ENS Event | |
|---|---|
06:00 Feb 16, 2012 | |
| Title | Agreement State Report - Misadministration of a Radiopharmaceutical |
| Event Description | The following information was received from the State of Texas via email:
On 2/22/12 the licensee notified the Agency [Texas Department of State Health Services] of a medical event that occurred on 2/16/12. The licensee reported that the wrong radiopharmaceutical had been administered to a patient. Tc-99m MAA was administered rather than the prescribed Tc-99m Pertechnitate. During the administration of the wrong drug, an estimated 1/3-1/2 of the dose infiltrated the skin causing an estimated 400 rad exposure subcutaneously. The referring physician and patient have been notified. No signs or symptoms have been observed in the patient as a result of the incident. The estimated exposure is being reevaluated by the licensee. Texas Incident: I-8937 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 | |
|---|---|
| University Of Texas Southwestern Medical Center Dallas, Texas (NRC Region 4) | |
| License number: | L00384 |
| Organization: | Texas Department Of Health |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+202.9 h8.454 days <br />1.208 weeks <br />0.278 months <br />) | |
| Opened: | Robert Free 16:54 Feb 24, 2012 |
| NRC Officer: | Vince Klco |
| Last Updated: | Feb 24, 2012 |
| 47698 - NRC Website | |
University Of Texas Southwestern Medical Center with Agreement State | |
WEEKMONTHYEARENS 476982012-02-16T06:00:00016 February 2012 06:00:00
[Table view]Agreement State Agreement State Report - Misadministration of a Radiopharmaceutical ENS 453782009-09-21T05:00:00021 September 2009 05:00:00 Agreement State Agreement State Report- Patient Received Improper Dosage 2012-02-16T06:00:00 | |