ML20135A178
| ML20135A178 | |
| Person / Time | |
|---|---|
| Site: | 07002994 |
| Issue date: | 11/25/1996 |
| From: | Hueter L NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION III) |
| To: | |
| References | |
| 301808, NUDOCS 9612030101 | |
| Download: ML20135A178 (10) | |
Text
KananaransAmmaniAinininiAiAini-- Ai6sniniAinig-)iOiOiGiniOiOiAini -- AinininiBiAiniBiBininininig I NR FORM 370A U.S.
EAR REGULATORY COEIMISSION PAGE
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License Number N
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MATERIALS LICENSE EI Docket or Reference Number 3
SUPPLEMENTARY SHEET 070-02994 Ell 5
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Amendment No. 03 El 9
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In accordance with letter dated September 3, 1996, License Number SNM-1933 is hereby E
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License Fee Management Branch, ARM
$ Program Code: 22160 and
- Status Code: 0 I
Regional Licensing Sections Fee Category: EX 7C Exp. Date: 20040531
- Fee Comments: PACEMAKER /24-17680-01
- Decom Fin Assur Re N
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LICENSE FEE TRANSMITTAL h
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REGION 1.
APFLICATION ATTACHED Applicant / Licensee: MEMORIAL COMMUNITY HOSPITAL I
Received Date:
960905 Docket No:
7002994 Control No.:
301808 License No.:
SNM-1933 I
Action Type:
Termination 2.
FEE ATTACHED Amount:
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SEP 191996
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o CAPITAL REGION MEDICAL CENTER MemorialCampus 1432 Southwest Boulevard P.O. Box 104420 Jefferson City, Missouri 65102-4420 314/635-6811 September 3,1996 ATTN: Monte Phillips, Branch Chief Materials Inspection, Section 2 /
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Materials Licensing Branch
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U. S. Nuclear Regulatory Commission i'
[b Region Three 801 Warrenville Road Lisle, IL 60532-4351 The following information is submitted for notification oflicense name change and termination of our license for plutonium-238 nuclear powered pacemakers:-
1.
License No. SNM-1933 2.
License name and address:
Memorial Community Hospital 1432 Southwest Boulevard P.O. Box 104420 Jefferson City, Mo. 651 IC 4420 3.
License new name and address:
Capital Region Medical Center Memorial Campus 1432 Southwest Boulevard P.O. Box 1128 Jefferson City, MO. 65102-1128 4.
This is a change in name but represents no change in ownership.
5.
The one patient who was implanted under this license has died. Notification to the Medtronic pacemaker company was given; however, this was not done prior to the patient being buried with the pacemaker. Absolutely no additional nuclear pacemakers will be implanted.
6.'
The patient's funeral was at Sassman's funeral home. The patient is buried in Linn Mo.
The Funeral Home number is 573-646-3377.
Ifyou have any additional questions concerning the abo 6iequest, please do not hesitate to call.
Sincerely, fAAI k a&A FEE E i agerm Ed Farnsworth President REGION III f/ rim'3~%
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Ed Farnsworth, President Capital Region Medical Center Memorial Campus 1432 Southwest Boulevard P.O. Box 1128 Jefferson City, MO 65102-1128
Dear Mr. Farnsworth:
Enclosed is Amendment No. 03 which terminates your NRC License Number SNM-1933 in accordance with your request.
If you have any questions or require clarification on any of the information stated above, 3
you may contact us at (630) 829-9887.
Sincerely, j
Original Signed By Loren J. Hueter Nuclear Materials Licensing Branch j
License No.: SNM-1933 Docket No.: 070-02994 4
i 1
Enclosure:
Amendment No. 03 1
DOCUMENT NAME: M:\\07002994.T6 To receive a copy of this document, indicate in the box: 'C' = Copy without attachment / enclosure "E" = Copy with attachment / enclosure
'N' = No copy OFFICE DNMS/ Rill Af l
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DATE 11by96
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OFFICIAL RECORD COPY
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Cindy Jones NMSS/IMNS (301) 415-6092 SUBJECT Control No. 301808 SNM-1933 SUMMAHY l asked James Cameron, Acting Branch Chief, Materials Inspection Section 2, if they needed to provide any input before we terminate License No. SNM-1933. He said he needed to call Larry Camper or in his absence, Cindy Jones of NMSS/IMNS, to see if there was any policy we needed to be aware of or notifications we needed to make regarding the patient being buried with the pacemaker still implanted.
James said he didn't have time today and asked if I would make the call, to which I agreed. In the absence of Larry, I talked to Cindy. She was aware of no special policy nor any required notifications.
She said she would discuss it in todays daily meeting and if anything she was not aware of came to
. light, she would call me back no later than tomorrow November 21,1996. She suggested we go ahead and terminate the license, being sure information was in the file about the fact of the pacemaker being buried with the patient. I relayed this information to Mr. Cameron and he concurred that we terminate the license. Mr. Cameron further suggested, after discussion with Ms. B. J. Holt, that a copy of the latter from the licensee regarding this matter and copies of the 2 conversation records be placed under the Decommissioning section of the licensee's file for their remaining license, License No. 24-12699-01 for future reference, should the need arise. I agreed to carry out these requests.
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TELEPHONE NO.
Ron Thompson, CNMT Memorial Community Hospital (573) 635-6811 SC0 JECT License No. SNM-1933, Docket No. 070-02994 Control No. 301808 - Patient buried without explanting pacemaker
SUMMARY
On September 5,1996, we received a letter dated September 3,1996, from Memorial Community Hospital, Jefferson City, Missouri, License No. SNM-1933, Docket No. 070-02944, notifying us of a 1
name change (no change in ownership) and requesting termination of subject license covering plutonium-238 nuclear powered pacemakers. The last patient covered by this license had die i and Medtronics, the p::cemaker manufacturer had been notified but only after the patient had been buried with the ptcemaker stillimplanted. The letter further stated that the patient was buried at Linn, Missouri with arrangements being made by Sassman Funeral Home, Telephone No. (573) 646-3377.
To gather more details, I phoned the hospital and in the absence of Ed Farnsworth, President. I was rsferred to Janet Weckenborg, V.P. of Quality and Clinical Services. She, in turn, referred me to Ron Thompson, CNMT, who provided additional details as follows:
Th3 patient died December 21,1993, and was buried December 23,1993, in Linn Memorial Cemetery, Linn, Missouri. No autopsy was performed, therefore, the cause of death was not determined.
Mr. Ron Thompson had been assigned responsibility for keeping track of patient and had been scheduling ennual visits / checkups of the patient for cardiologist, Dr. Jack Sanders. Ron stated that the patient, a school teacher, was " estranged" from his family and had refused to schedule appointments to come in as scheduled the last couple years of his life.
The patient had come in for physical check-up in June of 1989,1990 and 1992. He apparently had not come in for a check-up in 1991 although the nurse attempted to schedule him. Ron said that they had vcrified his being alive by phoning the school on September 10,1993, where the patient worked, about 31/2 months before he died. Ron said he had sort of forgotten about the patient until he learned of his death on September 2,1996. He notified Medtronics of the situation on that date and sent the letter /
notification, referenced above, to us on the following day, September 3,1996.
I discussed the above information with B. J. Holt, NMLB Chief on November 15,1996. She suggested I forward the above information to James Cameron, Acting Branch Chief, Materials inspection, Section 2, for prompt determination as to what inspection activity, if any, should be performed prior to termination of the license, as requested by the licensee. Accordingly, I provided this information to James Cameron on November 18,1996.
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September 6. 1996 Ed Farnsworth President Memorial Community Hospital P. O. Box 1128 1432 Southwest Boulevard Jefferson City. MO 65102-1128
SUBJECT:
ACKNOWLEDGEMENT OF CORRESPONDENCE (Letter Dated 09/03/96)
Dear Licensee:
In response to your request, we have completed the initial processing, which is an administrative review of your application for a(n):
_ New License
_ Amendment
_ Renewal X._ Termination
_ Auth User (Amendment not required)
_ OMP Revision
_ Other No administrative deficiencies were identified during this initial review.
However, it should be noted that a technical review may identify omissions in the-submitted information.
i It appears that your request is routine (see 1-3 below. as applicable).
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1.
New and amendment actions are normally processed within 90 days, unless we i
find major deficiencies, or policy issues requiring central program office assistance.
l 2.
Renewal actions are normally processed within 180 days, however, under timely filing (before expiration) you may continue to operate under your existing license.
3.
Termination actions are normally processed within 90 days, unless confirmatory surveys following decontamination / decommissioning activities are involved.
A copy of your corres3ondence has been forwarded to our Licensing Fee and Debt Collection Branca (301/415-6097) for approval of the fee category and amount, if required.
If you have a compelling safety or business-related reason for requesting expedited review, please contact the Materials Licensing Branch at (630) 829-9887.
We will try to complete your request as soon as practicable.
Any correspondence about this request should reference the control number.
i Nuclear Materials Support Branch Mail Control No. 301808 License No. SNM-1933
,