ENS Event | |
|---|---|
06:00 Nov 16, 2021 | |
| Title | Medical Overdosage |
| Event Description | The following was received from the Wisconsin Radiation Protection Section (the State):
On November 17, 2021, the licensee reported to the State a medical event involving Y-90 SIR-Spheres that was discovered that same day and occurred on November 16, 2021. Two administrations were prescribed to different segments of the left lobe of the liver, one of 0.4 GBq and one of 1.6 GBq. A calculation error occurred while converting these doses from GBq to milli-Ci which resulted in administered doses of 0.51 GBq and 2.3 GBq respectively; both of which are 27 percent above prescription. The State will continue to follow-up on the event. No deleterious effects to the patient are expected. All dose was delivered to the intended organ. Wisconsin Event Report ID Number: WI210008 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 | |
|---|---|
| Froedtert South, Inc. Pleasant Prairie, Wisconsin (NRC Region 3) | |
| License number: | 059-1319-01 |
| Organization: | Wisconsin Radiation Protection |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+35.38 h1.474 days <br />0.211 weeks <br />0.0485 months <br />) | |
| Opened: | Luther S. Loehrke 17:23 Nov 17, 2021 |
| NRC Officer: | Mike Stafford |
| Last Updated: | Nov 17, 2021 |
| 55588 - NRC Website | |
Froedtert South, Inc. with Agreement State | |
WEEKMONTHYEARENS 555882021-11-16T06:00:00016 November 2021 06:00:00
[Table view]Agreement State Medical Overdosage 2021-11-16T06:00:00 | |