United States Nuclear Regulatory Commission - Protecting People and the Environment

Morning Report for December 23, 1999

                       Headquarters Daily Report

                         DECEMBER 23, 1999

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                    REPORT             NEGATIVE            NO INPUT
                    ATTACHED           INPUT RECEIVED      RECEIVED

HEADQUARTERS                           X
REGION I                               X
REGION II                              X
REGION III          X
REGION IV                              X
PRIORITY ATTENTION REQUIRED  MORNING REPORT - REGION III  DEC. 23, 1999

Licensee/Facility:                     Notification:

                                       MR Number: 3-99-0107
Meriter Hospital                       Date: 12/22/99
Madison,Wisconsin                      Phone call from licensee
License No: 48-00395-02

Subject: UPDATE ON DECEMBER 14, 1999 MISADMINISTRATION PNO-RIII-99-052

Discussion:

On December 14, 1999, one needle containing iodine 125 seed broke,
leaving four seeds, each containing 0.326 millicuries, inside the
patient. The licensee decided to leave the needle in place for the time
being. On Wednesday December 22, 1999, the licensee indicated that a
thyroid scan identified 0.0015 millicuries of I-125, indicating that at
least one of the seed is leaking. The licensee estimated this amount of
iodine would result in a dose of approximately 6 rads to the thyroid. The
licensee is continuing their assessment of actions to mitigate the
consequences of the leaking seed. The licensee is also considering
removal of the broken needle and enclosed seeds some time in January
2000.

Regional Action:

Monitor licensees activities.

Contact:  G. Wright                  (630)829-9602
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