ENS Event | |
|---|---|
06:00 Mar 4, 2026 | |
| Title | Equipment Failure |
| Event Description | The following information was provided by the Wisconsin Department of Health Services via email:
The University of Wisconsin Madison (UWM) reported an equipment failure involving a Y-90 TheraSphere microsphere administration set (lot A182) which occurred on March 4, 2026. UWM reported the tubing was damaged when it was removed from the priming line and was unable to be connected to the patient's catheter. Since the dose vial had already been punctured in the set-up, the therapy was cancelled. The administration set was disassembled so that the dose vial could be put into waste without releasing any of the spheres. The faulty connectors were removed and given to the manufacturer's representative who was present. The UWM found an additional administration set from the same lot; this was pulled and will not be used. Areas of possible contamination were surveyed, and none were found. Wisconsin Event Report ID No.: WI260006 |
| Where | |
|---|---|
| University Of Wisconsin Madison Madison, Wisconsin (NRC Region 3) | |
| License number: | 025-1323-01 |
| Organization: | Wisconsin Radiation Protection |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+27.82 h1.159 days <br />0.166 weeks <br />0.0381 months <br />) | |
| Opened: | Sarah Bouche 09:49 Mar 5, 2026 |
| NRC Officer: | Karen Cotton |
| Last Updated: | Mar 5, 2026 |
| 58185 - NRC Website | |
University Of Wisconsin Madison with Agreement State | |
WEEKMONTHYEARENS 581852026-03-04T06:00:0004 March 2026 06:00:00
[Table view]Agreement State Equipment Failure 2026-03-04T06:00:00 | |