ML22094A092

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Washington University in St. Louis - NRC Form 591M Part 1, Inspection Report 03002271/2022001 and 03038167/2022001
ML22094A092
Person / Time
Site: 03002271, 03038167
Issue date: 03/07/2022
From: Geoffrey Warren
NRC/RGN-III
To: Amurao M
Washington Univ in St. Louis
References
IR 2022001
Download: ML22094A092 (3)


See also: IR 07100202/2020001

Text

NRC FORM 591M PART 1

U.S. NUCLEAR REGULATORY COMMISSION

(07-2012)

1ocFR 2.201

SAFETY INSPECTION REPORT AND COMPLIANCE INSPECTION

1. LICENSEE/LOCATION INSPECTED:

Washington University in St. Louis

Campus Box 8053

660 S. Euclid A venue

St. Louis, Missouri 63110-1093

REPORT NUMBER(S) 2022001

3. DOCKET NUMBER{S)

030-02271, 030-38167

LICENSEE:

2. NRG/REGIONAL OFFICE

Region III

U.S. Nuclear Regulatory Commission

2443 Warrenville Road, Suite 210

Lisle, IL 60532-4352

4. LICENSE NUMBER{S)

24-00167-11,24-00167-14

5. DATE(S) OF INSPECTION

Zo2.-Z.

March 7-10 ,~

The inspection was an examination of the activities conducted under your license as they relate to radiation safety and to compliance with the Nuclear

Regulatory Commission (NRC) rules and regulations and the conditions of your license. The inspection consisted of selective examinations of

procedures and representative records, interviews with personnel, and observations by the inspector. The inspection findings are as follows:

Based on the inspection findings, no violations were identified.

Previous violation(s) closed.

The violations(s), specifically described to you by the inspector as non-cited violations, are not being cited because they were self-identified,

non-repetitive, and corrective action was or is being taken, and the remaining criteria in the NRC Enforcement Policy, to exercise

discretion, were satisfied.

Non-cited violation(s) were discussed involving the following requirement(s):

During this inspection, certain of your activities, as described below and/or attached, were in violation of NRC requirements and are being

cited in accordance with NRC Enforcement Policy. This form is a NOTICE OF VIOLATION, which may be subject to posting in accordance

with 10 CFR 19.11.

(Violations and Corrective Actions)

Statement of Corrective Actions

I hereby state that, within 30 days, the actions described by me to the Inspector will be taken to correct the violations identified. This statement of

corrective actions is made in accordance with the requirements of 10 CFR 2.201 (corrective steps already taken, corrective steps which will be taken,

date when full compliance will be achieved). I understand that no further written response to NRC will be required, unless specifically requested.

TITLE

PRINTED NAME

SIGNATURE

DATE

LICENSEE'S

REPRESENTATIVE

NRC INSPECTOR

BRANCH CHIEF

Geoffrey Warren / Luis Nieves Folch

Michael Kunowski

NRC: FORM 591M PART 1 /07-2012\\

/

M*1chael A Kunowsk"1 DigitallysignedbyMichaelA.Kunowski

Date: 2022.04.01 09:41 :13 -05'00'

U.S. NUCLEAR REGULA TORY COMMISSION

Materials Inspection Record

1. Licensee Name:

2. Docket Number(s):

3. License Number(s)

Washington University in St. Louis

030-02271, 030-38167

24-00167-11 , 24-00167-14

4. Report Number(s):

5. Date(s) of Inspection:

030-02271/2022001 , 030-38167/2022001

March 7-10, 2022

6. lnspector(s):

7. Program Code(s):

8. Priority:

9. Inspection Guidance Used:

Geoffrey Warren, Sr. HP; Luis Nieves Felch, HP

02210,03210

2 (both)

87126,87127,87134

10. Licensee Contact Name(s):

11. Licensee E-mail Address:

12. Licensee Telephone Number(s):

Maxwell Amurao, Ph.D, RSO

maxwell.amurao@wustl.edu

314-362-2988

13. Inspection Type:

[Z] Routine

D Initial

[Z] Announced

D Unannounced

14. Locations Inspected:

[Z]

Main Office

15. Next Inspection Date (MM/DD/YYYY):

D Non-Routine

16. Scope and Observations:

D Temporary Job Site

[Z]

Field Office

D Remote

03/07/2024

[Z]

Normal D

D Reduced D

Extended

No change

This was an announced routine inspection of operations under Washington University in St. Louis's two NRC

licenses: (1) NRC License No. 24-00167-11, a Type A medical and research broad scope license and (2) NRC

License No. 24-00167-14 authorizing cyclotron production of licensed materials. Facilities inspected during this

inspection included the main medical campus and surrounding facilities, the Danforth campus, and Barnes-Jewish

West County Hospital.

The Type A medical broad scope licensee used a large variety of isotopes in medical and research applications. The

radiation safety committee had approved radiation users under approximately 250 medical and research permits, of

which around 150 were active permits, and oversaw around 1200 trained radiation workers. Research laboratories

used predominantly microcurie quantities of carbon-14, tritium, iodine-125, phosphorus-32, and sulfur-35. In

addition, the licensee possessed blood and research irradiators as described on the license. Research included

both animal and human (medical) research. The radiation safety office included eleven full-time technical staff

including the radiation safety officer as well as five part-time administrative staff.

The licensee operated multiple nuclear medicine areas, including Barnes-Jewish North and South areas, Children's

Hospital, and West County and South County cardiology facilities. At these facilities, nuclear medicine technologists

performed a wide variety of diagnostic procedures using technetium-99m, fluorine-18, xenon-133 and other isotopes.

In addition, nuclear medicine staff performed hyperthyroidism treatments and whole-body scans using iodine-131 in

capsule form. All areas received unit doses from licensed pharmacies or from the licensee's cyclotron operations.

The radiation oncology department performed therapy procedures using: (1) a Leksell Gamma Knife Icon gamma

stereotactic radiosurgery (GSR) unit, (2) two high dose rate remote afterloader (HOR) units, (3) brachytherapy

sealed sources (eye plaques and permanent prostate implants), (4) yttrium-90 microspheres procedures for liver

cancer, and (5) a variety of radiopharmaceutical materials, including iodine-131, lutetium-177, and radium-223. The

oncology department was staffed with multiple authorized user oncologists, authorized medical physicists,

dosimetrists, and radiation therapists. The licensee had authorized around 70 authorized medical users, including

authorized user physicians, authorized medical physicists, and authorized nuclear pharmacists.

Under the cyclotron license, the licensee operated one Siemens RDS Eclipse (11 MeV protons), one TR-19 (19 MeV

protons), and one CS-15 (15 MeV protons) for the production of materials for transfer to its broad scope license.

These materials included fluorine-18, carbon-11, oxygen-15, nitrogen-13, copper-64, and zirconium-89. The

licensee considered materials to be transferred to the broad scope license when they were transferred from the

NRG Form 592M (10-2020)

Page 1 of 2

NRC FORM 592M

(10-2020)

Materials Inspection Record (Continued)

U.S. NUCLEAR REGULA TORY COMMISSION

cyclotron, so all chemical processing ot cyclotron-produced materials was performed under the broad scope license.

These materials were used for medical or research purposes under the broad scope license or distributed to client

facilities in multiple states. In addition, the licensee possessed a JSW Model 168 cyclotron.

Performance Observations: The inspectors toured a variety of facilities and observed audits of research

laboratories, including leak tests, inventory, surveys, and interviews; an HOR source replacement by contractor

personnel; an yttrium-90 microspheres procedure; a radium-223 radiopharmaceutical therapy procedure; several

diagnostic procedures including dose preparation and disposal, contamination cleanup, and routine cyclotron

operations. In addition, licensee personnel described or demonstrated laboratory use of licensed materials, general

security of licensed materials, emergency procedures, a variety of therapeutic and diagnostic medical procedures

including planning and administration, patient release calculations for iodine-131 procedures, GSR and HOR daily

checks, morning nuclear medicine checks, daily and weekly contamination surveys in nuclear medicine, ordering

and receipt of laboratory materials, tracking and inventory or licensed materials, calibration of survey instruments,

waste pickup and tracking, and waste shipment for disposal. The inspectors noted no concerns with these activities.

The inspectors reviewed radiation safety committee minutes; program and laboratory audits; written directives,

treatment plans, and treatment documentation for all modalities of therapeutic procedures; inventory and tracking

records; dosimetry records; transfer of sealed sources for disposal, and other documents. Interviews with licensee

personnel indicated adequate knowledge of radiation safety concepts and procedures. Review of radiation

dosimetry records indicated no exposures of concern. Review of radiation safety committee minutes indicated good

attendance, discussion of appropriate topics. and appropriate oversight of of the radiation safety program. The

inspectors performed independent and confirmatory radiation measurements that were consistent with licensee

survey records and postings.

No violations of NRC requirements were identified as a result of this inspection.

NRC Form 592M (10-2020)

Page 2 of 2