ML20235S672

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: ML20235S672 ML20235S692 ML20235S702 ML20235S711 ML20235S716
References
NUDOCS 8903070217
Download: ML20235S672 (2)

Text

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l,(5-80) , U.S. NUCLEAR HEGULATORY COMMISSION MATERIALS LICENSE Amendment No. 04

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Pursuant to the Atomih Energy Act of 1954, as amended, the Energy Reorganization Act of 1974 (Publ5 Law 93-438), and Title 10,

' l Code of Federal Regulations, Chapter I, Parts 30,31,32,33,34,35,40 and 70, and in reliance on statements and representations g y

l heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive 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 I license shall be deemed to contain the conditions specified in Section 183 of the Atomic Energy Act of 1954, as amended, and is N l 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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N Licensee I

! In accordance with letter dated I

' August 26, 1987 N l 1. St. Mary's Hospital 3. License number SNM-1804 is amended in l

l its entirety to read as follows: g I  % .-- _ l l 2.

2323 North Lake Drive P. O. Box 503 h8 d

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i l Milwaukee, WI 53201-0503 (f y

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5. Docket or Reference No.

/ 070-02801 ,

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

! special nuclear material - form N N 5 [o 'bmay

/ possess at any one time N CQ "dnder this license N

A. Plutonium (Principal

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N l A. componendo,W f Coratomic Model N i nuclear-powered cafdac pacemake7skfdrM11n'initeY51fuation jiurposes. l g v, a v '% gyg g g CONDITIONS '# V p n

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Licensedmaterialshallfe')sedonlyatthelicensee(sh(facilitieslocated ) l N

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! at St. Mary's Hospital, 2323 North Lake Drive, Milwaukee, Wisconsin. N y TS4&V h I i 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. H I li l 12. The licensee shall not receive or transfer in any single transaction, 1 gram or more N i of plutonium-238 contained in nuclear-powered pacemakers without notifying the ly i Division of Safeguards, U.S. Nuclear Regulatory Commission, Washington, D.C. 20555, I and, in addition, completing and distributing Form NRC-741 as required by Section ' y 9 70.54 of 10 CFR Part 70. H l l

13. The licensee shall report to the Material Licensing Section, U.S. Nuclear Regula' tory l

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 (g i occurrence, the death of any nuclear pacemaker patient, and any adverse reaction y i I 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. E i

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j 8903070217 080225 w6 % l l l REG 3 LIC70 ..

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im m ==kr.mmm mmmm Am A mmm Mmm - - m m mmmimmum _mmA Em m mmmunmummmmmm mmmy NXC Fcrm 374 A U.S. NUCLEAR REcULATORY COMMISSION PAGE 2 of 2 PAGEs I

• * *

• License number l k: I MATERIALS LICENSE SNM-1804 I, SUPPLEMENTARY SHEET I 070-02801 Amendment No. 04 I I

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. l

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 otherwisej infthis license, the licensee shall~

l 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 p i For the U.S. Nuclear Regulatory Commission p

, f 5 a Original Signed l Date: February 25, 1988 By Kathy J. Graden p l l

Materials Licensing Section, Region III g P

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