ENS 46101: Difference between revisions
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| facility = University Of Pennsylvania | | facility = University Of Pennsylvania | ||
| Organization = Pa Bureau Of Radiation Protection | | Organization = Pa Bureau Of Radiation Protection | ||
| license number = | | license number = PA-0131 | ||
| region = 1 | | region = 1 | ||
| state = Pennsylvania | | state = Pennsylvania | ||
| Line 16: | Line 16: | ||
| event date = 07/07/2010 EDT | | event date = 07/07/2010 EDT | ||
| last update date = 07/23/2010 | | last update date = 07/23/2010 | ||
| title = Agreement State Report - Delivered Dose Differed | | title = Agreement State Report - Delivered Dose Differed from the Prescribed Dose by Greater than 50% | ||
| event text = The following was received via fax from the Pennsylvania Department of Environmental Protection: | | event text = The following was received via fax from the Pennsylvania Department of Environmental Protection: | ||
On July 7, 2010 a patient was beginning the first of three vaginal treatment fractions with an Ir-192 HDR. It was discovered on July 14, 2010 that the end of the treatment tube was placed 3.5 cm short of its intended location. When the patient returned for the second treatment, she was imaged again, and staff noticed the treatment tube was in a different location from the previous treatment. Licensee estimates that, for the first fraction, the intended treatment volume received only about 10% of the intended dose for that fraction. Per 10CFR35.3045(a)(1)(iii), it is required for the licensee to report any event in which the fractionated dose delivered differs from the prescribed dose, for a single fraction, by 50% or more. | On July 7, 2010 a patient was beginning the first of three vaginal treatment fractions with an Ir-192 HDR. It was discovered on July 14, 2010 that the end of the treatment tube was placed 3.5 cm short of its intended location. When the patient returned for the second treatment, she was imaged again, and staff noticed the treatment tube was in a different location from the previous treatment. Licensee estimates that, for the first fraction, the intended treatment volume received only about 10% of the intended dose for that fraction. Per 10CFR35.3045(a)(1)(iii), it is required for the licensee to report any event in which the fractionated dose delivered differs from the prescribed dose, for a single fraction, by 50% or more. | ||
Latest revision as of 19:22, 24 November 2018
| Where | |
|---|---|
| University Of Pennsylvania Philadelphia, Pennsylvania (NRC Region 1) | |
| License number: | PA-0131 |
| Organization: | Pa Bureau Of Radiation Protection |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+227.73 h9.489 days <br />1.356 weeks <br />0.312 months <br />) | |
| Opened: | David Allard 15:44 Jul 16, 2010 |
| NRC Officer: | John Knoke |
| Last Updated: | Jul 23, 2010 |
| 46101 - NRC Website
| |