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Event Notification Report for January 15, 2018

U.S. Nuclear Regulatory Commission
Operations Center

EVENT REPORTS FOR
01/14/2018 - 01/15/2018

EVENT NUMBERS
53171

Agreement State
Event Number: 53171
Rep Org: OR DEPT OF HEALTH RAD PROTECTION
Licensee: KAISER FOUNDATION HOSPITAL
Region: 4
City: PORTLAND   State: OR
County:
License #: ORE-90464
Agreement: Y
Docket:
NRC Notified By: DARYL LEON
HQ OPS Officer: DAVID AIRD
Notification Date: 01/17/2018
Notification Time: 16:45 [ET]
Event Date: 01/15/2018
Event Time: 00:00 [PST]
Last Update Date: 01/19/2018
Emergency Class: NON EMERGENCY
10 CFR Section:
Person (Organization):
DAVID PROULX (R4DO)
NMSS_EVENTS_NOTIFICA (EMAI)
Event Text
AGREEMENT STATE REPORT - DELIVERED DOSAGE DIFFERENT FROM PRESCRIBED

On January 15, 2018 a medical event occurred at the licensed facility in which a patient received a prescribed dose less than 80 percent of the target dose to the liver. The dose was delivered via Y-90 microspheres.

The State will investigate this medical event.

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.