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Event Notification Report for August 30, 2013

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
08/29/2013 - 08/30/2013

** EVENT NUMBERS **


49297 49306 49313 49314

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Agreement State Event Number: 49297
Rep Org: OR DEPT OF HEALTH RAD PROTECTION
Licensee: GOOD SAMARITAN REGIONAL MEDICAL CENTER
Region: 4
City: CORVALIS State: OR
County:
License #: 90202
Agreement: Y
Docket:
NRC Notified By: TODD CARPENTER
HQ OPS Officer: CHARLES TEAL
Notification Date: 08/22/2013
Notification Time: 14:33 [ET]
Event Date: 08/21/2013
Event Time: 13:45 [PDT]
Last Update Date: 08/22/2013
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
GREG WERNER (R4DO)
FSME EVENT RESOURCE (EMAI)

Event Text

AGREEMENT STATE REPORT - PATIENT GIVEN DOSE PRESCRIBED FOR ANOTHER PATIENT

The following was received from the State of Oregon via facsimile:

"The inpatient was having an Adenosine Myoview stress test. The Nuclear Medicine Technologist took the dose that was already in the dose calibrator (place there earlier by another Nuclear Medicine Technologist). It measured about the same activity as 99m-Tc Myoview would measure in the dose calibrator. The Nuclear Medicine Technologist gave the patient 37.4 millicuries of 99m-Tc DTPA (lung ventilation dose) instead of 30 millicuries of 99m-Tc Myoview. The route of administration for 99m-Tc DTPA is inhalation and the route of administration for 99m-Tc Myoview is intravenous. The 99m-Tc DTPA was intended for a different patient. The patient was informed of the mistake and the stress test will be repeated tomorrow (8/22/13). The ordering physician was also notified of the event. There were no adverse effects to the patient, just delayed the study.

"This will be reported at the next Radiation Safety Committee Meeting along with any actions that will be taken to prevent this in the future."

Oregon Event Number: 13-0031

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.

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Power Reactor Event Number: 49306
Facility: COLUMBIA GENERATING STATION
Region: 4 State: WA
Unit: [2] [ ] [ ]
RX Type: [2] GE-5
NRC Notified By: MATT HUMMER
HQ OPS Officer: PETE SNYDER
Notification Date: 08/25/2013
Notification Time: 00:46 [ET]
Event Date: 08/24/2013
Event Time: 16:14 [PDT]
Last Update Date: 08/29/2013
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
GREG WERNER (R4DO)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
2 N Y 100 Power Operation 100 Power Operation

Event Text

MALFUNCTION OF STACK RADIATION MONITOR SUPPORTING EQUIPMENT

"At 1614 hours PDT on August, 24, 2013 the Reactor Building Stack Radiation Monitor - High Range and Reactor Building Stack Radiation Monitor - Intermediate Range detectors were declared non-functional due to a loss of supporting equipment. Corrective actions are being pursued to restore the affected monitors to functional status.

"To compensate for the loss of assessment capability due to the non-functioning Radiation Monitoring Equipment, an additional Health Physics (HP) Technician trained to acquire offsite dose assessment information on offsite releases is available. The additional personnel are pre-staged in support of the Radiation Monitoring System outage and will be mobilized in accordance with guidance in the compensatory measure instructions.

"This event is being reported as a loss of emergency assessment capability in accordance with 10 CFR 50.72(b)(3)(xiii). A follow up notification will be made when the Equipment has been returned to service.

"The licensee has notified the NRC Resident Inspector."

* * * UPDATE FROM MATT HUMMER TO VINCE KLCO ON 8/29/13 AT 1739 EDT * * *

"Repairs have been completed and both the Intermediate and High Range Reactor Building Stack Radiation Monitors have been returned to service.

"The licensee has notified the NRC Resident Inspector."

Notified the R4DO (Hagar).

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Power Reactor Event Number: 49313
Facility: MILLSTONE
Region: 1 State: CT
Unit: [ ] [2] [ ]
RX Type: [1] GE-3,[2] CE,[3] W-4-LP
NRC Notified By: JASON BOOKMILLER
HQ OPS Officer: HOWIE CROUCH
Notification Date: 08/29/2013
Notification Time: 11:33 [ET]
Event Date: 08/29/2013
Event Time: 08:44 [EDT]
Last Update Date: 08/29/2013
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
CHRISTOPHER NEWPORT (R1DO)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
2 N Y 100 Power Operation 100 Power Operation

Event Text

LOSS OF ASSESSMENT CAPABILITY DUE TO RADIATION MONITOR OUT OF SERVICE FOR PLANNED MAINTENANCE

Millstone Unit 2 removed their plant high range stack radiation monitor RM-8168 from service for pre-planned maintenance. This represents a reportable loss of assessment capability under 10CFR50.72(b)(3)(xiii).

The licensee has notified the NRC Resident Inspector.

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Power Reactor Event Number: 49314
Facility: MONTICELLO
Region: 3 State: MN
Unit: [1] [ ] [ ]
RX Type: [1] GE-3
NRC Notified By: MARK IHLENFELDT
HQ OPS Officer: VINCE KLCO
Notification Date: 08/29/2013
Notification Time: 18:35 [ET]
Event Date: 08/29/2013
Event Time: 11:00 [CDT]
Last Update Date: 08/29/2013
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(ii)(B) - UNANALYZED CONDITION
Person (Organization):
RICHARD SKOKOWSKI (R3DO)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N Y 98 Power Operation 98 Power Operation

Event Text

FAILURE TO ADDRESS ALL THE EFFECTS OF EXTERNAL FLOODING SCENARIOS

"On August 28, 2013, Monticello Nuclear Generating Plant (MNGP) was notified of the NRC's final significance determination for a finding involving the failure to maintain a procedure addressing all of the effects of an external flooding scenario on the plant. Specifically, MNGP failed to maintain flood Procedure A.6, 'Acts of Nature,' such that it could support the timely implementation of flood protection activities within the 12 day timeframe credited in the design basis as stated in the updated safety analysis report.

"The finding is not a current safety concern. On February 15, 2013, actions were completed to reduce the flood mitigation plan timeline to less than 12 days by developing an alternate plan for flood protection features, pre-staging equipment and materials, improving the quality of the A.6 procedure, and preplanning work orders necessary to carry out Procedure A.6 actions.

"The NRC Resident Inspector has been notified."

Page Last Reviewed/Updated Friday, August 30, 2013
Friday, August 30, 2013