ENS 46975: Difference between revisions
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| event date = 06/15/2011 CDT | | event date = 06/15/2011 CDT | ||
| last update date = 06/21/2011 | | last update date = 06/21/2011 | ||
| title = Agreement State Report - Two I-125 Incidents Involving Total Dose Less | | title = Agreement State Report - Two I-125 Incidents Involving Total Dose Less than Prescribed Dose | ||
| event text = The State of Wisconsin sent the following report via email: | | event text = The State of Wisconsin sent the following report via email: | ||
On June 15, 2011, the licensee's Radiation Safety Officer reported the identification of two medical events that were discovered, involving permanent implants of I-125 for prostate brachytherapy where the total dose delivered differs from the prescribed dose by 20% or more. During a routine inspection conducted on March 8, 2011, DHS (Department of Health Services) inspectors determined that the licensee was not reviewing prostate brachytherapy cases against the medical event criteria and identified numerous potential medical events. A Confirmatory Action Letter was sent on April 6, 2011 which required the licensee to have all of their manual brachytherapy prostate implants reviewed by an outside radiation oncologist. Upon completion of the external review of the licensee's manual brachytherapy program for prostate implants, the licensee identified the following underdoses to the prostate (using D90<80% and D90>120% as medical event criteria): | On June 15, 2011, the licensee's Radiation Safety Officer reported the identification of two medical events that were discovered, involving permanent implants of I-125 for prostate brachytherapy where the total dose delivered differs from the prescribed dose by 20% or more. During a routine inspection conducted on March 8, 2011, DHS (Department of Health Services) inspectors determined that the licensee was not reviewing prostate brachytherapy cases against the medical event criteria and identified numerous potential medical events. A Confirmatory Action Letter was sent on April 6, 2011 which required the licensee to have all of their manual brachytherapy prostate implants reviewed by an outside radiation oncologist. Upon completion of the external review of the licensee's manual brachytherapy program for prostate implants, the licensee identified the following underdoses to the prostate (using D90<80% and D90>120% as medical event criteria): | ||
Latest revision as of 22:06, 1 March 2018
| Where | |
|---|---|
| St. Mary'S Hospital - Rhinelander Rhinelander, Wisconsin (NRC Region 3) | |
| License number: | 085-1296-01 |
| Organization: | Wisconsin Radiation Protection |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+151.62 h6.318 days <br />0.902 weeks <br />0.208 months <br />) | |
| Opened: | Cheryl K. Rogers 12:37 Jun 21, 2011 |
| NRC Officer: | Steve Sandin |
| Last Updated: | Jun 21, 2011 |
| 46975 - NRC Website | |