Event Notification Report for January 16, 2013

DISCOVERY OF TWO RADIOACTIVE GAUGES IN LOCKED STORAGE

The following information was obtained from the Commonwealth of Massachusetts via email:

"[On approximately] 1/16/13, two surface gauges [manufactured in 1961 were] found in locked storage within [a] remote airfield facilities building at Worcester Regional Airport, Worcester, MA. Third-party waste brokers [were] contacted to bid on proper removal. Wipe tests by a third-party waste broker indicate no leakage of radioactive contamination from [the] gauge sources. [The Massachusetts Radiation Control Program (the Agency) received the information via email] on 3/19/13. The Agency conducted a site visit to confirm device identifications on 3/26/13. A waste brokers' bid [was] accepted [and] packaging and removal [is] scheduled for 4/17/13. Gauges [are being] held in locked storage until removal by [the] waste broker.

"[The] items [are] described as one Nuclear-Chicago Corporation Model P21 Surface Moisture Probe, SN 136, containing 5 mCi Ra-Be, date stamped 5/2/61; and one Nuclear-Chicago Corporation Model P22A Surface Density Probe, SN 139, containing 3 mCi Cs-137, date stamped 5/23/61.

"The Agency considers this matter to be open until [the] items [are] confirmed removed on 4/17/13."

* * * UPDATE FROM ANTHONY CARPENITO TO CHARLES TEAL ON 4/19/13 AT 1132 EDT * * *

"4/19/13 UPDATE - The Agency [Massachusetts Radiation Control Program] considers this matter to be OPEN until items confirmed removed for disposal.

"Agency [Massachusetts Radiation Control Program] regulation 105 CMR 120.281 (A)(1) and USNRC regulation 20.2201 (a)(1)(i) requires 'immediate' telephone reporting of stolen, lost or missing licensed radioactive material in specified quantities under circumstances that it appears an exposure could result to individuals in unrestricted areas. The situation in this case involved 'found' radioactive material, devices already wipe tested to confirm no leakage of radioactive contamination and stored in a 'secure' location to prevent exposure to individuals until such time that scheduled packaging and removal by a waste broker is completed, and therefore, did not warrant immediate notification. This case was determined to be included in the 30-day notification category. The written report to NMED was issued one day after the Agency [Massachusetts Radiation Control Program] confirmatory site visit of 3/26/13."

NMED Report #: 130149

Notified R1DO (Cook) and FSME Event Resource via email.

* * * UPDATE ON 4/29/2013 AT 1142 EDT FROM TONY CARPENITO TO MARK ABRAMOVITZ * * *

"The gauges were removed and shipped for disposal on 4/24/13. The Agency (Massachusetts Radiation Control Program) considers this matter to be closed."

Notified the R1DO (Hunegs) and FSME Event Resource via email.


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 REPORT - DOSE DIFFERENT FROM PRESCRIBED USING YTTRIUM-90 THERASPHERE TREATMENT

The following event report was received from the State of Utah Division of Radiation Control via facsimile:

"The Utah Division of Radiation Control was notified at 11:45 a.m. MST on Thursday, January 17, 2013 of a medical event associated with a radioembolization brachytherapy treatment of liver cancer. Notification was provided by the licensee's Radiation Safety Officer. This incident report is the initial notification to the NRC Operations Center.

"The licensee's radiation safety officer reported to the Division that the treatment plan prescribed 1.33 GBq of yttrium-90 for treatment of liver cancer. The patient received 0.798 GBq of yttrium associated with the TheraSphere product. After the administration of the dosage, a nuclear medicine technologist determined that the total prescribed dosage was not delivered to the patient, as radioactive material was found to remain in the dosage vial and the administration apparatus. The licensee is working with the manufacturer of the treatment delivery system to determine the cause of the medical event."

Utah Event Report ID : UT130001

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.

LEAKING NI-63 SOURCE

The following was excerpted from email received from NASA Ames:

"The source in question is a 5 mCi solid Ni-63 beta foil source located inside a Valco electron capture detector that was previously used for gas chromatograph. The leaking source in question was not in service at the time the contamination was found. The source was in storage awaiting disposal to a licensed facility."

"The radiation safety officer identified elevated contamination results for the source mentioned above during his review of the semi-annual sealed source inventory and leak test report which was conducted by the former health physics contractor in December 2012. All contamination levels were well below the NRC contamination threshold of .005 micro Curie at that time. The RSO directed the former health physics contractor to take a follow-up survey to verify the counts begin detected were actually Ni-63, bag the source, perform a survey of the immediate area where the source was being stored awaiting disposal, and prepare a report documenting the follow-up report and isotope identification prior to his termination with the end of his company's contract on December 31, 2012.

"On January 15, 2013, the new contract Health Physicist for NASA Ames Research Center, conducted a follow-up survey and leak test for the 5 mCi Ni-63 source. On January 16 the RSO confirmed that approximately 0.162 micro Curie (~36,000 dpm) beta contamination was distributed on the exterior surface of the electron capture detector. This value is in excess of the allowable leakage of 0.005 micro Curie (11,100 dpm) of contamination. The cause of the leaking source is not certain at this time. The source is approximately 23 years old so its possible age played a factor. The source has been in storage for a researcher who no longer had funding to continue using them in his research. It is stored in the RSO's radioactive materials storage facility for the last 6 years. During storage, the leak tests for the source continued to be conducted and all semi-annual leak tests never revealed any leaking contamination from the internal source.

"No persons are expected to have received any dose or exposure to radioactive materials as a result of this event. Ni-63 is a weak beta emitter and not capable of penetrating the dead layer of skin if in contact with the skin and is thus not an external radiation hazard. A general area contamination survey was also conducted in the immediate vicinity of where the source was stored. Contamination levels were all found to be near background levels in all locations confirming that there is no contamination event for the storage facility. The device has been in storage in a locked cabinet with access only to the RSO and Health Physics contractor during the period in which the leaking occurred so this makes the possibility of inadvertent personnel contamination remote. Required procedure for performing sealed source leak tests is to always wear disposable impermeable gloves. This would have prevented any personnel contamination."