Event Notification Report for July 08, 2011
U.S. Nuclear Regulatory Commission
Operations Center
EVENT REPORTS FOR
07/07/2011 - 07/08/2011
Agreement State
Event Number: 47043
Rep Org: COLORADO DEPT OF HEALTH
Licensee: UNIVERSITY OF COLORADO HOSPITAL
Region: 4
City: State: CO
County:
License #: 828-01
Agreement: Y
Docket:
NRC Notified By: ED STROUD
HQ OPS Officer: JOE O'HARA
Licensee: UNIVERSITY OF COLORADO HOSPITAL
Region: 4
City: State: CO
County:
License #: 828-01
Agreement: Y
Docket:
NRC Notified By: ED STROUD
HQ OPS Officer: JOE O'HARA
Notification Date: 07/11/2011
Notification Time: 16:50 [ET]
Event Date: 07/08/2011
Event Time: 07:30 [MDT]
Last Update Date: 07/11/2011
Notification Time: 16:50 [ET]
Event Date: 07/08/2011
Event Time: 07:30 [MDT]
Last Update Date: 07/11/2011
Emergency Class: NON EMERGENCY
10 CFR Section:
10 CFR Section:
Person (Organization):
CHUCK CAIN (R4DO)
RICHARD TURTIL (FSME)
CHUCK CAIN (R4DO)
RICHARD TURTIL (FSME)
AGREEMENT STATE REPORT - MEDICAL EVENT OVEREXPOSURE TO THYROID GLAND
The following was received from the state via fax:
"The Colorado Department of Public Health and Environment received notification this date from The University of Colorado Hospital, Colorado License # 828-01, that a patient received the wrong dose of I-131 on July 8, 2011 resulting in a dose that exceeded prescribed by 50 rem and 50% of the dose expected from the administration defined in the written directive. The patient was prescribed 20 mCi of l-131 for Graves disease, but instead received 100 mCi of I-l31, which was intended for another patient. The patient was discharged before the error was discovered. The patient's physician and the patient have been contacted and made aware of the situation. The patient has been given additional instructions regarding contact with family members and members of the public. No other details are available at this time.
"The Colorado Department of Public Health and Environment has initiated an investigation."
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.
The following was received from the state via fax:
"The Colorado Department of Public Health and Environment received notification this date from The University of Colorado Hospital, Colorado License # 828-01, that a patient received the wrong dose of I-131 on July 8, 2011 resulting in a dose that exceeded prescribed by 50 rem and 50% of the dose expected from the administration defined in the written directive. The patient was prescribed 20 mCi of l-131 for Graves disease, but instead received 100 mCi of I-l31, which was intended for another patient. The patient was discharged before the error was discovered. The patient's physician and the patient have been contacted and made aware of the situation. The patient has been given additional instructions regarding contact with family members and members of the public. No other details are available at this time.
"The Colorado Department of Public Health and Environment has initiated an investigation."
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.
Non-Agreement State
Event Number: 47037
Rep Org: WILCOX ASSOCIATES
Licensee: WILCOX ASSOCIATES
Region: 3
City: CADILLAC State: MI
County:
License #: 21-23314
Agreement: N
Docket:
NRC Notified By: JOSH GOTTSCHALL
HQ OPS Officer: VINCE KLCO
Licensee: WILCOX ASSOCIATES
Region: 3
City: CADILLAC State: MI
County:
License #: 21-23314
Agreement: N
Docket:
NRC Notified By: JOSH GOTTSCHALL
HQ OPS Officer: VINCE KLCO
Notification Date: 07/08/2011
Notification Time: 13:34 [ET]
Event Date: 07/08/2011
Event Time: 11:30 [EDT]
Last Update Date: 07/08/2011
Notification Time: 13:34 [ET]
Event Date: 07/08/2011
Event Time: 11:30 [EDT]
Last Update Date: 07/08/2011
Emergency Class: NON EMERGENCY
10 CFR Section:
30.50(b)(2) - SAFETY EQUIPMENT FAILURE
10 CFR Section:
30.50(b)(2) - SAFETY EQUIPMENT FAILURE
Person (Organization):
DAVID HILLS (R3DO)
RICHARD TURTIL (FSME)
DAVID HILLS (R3DO)
RICHARD TURTIL (FSME)
DAMAGED MOISTURE DENSITY GAUGE
A gauge handle on a portable Troxler Gauge Model 3440 (S/N #16851) was run over by a truck in the Hastings, Michigan area. The measurement and source handle rod was bent. The licensee performed an area survey and no leakage was detected. The density gauge source was not exposed. The licensee plans to ship the damaged gauge to the Troxler Company for repair or replacement.
A gauge handle on a portable Troxler Gauge Model 3440 (S/N #16851) was run over by a truck in the Hastings, Michigan area. The measurement and source handle rod was bent. The licensee performed an area survey and no leakage was detected. The density gauge source was not exposed. The licensee plans to ship the damaged gauge to the Troxler Company for repair or replacement.