The following was received via email from the state of Colorado:
At approximately 1438 MST on February 28, 2019 the RSO [Radiation Safety Officer] for CO 152-01, St. Anthony Hospital - Centura Health, notified the Department [Colorado Department of Public Health and Environment] of a Y-90 SIR-Sphere misadministration. The procedure occurred at approximately 1300 MST and it was determined that 65 percent of the prescribed dose was delivered to the patient. The RSO noted that during the procedure there were issues with the delivering catheter. During the procedure, the catheter was replaced.
A department investigation will occur in the near future. A written report per section 7.21.4 is expected within 15 days.
Colorado Event Report ID No.: CO190003
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.