Event Notification Report for August 12, 2025

AGREEMENT STATE REPORT - DAMAGED RADIOGRAPHY DRIVE ASSEMBLY

The following is a summary of information provided by the Georgia Radioactive Materials Program via email:

The licensee reported that a source could not be returned to the locked shielded position following an exposure. A licensee radiation safety officer (RSO) reported to the scene with a source retrieval kit and attempted to retract the source. Initial attempts at straightening the guide tube were unsuccessful. Subsequently, it was noticed that a portion of the drive assembly conduit (return side) was melted due to being too close to a drop light. The drive assembly conduit (projection side) was disconnected from the crank handle and the source was successfully retracted into the locked shielded position by pulling the drive cable by hand. The exposure device was surveyed and secured.

While the source was exposed, a 2 mr/hr perimeter was established with continuous surveillance. The maximum dose received by a worker was to the RSO, who received 68 mrem, as indicated by a pocket dosimeter. The drive assembly will be removed from service until repairs can be made by the manufacturer.

Source: 67 Ci Ir-192, QSA model A424-9, s/n 16420P
Device: QSA 880 Delta Exposure, s/n D8607

Georgia incident number: 106

AGREEMENT STATE REPORT - MEDICAL EVENT

The following is a summary of information provided by the Nebraska Department of Health and Human Services via phone and email:

The licensee reported that on August 12, 2025, a patient was to receive a 200 mCi Lu-177 (Pluvicto) treatment for prostate cancer per a written directive, but was administered a 156 microcurie Ra-223 (Xofigo) treatment for metastatic prostate cancer instead. The licensee's initial estimate is that the patient received a 13 rem whole-body dose and 665 rem to the bone marrow. There were no immediate implications for patient health reported. The referring physician and patient have been notified of the event.

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.

EN Revision Imported Date: 9/10/2025

EN Revision Text: AGREEMENT STATE REPORT - STUCK OPEN GAUGE SHUTTER

The following information was provided by the SC Department of Environmental Services (the Department) via email:

"The licensee informed the Department via telephone on August 12, 2025, that a fixed gauging device was disabled or failed to function as designed. The licensee reported that the brass shaft that operates the shutter of a fixed gauging device broke in the open position. The device is located on a process vessel. The licensee reported that a representative from a licensed service provider is on-site and is in the process of shielding the device so that it can be removed from service and placed in storage.

"The device is a 5 millicurie cesium-137 Berthold Systems, LLC model 7440.

"The licensee did not report any overexposures or ongoing health/safety concerns.

"This event is still under investigation by the Department."

* * * UPDATE ON 09/10/25 AT 0830 EDT FROM JACOB PRICE TO ERIC SIMPSON * * *

The following information was provided by the SC Department of Environmental Services (the Department) via email:

"On August 13, 2025, the Department conducted an on-site investigation. The details of the event were consistent with the licensee's initial notification and subsequent written report. The Department performed ambient dose rate and removable contamination surveys, which revealed no abnormal readings or contamination. The licensee has contacted vendors and consultants to replace the affected device.

"On September 8, 2025, the Department received the 30-day written report. The details of this report were consistent with the information obtained during the on-site visit and interviews.

"This event remains under investigation by the Department."

DAMAGED MOISTURE DENSITY GAUGE

The following is a summary of information provided by the licensee via phone:

A Troxler model 3440 Plus (serial number 85009) moisture density gauge (8 mCi Cs-137, 40 mCi Am-241/Be) was damaged when it fell out of the back of a pickup truck. The source rod and track were damaged, and the source was dislodged from its safe position. The gauge was placed in temporary shielding until the source rod was returned to its safe position by a technician. No contamination or excessive exposures resulted from this event.

AGREEMENT STATE REPORT - STUCK RADIOGRAPHY SOURCE

The following is a summary of information provided by the New York State Department of Health (NYSDOH) via email:

On August 12, 2025, the licensee was conducting radiography with a Sentinal 880 Delta (serial number 4955) containing a 73.9 Ci Ir-192 source when it was discovered that the source was stuck in the unshielded position. The radiography crew called the radiation safety officer (RSO) and ensured the cordoned off area was clear of personnel. With assistance from the RSO, the crew was able to retract the source to the shielded position approximately 3.75 hours later.

TLD badges for personnel present were sent for expedited analysis, and direct reading dosimeter readings are listed below:

RSO: 345 mrem
Radiographer: 320 mrem
Operations manager: 210 mrem
Assistant radiographer: 150 mrem

NY incident number: 1540
NMED number: NY-25-07

AGREEMENT STATE REPORT - SEALED SOURCE SEPARATED FROM GAUGE

The following information was provided by the Texas Department of State Health Services (the Department) via email:

"On August 12, 2025, the Department was notified by the licensee that a sealed source had become dislodged from a Vega2 fixed gauge containing a 1,000 mCi Cs-137 source that was being removed by their contractor. The housing had been damaged and the gauge was being replaced. The source was not damaged. The area is at a well site and the source has been cordoned off with a person posted to ensure no one accesses the area.

"The radiation safety officer has contacted Vega and they are sending personnel to retrieve the source. The dose rate reading is 1.5 mR/hr at the barrier.

"There is no immediate threat to the public.

"Additional information will be provided in accordance with SA-300 reporting requirements."

Texas incident number: 10216

TECHNICAL SPECIFICATION REQUIRED SHUTDOWN

The following information was provided by the licensee via phone and email:

"At 1621 EDT on 8/12/2025, a technical specification required shutdown was initiated at Davis-Besse Nuclear Power Station Unit 1. Technical specification limiting condition for operation 3.3.11 for steam generator (SG) low level instrumentation channel requirements was not met, and condition 'B' was entered on 8/12/2025 at 1600 with required actions to be in mode 3 with a completion time of 6 hours and be in mode 4 with a completion time of 12 hours. This event is being reported as a four-hour, non-emergency notification per 10 CFR 50.72(b)(2)(i). There was no impact on the health and safety of the public or plant personnel. The NRC Resident Inspector has been notified."

The following additional information was obtained from the licensee in accordance with Headquarters Operations Officers Report Guidance:

The affected SG level instrumentation is for emergency feedwater automatic initiation. The instruments were declared inoperable due to a reference leg leak in containment.