Event Notification Report for December 02, 2024

EN Revision Imported Date: 12/18/2024

EN Revision Text: AGREEMENT STATE REPORT - SOURCE LOST IN TRANSIT

The following information was provided by the New Jersey Department of Environmental Protection (NJDEP) via email:

"The licensee reported to NJDEP on December 3, 2024, that a Ge-68 pin source that they sent for disposal has been lost in transit on December 2, 2024. The source is a Eckert & Ziegler model HEGL-0132, with current approximate activity of 0.267 mCi. The shipping container arrived at its destination damaged and empty. The licensee has filed a claim with the shipper. If the source is not located within the 30 days, the licensee will follow-up with a full written report to include root cause(s) and corrective actions.

"This event is reportable under 10 CFR 20.2201(a)(1)(ii)."

New Jersey Event Report ID number: To be determined

* * * UPDATE ON 12/17/24 AT 1421 EST FROM JACK TWAY TO ADAM KOZIOL * * *

"The missing Ge-68 pin source was found by the common carrier, repackaged, and returned to the supplier (Sanders Medical in Knoxville, TN). The source was located and shipped on December 10, 2024. The NJDEP is in possession of evidence of receipt by the supplier.

"This incident is closed."

NMED Report: 240435

Notified R1DO (Lally), NMSS Events (email), and ILTAB (email)

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 - SOURCE FAILED TO RETRACT

The following information was provided by the Illinois Emergency Management Agency (the Agency) via email and phone:

"The Agency was contacted on 12/2/24 by radiation oncology staff at Advocate Christ Hospital to advise a 4.3 Ci Ir-192 source for a high dose rate afterloader (HDR) was stuck in the exposed position. The source was extended for daily quality assurance checks and is within a shielded vault. There were no staff or patient exposures. The manufacturer has been contacted to dispatch a service technician to the site and is expected 12/3/24. Agency staff conducted a reactive inspection on 12/2/24 to verify public exposure rates were within limits, verify adequate room security could be maintained, and determine the resources made available by the licensee to prevent any radiation exposures. After investigation, inspectors found the licensee had effectively restricted access by installing a secondary key-pad controlled door outside the vault door. Appropriate signage had been installed and survey readings in all areas were confirmed to be below public exposure limits (max 40 microrem per hour). The fault appears to be electrical and updates will be provided once obtained from Varian staff."

Equipment information:
Device name: Remote afterloader HDR
Model number: GammaMed Plus iX
Serial number: H641313
Manufacturer: Varian

Illinois item number: IL240030

AGREEMENT STATE REPORT - LOST STATIC ELIMINATOR

The following report was received via phone and email from the Texas Department of State Health Services (the Department):

"On February 11, 2025, the Department received a notification from the licensee of a lost general licensed device. The device, a P-2021-5432 static eliminator containing a 10 mCi (original activity from May 2023) Po-210 (Polonium) source, was used in a controlled cleanroom environment as an ion gun for removing micro-particles from semiconductor machine components. The licensee stated the device was erroneously disposed of by a facilities technician during a preventative maintenance exercise on cleanroom air guns conducted on December 2, 2024. The licensee stated that to prevent a future recurrence of this incident, all facilities technicians have been trained on the proper identification, restrictions, and regulatory disposal requirements of these devices.

"Additional Information will be provided in accordance with SA 300 Requirements"

Texas Incident Number: 10167
Texas NMED Number: TX250009

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