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Event Notification Report for August 27, 2020

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
8/26/2020 - 8/27/2020

** EVENT NUMBERS **
 
54840 54841 54842 54845 54846 54859
 
Agreement State Event Number: 54840
Rep Org: OHIO DEPARTMENT OF HEALTH
Licensee: RIVERSIDE METHODIST HOSPITAL
Region: 3
City: Columbus   State: OH
County:
License #: OH-02120250070
Agreement: Y
Docket:
NRC Notified By: Michael Rubadue
HQ OPS Officer: Michael Bloodgood		 Notification Date: 08/18/2020
Notification Time: 13:13 [ET]
Event Date: 08/18/2020
Event Time: 00:00 [EDT]
Last Update Date: 08/18/2020
Emergency Class: Non Emergency
10 CFR Section:
Agreement State		 Person (Organization):
RICHARD SKOKOWSKI (R3DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)

Event Text

AGREEMENT STATE REPORT - PATIENT UNDERDOSE

The following report was received from the Ohio Department of Health via email.

"On August 14, 2020, the licensee attempted to treat a patient with Y-90 TheraSphere microspheres. Under the guidance of the manufacturer's representative, the AU [Authorized User] performed pre-patient checks on the device, including tubing patency check. After the infusion was started it became apparent the patient was not receiving the dose, and the licensee was unable to clear the blockage in the tubing. The procedure was terminated and the patient and referring physician were notified. Approximately 93% of the activity remained in the device. Static imaging was performed on the patient to determine the dose received. There was no measurable activity in the patient."

Ohio Event No.: OH200004

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.
 
Agreement State Event Number: 54841
Rep Org: COLORADO DEPT OF HEALTH
Licensee: COS School District #11, Holmes Middle School
Region: 4
City: Colorado Springs   State: CO
County:
License #: GL002325
Agreement: Y
Docket:
NRC Notified By: Kathryn Mote
HQ OPS Officer: Michael Bloodgood		 Notification Date: 08/18/2020
Notification Time: 16:47 [ET]
Event Date: 08/18/2020
Event Time: 00:00 [MDT]
Last Update Date: 08/18/2020
Emergency Class: Non Emergency
10 CFR Section:
Agreement State		 Person (Organization):
NICK TAYLOR (R4DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
ILTAB (EMAIL)
This material event contains a "Less than Cat 3" level of radioactive material.

Event Text

AGREEMENT STATE - LOST TRITIUM EXIT SIGNS

The following information was received from the Colorado Department of Health via email.

The licensee is unable to locate sixteen tritium exit signs that have an activity of 11.5 Ci each. The signs may have been removed by a contractor.

THIS MATERIAL EVENT CONTAINS A "LESS THAN CAT 3" LEVEL OF RADIOACTIVE MATERIAL

Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf.
 
Agreement State Event Number: 54842
Rep Org: ALABAMA RADIATION CONTROL
Licensee: PPG Industries
Region: 1
City: Huntsville   State: AL
County:
License #:
Agreement: Y
Docket:
NRC Notified By: Cason Coan
HQ OPS Officer: Michael Bloodgood		 Notification Date: 08/18/2020
Notification Time: 17:36 [ET]
Event Date: 08/14/2020
Event Time: 00:00 [CDT]
Last Update Date: 08/18/2020
Emergency Class: Non Emergency
10 CFR Section:
Agreement State		 Person (Organization):
JONATHAN GREIVES (R1DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
ILTAB (EMAIL)
This material event contains a "Less than Cat 3" level of radioactive material.

Event Text

AGREEMENT STATE REPORT - LOST SOURCE

The following information was received from the Alabama Department of Public Health via email.

"On August 14, 2020, the Agency [Alabama Department of Public Health] received e-mail communication from PPG Industries, a general license device registrant in Huntsville, Alabama. The registrant reported that apparently a registered device containing 10 milliCuries of polonium-210 (at assay) was unable to be located for inventory. The registrant reported that the area of use was searched for 3 weeks; the device remains unaccounted for. The device has been reported to the manufacturer (NRD Systems) as lost."

Alabama Event No.: 20-19

THIS MATERIAL EVENT CONTAINS A "LESS THAN CAT 3" LEVEL OF RADIOACTIVE MATERIAL

Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf
 
Agreement State Event Number: 54845
Rep Org: COLORADO DEPT OF HEALTH
Licensee: Bison Innovative Products
Region: 4
City: Denver   State: CO
County:
License #: GL002523
Agreement: Y
Docket:
NRC Notified By: Kathryn Mote
HQ OPS Officer: Donald Norwood		 Notification Date: 08/19/2020
Notification Time: 18:08 [ET]
Event Date: 06/10/2020
Event Time: 00:00 [MDT]
Last Update Date: 08/19/2020
Emergency Class: Non Emergency
10 CFR Section:
Agreement State		 Person (Organization):
NICK TAYLOR (R4DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
ILTAB (EMAIL)
This material event contains a "Less than Cat 3" level of radioactive material.

Event Text

AGREEMENT STATE REPORT - LOST TRITIUM EXIT SIGN

The following information was received via e-mail:

New owner reported one tritium exit sign lost. Model number SLXTU1RW10 containing 7.09 Ci of H-3.

THIS MATERIAL EVENT CONTAINS A "LESS THAN CAT 3" LEVEL OF RADIOACTIVE MATERIAL

Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf
 
Agreement State Event Number: 54846
Rep Org: COLORADO DEPT OF HEALTH
Licensee: Professional Flooring Supply
Region: 4
City: Colorado Springs   State: CO
County:
License #: GL001819
Agreement: Y
Docket:
NRC Notified By: Kathryn Mote
HQ OPS Officer: Donald Norwood		 Notification Date: 08/19/2020
Notification Time: 18:14 [ET]
Event Date: 06/09/2020
Event Time: 00:00 [MDT]
Last Update Date: 08/19/2020
Emergency Class: Non Emergency
10 CFR Section:
Agreement State		 Person (Organization):
NICK TAYLOR (R4DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
ILTAB (EMAIL)
This material event contains a "Less than Cat 3" level of radioactive material.

Event Text

AGREEMENT STATE REPORT - LOST TRITIUM EXIT SIGN

The following information was received via e-mail:

One tritium exit sign, model number SLXTUIGW10, containing 7.09 Ci of H-3 was reported as missing during annual registration.

THIS MATERIAL EVENT CONTAINS A "LESS THAN CAT 3" LEVEL OF RADIOACTIVE MATERIAL

Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf
 
Power Reactor Event Number: 54859
Facility: Prairie Island
Region: 3     State: MN
Unit: [1] [] []
RX Type: [1] W-2-LP,[2] W-2-LP
NRC Notified By: Jason Rhody
HQ OPS Officer: Kerby Scales		 Notification Date: 08/26/2020
Notification Time: 18:10 [ET]
Event Date: 08/26/2020
Event Time: 13:19 [CDT]
Last Update Date: 08/26/2020
Emergency Class: Non Emergency
10 CFR Section:
50.72(b)(2)(iv)(B) - RPS Actuation - Critical
50.72(b)(3)(iv)(A) - Valid Specif Sys Actuation		 Person (Organization):
RICHARD SKOKOWSKI (R3DO)
Unit SCRAM Code RX Crit Initial PWR Initial RX Mode Current PWR Current RX Mode
1 A/R Y 95 Power Operation 0 Hot Standby

Event Text

AUTOMATIC REACTOR TRIP DUE TO FLUX RATE

"At 1319 CDT, on August 26, 2020, with Unit 1 in Mode 1 at 95.2 percent power in coast down for the 1R32 refueling outage, the reactor automatically tripped due to flux rate. All systems responded normally to these conditions with auxiliary feedwater initiating as expected. Operations stabilized the plant without complication. Decay heat is being removed via a main feedwater pump to the steam generators. Unit 2 is not affected and remains at 100 percent power. Due to the Reactor Protection System actuation while critical, this event is being reported as a four-hour, non-emergency notification per 10 CFR 50.72(b)(2)(iv)(B) and an eight-hour report per 10 CFR 50.72(b)(3)(iv)(A), specified system actuation. The cause of the scram is under investigation.

"There was no impact on the health and safety of the public or plant personnel.

"The NRC Resident Inspector has been notified."

Page Last Reviewed/Updated Thursday, March 25, 2021