ENS Event | |
|---|---|
04:00 Jun 2, 2011 | |
| Title | Agreement State Report - Delivered Dose Different than Prescribed Dose |
| Event Description | The following information was sent by the State of Florida Bureau of Radiation Control via email:
[On June 2, 2011], a patient with over 100 tumors was being treated. One lesion was supposed to get 16 gray, but received only .85 gray. The physicist forgot to adjust for the weight factor. The physicians have been notified. The patient will receive the correct dose during the next visit. The licensee will submit a written report to the Radioactive Materials. Any further action is referred to Radioactive Materials. No further action will be taken on this incident by this office. The patient was undergoing Gamma Knife Stereotactic Radiosurgery using 3073 Ci of Co-60. Florida Incident: FL11-046 A Medical Event may indicate potential problems in a medical facility's use of radioactive materials. It does not necessarily result in harm to the patient. |
| Where | |
|---|---|
| Doctors Hospital Inc. Coral Gables, Florida (NRC Region 1) | |
| License number: | 3823-1 |
| Organization: | Florida Bureau Of Radiation Control |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+35.67 h1.486 days <br />0.212 weeks <br />0.0489 months <br />) | |
| Opened: | Charles Adams 15:40 Jun 3, 2011 |
| NRC Officer: | Vince Klco |
| Last Updated: | Jun 3, 2011 |
| 46921 - NRC Website | |
Doctors Hospital Inc. with Agreement State | |
WEEKMONTHYEARENS 469212011-06-02T04:00:0002 June 2011 04:00:00
[Table view]Agreement State Agreement State Report - Delivered Dose Different than Prescribed Dose 2011-06-02T04:00:00 | |