Event Notification Report for December 14, 2023
U.S. Nuclear Regulatory Commission
Operations Center
EVENT REPORTS FOR
12/13/2023 - 12/14/2023
Power Reactor
Event Number: 56889
Facility: Hope Creek
Region: 1 State: NJ
Unit: [1] [] []
RX Type: [1] GE-4
NRC Notified By: Jordan Halstead
HQ OPS Officer: Adam Koziol
Region: 1 State: NJ
Unit: [1] [] []
RX Type: [1] GE-4
NRC Notified By: Jordan Halstead
HQ OPS Officer: Adam Koziol
Notification Date: 12/14/2023
Notification Time: 21:05 [ET]
Event Date: 12/14/2023
Event Time: 19:39 [EST]
Last Update Date: 12/14/2023
Notification Time: 21:05 [ET]
Event Date: 12/14/2023
Event Time: 19:39 [EST]
Last Update Date: 12/14/2023
Emergency Class: Non Emergency
10 CFR Section:
50.72(b)(2)(iv)(B) - RPS Actuation - Critical
10 CFR Section:
50.72(b)(2)(iv)(B) - RPS Actuation - Critical
Person (Organization):
Gray, Mel (R1DO)
Gray, Mel (R1DO)
| Unit | SCRAM Code | RX Crit | Initial PWR | Initial RX Mode | Current PWR | Current RX Mode |
|---|---|---|---|---|---|---|
| 1 | A/R | Y | 88 | Power Operation | 0 | Hot Shutdown |
AUTOMATIC REACTOR SCRAM
The following information was provided by the licensee via phone call and email:
"On December 14, 2023, at 1939 EST, Hope Creek reactor scrammed following closure of turbine control valve number 4.
"All control rods fully inserted into the core. All safety systems responded as designed and expected. There was no radiological release. The unit is stable in mode 3 with decay heat being removed via the turbine bypass valves rejecting steam to the main condenser. Normal feedwater level control is providing makeup to the reactor vessel.
"No personnel injuries resulted from the event.
"The outage control center has been staffed to determine the cause of the reactor scram.
"The Hope Creek NRC Resident Inspector has been notified."
The following information was provided by the licensee via phone call and email:
"On December 14, 2023, at 1939 EST, Hope Creek reactor scrammed following closure of turbine control valve number 4.
"All control rods fully inserted into the core. All safety systems responded as designed and expected. There was no radiological release. The unit is stable in mode 3 with decay heat being removed via the turbine bypass valves rejecting steam to the main condenser. Normal feedwater level control is providing makeup to the reactor vessel.
"No personnel injuries resulted from the event.
"The outage control center has been staffed to determine the cause of the reactor scram.
"The Hope Creek NRC Resident Inspector has been notified."
Agreement State
Event Number: 56890
Rep Org: Illinois Emergency Mgmt. Agency
Licensee: G.E. Healthcare
Region: 3
City: Arlington Heights State: IL
County:
License #: IL-01109-01
Agreement: Y
Docket:
NRC Notified By: Whitney Cox
HQ OPS Officer: Bill Gott
Licensee: G.E. Healthcare
Region: 3
City: Arlington Heights State: IL
County:
License #: IL-01109-01
Agreement: Y
Docket:
NRC Notified By: Whitney Cox
HQ OPS Officer: Bill Gott
Notification Date: 12/15/2023
Notification Time: 10:09 [ET]
Event Date: 12/14/2023
Event Time: 00:00 [CST]
Last Update Date: 01/19/2024
Notification Time: 10:09 [ET]
Event Date: 12/14/2023
Event Time: 00:00 [CST]
Last Update Date: 01/19/2024
Emergency Class: Non Emergency
10 CFR Section:
Agreement State
10 CFR Section:
Agreement State
Person (Organization):
McCraw, Aaron (R3DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
ILTAB, (EMAIL) (EMAIL)
McCraw, Aaron (R3DO)
McCraw, Aaron (R3DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
ILTAB, (EMAIL) (EMAIL)
McCraw, Aaron (R3DO)
EN Revision Imported Date: 1/22/2024
EN Revision Text: AGREEMENT STATE - LOST PACKAGE
The following information was provided by the Illinois Emergency Management Agency (the Agency) via email:
"On December 14, 2023, the Agency was contacted by G.E. Healthcare in Arlington Heights, IL (IL-01109-01) to advise of a radiopharmaceutical package missing in transit. The last known location was the Memphis, TN [common carrier] hub where it was scanned on December 12, 2023. The carrier has declared the package lost. This package does not represent a significant public safety hazard and there is no indication of intentional theft or diversion.
"The subject package is 16 centimeters square, labeled Yellow-II (TI of 0.1), UN2915 and contains a single 3 mL shielded vial of In-111. The activity was 5.210 millicuries at the time of shipment but has since decayed to approximately 1.154 millicuries. It was offered for shipment on December 8, 2023, for delivery to a customer in Clovis, CA on December 11, 2023. Upon failure to arrive, the licensee contacted the carrier and was informed the package was currently unaccounted for."
Item Number: IL230035
THIS MATERIAL EVENT CONTAINS A 'Less than Cat 3' LEVEL OF RADIOACTIVE MATERIAL
Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf
* * * UPDATE ON 01/19/24 AT 1341 EST FROM W. COX TO T. HERRITY * * *
"As of 1/11/2024, the package is now back at the pharmacy and in storage for decay. The package did eventually arrive at its intended location but was then sent back to the pharmacy. The inner packaging was damaged but the vial containing radioactive material was undamaged. This matter is now considered closed."
Notified R3DO (Orlikowski), and NMSS via email.
EN Revision Text: AGREEMENT STATE - LOST PACKAGE
The following information was provided by the Illinois Emergency Management Agency (the Agency) via email:
"On December 14, 2023, the Agency was contacted by G.E. Healthcare in Arlington Heights, IL (IL-01109-01) to advise of a radiopharmaceutical package missing in transit. The last known location was the Memphis, TN [common carrier] hub where it was scanned on December 12, 2023. The carrier has declared the package lost. This package does not represent a significant public safety hazard and there is no indication of intentional theft or diversion.
"The subject package is 16 centimeters square, labeled Yellow-II (TI of 0.1), UN2915 and contains a single 3 mL shielded vial of In-111. The activity was 5.210 millicuries at the time of shipment but has since decayed to approximately 1.154 millicuries. It was offered for shipment on December 8, 2023, for delivery to a customer in Clovis, CA on December 11, 2023. Upon failure to arrive, the licensee contacted the carrier and was informed the package was currently unaccounted for."
Item Number: IL230035
THIS MATERIAL EVENT CONTAINS A 'Less than Cat 3' LEVEL OF RADIOACTIVE MATERIAL
Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf
* * * UPDATE ON 01/19/24 AT 1341 EST FROM W. COX TO T. HERRITY * * *
"As of 1/11/2024, the package is now back at the pharmacy and in storage for decay. The package did eventually arrive at its intended location but was then sent back to the pharmacy. The inner packaging was damaged but the vial containing radioactive material was undamaged. This matter is now considered closed."
Notified R3DO (Orlikowski), and NMSS via email.
Agreement State
Event Number: 56891
Rep Org: California Radiation Control Prgm
Licensee: LA Dept. of Public Works
Region: 4
City: Palmdale State: CA
County:
License #: 1533-19
Agreement: Y
Docket:
NRC Notified By: Donald Oesterle
HQ OPS Officer: Thomas Herrity
Licensee: LA Dept. of Public Works
Region: 4
City: Palmdale State: CA
County:
License #: 1533-19
Agreement: Y
Docket:
NRC Notified By: Donald Oesterle
HQ OPS Officer: Thomas Herrity
Notification Date: 12/15/2023
Notification Time: 14:29 [ET]
Event Date: 12/14/2023
Event Time: 00:00 [PST]
Last Update Date: 12/15/2023
Notification Time: 14:29 [ET]
Event Date: 12/14/2023
Event Time: 00:00 [PST]
Last Update Date: 12/15/2023
Emergency Class: Non Emergency
10 CFR Section:
Agreement State
10 CFR Section:
Agreement State
Person (Organization):
Agrawal, Ami (R4DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
ILTAB, (EMAIL) (EMAIL)
CNSNS (Mexico), - (EMAIL)
Agrawal, Ami (R4DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
ILTAB, (EMAIL) (EMAIL)
CNSNS (Mexico), - (EMAIL)
AGREEMENT STATE REPORT - LOST TROXLER GAUGE
The following was submitted by the California Radiation Control Program via email:
"Licensee reported the loss of a Troxler 4640-B # 1383, containing a sealed source of 8 mCi of Cs-137, on December 14, 2023, in the evening. Los Angeles (LA) County-Duty Officer took the initial call from the assistant radiation safety officer. The report was forwarded to LA County Radiation Management and the [State of California] Radiologic Health Branch-South. It was reported that the operator of the device drove only about one mile from the jobsite before realizing the gauge was not in his vehicle's enclosed camper-shell. The driver turned around to search for it and was unsuccessful. The LA County Sheriff's office was also contacted."
THIS MATERIAL EVENT CONTAINS A 'Less than Cat 3' LEVEL OF RADIOACTIVE MATERIAL
Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf
The following was submitted by the California Radiation Control Program via email:
"Licensee reported the loss of a Troxler 4640-B # 1383, containing a sealed source of 8 mCi of Cs-137, on December 14, 2023, in the evening. Los Angeles (LA) County-Duty Officer took the initial call from the assistant radiation safety officer. The report was forwarded to LA County Radiation Management and the [State of California] Radiologic Health Branch-South. It was reported that the operator of the device drove only about one mile from the jobsite before realizing the gauge was not in his vehicle's enclosed camper-shell. The driver turned around to search for it and was unsuccessful. The LA County Sheriff's office was also contacted."
THIS MATERIAL EVENT CONTAINS A 'Less than Cat 3' LEVEL OF RADIOACTIVE MATERIAL
Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf
Agreement State
Event Number: 56906
Rep Org: Louisiana DEQ
Licensee: St. Tammany Parish Hospital
Region: 4
City: Covington State: LA
County: St. Tammany Parish
License #: LA-0569-L01, Amendment #64
Agreement: Y
Docket:
NRC Notified By: James Pate
HQ OPS Officer: Bethany Cecere
Licensee: St. Tammany Parish Hospital
Region: 4
City: Covington State: LA
County: St. Tammany Parish
License #: LA-0569-L01, Amendment #64
Agreement: Y
Docket:
NRC Notified By: James Pate
HQ OPS Officer: Bethany Cecere
Notification Date: 12/22/2023
Notification Time: 10:56 [ET]
Event Date: 12/14/2023
Event Time: 00:00 [CST]
Last Update Date: 12/26/2023
Notification Time: 10:56 [ET]
Event Date: 12/14/2023
Event Time: 00:00 [CST]
Last Update Date: 12/26/2023
Emergency Class: Non Emergency
10 CFR Section:
Agreement State
10 CFR Section:
Agreement State
Person (Organization):
Taylor, Nick (R4DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
Taylor, Nick (R4DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
AGREEMENT STATE REPORT - SAFETY EQUIPMENT FAILURE LEAD TO UNDERDOSE
The following information was provided by the Louisiana Department of Environmental Quality (DEQ) via email:
"On December 14, 2023, the licensee was performing a Y-90 procedure. A tubing failure resulted in an incomplete dosing of the patient. All of the unadministered radiopharmaceutical was contained within the administrating device's tubing. There was no spill involved.
"No effect on the individual was determined. Of the prescribed dose of 105 Gy, only 50.5 Gy was administered. The remainder of the prescribed dose is scheduled to be administered on January 2, 2024.
"A representative from TheraSphere was in attendance during the procedure and witnessed the tube failure. The TheraSphere representative alerted their colleagues at Boston Scientific.
"Improvements needed to prevent recurrence: More thorough inspection of device tubing prior to administration."
LA Event Report ID No.: LA20230013
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.
The following information was provided by the Louisiana Department of Environmental Quality (DEQ) via email:
"On December 14, 2023, the licensee was performing a Y-90 procedure. A tubing failure resulted in an incomplete dosing of the patient. All of the unadministered radiopharmaceutical was contained within the administrating device's tubing. There was no spill involved.
"No effect on the individual was determined. Of the prescribed dose of 105 Gy, only 50.5 Gy was administered. The remainder of the prescribed dose is scheduled to be administered on January 2, 2024.
"A representative from TheraSphere was in attendance during the procedure and witnessed the tube failure. The TheraSphere representative alerted their colleagues at Boston Scientific.
"Improvements needed to prevent recurrence: More thorough inspection of device tubing prior to administration."
LA Event Report ID No.: LA20230013
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.