach my collegues with significant evidence to back up changes in our policies and provide the impetus to alter in-grained aloof attitudes that upper management presumes to achieve higher patient throughput which put our patients at risk.

Supporting Documentation

Patient Safety Concerns-Carl Phillips (PDF, 3 MB)

Optional Information About You

What is your role or perspective? In-house Radiological Engineering-Medstar

If you are you making a suggestion on behalf of an organization, please state the name of the organization Medstar

May we contact you if we have questions about your nomination? Yes