ENS 44813

v t e ENS Event
08:00 Jan 27, 2009
Title	Medical Event - Actual Dose Less than Prescribed Dose
Event Description	Two medical events were discovered on January 27, 2009, for patients treated during 2005 at VA Greater Los Angeles Healthcare System, Los Angeles, California. These two medical events involved patients who had undergone permanent implant prostate seed brachytherapy using iodine-125 seeds. The resulting seed distributions in the patients were associated with a D90 dose to the treatment site that was less than 80% of the prescribed dose. These patient circumstances are interpreted to meet the definition of a medical event under 10 CFR 35.3045(a)(1)(i). A 15-day written report for the medical events will be submitted to NRC Region III. We have notified our NRC Project Manager (Cassandra Frazier, NRC Region III) of the medical events. A Medical Event may indicate potential problems in a medical facilities use of radioactive materials. It does not necessarily result in harm to the patient.

ENS 44813 +/-
Where
Va National Health Physics Program Los Angeles, California (NRC Region 4)
License number:	03-23853-01VA
Organization:	Va National Health Physics Program
Reporting

10 CFR 35.3045(a)(1)
Time - Person (Reporting Time:+31.8 h1.325 days <br />0.189 weeks <br />0.0436 months <br />)
Opened:	Tomas Huston 15:48 Jan 28, 2009
NRC Officer:	Jason Kozal
Last Updated:	Jan 28, 2009
44813 - NRC Website
v • d • e

v t e Emergency Notification System
Va National Health Physics Program with 10 CFR 35.3045(a)(1)
WEEKMONTHYEAR2009-01-27T08:00:00 [Table view]
[ENS list for Va National Health Physics Program]

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