ML20235S672

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Amend 4 to License SNM-1804 for St Marys Hosp,Amending License in Entirety
ML20235S672
Person / Time
Site: 07002801
Issue date: 02/25/1988
From: Graden K
NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION III)
To:
Shared Package
ML20235S674 List:
References
NUDOCS 8903070217
Download: ML20235S672 (2)


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NRC Form 374

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U.S. NUCLEAR HEGULATORY COMMISSION

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MATERIALS LICENSE Amendment No. 04 l

Pursuant to the Atomih Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Publ5 Law 93-438), and Title 10, Code of Federal Regulations, Chapter I, Parts 30,31,32,33,34,35,40 and 70, and in reliance on statements and representations y

l heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive g

i source, and special nuclear material designated below; to use such inaterial for the purpose (s) and at the place (s) designated below; to 1

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

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

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

conditions specified below.

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Licensee In accordance with letter dated I

August 26, 1987 N

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St. Mary's Hospital

3. License number SNM-1804 is amended in l

its entirety to read as follows:

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2323 North Lake Drive h8 ieg p,

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Reference No.

070-02801

6. Byproduct, source, and/or
7. Chemical and/or physical Maximum amount that licensee N

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[o 'bmay possess at any one time N

special nuclear material form

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To be used for impGntationdnjhumins:'asya! 7b 3 N 1 N' '

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CONDITIONS V

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N at St. Mary's Hospital, 2323 North Lake Drive, Milwaukee, Wisconsin.

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11. The specified possession limit incitides#a11' licensed material possessed by the g

i licensee under this license whether in storage, implanted in patients or otherwise g

i in use.

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12. The licensee shall not receive or transfer in any single transaction, 1 gram or more i

of plutonium-238 contained in nuclear-powered pacemakers without notifying the l

i Division of Safeguards, U.S. Nuclear Regulatory Commission, Washington, D.C. 20555, y

I and, in addition, completing and distributing Form NRC-741 as required by Section '

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70.54 of 10 CFR Part 70.

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13. The licensee shall report to the Material Licensing Section, U.S. Nuclear Regula' tory (g Commission, 799 Roosevelt Road, Glen Ellyn, Illinois 60137 within 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> of i

occurrence, the death of any nuclear pacemaker patient, and any adverse reaction y

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and/or malfunction involving a pacemaker system, including the leads. A written p

i report giving details of the adverse reaction and/or malfunction shall be submitted y

within 30 days.

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I, MATERIALS LICENSE SNM-1804 SUPPLEMENTARY SHEET I

070-02801 Amendment No. 04 I

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14. The licensee shall report to the Material Licensing Section, U.S. Nuclear Regulatory 1

Commission, 799 Roosevelt Road, Glen Ellyn, Illinois 60137 within 10 days, loss of I

contact with a nuclear pacemaker patient.

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15. The licensee shall continue patient follow-up and replacement procedures for the l

nuclear pacemaker during the life of the patient; and the procedures for recovery I

and authorized disposal of the nuclear pacemaker by return to the manufacturer shall I

be followed upon the death of the patient.

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16. Except as specifically provided otherwise infthis license, the licensee shall l

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conduct its program in accorda'ncPsith the statements, representations, and g

procedures contained in theiddc'uments including'ini enclosures, listed below.

l The Nuclear Regulatory C6mmission's regulations shalligovern unless the statements, u

representations.andppoceduresin'thelicensee'sapplicationandcorrespondenceare I

more restrictive thandthe regulations.

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i For the U.S. Nuclear Regulatory Commission p

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a Original Signed l

Date: February 25, 1988 By Kathy J. Graden p

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Materials Licensing Section, Region III g

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