ML24053A087
| ML24053A087 | |
| Person / Time | |
|---|---|
| Issue date: | 12/02/2014 |
| From: | Bob Gattone NRC/RGN-III, NRC/NMSS/DMSST/ASPB |
| To: | |
| References | |
| Download: ML24053A087 (1) | |
Text
Insights on Identifying Medical Events During Inspections Presented by Bob Gattone Senior Health Physicist, Region III, NRC
Insights on Identifying Medical Events During Inspections Presented by Bob Gattone Senior Health Physicist, Region III, NRC
The Devil is in the Details
Inattention to Detail
- Has caused medical events
- Has resulted in missed opportunities for licensees to identify medical events
- Has probably resulted in missed opportunities for inspectors to identify medical events.
Identification of medical events is usually not fast or easy
Understand the Licensees Processes and Procedures Through Observations, Interviews, and Record Reviews
- As you look at the licensees processes and procedures, look for vulnerabilities for errors
- As you look at the licensees processes and procedures, look for vulnerabilities for errors
Low Dose Rate Brachytherapy Cs-137 GYN Medical Event
Low Dose Rate Brachytherapy Cs-137 GYN Medical Event
Low Dose Rate Brachytherapy Cs-137 GYN Medical Event
Low Dose Rate Brachytherapy Cs-137 GYN Medical Event
Low Dose Rate Brachytherapy Cs-137 GYN Medical Event
Low Dose Rate Brachytherapy Cs-137 GYN Medical Event
Low Dose Rate Brachytherapy Cs-137 GYN Medical Event
HDR GYN Medical Event
HDR GYN Medical Event
HDR GYN Medical Event
HDR GYN Medical Event
Breast Medical Event
Breast Medical Event
Breast Medical Event
Breast Medical Event
HDR Catheter Problem Medical Event
HDR Catheter Problem Medical Event
HDR Catheter Problem Medical Event
GSR
GSR
GSR
Radiopharmaceutical Therapy Gamma Emitters
Root Cause and Contributing Causes
Root Cause and Contributing Causes
Root Cause and Contributing Causes
Corrective Actions
Iodine-131 Medical Event
Beta Emitters Radioactivity Measurements
Technetium-99m Event
QUESTIONS?