ML20127F916

Matls Licensing Package for Amend 5 to License 50-23214-01 for Anchorage Diagnostic Imaging Ctr,Inc.Control:571713

ML20127F916
Person / Time
Site:	03020372
Issue date:	12/24/1992
From:	Prange B NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION V)
To:
References
50-23214-01, 50-23214-1, 571713, NUDOCS 9301210084
Download: ML20127F916 (13)

See also: IR 05000232/2014001

Text

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MATERIALS LICENSE - Amendment No. 5.

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l 4 Pursuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 9

Code of Federal Regulations, Chapter 1, Parts 30,31. 32,33,34,35,40 and 70, and in reliance on statements and representations I

heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, posses

source, and special nuclear material designated below; to use such material for the purpose (s) and at the place (s) designated below;to [

deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the apphcable Part(s). This f'

license shall be deemed to contain the conditions specined in Section 183 of the Atomic Energy Act of 1954, as amended, and is d

subject to all applicable rules, regulations and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any b

i conditions specined below.

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Licensee b

, in accordance with letter J;

dated October 27, 1992 h

1- Anchorage Diagnostic Imaging 3 Licen$e number 50-23214-01 is amended in h

Center, Inc. its entirety to read as follows:  !

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2. 4003 Lake Otis Parkway, #101. - 'i l

Anchorage, Alaska 99508 j 4. Eipiratio'n daie September 30, 1994 l

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S. Docket or

Reference No. 030-20372 g

6. Byproduct, source, and/or -3 7. Chemical and/or physical 8. Maximum amount that licensee E'

special nuclear material form may possess at any one time E

under this license

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A. Any byproduct - A. Any

material identified radiopharmaceutical '

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in 10 CFR 35.100 identified in 10 CFR j y_

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material identifled ,radiopharmaceutical l

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35.200 g

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C. Iodine-131 . C. Iodide  :#

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C. 30 millicuries per R

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9. Authorized use il

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i B. Medical use described in-10 CFR 35.200. g-

C. Diagnosis and treatment of hyperthyroidism and cardiac dysfunction. E

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CONDIIIONS ii

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10. Location of use: 4003 Lake-0 tis Parkway, #101, Anchorage, Alaska.

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p 11. Radiation Safety officer:- Harold F. Cable, M.D. (

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Amendment No. 5 p

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CONDITIONS l

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12. Licensed material listed in Item 6 above is authorized for use, or under the p

1 supervision of, the following individual (s) for the materials and uses indicated: i

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i Harold F. Cable, M.D. 10 CFR 35.100, 35.200 and Iodine 131

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George H. Ladyman, M.D. 10 CFR 35.100, 35.200 and Iodine 131 y

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James L. Faries, M.D. '4, !s^ q' ~10 CFR'35.100, 35.200 and Iodine 131 I

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't Lester B. Lewis, M.DU 10 CFR 35.100,~ 35.200 and Iodine 131 pl

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q Julee K. Holayter', M.D. . kN( .f w A10 CFR 35.100,q35.200

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CONDITIONS

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'i 14. Except as specifically provided otherwise in this license, the licensee shall i l

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Date DEC 2 41992 -

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Bethh.Prange(f E

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. [waso%eo UNITED STATES '

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1450 MARIA LANE

WALNUT CREEK, CAUFORNIA 94596-5368

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DEC 2 41992 -

Docket No. : 030-20372 ,

License No.: 50-23214-01

Control No.: 571713

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Anchorage Diagnostic Imaging Center, Inc.

4003 Lake Otis Parkway, #101

Anchorage, Alaska 99508

Attention: George H. Ladyman, M.D.,

President

Enclosed is the NRC license amendment which you requested.

Please review the enclosed document carefully and be sure that you understand

all conditions. If there are any errors or questions, please notify'us so

that we can provide appropriate corrections and answers.

Any future correspondence relating to your license should specifically

reference your license and docket numbers to expedite your. inquiry.

Sincerely,

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Beth A. Prange

Senior Health Physicist (Licensing)

. Radioactive Materials Safety Branch

Enclosure: Attachment A

Amendment No. 5 to License No. 50-23214-01

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L icense f ee M3nagement Branch. ARM  : Program Code: 0?200

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Status Code: 0

Regional ticensing Sect ions  : fee Category: 7C

Exp. Date: 19940930

fee Comments:

Decom f in AssuFT<eiid: N

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u.4 LICENSE fl[ TRANSMITTAL

A. REGION

1. APPLICATION ATTACt1[D

n g", .o n . q Applicant / Licensee: ANCHORAGE DIAGNOSTIC IMAGING CTR,

1 Received Date: 971104

Docket No: 3020372

Control No.: S/1713

License No.. 50-23214-01

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Action Type: Amendment

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October 19, 1992 'j, y

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Mr. J. Frank Pang

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United States Nuclear Regulatory Commission '?

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Region V

1450 Maria Lane, suite 210

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Walnut Creek, California 94596-5368

Reference: Nuclear Regulatory Inspecticn

Nuclear By-Product Material License 50-23214-01

September 25, 1992

Dear Mr. Pang:

This is an additional response to your conversation with Ronald G. Shriver, M.D.

Dr. Shriver has been with our group for almost 5 years. During this time he

has observed and participated in more than 10 thyroid therapies for hyper-

'

thyroidism. These were accomplished under the direct supervision of James L.

Faries M.D. or myself. This paragraph refers to patients treated at

Pumann Hospital-Alaska.

With respect to those thyroid therapies performed at Anchorage Diagnostic

Imaging Center, James L. Faries, M.D., Harold F. Cable, M.D. or I was on

the premises or available for immediate consultation with Dr. Shriver.

If any further information is required please contact me.

Sincerely.

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George H. Ladyman, M.D.

l Chairman, Department of Radiology

Humana Hospital Alaska

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Anchorage Diagnostic Imaging Center

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4003 Lake Otis Parkway * * 101 * Anchorage. Alaska 99508 *(907)563-3493

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October 27, 1992

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U. S. Nuclear Regulatory Commission

Region V

Nuclear Material Safety Section

1450 Maria Lane, Suite 210

Walnut Creek, California 94596

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RE: License Number _50-23214-OL

Gentlemen:

Please amend the above referenced byproduct material license to reflect the

following items:

1. AMEND TO CHANGE OWNERSHIP OF THIS LICENSE. The principal shareholders shall

include James L. Faries, M.D., John J. McCormick, M.D. and myself. We shall

follow the current license application (dated July 12, 1989)-and letter dated

April 19, 1990 as well as applicable parts to the Code of Federal Regulations.  ;

The official business transaction is to be completed on November 30, 1992.

l

2. IN ADDITION TO AN OWNERSHIF CHANGE, THE LICENSE SHOULD REFLECT A CHANGE IN

THE FACILITY NAME, Byproduct material license number 50-23214-01 should be. -j

issued to Anchorage Diagnostic Imaging Center, Inc. rather than Anchorage

Diagnostic Imaging Center.- The location of use shall remain the same (4003

Lake Otis Parkway, Anchorage, Alaska 99508).

3. AMEUD TO LIST OF -AUTHORIZED USERS TO REFLECT THE FOLLOWING:

Amend to delete: Gerald H. Phillips, M.D.

Amend-to add: j

AUTHORIZED USER AUTHORIZATION

George H. Ladyman, M.D. 10 CFR 35.100,- 35.200 + Iodine-131 j

-James L. Farles, M.D. 10 CFR 35.100. 35.200 & Iodine-131

Bradley K. Cruz, M.D. 10 CFR 35.100, 35.200-&. Iodine-131

Lester'B.-Lewis, M.D. 10 CFR 35.100,-35.200 & Iodine-131

Ronald G. Shriver, M.D. 10 CFR 35.100, 35.200 & Iodine-131.

John J. McCormick, M.D. 10'CFR 35.100 and 35.200-

Julee K.'Holayter, M.D. 10 CFR 35.100 and 35.200 l

All proposed authorized users are currently listed on byproduct material ~

license number 50-18244-01 issued to Humana Hospital-Alaska (enclosed).

We are requesting to amend license number 50-23214-01 to add Iodine-131 to

Ronald G. Shriver, M.D.'s_ authorization. You have previously received advice

4003 Lake Otis Parkway * * 101 * Anchorage. Alaska 99508 * (907) 563 3493 . -

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October 27, 1992 U. S. Nuclear Regulatory Commission. Page two -

with respect.to his academic credentials and participation in more than 10

_

therapies for hyperthyroidism at'Humana Hospital-Alaska. While this

authorization is not reflected on Humana's ifcense, a request for this

additional authorization shall soon be initiated.

Harold F. Cable, M.D. s' hall remain as the Radiation Safety Officer to

this material license.

All other items concerning this byproduct material license remain unchanged at

this time. Please contact me at this office if further information is required.

Sincerely,

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George-H. Ladyman, M.D., President

ANCHORAGE DIAGNOSTIC IMAGING CENTER, INC.

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U.S. NUCLEAR RESULATO3Y COMMISSION

Amendment No. 12-

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MATERIALS LICENSE.

c. Pursuant to the Atomic Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Public Law 93-438), and Title 10,

Code of Federal Regulations, Chapter 1, Parts 30,31,32,33,34,35,40 and 70,

. heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, acquire, possess, and transfer byproduct, y

source, and special nuclear material designated below; to use such material for the purpose (s) and at the place (s) designated below; to g

deliver or transfer such material to persons authorized to receive it in accordance with the regulations of the appbcable Part(s). This F

license shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is-

subject to all applicable rules, regulations and orders of the Nuclear Regulatory Commission now or hereafter in effect and to any

conditions specified below,

ucense' In accordance with letter

dated July 14, 1992

1. Humana Hospital Alaska 3. Ucense number 50-18244-01 is amended in

its entirety to read as follows:-

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2. P. O. Box 143889 *

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Anchorage, Alaska 99514-3 ' 4, bpkrAik4pe, November 30, 1994-

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5. Docket or i

Reference No.3 31,,14720

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6. Byproduct, source, and/or 7. Chemical and/or physical i

special nuclear material

f-[* form . ((8'.mayMaximum

possess at any oneamount time fthat l

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under this license

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CONDITIONS fM

10. Location of use: 2801 De Barr Road, Anchorage, Alaska H

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Radiation Safety Officer: - George H. Ladyman, M.D.

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Amendment No. 12_ f

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(continued) f

12. License material listed in item 6 above is authorized for use by, or under the f

• - supervision of, the following individuals for the materials and uses indicated:

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Authorized Users Material and Use(s): >

Donald R. Rogers, M.D. 35.100, 35.200, 35.300

George H. Ladyren, M.D. \,

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James L. Faries, M.D. h 10 CFR 00, 35.200, 35.300

Ronald G. Shriver, n 10CFR3,51[0 35.200 l

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Harold F. Cable, [D. e

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Lester B. Lewis, M.D. '.. LL g Aj 10ffR35.1,00.;35.200,35.300 I,'

The licensee shall maintain recoYdstof fiYfor)matf5h relatedko decommissioning at the

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Amendment No. 12

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CONDITIONS (>f

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(continued) (

14. Except as specifically provided otherwise in this license, the licensee shall h

conduct its program in accordance with the statements, representations, and p.

procedures contained in the documents including any enclosures, listed below. The >:

Nuclear Regulatory Commission's regulations shall govern unless the statements, >

representations and procedures in the licensee's app 1; cation and correspondence are

more restrictive than the regu [

A. Application dated nQ, 988 .R M g[ [0

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Application dated rth 24,1989

Application dat anuary 15, 1990

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D. Letter with en sures dated June 21, 1990 V h

Letter with c sur- dated August 22, 1990 #

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F. Letter dated emb 1991 '/

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FOR THE U. S. NUCLEAR REGULATORY COMMISSION ).

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Date SEP 141992 By:

Beth A. Frange

Sr. Health Physicist. (Licensing) >!

Nuclear Materials an'd P'

Fuel Fabrication Branch h

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{ 35.930 Training for therapeutic use of

radiopharmaceuticola.

Except as provided in i 35.970, the

licensee shall require the authorized

user of radiopharmaceuticals in i 35.300

to be a physician who:

(a)is certified by:

(1)The American Board of Nuclear

Medicine; or

(2)The American Board of Radiology

in radiology or therapeutic radiology: or

(b) Has had classroom and laboratory

training in basic radioisotope handling

techniques applicable to the use of

therapeutic radiopharmaceuticals and

supervised clinical experience as

follows:

(1) 80 hours9.259259e-4 days <br />0.0222 hours <br />1.322751e-4 weeks <br />3.044e-5 months <br /> of classroom and

laboratory training that includes:

(1) Radiation physics and

instrumentation:

(ii) Radiation protection:

(iii) Mathematics pertaining to the use

and measurement of radioactivity; and

(iv) Radiation biology; and

(2) Supervised clinical experience '

under the supervision of an authorized

user at a medicalinstitution that

includes:

(i) Use of iodine 131 for diagnosis of i

thyroid function and the treatment of

hyperthyroidism or cardiac dysfunction

in 10 individuals; and -

(ii) Use of iodine 131 for treatment of '

thyroid carcinoma in 3 individuals.

.. . . . .

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