Event Notification Report for February 23, 2022
U.S. Nuclear Regulatory Commission
Operations Center
EVENT REPORTS FOR
02/22/2022 - 02/23/2022
EVENT NUMBERS55740 55743 55750
Agreement State
Event Number: 55740
Rep Org: PA Bureau of Radiation Protection
Licensee: Northeast Radiation Oncology Center
Region: 1
City: Dunmore State: PA
County:
License #: PA-1541
Agreement: Y
Docket:
NRC Notified By: John Chippo
HQ OPS Officer: Mike Stafford
Notification Date: 02/16/2022
Notification Time: 10:38 [ET]
Event Date: 02/11/2022
Event Time: 00:00 [EST]
Last Update Date: 02/16/2022
Emergency Class: Non Emergency
10 CFR Section:
Agreement State
Person (Organization):
Schroeder, Dan (R1)
NMSS_Events_Notification, (EMAIL)
Rivera-Capella, Gretchen (NMSS DAY)
Event Text
EN Revision Imported Date: 2/23/2022
EN Revision Text: AGREEMENT STATE REPORT - DOSE TO AN INCORRECT TREATMENT SITE
The following report was received from the Pennsylvania Department of Bureau Radiation Protection (the Department) via email:
"The Department [DEP] received notification from a licensee on February 15, 2022, of medical event involving dose to an incorrect treatment site. An Elekta/Nucletron Remote Afterloader containing 6.421 Curies of iridium 192 (serial number V3/ 10799) with a Valencia skin applicator was to treat the lower third nasal dorsum with 600 cGy. However, the prescribing physician specified the right nasal sidewall. Therefore, the patient received 600 cGy to her lower 3rd nasal dorsum and not right nasal sidewall. The patient and prescribing physician were informed on February 14, 2022. The patient is being monitored and at this time no adverse effects are evident. The DEP is currently in contact with the licensee and will update this event as soon as more information is provided."
Pennsylvania Event Report Number: PA220007
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.
Agreement State
Event Number: 55743
Rep Org: Texas Dept of State Health Services
Licensee: Mistras Group INC
Region: 4
City: LaPorte State: TX
County:
License #: L 06369
Agreement: Y
Docket:
NRC Notified By: Art Tucker
HQ OPS Officer: Bethany Cecere
Notification Date: 02/16/2022
Notification Time: 20:26 [ET]
Event Date: 02/16/2022
Event Time: 00:00 [CST]
Last Update Date: 02/16/2022
Emergency Class: Non Emergency
10 CFR Section:
Agreement State
Person (Organization):
Azua, Ray (R4)
NMSS_Events_Notification, (EMAIL)
Event Text
EN Revision Imported Date: 2/23/2022
EN Revision Text: AGREEMENT STATE REPORT - SAFETY EQUIPMENT FAILURE
The following information was provided by the Texas Department of State Health Services (the Agency) by email:
"On February 16, 2022, the Agency was notified by the licensee's radiation safety officer (RSO) that one of his crews [at a temporary job site in Baytown, TX] were unable to retract an 89 Curie iridium - 192 source back into a QSA 880D exposure device. The radiographers were performing radiography when a pipe fell on the guide tube crimping it to the point that the source assemble could not pass through it. The radiographers isolated the area and contacted the company's RSO. A retrieval team went to the location and was able to recover the source within the hour of the start of the event. No member of the public received an exposure from the event. The radiographers did not exceed any exposure limits. The radiographer's dosimetry will be sent for processing."
Texas Incident #: 9914
Power Reactor
Event Number: 55750
Facility: Oconee
Region: 2 State: SC
Unit: [2] [] []
RX Type: [1] B&W-L-LP,[2] B&W-L-LP,[3] B&W-L-LP
NRC Notified By: Carl Seymour
HQ OPS Officer: Brian P. Smith
Notification Date: 02/22/2022
Notification Time: 01:44 [ET]
Event Date: 02/21/2022
Event Time: 22:07 [EST]
Last Update Date: 02/22/2022
Emergency Class: Non Emergency
10 CFR Section:
50.72(b)(2)(iv)(B) - RPS Actuation - Critical
Person (Organization):
Miller, Mark (R2)
Power Reactor Unit Info
| Unit |
SCRAM Code |
RX Crit |
Initial PWR |
Initial RX Mode |
Current PWR |
Current RX Mode |
| 2 |
M/R |
Y |
68 |
Power Operation |
0 |
Hot Standby |
Event Text
EN Revision Imported Date: 2/23/2022
EN Revision Text: MANUAL REACTOR TRIP
The following information was provided by the licensee via fax or email:
"At 22:07 [EST] on 2/21/2022 with Unit 2 in Mode 1 at 68 percent power, the reactor was manually tripped due to lowering water level in the 2A Steam Generator. The trip was not complex with all systems responding normally post-trip.
"Operators responded and stabilized the plant. Decay heat is being removed by discharging steam to the main condenser using the turbine bypass valves. Units 1 and 3 were not affected.
"Due to the Reactor Protection System actuation while critical, this event is being reported as a four-hour, non- emergency notification per 10 CFR 50.72(b)(2)(iv)(B).
"There was no impact on the health and safety of the public or plant personnel. The NRC Resident Inspector has been notified."