Event Notification Report for January 13, 2012
U.S. Nuclear Regulatory Commission
Operations Center
EVENT REPORTS FOR
01/12/2012 - 01/13/2012
Power Reactor
Event Number: 47590
Facility: WOLF CREEK
Region: 4 State: KS
Unit: [1] [] []
RX Type: [1] W-4-LP
NRC Notified By: TERRY DAMASHEK
HQ OPS Officer: HOWIE CROUCH
Region: 4 State: KS
Unit: [1] [] []
RX Type: [1] W-4-LP
NRC Notified By: TERRY DAMASHEK
HQ OPS Officer: HOWIE CROUCH
Notification Date: 01/13/2012
Notification Time: 16:05 [ET]
Event Date: 01/13/2012
Event Time: 14:03 [CST]
Last Update Date: 01/13/2012
Notification Time: 16:05 [ET]
Event Date: 01/13/2012
Event Time: 14:03 [CST]
Last Update Date: 01/13/2012
Emergency Class: UNUSUAL EVENT
10 CFR Section:
50.72(a) (1) (i) - EMERGENCY DECLARED 50.72(b)(2)(iv)(B) - RPS ACTUATION - CRITICAL 50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION 50.72(b)(3)(v)(A) - POT UNABLE TO SAFE SD
10 CFR Section:
50.72(a) (1) (i) - EMERGENCY DECLARED 50.72(b)(2)(iv)(B) - RPS ACTUATION - CRITICAL 50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION 50.72(b)(3)(v)(A) - POT UNABLE TO SAFE SD
Person (Organization):
DALE POWERS (R4DO)
ART HOWELL (R4RA)
ERIC LEEDS (NRR)
JANE MARSHALL (IRD)
JOHN THORP (NRR)
DALE POWERS (R4DO)
ART HOWELL (R4RA)
ERIC LEEDS (NRR)
JANE MARSHALL (IRD)
JOHN THORP (NRR)
| Unit | SCRAM Code | RX Crit | Initial PWR | Initial RX Mode | Current PWR | Current RX Mode |
|---|---|---|---|---|---|---|
| 1 | A/R | Y | 100 | Power Operation | 0 | Hot Standby |
NOTIFICATION OF UNUSUAL EVENT AND REACTOR TRIP DUE TO LOSS OF OFFSITE POWER
"At 1403 CST, Wolf Creek experienced a reactor trip due to loss of power in the switchyard. At 1415 CST, Wolf Creek declared a Notification of Unusual Event (NOUE) when it was determined that the switchyard would not be restored within 15 minutes.
"All systems functioned as expected in response to this event and both Emergency Diesel Generators started and energized the safety-related buses.
"The plant is currently stable in Mode 3 and investigation into the cause for loss of power in the switchyard is underway."
During the trip, all rods inserted into the core. No primary relief valves lifted as a result of the transient. Decay heat is being removed via the atmospheric steam dumps with auxiliary feedwater supplying the steam generators. The plant is stable at NOP/NOT. No safety significant equipment is reported out of service.
The licensee has notified state and local governments and the NRC Resident Inspector.
* * * UPDATE FROM DAVE DEES TO VINCE KLCO AT 1851 EST ON 1/13/12 * * *
At 1709 CST, the licensee exited the NOUE when power was restored to the east bus from offsite. Additionally, the licensee is reporting a loss of safe shutdown capability in accordance with 10CFR50.72(b)(3)(v)(A) due to the initial loss of offsite power.
The licensee has notified state and local governments, the NRC Resident Inspector, and will be issuing a press release on the event.
Notified R4DO (Powers), IRD (Marshall), NRR (Cheok), FEMA (Burckart) and DHS (Hill).
"At 1403 CST, Wolf Creek experienced a reactor trip due to loss of power in the switchyard. At 1415 CST, Wolf Creek declared a Notification of Unusual Event (NOUE) when it was determined that the switchyard would not be restored within 15 minutes.
"All systems functioned as expected in response to this event and both Emergency Diesel Generators started and energized the safety-related buses.
"The plant is currently stable in Mode 3 and investigation into the cause for loss of power in the switchyard is underway."
During the trip, all rods inserted into the core. No primary relief valves lifted as a result of the transient. Decay heat is being removed via the atmospheric steam dumps with auxiliary feedwater supplying the steam generators. The plant is stable at NOP/NOT. No safety significant equipment is reported out of service.
The licensee has notified state and local governments and the NRC Resident Inspector.
* * * UPDATE FROM DAVE DEES TO VINCE KLCO AT 1851 EST ON 1/13/12 * * *
At 1709 CST, the licensee exited the NOUE when power was restored to the east bus from offsite. Additionally, the licensee is reporting a loss of safe shutdown capability in accordance with 10CFR50.72(b)(3)(v)(A) due to the initial loss of offsite power.
The licensee has notified state and local governments, the NRC Resident Inspector, and will be issuing a press release on the event.
Notified R4DO (Powers), IRD (Marshall), NRR (Cheok), FEMA (Burckart) and DHS (Hill).
Agreement State
Event Number: 47593
Rep Org: TEXAS DEPARTMENT OF HEALTH
Licensee: MEMORIAL HERMANN HOUSTON
Region: 4
City: HOUSTON State: TX
County:
License #:
Agreement: Y
Docket:
NRC Notified By: BOB FREE
HQ OPS Officer: VINCE KLCO
Licensee: MEMORIAL HERMANN HOUSTON
Region: 4
City: HOUSTON State: TX
County:
License #:
Agreement: Y
Docket:
NRC Notified By: BOB FREE
HQ OPS Officer: VINCE KLCO
Notification Date: 01/13/2012
Notification Time: 18:27 [ET]
Event Date: 01/13/2012
Event Time: 00:00 [CST]
Last Update Date: 01/17/2012
Notification Time: 18:27 [ET]
Event Date: 01/13/2012
Event Time: 00:00 [CST]
Last Update Date: 01/17/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
10 CFR Section:
Person (Organization):
DALE POWERS (R4DO)
RICHARD TURTIL (FSME)
DALE POWERS (R4DO)
RICHARD TURTIL (FSME)
AGREEMENT STATE REPORT - POTENTIAL MEDICAL EVENT
A patient of Memorial Hermann in Houston received the wrong radioisotope. A dose of Gallium-67 was ordered, but a dose of Thallium-201 was delivered. Because the dose was improperly labeled as Gallium-67, the dose calibration process indicated an acceptable radioisotope and dose. The patient was injected with the wrong radioisotope on January 11, 2012. During patient imaging on January 13, 2012, it was realized that the patient received the wrong radioisotope. The pharmacy was notified of the error and admitted to delivery of the wrong isotope. The physicist at the hospital estimates that the patient received a dose of about 6 REM whole body.
Texas Incident Number: I-8921
* * * UPDATED AT 1434 EST ON 01/17/12 FROM ROBERT FREE TO S. SANDIN * * *
The following information was received as an update:
"The licensee called to report that the wrong isotope was administered to a patient. Thallium 201 had been injected in a patient instead of Gallium 67 that was ordered. Apparently, the pharmacy sent the wrong isotope. 8 mCi of Gallium was ordered and a estimated 4.7 mCi of Thallium was delivered. Dose activities were similar and the dose calibrator didn't pick up the difference in isotope. Patient was injected on 1/11/12 and imaged 1/13/12. The mistake was discovered in imaging. The licensee will file a written report within 15 days."
Notified R4DO (Pick) and FSME (McIntosh).
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.
A patient of Memorial Hermann in Houston received the wrong radioisotope. A dose of Gallium-67 was ordered, but a dose of Thallium-201 was delivered. Because the dose was improperly labeled as Gallium-67, the dose calibration process indicated an acceptable radioisotope and dose. The patient was injected with the wrong radioisotope on January 11, 2012. During patient imaging on January 13, 2012, it was realized that the patient received the wrong radioisotope. The pharmacy was notified of the error and admitted to delivery of the wrong isotope. The physicist at the hospital estimates that the patient received a dose of about 6 REM whole body.
Texas Incident Number: I-8921
* * * UPDATED AT 1434 EST ON 01/17/12 FROM ROBERT FREE TO S. SANDIN * * *
The following information was received as an update:
"The licensee called to report that the wrong isotope was administered to a patient. Thallium 201 had been injected in a patient instead of Gallium 67 that was ordered. Apparently, the pharmacy sent the wrong isotope. 8 mCi of Gallium was ordered and a estimated 4.7 mCi of Thallium was delivered. Dose activities were similar and the dose calibrator didn't pick up the difference in isotope. Patient was injected on 1/11/12 and imaged 1/13/12. The mistake was discovered in imaging. The licensee will file a written report within 15 days."
Notified R4DO (Pick) and FSME (McIntosh).
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.