The following report was received from the State of
Colorado via email:
On September 22, 2015, during a routine inspection at Colorado licensee St. Thomas More Hospital and Progressive Care (license CO 397-01), [Colorado State] inspectors noted multiple areas with contamination. Upon further investigation, the inspectors learned a patient earlier in the day was undergoing a diagnostic test involving nebulized Tc-99m DTPA for a lung scan. The patient began coughing and pulled off the mask during administration and coughed, spreading the contamination in the diagnostic area. The patient began to require elevated levels of medical care and nursing staff and nuclear medicine staff may have been contaminated while caring for the patient. Arrangements were made to transfer the patient to a different medical facility via helicopter. The second facility was notified and nuclear medicine technologists surveyed the helicopter and patient upon arrival with no contamination found.
Reporting requirement: 10 CFR 30.50(b)(3); Colorado Part 4, Section 4.52.2.4
Cause and corrective action: patient intervention. St. Thomas More has closed the affected areas to allow for decay. Surveys will be performed in affected areas prior to re-opening for additional patients.
A full report of investigation and evaluations will follow within the next 30 days.
Incident identification: CO15-I15-27