EA-96-534 - V. A. Department of, TX

March 10, 1997

EA 96-534

Mr. Robert F. Scott, Director
Department of Veterans Affairs
Veterans Administration Medical Center (VAMC)
2202 Holcombe Boulevard
Houston, Texas 77030

SUBJECT: NRC INSPECTION REPORT NO. 999-90004/96-02 AND NOTICE OF VIOLATION

Dear Mr. Scott:

On January 10, 1997, the NRC concluded a reactive inspection of activities associated with the use of generally-licensed sources at the Veterans Administration Medical Center (VAMC) Houston, Texas. The inspection was prompted by your notification of the loss of a source previously used in a liquid scintillation counter at the VAMC. The inspection included a review of relevant records and interviews of your staff on October 18-21, 1996, and our review of records subsequently provided to the inspector by your staff. The inspection findings were discussed with Mr. Adam Walmus of your staff during a telephonic exit briefing on January 10, 1997. The enclosed Inspection Report 99990004/96-02 documents the NRC's review of this incident.

Based on information developed during the inspection and information provided in your report dated November 1, 1996, the NRC has determined that a violation of NRC requirements occurred. The violation involved the failure to properly transfer or dispose of a generally-licensed source in accordance with 10 CFR 31.5(c)(8) and is cited in the enclosed Notice of Violation (Notice). The circumstances associated with the violation are described in detail in the subject inspection report. As noted in the enclosed report, the failure to ensure that the source was properly transferred or disposed of resulted in its release to the public domain.

The NRC considers the loss of byproduct material to be of significant concern because of the potential for members of the public to receive unintended and possibly significant radiation exposures, the potential for contamination of other material, and the impact on the environment of improper disposal of byproduct material. Therefore, in accordance with the "General Statement of Policy and Procedures for NRC Enforcement Actions," NUREG-1600 (Enforcement Policy) the violation has been categorized as Severity Level III, indicating a significant regulatory concern. Although the VAMC had some controls in place, as described below, to prevent improper disposal of generally-licensed material, in this case the source was left in equipment that was destined to be sold for scrap metal and transferred to a salvage broker. Thus, greater caution should have been exercised prior to releasing equipment from the research department and prior to transferring the counter to the scrap metal dealer.

We recognize that in this case loss of the sealed source was not an intentional act to avoid the cost associated with proper disposal. Further, we note that you had in place at the time of the incident some controls to prevent generally-licensed sources from inadvertently being disposed of in an improper manner, including: 1) written instructions had been made available to several groups of individuals which should have prevented the improper transfer and disposal; 2) semi-annual physical inventories had been conducted for equipment containing byproduct material destined for salvage; and 3) research department personnel had been instructed to remove sealed sources from liquid scintillation counters prior to releasing them from the research department.

Additionally, we noted that corrective actions described in your November 1, 1996, report appeared comprehensive, including: 1) labeling the remainder of the liquid scintillation counters in your possession with two (3-by-5 inch) metal warning and caution signs; 2) documents used for inventory control will automatically include a warning concerning the presence of radioactive sources; and, 3) the radiation safety office will initiate quarterly physical inventories of all scintillation counters containing sources, including those in storage.

In accordance with the Enforcement Policy, a base civil penalty in the amount of $2,500 is considered for a Severity Level III violation. Because your facility has not been the subject of escalated enforcement action within the last 2 inspections, the NRC considered whether credit was warranted for Corrective Action in accordance with the civil penalty assessment process in Section VI.B.2 of the Enforcement Policy. Given that the corrective actions described above were both prompt and comprehensive, credit is due for your corrective actions, resulting in no civil penalty being assessed in this case.

Accordingly, to encourage prompt and comprehensive correction of violations, and in recognition of the absence of previous escalated enforcement action, I have been authorized not to propose a civil penalty in this case. However, significant violations in the future, particularly violations of a similar nature, could result in a civil penalty. In addition, issuance of this Severity Level III violation constitutes escalated enforcement action which may subject you to more frequent inspection by NRC.

The NRC has concluded that information regarding the reasons for the violation, the corrective actions taken and planned to correct the violation and prevent recurrence, and the date when full compliance was achieved is already adequately addressed on the docket in the subject inspection report and your written report dated November 1, 1996. Therefore, you are not required to respond to this letter unless the description therein does not accurately reflect your corrective actions or your position. In that case, or if you choose to provide additional information, you should follow the instructions specified in the enclosed Notice.

In accordance with 10 CFR 2.790 of the NRC's "Rules of Practice," a copy of this letter, its enclosures, your November 1, 1996, event report, and your response (if you choose to provide one) will be placed in the NRC Public Document Room (PDR).

Should you have any questions concerning this letter or its enclosures, please contact Mr. Richard A. Leonardi at (817) 860-8187 or Ms. Linda L. Howell at (817) 860-8213.

Sincerely, s/Frank W. Wenslawski for Ross A. Scarano, Director Division of Nuclear Materials Safety

Docket No. 999-90004
License No. General License Pursuant to 10 CFR 31.5

Enclosure:

1. Notice of Violation

2. NRC Inspection Report 999-90004/96-02

cc w/Enclosures
Texas Radiation Control Program Director
Fran Herbig
National Health Physics Program (115HP)
Department of Veterans Affairs
915 North Grand Boulevard
St. Louis, Missouri 63106

---

NOTICE OF VIOLATION

Department of Veterans Affairs Veterans Administration Medical Center Houston, Texas

Docket No. 999-90004 License No. General License License No. General License Pursuant to 10 CFR 31.5 EA 96-534

During an NRC reactive inspection conducted from October 18 through January 10, 1997, a violation of NRC requirements was identified. In accordance with the "General Statement of Policy and Procedure for NRC Enforcement Actions," NUREG-1600, the violation is listed below:

10 CFR 31.5(c)(8) requires, in part, that any person who acquires, receives, possesses, uses or transfers byproduct material in a device pursuant to a general license shall, except as provided in 10 CFR 31.5(c)(9), transfer or dispose of the device containing byproduct material only by transfer to persons holding a specific license pursuant to 10 CFR Parts 30 and 32 or from an Agreement State to receive the device.

Contrary to the above, in March or April 1996, the licensee transferred and subsequently disposed of a 130 microcurie americium-241 sealed calibration source (Model AMCK599) contained in a Packard Model 3385 liquid scintillation counter by a means other than transfer to a person holding a specific license pursuant to 10 CFR Parts 30 and 32 or from an Agreement State and the exemption in 10 CFR 31.59(c)(9) did not apply. Specifically, the licensee determined that the sealed source housed in the liquid scintillation counter was removed from its facility by a scrap metal dealer and may have been smelted or lost in the public domain. (01013)

This is a Severity Level III violation (Supplement IV).

The NRC has concluded that information regarding the reason for the violation, the corrective actions taken and planned to correct the violation and prevent recurrence is already adequately addressed on the docket in Inspection Report No. 999-90004/96-02 and event report from licensee dated November 1, 1996. However, you are required to respond to the provisions of 10 CFR 2.201 if the description therein does not accurately reflect your corrective actions or your position. In that case, or if you choose to respond, clearly mark your response as a "Reply to a Notice of Violation," and send it to the U.S. Nuclear Regulatory Commission, ATT: Document Control Desk, Washington, D.C. 20555 with a copy to the Regional Administrative, Region IV, 611 Ryan Plaza Drive, Suite 400, Arlington, Texas 76011 within thirty days of the date of the letter transmitting this Notice of Violation.

Dated at Arlington, Texas,
this 10th day of March, 1997