ENS 54782
From kanterella
Jump to navigation
Jump to search
ENS Event | |
|---|---|
13:15 Jul 14, 2020 | |
| Title | Agreement State Report - Therasphere Procedure Underdose |
| Event Description | The following information was received via E-mail:
On 7/15/2020, at 1340 EDT, the licensee reported that yesterday, 7/14/2020, sometime between 0915 and 0930 EDT, a male patient receiving TheraSphere treatment was underdosed by approximately 30 percent due to a leak in the delivery assembly. This was discovered around half-way through the procedure. No exposure to anyone other than the patient occurred. Contamination has been contained and removed. The prescribed activity was 5.7 GBq and dose was 150 Gy. The actual activity delivered is estimated to be 3.99 GBq and dose was 105 Gy. The patient is scheduled to return next week for follow-up treatment. Florida Incident Number: FL20-080 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 | |
|---|---|
| Florida Bureau Of Radiation Control Altamontesprings, Florida (NRC Region 1) | |
| License number: | 2897-1 |
| Organization: | Florida Bureau Of Radiation Control |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+25.33 h1.055 days <br />0.151 weeks <br />0.0347 months <br />) | |
| Opened: | Matthew Senison 14:35 Jul 15, 2020 |
| NRC Officer: | Donald Norwood |
| Last Updated: | Jul 15, 2020 |
| 54782 - NRC Website | |
Florida Bureau of Radiation Control with Agreement State | |||||
| Agreement State Report - Vehicle Carrying Radio-Pharmaceuticals Involved in Accident ENS 549092020-09-24T13:30:00024 September 2020 13:30:00 Agreement State | Agreement State Report - Lost/Stolen Troxler Gauge ENS 549262020-09-04T04:00:0004 September 2020 04:00:00 Agreement State | Agreement State Report - Leaking Sealed Source ENS 548022020-07-27T04:00:00027 July 2020 04:00:00 Agreement State Agreement State Report - Troxler Gauge on Ebay ENS 547992020-07-23T04:00:00023 July 2020 04:00:00 Agreement State Agreement State Report - Lost Shipment of I-125 Seeds ENS 547882020-07-17T04:00:00017 July 2020 04:00:00 Agreement State Agreement State Report - Underdose Administered to Patient ENS 547862020-07-16T04:00:00016 July 2020 04:00:00 Agreement State Agreement State Report - Medical Misadministration ENS 547822020-07-14T13:15:00014 July 2020 13:15:00 Agreement State Agreement State Report - Therasphere Procedure Underdose ENS 547632020-07-01T04:00:0001 July 2020 04:00:00 Agreement State Agreement State Report - Medical Event ENS 547432020-06-05T04:00:0005 June 2020 04:00:00 Agreement State Agreement State Report - Medical Event ENS 547172020-05-12T04:00:00012 May 2020 04:00:00 Agreement State Agreement State Report - Medical Event ENS 547032020-05-12T00:30:00012 May 2020 00:30:00 Agreement State Agreement State Report - Lost Gauge ENS 547042020-05-11T04:00:00011 May 2020 04:00:00 Agreement State Agreement State Report - Patient Underdose ENS 546842020-04-20T04:00:00020 April 2020 04:00:00 Agreement State Agreement State Report - Used Beverage Can (Ubc) Baled Aluminum Returned to Florida ENS 546182020-03-26T04:00:00026 March 2020 04:00:00 Agreement State Agreement State Report - Damaged Moisture Denisty Gauge Case ENS 545582020-03-02T21:30:0002 March 2020 21:30:00 Agreement State Agreement State Report - Source Failed to Retract ENS 545442020-02-24T18:15:00024 February 2020 18:15:00 Agreement State Agreement State Report - Patient Underdose ENS 545482020-02-24T05:00:00024 February 2020 05:00:00 Agreement State Medical Event - Hdr Underdose to Patient ENS 545832020-02-03T04:00:0003 February 2020 04:00:00 Agreement State Agreement State Report - Loss of Control of a Cs-137 Source ENS 545042020-01-31T05:00:00031 January 2020 05:00:00 Agreement State Gamma Alarm Fixed Radiation Portal Monitor ENS 544582019-12-30T05:00:00030 December 2019 05:00:00 Agreement State Agreement State Report - Unaccounted Material ENS 544552019-12-20T05:00:00020 December 2019 05:00:00 Agreement State Agreement State Report - Patient Underdose ENS 544392019-12-11T05:00:00011 December 2019 05:00:00 Agreement State Agreement State Report - Dose Delivered Less than Prescribed ENS 516262015-12-29T13:00:00029 December 2015 13:00:00 Agreement State | ENS 413642005-02-01T22:00:0001 February 2005 22:00:00 Agreement State Agreement State Report - Nonlicensed Radiography Camera Confiscated by Us Customs in Florida 2020-09-04T04:00:00 [Table view] | ||
Retrieved from "https://kanterella.com/w/index.php?title=ENS_54782&oldid=3085997"