U.S. Nuclear Regulatory Commission Operations Center Event Reports For 02/15/2007 - 02/16/2007 ** EVENT NUMBERS ** | General Information or Other | Event Number: 43163 | Rep Org: TEXAS DEPARTMENT OF HEALTH Licensee: CHRISTUS SANTA ROSA SURGERY CENTER - LLP Region: 4 City: SAN ANTONIO State: TX County: License #: L05805 Agreement: Y Docket: NRC Notified By: RAY JISHA HQ OPS Officer: STEVE SANDIN | Notification Date: 02/13/2007 Notification Time: 12:50 [ET] Event Date: 02/12/2007 Event Time: [CST] Last Update Date: 02/13/2007 | Emergency Class: NON EMERGENCY 10 CFR Section: AGREEMENT STATE | Person (Organization): LINDA SMITH (R4) SCOTT MOORE (NMSS) | Event Text AGREEMENT STATE REPORT INVOLVING MULTIPLE PATIENTS RECEIVING >20% PRESCRIBED DOSE The following information was received via email: "On Tuesday, February 13, 2007, the Agency [Texas Department of Health] was notified of a series of at least five medical events that were discovered when an improper dose rate constant was used in the treatment planning of the therapeutic application of permanent implants. The radioisotope is I-125 and it was used exclusively for the treatment of prostate cancer. The range of misadministrations is 21-36% over that which was prescribed in the written directive. The licensee is investigating the situation that involved some 28 patients treated over the past year but only one patient complication has been reported thus far. The Agency is continuing to investigate the events with the licensee and will provide updated information as it is received." Texas Incident No.: I-8391 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. | Other Nuclear Material | Event Number: 43168 | Rep Org: MCCALLUM TESTING LABORATORY Licensee: MCCALLUM TESTING LABORATORY Region: 1 City: CHESAPEAKE State: VA County: License #: 45-15325-01 Agreement: N Docket: NRC Notified By: PHIL BERMAN HQ OPS Officer: PETE SNYDER | Notification Date: 02/15/2007 Notification Time: 14:17 [ET] Event Date: 02/15/2007 Event Time: 13:50 [EST] Last Update Date: 02/15/2007 | Emergency Class: NON EMERGENCY 10 CFR Section: 20.2201(a)(1)(i) - LOST/STOLEN LNM>1000X | Person (Organization): JOHN WHITE (R1) MICHELE BURGESS (NMSS) ILTAB (e-mail) () | This material event contains a "Less than Cat 3" level of radioactive material. | Event Text LOST TROXLER MOISTURE DENSITY GAUGE A Troxler Moisture Density Gauge (model 3411, serial number 6957) was lost at a traffic intersection in Chesapeake, VA. The location of the intersection is at Route 17 and George Washington Parkway. The licensee called local police. The radiation safety officer (RSO) is responding to the site to see if the gauge can be found or if any damage to instrument exists. * * * UPDATE AT 1447 ON 2/15/07 FROM P. BERMAN TO P. SNYDER * * * The licensee reports that the gauge has been found and taken to the local fire department. The RSO is going to the location to examine the gauge for damage. 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. | Power Reactor | Event Number: 43169 | Facility: OCONEE Region: 2 State: SC Unit: [1] [2] [ ] RX Type: [1] B&W-L-LP,[2] B&W-L-LP,[3] B&W-L-LP NRC Notified By: ROB MEIXELL HQ OPS Officer: JEFF ROTTON | Notification Date: 02/15/2007 Notification Time: 19:00 [ET] Event Date: 02/15/2007 Event Time: 16:54 [EST] Last Update Date: 02/15/2007 | Emergency Class: NON EMERGENCY 10 CFR Section: 50.72(b)(2)(iv)(B) - RPS ACTUATION - CRITICAL 50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION | Person (Organization): PAUL FREDRICKSON (R2) | Unit | SCRAM Code | RX CRIT | Initial PWR | Initial RX Mode | Current PWR | Current RX Mode | 1 | A/R | Y | 100 | Power Operation | 0 | Hot Standby | 2 | A/R | Y | 100 | Power Operation | 0 | Hot Standby | Event Text UNIT 1 AND UNIT 2 REACTOR TRIP "At 1654 EST on 2-15-07, Oconee Units 1 & 2 tripped from 100% power. The cause of the trips is under investigation. Unit 1 experienced a partial loss of 4160 volt power [Non-Safety Related] which resulted in a loss of Main Feedwater. Emergency Feedwater started on Unit 1. Unit 2 remained on Main Feedwater. Reactor Coolant Pump power was not affected by the trip on either Unit. Post trip equipment response on Unit 2 was normal. On Unit 1, a second HPI pump auto-started due to a non-safety low seal flow signal [one normally running for normal RCS makeup]. "Units 1 & 2 have been stabilized in Mode 3. Restoration of 4160 volt loads on Unit 1 is in progress." All Control rods fully inserted on both units. No PORVs or Safety valves lifted during the event for either unit. Both units are removing decay heat by steaming to the Main Condenser via the Turbine Bypass valves. Both units are in a normal shutdown electrical lineup. Unit 3 was not affected by this event. The licensee notified the NRC Resident Inspector. | |