ENS 54788: Difference between revisions
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{{ENS notification | {{ENS notification | ||
| event number = 54788 | | event number = 54788 | ||
| facility = | | facility = | ||
| Organization = Florida Bureau Of Radiation Control | | Organization = Florida Bureau Of Radiation Control | ||
| license number = 1812-3 | | license number = 1812-3 | ||
| Line 10: | Line 10: | ||
| utype = | | utype = | ||
| cfr = Agreement State | | cfr = Agreement State | ||
| emergency class = | | emergency class = Non Emergency | ||
| notification date = 07/17/2020 17:20 | | notification date = 07/17/2020 17:20 | ||
| notification by = John Williamson | | notification by = John Williamson | ||
| Line 16: | Line 16: | ||
| event date = 07/17/2020 00:00 EDT | | event date = 07/17/2020 00:00 EDT | ||
| last update date = 07/17/2020 | | last update date = 07/17/2020 | ||
| title = Agreement State Report - Underdose Administered to Patient | | title = Agreement State Report - Underdose Administered to Patient | ||
| event text = The following was reported by the Florida Bureau of Radiation Control: | | event text = The following was reported by the Florida Bureau of Radiation Control: | ||
On 7/17/2020 during ablative treatment with Y-90 TheraSpheres to the male patient, it was discovered that only a partial treatment was administered to the patient. | On 7/17/2020 during ablative treatment with Y-90 TheraSpheres to the male patient, it was discovered that only a partial treatment was administered to the patient. 511.6 Gy was prescribed, 358.9 Gy was delivered, for a 70% delivery rate. The event was discovered during a routine check of waste activity. The Radiation Safety Officer (RSO) reports that from initial information from the tech, all procedures were followed. No abnormal events were noted during the procedure. The prescribing physician and patient have been notified. Clinical outcome is expected to be ok. The RSO will phone in more details on Monday as he was working remotely on Friday. A fifteen day letter will follow. Licensing and Technology will be tasked to investigate. | ||
FL incident number: FL20-082 | FL incident number: FL20-082 | ||
Notified RI and NMSS Events Notification. | Notified RI and NMSS Events Notification. | ||
A Medical Event may indicate potential problems in a medical facility's use of radioactive materials. | 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. | ||
| URL = https://www.nrc.gov/reading-rm/doc-collections/event-status/event/2020/20200728en.html#en54788 | | URL = https://www.nrc.gov/reading-rm/doc-collections/event-status/event/2020/20200728en.html#en54788 | ||
}} | }} | ||
{{ENS-Nav}} | {{ENS-Nav}} | ||
Latest revision as of 12:29, 15 January 2021
| Where | |
|---|---|
| Florida Bureau Of Radiation Control Jacksonville, Florida (NRC Region 1) | |
| License number: | 1812-3 |
| Organization: | Florida Bureau Of Radiation Control |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+13.33 h0.555 days <br />0.0793 weeks <br />0.0183 months <br />) | |
| Opened: | John Williamson 17:20 Jul 17, 2020 |
| NRC Officer: | Thomas Herrity |
| Last Updated: | Jul 17, 2020 |
| 54788 - NRC Website | |