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Event Notification Report for July 23, 2002
U.S. Nuclear Regulatory Commission
Operations Center
Event Reports For
07/22/2002 - 07/23/2002
** EVENT NUMBERS **
39068 39081 39082 39083
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!!!!!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED !!!!!!!
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|General Information or Other |Event Number: 39068 |
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| REP ORG: KENTUCKY DEPT OF RADIATION CONTROL |NOTIFICATION DATE:
07/18/2002|
|LICENSEE: MONROE COUNTY MEDICAL CENTER |NOTIFICATION TIME: 11:40[EDT]|
| CITY: TOMPKINSVILLE REGION: 2 |EVENT DATE: 07/12/2002|
| COUNTY: STATE: KY |EVENT TIME: 16:00[CDT]|
|LICENSE#: 202-247-24 AGREEMENT: Y |LAST UPDATE DATE: 07/18/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |CHARLIE PAYNE R2 |
| |FRED BROWN NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: JOHN A. VOLPE | |
| HQ OPS OFFICER: JOHN MacKINNON | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
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EVENT TEXT
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| AGREEMENT STATE REPORT INVOLVING A MEDICAL MISADMINISTRATION |
| |
| "The Technologist (S.H) received a request to perform a Bone Scan on an |
| impatient. She selected an MDP Dose (25.1 mCi) and proceeded to the room |
| listed on requisition. She approached the patient stated the name. The |
| patient acknowledged the name. The technologist explained the procedure |
| and injected the patient. When the patient presented to the Nuclear |
| Medicine Department with hospital chart it was discovered that the |
| misadministration had occurred. The technologist notified the authorized |
| user, the referring physician [and] the Radiation Safety officer. The |
| referring physician agreed to notify the patient. The Technologist was |
| reinstructed to check the hospital chart for a written order and verify the |
| patients identity by checking the hospital ORM board." |
| |
| Used Tc-99m MDP Bone. |
| |
| *****RETRACTED ON 7/18/02 AT 15:27 EDT FROM VOLPE TO LAURA***** |
| |
| The licensee determined the event was NOT reportable since the dose was |
| below the threshold (greater than 5 REM whole body or greater than 50 REM |
| for organs) for reportability. |
| |
| Notified R2DO (C. PAYNE) and NMSS (F. Brown). |
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|Power Reactor |Event Number: 39081 |
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| FACILITY: COOK REGION: 3 |NOTIFICATION DATE: 07/22/2002|
| UNIT: [] [2] [] STATE: MI |NOTIFICATION TIME: 02:33[EDT]|
| RXTYPE: [1] W-4-LP,[2] W-4-LP |EVENT DATE: 07/22/2002|
+------------------------------------------------+EVENT TIME: 00:45[EDT]|
| NRC NOTIFIED BY: JOHNSON |LAST UPDATE DATE: 07/22/2002|
| HQ OPS OFFICER: CHAUNCEY GOULD +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: NON EMERGENCY |MONTE PHILLIPS R3 |
|10 CFR SECTION: | |
|ARPS 50.72(b)(2)(iv)(B) RPS ACTUATION - CRITICA| |
| | |
| | |
| | |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE
|
+-----+----------+-------+--------+-----------------+--------+-----------------+
| | |
|2 A/R Y 100 Power Operation |0 Hot Standby |
| | |
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EVENT TEXT
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| REACTOR AUTOMATICALLY TRIPPED FROM 100% POWER ON REACTOR
TRIP/TURBINE TRIP |
| |
| The reactor trip/turbine trip from 100% power was caused by a loss of main |
| turbine condenser vacuum that occurred while flushing the condenser |
| waterboxes. The cause is unknown and being investigated at this time. All |
| control rods fully inserted, no ECCS actuated and all emergency and |
| non-emergency systems functioned as designed. The main steam stop valves |
| were manually closed to arrest RCS cooldown. RCS temperature was |
| stabilized using the atmospheric relief valves. |
| |
| The NRC Resident Inspector was notified, |
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|Power Reactor |Event Number: 39082 |
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| FACILITY: FITZPATRICK REGION: 1 |NOTIFICATION DATE: 07/22/2002|
| UNIT: [1] [] [] STATE: NY |NOTIFICATION TIME: 19:14[EDT]|
| RXTYPE: [1] GE-4 |EVENT DATE: 07/22/2002|
+------------------------------------------------+EVENT TIME: 17:10[EDT]|
| NRC NOTIFIED BY: GENE DORMAN |LAST UPDATE DATE: 07/22/2002|
| HQ OPS OFFICER: LEIGH TROCINE +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: NON EMERGENCY |RICHARD CONTE R1 |
|10 CFR SECTION: | |
|AIND 50.72(b)(3)(v)(D) ACCIDENT MITIGATION | |
| | |
| | |
| | |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE
|
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1 N Y 100 Power Operation |100 Power Operation |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
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| DISCOVERY OF A HIGH PRESSURE COOLANT INJECTION (HPCI) FLOW CONTROLLER
|
| INDICATION OF 500 GPM DURING RESTORATION FROM A CORE SPRAY SYSTEM
|
| SURVEILLANCE TEST AND WITH THE HPCI SYSTEM IN STANDBY |
| |
| The following text is a portion of a facsimile received from the licensee: |
| |
| "During restoration from surveillance testing on the 'B' core spray system, |
| the flow controller for the HPCI system (23FI-108-1) was observed to be |
| reading 500 gpm with the HPCI system in standby. The HPCI system was |
| declared inoperable, and [Technical Specification] 3.5.C.1.b was entered |
| requiring [either] restoration of 'B' core spray or HPCI to operable status |
| within 24 hours or [commencement of a unit] shutdown. 'B' core spray was |
| restored to operability at 1732, and the plant exited [Technical |
| Specification] 3.5.C.1.b and entered [Technical Specification] 3.5.C.1.a |
| placing the plant in a [7-day limiting condition for operation (LCO)]." |
| |
| "Since no actuations occurred and [since] no shutdown was initiated, this is |
| only reportable under 10CFR50.72(b)(3) criteria, specifically 10 CFR |
| 50.72(b)(3)(v)(D). This is based on the guidance in NUREG 1022, Rev. 2. |
| Since HPCI is a single train system, even though [technical specifications] |
| allow a 7-day LCO, declaring HPCI [inoperable] is reportable." |
| |
| "The only unusual/not understood thing associated with this is the flow |
| indication of 500 gpm. There were no actuations required so all equipment |
| functioned and continues to function as expected. There are no radiological |
| releases associated with this event." |
| |
| The licensee plans to notify the NRC resident inspector. |
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|Power Reactor |Event Number: 39083 |
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| FACILITY: MONTICELLO REGION: 3 |NOTIFICATION DATE: 07/22/2002|
| UNIT: [1] [] [] STATE: MN |NOTIFICATION TIME: 21:26[EDT]|
| RXTYPE: [1] GE-3 |EVENT DATE: 07/22/2002|
+------------------------------------------------+EVENT TIME: 16:30[CDT]|
| NRC NOTIFIED BY: DUANE BISTODEAU |LAST UPDATE DATE: 07/22/2002|
| HQ OPS OFFICER: LEIGH TROCINE +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: NON EMERGENCY |CHRIS MILLER R3 |
|10 CFR SECTION: | |
|AIND 50.72(b)(3)(v)(D) ACCIDENT MITIGATION | |
| | |
| | |
| | |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE
|
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1 N Y 100 Power Operation |100 Power Operation |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
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| INOPERABILITY OF BOTH CONTROL ROOM VENTILATION TRAINS |
| |
| The following text is a portion of a facsimile received from the licensee: |
| |
| "Both control room ventilation (CRV) trains [were] declared inoperable. |
| While [the] 'B' CRV was inoperable for testing, [the] 'A' CRV chiller |
| compressor tripped causing [the] 'A' CRV to be inoperable. [A] 24-hour |
| [limiting condition for operation (LCO)] was entered per [Technical |
| Specification] 3.17.A.3.a. 'B' CRV was restored to operable and [the] |
| 24-hour LCO [was exited] at 1701 [CDT]. [The] 'A' CRV is in a 30-day LCO |
| per [Technical Specification] 3.17.A.2.a. [The] 'A' CRV chiller compressor |
| trip cause [is] unknown." |
| |
| The licensee plans to notify the NRC resident inspector as well as |
| applicable state and local officials. |
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