ML20134A598
| ML20134A598 | |
| Person / Time | |
|---|---|
| Site: | 07002134 |
| Issue date: | 01/15/1997 |
| From: | Adams J GRANDVIEW HOSP. & MEDICAL CENTER, DAYTON, OH |
| To: | NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION III) |
| References | |
| NUDOCS 9701290009 | |
| Download: ML20134A598 (3) | |
Text
~
n
.J %
O W
v O
v f m.; fM
% t" GIONDVIEW SOUTHVIEW d'/0 Oc2I3 15 January 1997 U.S; Nuclear Regulatory Commission Region III ATTN:
Chief, Nuclear Materials Safety and Safeguard Branch 801 Warrenville Rd Lisle, IL 60532-4351
Dear Madam or Sir:
This is to provide written report of the death of a nuclear pacemaker patient in accordance with the requirements of condition 13 of USNRC License SNM-1603.
The patient died at 12:32 AM on 28 December 1996 at Good Samaritan Hospital in West Palm Beach, Florida where she had been visiting relatives.
The body was moved to a local mortuary, Dorsey Funeral Home.
At approximately 8 AM that morning Grandview Hospital communications personnel were advised of the patient's demise by a next of kin and contacted me, as Radiation i
Safety Officer, as per established protocol.
After speaking with the patient's daughter in Florida telephone notification to Region III was attempted 9:40 AM EST.
28 December was a Saturday and the offices were closed, therefore contact was made via the emergency number 301-816-5100, where Mr.
MacKinnon was advised of the situation.
Mr. MacKinnon subsequently notified personnel at Regions II and III and in the late morning of 28 December, John Madera of your region had personal notification.
On 31 December the body was returned to the Dayton, Ohio area.
The body was transported to Grandview Hospital where at 10:30 AM the monitoring physician, James G.
Laws, D.O.
explanted the pacemaker without incident.
The device was immediately placed in the Radiation Safety Officer's possession and was held in a locked storage facility pending shipment to the.nanufacturer.
The unit was properly identified as a Cordis Omni-Stanicor pacemaker bearing model and serial number 184A-631.
1 On 10 January 1997, per instructions from Jeffrey Hill of Telectronics Pacing Systems in Englewood, Colorado, the pacing g
unit was shipped to the manufacturer's facility at 14420 N.W.
60th Ave Building 7B in Miami Lakes, Florida 33014.
The unit was returned in packing provided by and per instructions of the manufacturer.
Shipment was via Federal Express.
J{ u 9701290009 970115
(
PDR.ADOCK 07002134 C
, Osteopathic Health Care I
Grandview + 405 Grand Avenue
- Dayton, Ohio 45405-4796 + 513 226-3200 Southview
- 1997 Miamisburg-Centerville Road + Dayton, Ohio 45459-3811 + 513 439-6000
O O
The removal and recovery data forms are not included with this notification as per your letter of 12 January 1995.
The forms will be retained on site and available for future reference.
Should any questions arise concerning this report, please contact me at 937-439-6210.
, S'ncerely, j
L&f ll#ff mes
. Adams, Radiation Safety Officer State of Florida Bureau of Radiation Control c:
6 l
1
O O
DATE:
/ /
/
/
CORRESPONDENCE CLARIFICATION SHEET e
REVIEWER:
BJ HOLT JX $ U24 k 1lb M v LICENSEE:
LICENSE NUMBER:
8[#/-/dO3 The follwing correspondence has been received from the above licensee and it is not clear what action (s) is(are) required:
Please review this corresmndence and indicate which of the following applies, and please return to Debaie Hersey, as soon as possible.
+
Additional Information to Control No.
Process in as a new action, additional information, and no fee required.
3 Process as new licensing action. Review has already been started on Control No.
and this information cannot be combined with current in house action.
4.
Can be combined with Control No.
Review has not started.
4 v Ap) rs to be information for the license file - file it.
d/A
'k
){
/()). _ ffu lJ S
<A " & ba f
Licensee is adding Nuclear Pharmacists.
Amendment is necessary
. Amendment is not necessary (Information for license file) 4 l
Licensee is adding authorized users.
A check is included No check is included Amendment is necessary Amendment is not necessary (This is a Notification)
Process in as a new licensing action:
A.
Amendment B.
Renewal i
C.
New License Application Other:
Thank You For Your Help!!!
10/16/96
-..-