Event Notification Report for February 20, 2008

RHR SERVICE WATER SYSTEM DECLARED INOPERABLE DUE TO INABILITY TO MEET FSAR REQUIREMENT

"At 1505 EST, it was determined by an engineering analysis that a leak on a 3/4 inch vent line of the Residual Heat Removal Service Water (RHRSW) System common discharge line would prevent continuous operation of the system for 30 days as required by the Unit 2 FSAR.

"Specifically, if the line were to completely shear, the resulting leak would have exceeded the capacity of the building sumps and over a prolonged period of operation would have resulted in the excessive water levels in the Reactor Building Torus room area. In order to mitigate the condition, supplemental pumping capacity would be needed in the building sumps or the RHRSW system would have to be temporarily secured.

"The RHRSW system has been tagged out for repair of the line. The appropriate 8-hour RAS in Tech Spec has been entered. The line will be repaired and the system returned to service."

The licensee identified the crack in the socket weld during a system walkdown and anticipates completion of repairs in approximately 6 hours.

The licensee informed the NRC Resident Inspector.

* * * UPDATE AT 2140 EST ON 02/20/08 FROM BILL DUVALL TO S. SANDIN * * *

At 2120 EST on 02/20/08 the RHR SW System was declared OPERABLE after completion of repairs and testing. The failure of the socket weld at 2E11-FV001 is preliminarily attributed to fatigue cracking caused by vibration. A root cause investigation is ongoing. A system walkdown did not identify any additional deficiencies.

The licensee informed the NRC Resident Inspector. Notified R2DO(Robert Haag).

FITNESS FOR DUTY REPORT INVOLVING A CONTRACTOR SUPERVISOR

A non-licensed contract employee supervisor tested positive for alcohol during a random fitness-for-duty test. The contractor's access to the plant has been terminated. Contact the Headquarters Operations Officer for additional details.

The licensee informed the State of New York and the NRC Resident Inspector.

VEHICLE TRANSPORTING SOIL DENSITY GAUGE INVOLVED IN ACCIDENT

An employee for Mid-Atlantic LLC transporting a soil density gauge was involved in an accident at 1600 EST on Route 30 near Columbia, PA. The gauge is a CPN-MC1 with approximately 50mCuries Am-241/Be and 10mCuries Cs-137. The gauge was thrown from the vehicle during the accident. Local emergency response and hazmat team cordoned off the area and determined that there were no significant radiation levels. The RSO responded to the scene and noted that the gauge was still in its shipping container. The container had only minimal damage. When the container was opened, the gauge itself appeared to be undamaged. The RSO performed surveys and swipes confirming that there was no likely damage. The RSO has taken possession of the gauge and returned to the company offices. He plans on conducting a leak and functionality test to confirm the gauge was not impacted by the accident.

POTENTIAL MEDICAL EVENT - UNDERDOSE OF Y-90 MICROSPHERES

The licensee reported that a patient being treated for liver cancer received approximately half of the prescribed dose of Y-90 microspheres. The licensee calculates the patient received 16 Grays instead of the prescribed 38 Grays.

The treatment is performed in three flushes. The patient receives 50% of the medication in the first flush and the remaining 50% in the second flush. The third flush is performed to ensure all the prescribed medication has been applied to the patient. In this case, the patient received the first flush but the second flush wouldn't go through the line. The licensee is investigating a problem with the three-way valve used in the treatment or potentially a crimp in the line which caused a blockage.

Both the patient and prescribing physician are aware of this problem, and the other half of the patient's therapy is planned for a future time period.


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.