Event Notification Report for February 27, 2004
U.S. Nuclear Regulatory Commission
Operations Center
EVENT REPORTS FOR
02/26/2004 - 02/27/2004
EVENT NUMBERS
40848
General Information or Other
Event Number: 40848
Rep Org: LOUISIANA RADIATION PROTECTION DIV
Licensee: CARDINAL HEALTH
Region: 4
City: HOUMA State: LA
County:
License #: LA-7096-L01
Agreement: Y
Docket:
NRC Notified By: SCOTT BLACKWELL
HQ OPS Officer: HOWIE CROUCH
Licensee: CARDINAL HEALTH
Region: 4
City: HOUMA State: LA
County:
License #: LA-7096-L01
Agreement: Y
Docket:
NRC Notified By: SCOTT BLACKWELL
HQ OPS Officer: HOWIE CROUCH
Notification Date: 06/30/2004
Notification Time: 14:42 [ET]
Event Date: 02/27/2004
Event Time: 00:00 [CDT]
Last Update Date: 06/30/2004
Notification Time: 14:42 [ET]
Event Date: 02/27/2004
Event Time: 00:00 [CDT]
Last Update Date: 06/30/2004
Emergency Class: NON EMERGENCY
10 CFR Section:
10 CFR Section:
Person (Organization):
JACK WHITTEN (R4)
TOM ESSIG (NMSS)
JACK WHITTEN (R4)
TOM ESSIG (NMSS)
LOUSIANA AGREEMENT STATE REPORT - MEDICAL EVENT
The following information was obtained from the Louisiana Department of Environmental Quality:
"On February 27, 2004, Woman's Hospital in Baton Rouge, LA ordered a 2 [milliCuries] capsule of I-131 [Iodine-131]. When the dose was sent it was 2.8 [milliCuries] which is greater that 10% of the prescribed dose. A verbal order was given to administer the dose to the patient. Woman's Hospital notified Cardinal Health of the irregularity on March 1, 2004 when they received the dose. The RSO [Radiation Safety Officer] notified the corporate office by fax of the irregularity but that person was not there and it went unnoticed until March 31, 2004. Cardinal Health notified LDEQ [Louisiana Department of Environmental Quality] on March 31, 2004 which was over the ten day limit for notifications. The facility was cited for not notifying LDEQ within ten days. Cardinal Health changed their procedures so that two people are notified of events, and the new pharmacist that made the dose received additional training on policies and procedures."
Louisiana State Event Report ID number is LA040006.
The following information was obtained from the Louisiana Department of Environmental Quality:
"On February 27, 2004, Woman's Hospital in Baton Rouge, LA ordered a 2 [milliCuries] capsule of I-131 [Iodine-131]. When the dose was sent it was 2.8 [milliCuries] which is greater that 10% of the prescribed dose. A verbal order was given to administer the dose to the patient. Woman's Hospital notified Cardinal Health of the irregularity on March 1, 2004 when they received the dose. The RSO [Radiation Safety Officer] notified the corporate office by fax of the irregularity but that person was not there and it went unnoticed until March 31, 2004. Cardinal Health notified LDEQ [Louisiana Department of Environmental Quality] on March 31, 2004 which was over the ten day limit for notifications. The facility was cited for not notifying LDEQ within ten days. Cardinal Health changed their procedures so that two people are notified of events, and the new pharmacist that made the dose received additional training on policies and procedures."
Louisiana State Event Report ID number is LA040006.