ENS Event | |
|---|---|
16:00 Apr 2, 2021 | |
| Title | Agreement State - Medical Underdose Event |
| Event Description | The following report was received by the Maine Radiation Control Program via email:
[The doctor] prescribed a patient 3.60 GBq Y-90 resin microspheres (Sirtex SIR-Spheres) for treatment of hepatocellular carcinoma (HCC). Due to the patient's anatomy, [the doctor] administered the dosage through two separate arteries using Surefire catheters. The two administrations were 0.90 GBq and 2.70 GBq. The first dosage was administered successfully, with an estimated 0.87 GBq (97 percent) of the planned 0.90 GBq being deposited within the patient's liver. The second dosage was not administered successfully, with an estimated 1.59 GBq (58.7 percent) of the planned 2.70 GBq being deposited within the patient's liver. This occurred because the catheter became occluded during the administration of Y-90 microspheres. Overall, the patient did not receive the full prescribed dose, with an estimated 2.46 GBq (68.3 percent) of the prescribed 3.60 GBq being deposited within the patient's liver. The event occurred on April 2, 2021 around 1200 EDT. Maine Event Number: ME 21-001 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 | |
|---|---|
| Maine Health Medical Center Portland, Maine (NRC Region 1) | |
| License number: | ME 05611 |
| Organization: | Maine Radiation Control Program |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+306.25 h12.76 days <br />1.823 weeks <br />0.42 months <br />) | |
| Opened: | Catherine Perham 10:15 Apr 15, 2021 |
| NRC Officer: | Brian P. Smith |
| Last Updated: | Apr 15, 2021 |
| 55195 - NRC Website | |
Maine Health Medical Center with Agreement State | |
WEEKMONTHYEARENS 551952021-04-02T16:00:0002 April 2021 16:00:00
[Table view]Agreement State Agreement State - Medical Underdose Event 2021-04-02T16:00:00 | |