ENS Event | |
|---|---|
17:00 Jul 19, 2007 | |
| Title | Agreement State Report from the State of Nebraska |
| Event Description | On 07/20/07 at 1445 CDT the Radiation Safety Officer for Becton-Dickinson Infusion Therapy System, Inc Pool Irradiator located in Broken Bow reported a component failure at the Pool Irradiator.
The irradiator was operating on 07/19/07 when one of the totes carrying medical supplies to be sterilized became jammed in the irradiator. The alarm sounded as expected. The source of the Pool Irradiator went back to its shielded position, lowered back into the pool. The Control Panel for the pool irradiator did not indicate, light did not come on, that the source had gone back into the pool. The licensee went to the penthouse, above the irradiator pool, and found that there was no extra cable in the penthouse which indicated the source had gone to its safe position, entered the pool. Radiation readings taken in the penthouse also indicated that the source was in the pool. The licensee tried to unlock the door to enter the maze to unjam the tote but they were unable to unlock the door because the control panel indicated that the source had not gone to its safe position. The licensee then called MDS Nordion, manufacturer of the irradiator and owner of the irradiator fuel, and informed them of the problem. MDS Nordion informed them how to over ride the access system. After three tries they successfully over rode the access system, required 3 people at 3 different locations at the same time to over ride the system. After opening the access door 2 people with 2 separate radiation survey meters entered the maze. Normal background radiation levels were detected. It was found that the control switch indicating that the source was in its safe position was not in its correct position, down. The switch was replaced. As of 07/20/07 the Pool Irradiator is operating. |
| Where | |
|---|---|
| Becton-Dickinson Infusion Therapy System, Inc Broken Bow, Nebraska (NRC Region 4) | |
| License number: | 04-01-01 |
| Organization: | Ne Div Of Radioactive Materials |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+24.47 h1.02 days <br />0.146 weeks <br />0.0335 months <br />) | |
| Opened: | Defrain 17:28 Jul 20, 2007 |
| NRC Officer: | John Mackinnon |
| Last Updated: | Jul 20, 2007 |
| 43509 - NRC Website | |
Becton-Dickinson Infusion Therapy System, Inc with Agreement State | |
WEEKMONTHYEARENS 435092007-07-19T17:00:00019 July 2007 17:00:00
[Table view]Agreement State Agreement State Report from the State of Nebraska 2007-07-19T17:00:00 | |