PNO-II-85-101, on 851024,Siemens Gammatron 3 Teletherapy Unit,Containing Approx 4,000 Ci Co-60,could Not Be Returned to Shielded Position.Cause Undetermined.Treatment Room Sealed.Nurses Film Badges Mailed to Supplier for Evaluation
| ML20134A313 | |
| Person / Time | |
|---|---|
| Site: | 03017482 |
| Issue date: | 10/25/1985 |
| From: | Brown R, Potter J NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION II) |
| To: | |
| References | |
| PNO-II-85-101, NUDOCS 8511040340 | |
| Download: ML20134A313 (1) | |
AEibDWe October 25, 1985 PRELIMINARY NOTIFICATION OF EVENT OR UNUSUAL OCCURRENCE PN0-II-85-101 This preliminary notification constitutes EARLY notice of events of POSSIBLE safety or public interest significance. The information is as initially received without verifi-cation or evaluation, and is basically all that is known by the Region II staff on this dato.
FACILITY: Metropolitan Hospital Licensee Emergency Classification:
Notification of Unusual Event License No. 52-16033-02 Alert San Juan, PR Site Area Emergency General Emergency X Not Applicable
SUBJECT:
TELETHERAPY UNIT MALFUNCTION On October 25, 1985 the licensee notified NRC Region II that their Siemens Ganmatron 3 teletherapy unit containing approximately 4000 Curies of Cobalt-60 malfunctioned at 9:50 a.m. on October 24, 1985. They were unable to return the source to the shielded position.
Two nurse / technologists entered the treatment room to remove the patient and to attempt; unsuccessfully, to manually return the source to the shielded position. The film badges worn by the nurses were express mailed to the supplier for evaluation.
Tha licensee's physicist estimated that the whole body exposures to the nurses were between 3 and 5 rem. As of 2:30 p.m., October 25, 1985 the source remained in the unshielded position; however, the treatment room has been locked and sealed. The source supplier was expected to be on site at approximately 3:00 p.m. October 25, 1985 toteturn the source to the shielded position and determine the cause of the malfunction. Region II will follow-up to determine dose to patient, cause or the malfunction and exposures to personnel. Neither the licensee nor Region II plans to issue a Press Release at this time.
The Connonwealth of Puerto Rico will be notified.
This information is current as of 3:30 p.m. on October 25.
Contact:
R. B rowr. , 242-5554 J. Potter, 242-5571 g /p 6 Ch J
DISTRIBUTIONbs H. Street (i MNBB Y Phillips E/W d Willste[ MAIL:
Chairman Palladino IDTI- NRR TF NMSS XDFiBtB Ccmm. Roberts PA OIA RES DOT: Trans Only Comm. Asselstine MPA AE0D Applicable State Comm. Bernthal ELD i Comm. Zech Air Rights N g INP0 N'ef)
SECY SP NSAC Regions:
Licensee:
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(ReactorLicensees)
Applicable Resident Site 8511040340 851025 '
E-Ih-85-101 PDR
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