Event Notification Report for November 6, 2002
U.S. Nuclear Regulatory Commission
Operations Center
Event Reports For
11/05/2002 - 11/06/2002
** EVENT NUMBERS **
39334 39335 39336 39341 39344 39345
+------------------------------------------------------------------------------+
|General Information or Other |Event Number: 39334 |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| REP ORG: COLORADO DEPT OF HEALTH |NOTIFICATION DATE: 10/31/2002|
|LICENSEE: KUMAR AND ASSOCIATES, INC |NOTIFICATION TIME: 12:10[EST]|
| CITY: DENVER REGION: 4 |EVENT DATE: 10/30/2002|
| COUNTY: STATE: CO |EVENT TIME: [MST]|
|LICENSE#: 778-01 AGREEMENT: Y |LAST UPDATE DATE: 11/04/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |CLAUDE JOHNSON R4 |
| |DOUG BROADDUS NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: ED STROUD | |
| HQ OPS OFFICER: MIKE NORRIS | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
+------------------------------------------------------------------------------+
| AGREEMENT STATE REPORT INVOLVING A STOLEN TROXLER GAUGE |
| |
| Licensee reported that a Troxler gauge, was stolen from the open bed of a |
| pickup truck parked in front of a private residence, sometime during the |
| night of 10/30/02. The gauge, model #3440 serial #16911, contained |
| approximately 44 millicuries of Am-241:Be, and approximately 9 millicuries |
| of Cs-137. The gauge was locked and the chain was cut. The licensee will be |
| notifying the Denver police department of the theft. |
| |
| * * * * * UPDATE 1800 EST 11/4/2002 TO MIKE RIPLEY FROM COLORADO DEPARTMENT |
| OF PUBLIC HEALTH AND ENVIRONMENT (received via fax) * * * * |
| |
| "The police recovered a Troxler moisture-density gauge that was reported |
| stolen last week. Kumar and Associates, a Colorado licensee, reported the |
| gauge stolen on 10/31/02 (sec preliminary report 39334). Later that same |
| night, police were called to a Denver location because of a suspicious |
| package that was left by a dumpster. The package was labeled with, a |
| radioactive sticker. The Denver Fire Department's Haz-mat team checked the |
| package and removed it to a safe storage location. Today, 11/4/02, the |
| package was positively identified as the stolen gauge, and returned to the |
| licensee. The licensee reported that the gauge was intact and that the |
| sources appeared undisturbed." |
| |
| Notified R4 DO (C. Marschall) and NMSS EO (P. Holahan) |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
|General Information or Other |Event Number: 39335 |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| REP ORG: FLORIDA BUREAU OF RADIATION CONTROL |NOTIFICATION DATE: 10/31/2002|
|LICENSEE: BAYFRONT MEDICAL CENTER |NOTIFICATION TIME: 16:45[EST]|
| CITY: ST. PETERSBURG REGION: 2 |EVENT DATE: 10/31/2002|
| COUNTY: STATE: FL |EVENT TIME: [EST]|
|LICENSE#: 0023-2 AGREEMENT: Y |LAST UPDATE DATE: 11/05/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |KERRY LANDIS R2 |
| |PATRICIA HOLAHAN NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: CHARLES ADAMS(email) | |
| HQ OPS OFFICER: ARLON COSTA | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
+------------------------------------------------------------------------------+
| AGREEMENT STATE REPORT INVOLVING A MEDICAL EVENT |
| |
| "Manufacturer's employee changed the Gamma Knife's printer on 2 Aug 02 and |
| during the process the calibration parameters for the Gamma Knife instrument |
| were reset from 3.52 c/gray (on 6-02) to 3.5 c/gray (on 1-99). Licensee was |
| not aware of the change. Ten patients were treated with this instrument from |
| 26 Aug-30 Oct 02. The area treated was the brain and the overexposure was as |
| much as 60% above the prescribed dose of 12-24 grays. The physicians and |
| patients involved are being notified. The error was discovered during a |
| recalibration on 10-30-02. The instrument has been removed from service. |
| Florida is investigating." |
| |
| The isotope used by the Gamma Knife Model C S/N 4189C is Co-60 (Activity |
| 5.72 Ci). |
| |
| *** UPDATE AT 0800 11/5/2002 FROM CHARLIE ADAMS TO ERIC THOMAS *** |
| |
| The above Co-60 activity was listed incorrectly in the original report. The |
| correct value is 5720 Ci. |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
|General Information or Other |Event Number: 39336 |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| REP ORG: UTAH DIVISION OF RADIATION CONTROL |NOTIFICATION DATE: 11/01/2002|
|LICENSEE: AMERICAN TESTING SERVICES, INC |NOTIFICATION TIME: 16:11[EST]|
| CITY: WEST VALLEY CITY REGION: 4 |EVENT DATE: 11/01/2002|
| COUNTY: STATE: UT |EVENT TIME: 11:00[MST]|
|LICENSE#: UT 1800062 AGREEMENT: Y |LAST UPDATE DATE: 11/01/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |CLAUDE JOHNSON R4 |
| |TOM ESSIG NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: JULIE R. FELICE (e-mail) | |
| HQ OPS OFFICER: MIKE NORRIS | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
+------------------------------------------------------------------------------+
| AGREEMENT STATE REPORT INVOLVING A STOLEN TROXLER GAUGE |
| |
| "A Troxler Electronic Laboratories, Inc. Model 3411B, portable gauging |
| device [serial number 7940, containing approximately 8.0 millicuries of |
| Cs-137 (source serial number CC-571), and approximately 40 millicuries of |
| Am-241/Be (source serial number CAA-4262)] was stolen from the bed of a |
| pickup truck while the licensee's employee went into [ ] Food & Drug to |
| purchase some batteries. The gauging device's source rod was locked in the |
| safe shielded position, the gauging device's transport case was locked, and |
| the transportation case was chained to the licensee's pickup truck. Bolt |
| cutters were used to remove the gauging device from the pickup truck." |
| |
| The Licensee notified the West Valley City Police. |
| |
| The state of Utah has issued a press release. |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
|General Information or Other |Event Number: 39341 |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| REP ORG: CALIFORNIA RADIATION CONTROL PRGM |NOTIFICATION DATE: 11/02/2002|
|LICENSEE: AMGEN, INC |NOTIFICATION TIME: 12:10[EST]|
| CITY: THOUSAND OAKS REGION: 4 |EVENT DATE: 11/01/2002|
| COUNTY: STATE: CA |EVENT TIME: 14:45[PST]|
|LICENSE#: AGREEMENT: Y |LAST UPDATE DATE: 11/02/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |CLAUDE JOHNSON R4 |
| |PATRICIA HOLAHAN NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: ROBERT GREGOR | |
| HQ OPS OFFICER: MIKE NORRIS | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
+------------------------------------------------------------------------------+
| AGREEMENT STATE REPORT INVOLVING UNACCOUNTED FOR Po-210 SOURCE |
| |
| Licensee reported that a 1.5 millicurie Po-210 source is unaccounted for. |
| The source is believed to be at the facility and a search is being |
| performed. |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
|Hospital |Event Number: 39344 |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| REP ORG: GRAND VIEW HOSPITAL |NOTIFICATION DATE: 11/05/2002|
|LICENSEE: GRAND VIEW HOSPITAL |NOTIFICATION TIME: 10:33[EST]|
| CITY: SELLERSVILLE REGION: 1 |EVENT DATE: 11/04/2002|
| COUNTY: STATE: PA |EVENT TIME: 11:00[EST]|
|LICENSE#: 37-13187-02 AGREEMENT: N |LAST UPDATE DATE: 11/05/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |LAWRENCE DOERFLEIN R1 |
| |PATRICIA HOLAHAN NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: DAVID LIGHTFOOT | |
| HQ OPS OFFICER: ERIC THOMAS | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|BLO2 20.2201(a)(1)(ii) LOST/STOLEN LNM>10X | |
| | |
| | |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
+------------------------------------------------------------------------------+
| REPORTED LOSS OF I-125 SEED FOLLOWING IMPLANTATION |
| |
| On 11/4/2002 at approximately 1100 hours, following a procedure to implant |
| I-125 seeds into the prostate of a patient, the licensee counted only 57 of |
| planned 58 seeds implanted. Survey of area, surrounding materials, and |
| counting room did not turn up any indications of the lost seed. The |
| unaccounted for seed contains 382 microcuries. Licensee contacted Region I. |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
|Power Reactor |Event Number: 39345 |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: CALLAWAY REGION: 4 |NOTIFICATION DATE: 11/05/2002|
| UNIT: [1] [] [] STATE: MO |NOTIFICATION TIME: 15:19[EST]|
| RXTYPE: [1] W-4-LP |EVENT DATE: 11/05/2002|
+------------------------------------------------+EVENT TIME: 11:10[CST]|
| NRC NOTIFIED BY: E. HENSON |LAST UPDATE DATE: 11/05/2002|
| HQ OPS OFFICER: MIKE RIPLEY +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: NON EMERGENCY |CHARLES MARSCHALL R4 |
|10 CFR SECTION: | |
|ADEG 50.72(b)(3)(ii)(A) DEGRADED CONDITION | |
| | |
| | |
| | |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1 N N 0 Refueling |0 Refueling |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
+------------------------------------------------------------------------------+
| DEFECTIVE STEAM GENERATOR TUBES DISCOVERED DURING INSPECTION |
| |
| "During refueling outage RF12, interim results of "A" Steam Generator tube |
| inspections indicate 62 tubes out of 5431 tubes (i.e.,> 1%) have been found |
| to be defective. This steam generator tube inspection result for the "A" |
| Steam Generator is classified as category C-3 in accordance with Technical |
| Specification 5.5.9, Table 5.5.9-2. All defective tubes will be plugged |
| before the steam generator is returned to service. There were no adverse |
| safety consequences or implications as a result of this event. This event |
| did not adversely affect the safe operation of the plant or the health and |
| safety of the public." |
| |
| The licensee notified the NRC Resident Inspector. |
+------------------------------------------------------------------------------+
Page Last Reviewed/Updated Thursday, March 25, 2021