ENS 47623

v t e ENS Event
14:30 Jan 25, 2012
Title	Misadministration of Thallium During Cardio Stress Test
Event Description	A patient received 100% more than the prescribed dose of thallium. The patient was to receive 3.5 milliCuries of thallium followed by 30 milliCuries of Cardiolite, a Tc-99M radiopharmaceutical. Instead, the patient received 3.5 milliCuries of thallium then received an additional 3.6 milliCuries of Thallium. The technician stated that he got confused where the patient was in the treatment process. The patient and physician have been informed. The licensee is awaiting dosimetry results to determine the organ dosage but does not believe there will be any recurring medical effects from this event. * * RETRACTION AT 1227 EST ON 1/27/12 FROM MUNDORF TO HUFFMAN * * * The licensee is retracting this event report after a review and evaluation of the doses administered. The licensee has determined that this event is not reportable based on the unintended dose being less than 5 Rem effective dose equivalent and therefore not reportable under 10 CFR 35.3045. The licensee has discussed this conclusion with NRC Region 1 (Lanzisera). R1DO (Dental) and FSME (McIntosh) have been notified.

ENS 47623 +/-
Where
Bayhealth Medical Center Milford, Delaware (NRC Region 1)
License number:	07-148-50-01
Organization:	Bayhealth Medical Center
Reporting

10 CFR 35.3045(a)(1)
Time - Person (Reporting Time:+24.87 h1.036 days <br />0.148 weeks <br />0.0341 months <br />)
Opened:	Cathy Mundorf 15:22 Jan 26, 2012
NRC Officer:	Joe O'Hara
Last Updated:	Jan 27, 2012
47623 - NRC Website
v • d • e

v t e Emergency Notification System
Bayhealth Medical Center with 10 CFR 35.3045(a)(1)
WEEKMONTHYEAR2013-07-24T05:00:00 [Table view]
[ENS list for Bayhealth Medical Center]

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