Event Notification Report for December 05, 2002
U.S. Nuclear Regulatory Commission
Operations Center
EVENT REPORTS FOR
12/04/2002 - 12/05/2002
EVENT NUMBERS
3942839426394223942339424
Hospital
Event Number: 39428
Rep Org: TENNESSEE DIV OF RAD HEALTH
Licensee: VANDERBILT UNIVERSITY MEDICAL CENTER
Region: 2
City: NASHVILLE State: TN
County:
License #: R-19014-E05
Agreement: Y
Docket:
NRC Notified By: DEBRA SHULTS
HQ OPS Officer: HOWIE CROUCH
Licensee: VANDERBILT UNIVERSITY MEDICAL CENTER
Region: 2
City: NASHVILLE State: TN
County:
License #: R-19014-E05
Agreement: Y
Docket:
NRC Notified By: DEBRA SHULTS
HQ OPS Officer: HOWIE CROUCH
Notification Date: 12/06/2002
Notification Time: 16:38 [ET]
Event Date: 12/05/2002
Event Time: 15:45 [EST]
Last Update Date: 12/06/2002
Notification Time: 16:38 [ET]
Event Date: 12/05/2002
Event Time: 15:45 [EST]
Last Update Date: 12/06/2002
Emergency Class: NON EMERGENCY
10 CFR Section:
10 CFR Section:
Person (Organization):
ROBERT HAAG (R2)
DANIEL GILLEN (NMSS)
ROBERT HAAG (R2)
DANIEL GILLEN (NMSS)
AGREEMENT STATE REPORT - RADIOACTIVE MATERIAL SPILL IN X-RAY ROOM
Tennessee Event Report ID No.: TN-02-170
"[State of Tennessee] DRH [Division of Radiological Health] was notified on 12/6/02 by the Radiation Safety Officer at Vanderbilt University Medical Center of a spill of Yttrium-90 microspheres. The material was being used in an x-ray room for treatment of hepatic tumors. Approximately 4% of the 64 millicurie dose was spilled onto the floor of the room. The room was isolated and is being decontaminated. The Radiology Department was closed after the spill to survey for any possible spread of contamination and was reopened this morning. The room where the spill occurred is still restricted. The State will investigate and will inform the NRC of the results of the investigation."
Tennessee Event Report ID No.: TN-02-170
"[State of Tennessee] DRH [Division of Radiological Health] was notified on 12/6/02 by the Radiation Safety Officer at Vanderbilt University Medical Center of a spill of Yttrium-90 microspheres. The material was being used in an x-ray room for treatment of hepatic tumors. Approximately 4% of the 64 millicurie dose was spilled onto the floor of the room. The room was isolated and is being decontaminated. The Radiology Department was closed after the spill to survey for any possible spread of contamination and was reopened this morning. The room where the spill occurred is still restricted. The State will investigate and will inform the NRC of the results of the investigation."
General Information or Other
Event Number: 39426
Rep Org: ILLINOIS DEPT OF NUCLEAR SAFETY
Licensee: NORTHWEST COMMUNITY HOSPITAL
Region: 3
City: ARLINGTON HEIGHTS State: IL
County:
License #: IL-01094-01
Agreement: Y
Docket:
NRC Notified By: JOE KLINGER
HQ OPS Officer: FANGIE JONES
Licensee: NORTHWEST COMMUNITY HOSPITAL
Region: 3
City: ARLINGTON HEIGHTS State: IL
County:
License #: IL-01094-01
Agreement: Y
Docket:
NRC Notified By: JOE KLINGER
HQ OPS Officer: FANGIE JONES
Notification Date: 12/06/2002
Notification Time: 13:13 [ET]
Event Date: 12/05/2002
Event Time: 00:00 [CST]
Last Update Date: 12/06/2002
Notification Time: 13:13 [ET]
Event Date: 12/05/2002
Event Time: 00:00 [CST]
Last Update Date: 12/06/2002
Emergency Class: NON EMERGENCY
10 CFR Section:
10 CFR Section:
Person (Organization):
KENNETH RIEMER (R3)
FRED BROWN (NMSS)
KENNETH RIEMER (R3)
FRED BROWN (NMSS)
AGREEMENT STATE REPORT - MEDICAL EVENT, DOSE GREATER THAN 20% LARGER THAN PRESCRIBED
"On December 5, 2002, the RSO at Northwest Community Hospital, Arlington Heights IL, notified the department of a 'reportable' (misadministration) event that occurred involving Intravascular Brachytherapy. The treatment was for a 52 mm lesion using 85 mCi [millicuries] of P-32 (GDT source) in a Guidant Corporation Galileo device. The prescribed dose was 20 gray. Using a three step automated system, as the 1st step was completed, the authorized user intervened and repositioned the markers for the system to intentionally deliver an additional dose to this area of the lesion. After completing the treatment. The calculated dose to the lesion was determined to be 24.6 gray. This is greater than 20% over the prescribed dose for this treatment and thus a reportable event. The RSO reported that the clinical range for this treatment is 15-26 gray so no adverse health effects are anticipated with this event. The RSO stated that a written report would be filed with the department within the required 15 day period.
"Event Date 12/05/2002 License No: IL-01094-01 Licensee: Northwest Community Hospital
City: Arlington Heights State: IL Event Class: MD2 - MEDICAL EVENT
Medical Event Information: Patient Number: 1
% Overexposed: 23
Procedure: BRACHY, REMOTE AFTERLOADER,
Dose in RAD: 2460 Organ: HEART Study: CARDIOVASCULAR SYSTEM Radionuclide: P-32
Administered By: PHYSICIAN Keywords: INTRAVASCULAR BRACHYTHERAPY"
Item Number: IL020074
"On December 5, 2002, the RSO at Northwest Community Hospital, Arlington Heights IL, notified the department of a 'reportable' (misadministration) event that occurred involving Intravascular Brachytherapy. The treatment was for a 52 mm lesion using 85 mCi [millicuries] of P-32 (GDT source) in a Guidant Corporation Galileo device. The prescribed dose was 20 gray. Using a three step automated system, as the 1st step was completed, the authorized user intervened and repositioned the markers for the system to intentionally deliver an additional dose to this area of the lesion. After completing the treatment. The calculated dose to the lesion was determined to be 24.6 gray. This is greater than 20% over the prescribed dose for this treatment and thus a reportable event. The RSO reported that the clinical range for this treatment is 15-26 gray so no adverse health effects are anticipated with this event. The RSO stated that a written report would be filed with the department within the required 15 day period.
"Event Date 12/05/2002 License No: IL-01094-01 Licensee: Northwest Community Hospital
City: Arlington Heights State: IL Event Class: MD2 - MEDICAL EVENT
Medical Event Information: Patient Number: 1
% Overexposed: 23
Procedure: BRACHY, REMOTE AFTERLOADER,
Dose in RAD: 2460 Organ: HEART Study: CARDIOVASCULAR SYSTEM Radionuclide: P-32
Administered By: PHYSICIAN Keywords: INTRAVASCULAR BRACHYTHERAPY"
Item Number: IL020074
Power Reactor
Event Number: 39422
Facility: CATAWBA
Region: 2 State: SC
Unit: [1] [2] []
RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: JIMMY BURGESS
HQ OPS Officer: STEVE SANDIN
Region: 2 State: SC
Unit: [1] [2] []
RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: JIMMY BURGESS
HQ OPS Officer: STEVE SANDIN
Notification Date: 12/05/2002
Notification Time: 01:52 [ET]
Event Date: 12/05/2002
Event Time: 00:43 [EST]
Last Update Date: 12/08/2002
Notification Time: 01:52 [ET]
Event Date: 12/05/2002
Event Time: 00:43 [EST]
Last Update Date: 12/08/2002
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
ANNE BOLAND (R2)
ANNE BOLAND (R2)
| Unit | SCRAM Code | RX Crit | Initial PWR | Initial RX Mode | Current PWR | Current RX Mode |
|---|---|---|---|---|---|---|
| 1 | N | Y | 100 | Power Operation | 100 | Power Operation |
| 2 | N | Y | 100 | Power Operation | 100 | Power Operation |
LOSS OF OFFSITE EMERGENCY SIRENS DUE TO ADVERSE WEATHER
"Twenty-four (24) emergency sirens out-of-service due to loss of power because of ice storm. These sirens have been out-of-service more than one hour and preparations underway to restore to service."
The licensee will inform state/local agencies and the NRC resident inspector.
* * * UPDATE ON 12/05/02 @ 1028 BY BRADLEY TO GOULD * * *
The site currently has 47 of 89 sirens out of service and has placed their backup route alerting system in service in the affected counties. They also have a reverse 911 callup system in place in the county that the site is located.
Present estimates for returning power to the counties and thus to the sirens is approximately one or two days.
The Resident Inspector was notified.
* * * UPDATE ON 12/08/02 AT 1730 EST BY BRADLEY TO JONES * * *
"This report is concerning Catawba Nuclear Station present siren status. There are still 9 out of 89 CNS sirens out of service due to loss of power in the EPZ Counties from the ice storm.
"Significant progress has been made on restoring power to the EPZ counties as shown by the following siren status: 2 of 72 in York County, 3 of 6 in Gaston County, and 4 of 11 in Mecklenburg equals 9 out of 89 sirens without power. Route alerting for all counties is still in place and available if needed. Present estimation for the return of these nine sirens [is] one to two more days." The NRC Resident Inspector will be notified.
Notified R2DO (B. Bonser)
"Twenty-four (24) emergency sirens out-of-service due to loss of power because of ice storm. These sirens have been out-of-service more than one hour and preparations underway to restore to service."
The licensee will inform state/local agencies and the NRC resident inspector.
* * * UPDATE ON 12/05/02 @ 1028 BY BRADLEY TO GOULD * * *
The site currently has 47 of 89 sirens out of service and has placed their backup route alerting system in service in the affected counties. They also have a reverse 911 callup system in place in the county that the site is located.
Present estimates for returning power to the counties and thus to the sirens is approximately one or two days.
The Resident Inspector was notified.
* * * UPDATE ON 12/08/02 AT 1730 EST BY BRADLEY TO JONES * * *
"This report is concerning Catawba Nuclear Station present siren status. There are still 9 out of 89 CNS sirens out of service due to loss of power in the EPZ Counties from the ice storm.
"Significant progress has been made on restoring power to the EPZ counties as shown by the following siren status: 2 of 72 in York County, 3 of 6 in Gaston County, and 4 of 11 in Mecklenburg equals 9 out of 89 sirens without power. Route alerting for all counties is still in place and available if needed. Present estimation for the return of these nine sirens [is] one to two more days." The NRC Resident Inspector will be notified.
Notified R2DO (B. Bonser)
Power Reactor
Event Number: 39423
Facility: MCGUIRE
Region: 2 State: NC
Unit: [1] [2] []
RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: TONY COOK
HQ OPS Officer: STEVE SANDIN
Region: 2 State: NC
Unit: [1] [2] []
RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: TONY COOK
HQ OPS Officer: STEVE SANDIN
Notification Date: 12/05/2002
Notification Time: 02:00 [ET]
Event Date: 12/05/2002
Event Time: 01:45 [EST]
Last Update Date: 12/05/2002
Notification Time: 02:00 [ET]
Event Date: 12/05/2002
Event Time: 01:45 [EST]
Last Update Date: 12/05/2002
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
ANNE BOLAND (R2)
ANNE BOLAND (R2)
| Unit | SCRAM Code | RX Crit | Initial PWR | Initial RX Mode | Current PWR | Current RX Mode |
|---|---|---|---|---|---|---|
| 1 | N | Y | 100 | Power Operation | 100 | Power Operation |
| 2 | N | Y | 100 | Power Operation | 100 | Power Operation |
LOSS OF OFFSITE EMERGENCY SIRENS DUE TO ADVERSE WEATHER
"Any event that results in a major loss of emergency assessment capability, offsite response capability; or offsite communications capability. Currently greater than 16 ENS sirens are inoperable which is greater than 25% of siren capability."
The licensee will inform local agencies and the NRC resident inspector.
* * * * UPDATE FROM LICENSEE TO MIKE RIPLEY AT 1647 EST 12/5/02 * * * *
The licensee stated that crews are continuing to restore all ENS sirens to service and that currently only 13 ENS sirens are inoperable which is less than the 25% of siren capability criteria.
Notified R2DO (Robert Haag)
"Any event that results in a major loss of emergency assessment capability, offsite response capability; or offsite communications capability. Currently greater than 16 ENS sirens are inoperable which is greater than 25% of siren capability."
The licensee will inform local agencies and the NRC resident inspector.
* * * * UPDATE FROM LICENSEE TO MIKE RIPLEY AT 1647 EST 12/5/02 * * * *
The licensee stated that crews are continuing to restore all ENS sirens to service and that currently only 13 ENS sirens are inoperable which is less than the 25% of siren capability criteria.
Notified R2DO (Robert Haag)
Power Reactor
Event Number: 39424
Facility: HARRIS
Region: 2 State: NC
Unit: [1] [] []
RX Type: [1] W-3-LP
NRC Notified By: CHERIE L. GRIFFITH
HQ OPS Officer: STEVE SANDIN
Region: 2 State: NC
Unit: [1] [] []
RX Type: [1] W-3-LP
NRC Notified By: CHERIE L. GRIFFITH
HQ OPS Officer: STEVE SANDIN
Notification Date: 12/05/2002
Notification Time: 08:45 [ET]
Event Date: 12/05/2002
Event Time: 03:07 [EST]
Last Update Date: 12/05/2002
Notification Time: 08:45 [ET]
Event Date: 12/05/2002
Event Time: 03:07 [EST]
Last Update Date: 12/05/2002
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
BRIAN BONSER (R2DO)
BRIAN BONSER (R2DO)
| Unit | SCRAM Code | RX Crit | Initial PWR | Initial RX Mode | Current PWR | Current RX Mode |
|---|---|---|---|---|---|---|
| 1 | N | Y | 100 | Power Operation | 100 | Power Operation |
LOSS OF OFFSITE EMERGENCY SIRENS DUE TO ADVERSE WEATHER
"At 0307, greater than 20% of the Off Site Emergency Sirens were inoperable due to loss of power during the current Ice Storm. Currently 59 of 81 sirens are out of service. This requires an 8 hour notification per 10CFR 50.72. Additionally, at 0645, Lee County had gone one hour without any operable sirens. At 0830, Harnett County had gone one hour without any operable sirens. Transmission is aware and are prioritizing repairs."
The licensee informed state/local agencies and the NRC resident inspectors.
"At 0307, greater than 20% of the Off Site Emergency Sirens were inoperable due to loss of power during the current Ice Storm. Currently 59 of 81 sirens are out of service. This requires an 8 hour notification per 10CFR 50.72. Additionally, at 0645, Lee County had gone one hour without any operable sirens. At 0830, Harnett County had gone one hour without any operable sirens. Transmission is aware and are prioritizing repairs."
The licensee informed state/local agencies and the NRC resident inspectors.