Event Notification Report for April 17, 2018

WRITTEN DIRECTIVE FOR RA-223 ADMINISTRATION INCORRECT

A quarterly review conducted on 4/17/18, identified that the written directive for administration of Ra-223 was incorrect. The written directive stated that the Ra-223 should be administered orally, but should have stated that it was to be administered intravenously (IV). The review determined that there was no impact to any patients as a result of the error in the written directive. The review identified one case where the written directive was used. However, the technician administered the Ra-223 to the patient via IV and not orally.

The corrective actions taken by the licensee were to correct the written directive, and review the directive with the technician to understand why the technician did not consult with the physician when there was an error in the directive.

The licensee notified the NRC R3 Office (Warren).

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.

HIGH PRESSURE COOLANT INJECTION SYSTEM DECLARED INOPERABLE

"Unit 1 HPCI [High Pressure Coolant Injection] was declared inoperable due to a Main Pump seal leak that was identified during surveillance testing. Unit 1 HPCI was declared inoperable at 1030 EDT. HPCI was secured and was manually re-aligned to an available status."

At the time of this notification, repairs have been completed and the licensee is making preparations to re-perform the surveillance.

The licensee has notified the NRC Resident Inspector.

HIGH PRESSURE COOLANT INJECTION SYSTEM INOPERABLE

"At 0416 CDT on April 17, 2018, the High Pressure Coolant Injection System (HPCI) was isolated due to a water side leak from the gland seal condenser. Unit 1 HPCI remains inoperable pending repairs to the gland seal condenser.

"This condition is being reported pursuant to 10 CFR 50.72(b)(3)(V)(D), 'Any event or condition that at the time of discovery could have prevented the fulfillment of the safety function of structures or systems that are needed to mitigate the consequences of an accident.' This is also reportable as a 60-day written report in accordance with 10 CFR 50.73(a)(2)(V)(D).

"There was no impact on the health and safety of the public or plant personnel. The NRC Resident Inspector has been notified of this event."

* * * RETRACTION ON 6/8/18 AT 1500 EDT FROM BILL BALL TO BETHANY CECERE * * *

"ENS Event Number 53340, made on 4/17/2018 is being retracted.

"NRC notification 53340 was made to ensure that the Eight-Hour Non-Emergency reporting requirements of 10 CFR 50.72 were met when a leak was identified on U1 HPCls Gland Seal Condenser.

"A Past Operability Evaluation [POE] was performed under CR# 1406178. The evaluation concluded that HPCI was degraded, but met the threshold for TS operability. Specifically the POE states that if the leak was left unaddressed for 8 hours (mission time) with HPCI in operation, the additional volume of water that would accumulate on the HPCI room floor would be approximately 5520 gallons which would be within the capacity of the floor drain pumps and spill over into Torus area to prevent water level from reaching a value which would preclude operation of HPCI critical components. Additionally the leak was upstream of the system flow controller, so the leakage rate of 11.5 gpm would not affect the ability of the HPCI pump to provide rated flow of 5000gpm.

"As such, the circumstances discussed in the report did not result in any condition that at the time of discovery could have prevented the fulfillment of the safety function of structures of system that are needed to remove residual heat. Thus, there was no impact on nuclear safety. Therefore, this event is not reportable under 10 CFR 50.72(b)(3)(v)(B).

"TVA's evaluation of this event notification is documented in the corrective action program.

"The licensee has notified the NRC Resident lnspector."

Notified R2DO (Ernstes).