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Event Notification Report for April 14, 2017

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
04/13/2017 - 04/14/2017

** EVENT NUMBERS **


52667 52677 52678

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Agreement State Event Number: 52667
Rep Org: NEW YORK STATE DEPT. OF HEALTH
Licensee: NOT PROVIDED
Region: 1
City: NOT PROVIDED State: NY
County:
License #: NOT PROVIDED
Agreement: Y
Docket:
NRC Notified By: JANAKI KRISHNOMOORTHY
HQ OPS Officer: JEFF ROTTON
Notification Date: 04/06/2017
Notification Time: 12:11 [ET]
Event Date: 04/05/2017
Event Time: [EDT]
Last Update Date: 04/06/2017
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
CHRISTOPHER CAHILL (R1DO)
NMSS_EVENTS_NOTIFIC (EMAI)

Event Text

AGREEMENT STATE REPORT - LESS THAN PRESCRIBED DOSE ADMINISTERED TO PATIENT

The following information was provided by the State of New York via facsimile:

"On 04/05/2017, a patient with metastatic esophageal cancer received right hepatic lobar treatment [to the liver] with Y90 from SIRTEX microspheres.

"The intended activity was 32.9 mCi. Drawn activity was 32.7 mCi. The administered activity measured at the end of the procedure was 8.2 mCi [25 percent of intended activity].

"Probable cause stated by the licensee: 'clumping' of microspheres resulting in occlusion of vial 'delivery C' needle provided by the vendor. The licensee plans to (1) request review from the manufacturer of the preparation and handling of the microspheres prior to arrival to the IR suite, (2) Since the patient is already planned for a left lobar treatment, a whole liver treatment will be planned to deliver the deficit dose to the right lobe."

NY Event Report ID No. NYDOH-NY-17-06

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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Part 21 Event Number: 52677
Rep Org: ABB INC
Licensee: ABB INC
Region: 1
City: CORAL SPRINGS State: FL
County:
License #:
Agreement: Y
Docket:
NRC Notified By: RICHARD LINDO
HQ OPS Officer: HOWIE CROUCH
Notification Date: 04/13/2017
Notification Time: 14:04 [ET]
Event Date: 02/15/2017
Event Time: [EDT]
Last Update Date: 04/13/2017
Emergency Class: NON EMERGENCY
10 CFR Section:
21.21(d)(3)(i) - DEFECTS AND NONCOMPLIANCE
Person (Organization):
MARVIN SYKES (R2DO)
MARK JEFFERS (R3DO)
PART 21/50.55 REACT (EMAI)

Event Text

PART 21 REPORT - VENDOR SUPPLIED INCORRECT RELAYS FOR CLASS 1E APPLICATION

In 1993, ABB Switchgear Division supplied 12 ABB Ground-Shield ground fault relays to the Point Beach Nuclear Plant that did not meet the seismic qualifications required of Class 1E rated relays.

This deviation is for GKT relay model 202L.

If you have any questions regarding this notice, please contact ABB Technical Support at 954-752-6700 or 1-800-222-1946.

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Part 21 Event Number: 52678
Rep Org: EMERSON PROCESS MANAGEMENT
Licensee: FISHER CONTROLS INTERNATIONAL LLC
Region: 3
City: MARSHALLTOWN State: IA
County:
License #:
Agreement: Y
Docket:
NRC Notified By: KIM SAGAR
HQ OPS Officer: HOWIE CROUCH
Notification Date: 04/13/2017
Notification Time: 15:53 [ET]
Event Date: 08/30/2016
Event Time: [CDT]
Last Update Date: 04/13/2017
Emergency Class: NON EMERGENCY
10 CFR Section:
21.21(d)(3)(i) - DEFECTS AND NONCOMPLIANCE
Person (Organization):
DON JACKSON (R1DO)
MARVIN SYKES (R2DO)
MARK JEFFERS (R3DO)
JOHN KRAMER (R4DO)
PART 21/50.55 REACT (EMAI)

Event Text

PART 21 NOTIFICATION - IDENTIFIED FISHER 546S ELECTRO-PNEUMATIC TRANSDUCERS STANDARD MOUNTING BRACKETS FAILED SEISMIC TESTING STANDARDS

Fisher Controls International LLC issued Fisher Information Notice FIN 2017-02 to inform users that certain identified Model 546NS electro-pneumatic transducers, when mounted on the supplied standard mounting brackets, were determined to be not adequately robust at seismic test levels.

Affected customers have been notified.

Fisher requests that the recipient of this FIN review it and take appropriate action in accordance with 10 CFR 21. If there are any technical questions or concerns, please contact:

Ben Ahrens
Quality Manager
Emerson Automation Solutions
Fisher Controls International LLC
301 South First Avenue
Marshalltown, IA 50158
Phone: (641) 754-2249
Benjamin. ahrens@emerson.com

Page Last Reviewed/Updated Friday, April 14, 2017
Friday, April 14, 2017