ENS 50151

v t e ENS Event
05:00 Apr 1, 2014
Title	Administrative Error Medical Event
Event Description	A patient at the Lee's Summit location in Missouri was administered the radiopharmaceutical Xofigo. The normal therapy regimen is six doses. On two of those instances (April 29 and April 1, 2014), the prescription sheet/written directive form that was used shows the units in millicurie instead of microcurie. The dosing amount of Xofigo is in microcuries. This was discovered during a routine NRC inspection on May 19, 2014. The NRC contacted us on May 29, 2014 to inform us that this was being declared a medical event. The patient received the correct dose in both instances; the error was a transcription error on the paperwork. A new form just for Xofigo administrations has been created which defaults to showing the units in microcurie." The licensee notified R3 (Bramnik). 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.

ENS 50151 +/-
Where
University Of Kansas Cancer Center Lee'S Summit, Missouri (NRC Region 3)
License number:	24-32517-01
Organization:	University Of Kansas Cancer Center
Reporting

10 CFR 35.3045(a)(1)
Time - Person (Reporting Time:+1425.25 h59.385 days <br />8.484 weeks <br />1.952 months <br />)
Opened:	Steve Howard 14:15 May 30, 2014
NRC Officer:	Dong Park
Last Updated:	May 30, 2014
50151 - NRC Website
v • d • e

v t e Emergency Notification System
University Of Kansas Cancer Center with 10 CFR 35.3045(a)(1)
WEEKMONTHYEAR2014-04-01T05:00:00 [Table view]
[ENS list for University Of Kansas Cancer Center]

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