ML20244B341
| ML20244B341 | |
| Person / Time | |
|---|---|
| Site: | 07002134 |
| Issue date: | 01/21/1981 |
| From: | Rosalyn Jones, Laws J, Posevitz L GRANDVIEW HOSP. & MEDICAL CENTER, DAYTON, OH |
| To: | Vacca P NRC OFFICE OF NUCLEAR MATERIAL SAFETY & SAFEGUARDS (NMSS) |
| Shared Package | |
| ML20244B344 | List: |
| References | |
| 18308, NUDOCS 8102270359 | |
| Download: ML20244B341 (4) | |
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I GRANDVIEW HOSPITAL
-n 405 GRAND AVENUE
- DAYTON, OlllO 45405 f-f d.
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January 21, 1981-7%
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O P-o4 Mrs. Patricia Vacca License Management Branch Division' of Fuel Cycle and Material Safety Nuclear Regulatory Commission
. Washington, D.C.
20555 Re: Renewal of License' Number SNM-1603-for implantation of nuclear powered pacers.
Dear Mrs. Vacca:
The following revisions of our Special Materials License are submitted in application for. renewal of this license.
I.
Physicians Responsible' for Study:
1.
James G. Laws, D.O.
Change: Total number of pacemakers done at Grandview from 40 to 100.
2.
Robert W. Jones, D.O.
Change: Office address from 325 Grand Avenue to 359 Forest Avenue, Dayton, Ohio 45405.
o Change: Telephone number from 513-224-1764 t_o 513-222-8072.
o Change: Total number of pacemakers done at Grandview from 15 to 82.
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Leslie R. White, D.O.
b Please delete this physician from the license r
since he has not actively participated in the pacemaker study for the last few years.
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Mrs. Patricia Vacca Nuclear Regulatory Commission January 21, 1981 Page 2 4.
Add: John Ribic, D.O.
Office address: Ambulatory Care Center 1997 Miamisburg-Centerville Road Centerville, Ohio 45459 Telephone number:
513-433-2378 Ohio License Number: 2534 States licensed in which to practice: Ohio, Michigan Specialty Board Certification:
Internal Medicine, Cardiology Training: Kirksville College of Osteopathic Medicine Internship / Residency: Flint Osteopathic Hospital, Flint, Michigan Cardiology Fellowship, Cleveland Clinic Previous experience in implantation and follow-up of pacemakers:
Duration of study, 1977-1979; Number of pacers implanted and followed, 42.
Number of pacers implanted at Grandview:
30 Current position with Grandview Hospital: Medical Staff Cardiologist 5.
Add: Laszlo Posevitz, D.O.
Office address:
1217 Salem Avenue, Dayton, Ohio 45405 Telephone number: 513-274-4331 BNDD number: AP 284 4997 Ohio License Number:
1874 States licensed in which to practice: Ohio, Florida, Missouri Specialty Board Certification: General Surgery; Eligible - Thoracic and Vascular Training:
Chicago College of Osteopathic Medicine Jewish Hospital, Cincinnati, Ohio Grandview Hospital, Dayton, Ohio Previous experience in implantation and follow-up pacemakers:
Duration of study, 10 years; Number of pacers implanted and followed, 100.
Current position with Grandview Hospital:
Chairman, Department of General Surgery Chairman, Department of Thoraco-Vascular Surgery
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- Mrs. Pctricic Vaces
. Nuclear Regulatory. Commissions
-January 21,-':19817 s,
, lPage 3' 6.
Julian' Milton Zimmerman, D.O.
Please delete this. physician from the license
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since:he no longer wishes-to participate in the.
- pacemaker study.
His. responsibilities as' Chair-i man, Medical Isotopes Committee, and Radiation 3,
Safety Officer have been assumed by Shirley:
Toebes Williams, M.S.
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Protocol to beIfo11 owed:
Master Protocol for Clinical Evaluation of the Cordis Omni-Stanicor (Nu),1 dated November:1, 1977.
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' All physicians responsible for an'd participating in this: program have certifiedithat th'ey are familiar with the Master Protocol for Clinical. Evaluation of the Cordis Omni-Stanicor, (Nu), dated Novem-
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' ber 1,1977, and - the " Guide for Licensing the investigational.Use.
of Nuclear: Powered Cardiac' Pacemakers," September, 1975. They understand that the' issuing of a license renewal is conditional upon following the protocol. and guide.
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EMrs. Patricio Vecco-Nuclear Regulatory Commission
' January _ 21,:1981 Page 4-
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. Grandview Hospital hereby requests renewal of our Materials License #SNM-1603-in accordance with this application.
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Signed:.
Applicants:
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James G. Laws,-D.O.
Kok#t'W.'Joney',U.d'.
Grandview Hospital-Grandview Hos i al-U Lasz1'oPosevitz,D.O.(
fnRibic,D.O.
Grandview Hospital (Frandview Hospital I.
ShirleyTpbesWilliams,M.S.
Richa ' J.'/inor, President' Grandview Hospital Grand iew Hospital
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