ENS Event | |
|---|---|
05:00 Jan 7, 2021 | |
| Title | Underdose of Greater than 20 Percent |
| Event Description | The following was received from Massachusetts Radiation Control Program via email:
The licensee reported by telephone on January 12, 2021 that it discovered on January 11, 2021 a radiopharmaceutical medical event involving the therapeutic administration of iodine-131 for treatment of thyroid cancer. The licensee reported that the administered dose was an underdose of greater than 20 percent and was a difference of greater than 50 rem to an organ, the thyroid, when compared with the prescribed dose, meeting the reporting requirements 105 CMR 120.594(A)(1)(a). One iodine-131 capsule instead of two iodine-131 capsules were administered. The prescribed total activity was 100 milliCuries and the administered total activity was 19.5 milliCuries. The second iodine-131 capsule that was not administered was accounted for and contained in its original glass vial. The licensee reported that the referring physician and the patient has been notified. The licensee reported that its staff had discussed the medical event and put into place competencies to prevent future recurrence and that a written report will be submitted to the Agency within 15 days of the telephone report in accordance with 105 CMR 120.594(A)(4). The Agency considers this event to be open. 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. |
| Where | |
|---|---|
| Steward Good Samaritan Medical Center Brockton, Massachusetts (NRC Region 1) | |
| License number: | 44-0023 |
| Organization: | Ma Radiation Control Program |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+152.65 h6.36 days <br />0.909 weeks <br />0.209 months <br />) | |
| Opened: | Joshua E. Daehler 13:39 Jan 13, 2021 |
| NRC Officer: | Ossy Font |
| Last Updated: | Jan 13, 2021 |
| 55067 - NRC Website | |
Steward Good Samaritan Medical Center with Agreement State | |
WEEKMONTHYEARENS 550672021-01-07T05:00:0007 January 2021 05:00:00
[Table view]Agreement State Underdose of Greater than 20 Percent 2021-01-07T05:00:00 | |