PNO-II-97-056, on 970923,therapeutic Misadministration Occurred.Event Occurred When Patient Urologist Sent Wrong Patient to Licensee Facility for Permanent Prostate Implant Using Pd-103.State of Sc Notified by Ltr
| ML20211M787 | |
| Person / Time | |
|---|---|
| Issue date: | 10/15/1997 |
| From: | Woodruff R NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION II) |
| To: | |
| References | |
| PNO-II-97-056, PNO-II-97-56, NUDOCS 9710150146 | |
| Download: ML20211M787 (1) | |
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o e' October 15, 1997 PRELIMINARY.. NOTIFICATION OF EVENT OE UNUSUAL OCCURREEE PFO-II-97-056 Thio preliminary notification constitutes EARLY notice of events of POSSIBLE enfoty or public interest significance. The information is as initially roccived without verification or evaluation, and is basically all that is known by Region II staff in Atlanta, Georgia on this date.
Fkollity Licensee Emeraency Classification Tuomay Regional Medical Center Notification of Unusual Event (An Agreement State Licensee)
Alert Sumter, South Carolir' Site Area Emergency License No 10-0010 General Emergency X Not Applicable
Subject:
THERAPEUTIC MISADMINISTRATION South Carolina, an Agreement State, notified NRC, Region II on October 14, 1997 of a therapeutic misadministration, which was reported by the licensee.
The event occurred when the patient's urologist sent the wrong pationt to the licensee's facility for a permanent prostate implant using pn?,adium-103.
The patient reportedly had the same first and last name as the intended person, similar physical features, and was about the same ago.
The event occurred on September 23, 1997 but was not discovered until September 25, 1997, and the State was notified by letter dated October 7,
- 1997, Tho-State has requested additional information from the licensee, and is following up on the event including an onsite inspection.
A formal report will be provided following the State's investigation.
Thic information is-current as-of 9:00 a.m.
(EDT), October 15,-1997.
Contact -
R.L. Woodruff (404)562-4704 1
9710150146 971015
()
-PDR 1&E PNO-II-97-056 PDR
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