Semantic search
| Start date | Reporting criterion | Title | Event description | System | LER | |
|---|---|---|---|---|---|---|
| ENS 56895 | 17 December 2023 05:00:00 | Agreement State | Stuck Source Rack | The following information was received from the Illinois Emergency Management Agency (IEMA-OHS) via email: The IEMA-OHS Operations Center was contacted at 1712 CDT on December 17, 2023, by the radiation safety officer for Sterigenics to report a stuck source rack. The rack reportedly became stuck around 2300 on December 16, 2023, with approximately 10 percent of the sources above the pool level. The area was isolated with an additional restricted area established to maintain occupational exposures within limits. At this time, no public or occupational exposures above regulatory limits have been reported. This matter has a 24-hour reporting requirement under 32 Ill. Adm. Code 346.830 which was met by the licensee. IEMA-OHS inspectors will arrive at the facility on 12/18 to evaluate timelines for corrective action and the efficacy of safety systems. Staff will also evaluate the site and review staff dosimetry, potential impacts to source capsule integrity, any anticipated heat impacts, and plans for quality assurance of the impacted system(s). Source type: sealed source irradiator Radionuclide: Co-60 Activity: 24 MCi (888 PBq) Model no.: C-188 Illinois report no.: IL230036
The following information was received from the Illinois Emergency Management Agency (IEMA-OHS) via email: Agency staff arrived at the site on 12/18/23 and surveys indicate no public or occupational exposure levels above normal operation. The source rack is still stuck in the unshielded position. The Agency continues to monitor the situation and will update when additional information is available. Notified R3DO (Edwards), NMSS (via email).
The following information was received from the Illinois Emergency Management Agency (IEMA-OHS) via email: The Licensee reports 18 modules (3 rows), constituting 626,000 curies of Co-60, in the B/C cell remain stuck in the unshielded position due to product carts impeding travel of the rack. The sources are below the point of product cart impact. A second IEMA-OHS inspection was conducted to increase coordination on response activities and obtain additional data on the following: security requirements (all operational), radiation levels (700 microR/hour maximum reading), dosimetry procedures (transitioned to digital dosimetry which is read daily and employed at a 40 mrem/day investigational level), total occupational doses to date (20 mrem), exposure rate maps including access points used for radiation hardened cameras, personnel access, pool conductivity (within specifications), updated operations and emergency procedures (confirmed), on site staff and safety culture (satisfactory, additional manufacturer health physics staff brought in to assist), fire hazards (none at this time), status of deionizer (satisfactory), and mitigation planning. The Licensee is awaiting cameras and remote vehicles capable of withstanding radiation levels and manipulating product totes. The facility was confirmed to be in a safe and stable condition and ongoing response operations will be coordinated with IEMA-OHS. IEMA-OHS has now transitioned to weekly inspections until the incident is remedied. Updates will be provided as they become available. Notified R3DO (Stoedter), NMSS (via email).
The following information was received from the Illinois Emergency Management Agency (IEMA-OHS) via email: The source rack was successfully returned to the shielded position. Sterigenics staff employed engineered tooling to access the stuck rack through roof projections on the evening of 1/25/24. IEMA-OHS staff were on site to observe setup and operations throughout the week. A review of digital dosimetry in use for all phases of the operations indicates there were no occupational exposures in excess of regulatory limits. Full report and root cause analysis pending. This report will be updated. Notified R3DO (Orlikowski), NMSS (via email). |