ENS 54128
ENS Event | |
|---|---|
05:00 Jun 21, 2019 | |
| Title | En Revision Imported Date 8/2/2019 |
| Event Description | EN Revision Text: AGREEMENT STATE REPORT - OVEREXPOSURE DURING RADIOGRAPHY
The following report was received from the Texas Department of State Health Services (the Agency) via email: The licensee called [the Agency] to report an event involving a radiographer and trainee. They were conducting [non-destructive testing] NDT on pipe, shooting 8 second shots with a 76.3 Curie Ir-192 source and a QSA Global D888 camera. The radiographer went to the darkroom to complete some paperwork. The trainee took down film and moved the collimator to the next shot location. It was about then [the trainee] realized [the trainee] had not retracted the source. [The trainee] reported the mistake to the radiographer trainer. The trainee did not have dosimetry and did not conduct a camera survey prior to moving the camera. Both the trainer and trainee were issued RadEye G's so they did not have direct reading dosimeters. [The trainer and trainee] took the trainee's dosimeter that was left in the truck and decided to expose it to the source for a few seconds. Then they reported that [the trainee] received 145 mrem on his dosimeter. When the RSO questioned them, they told [the RSO] what had happened and [the RSO] then conducted a time dose study. Based on reenactment, the RSO determined the trainee was exposed to the source about 6 seconds. The calculations indicated the trainee may have received 1456 rem to the hand. [The RSO] didn't take credit for the collimator shielding and used 5.9 R/hr/Curie at 1 foot as the basis for the calculation. The radiographer and trainee have been placed on administrative leave pending a decision from the company's review board. [The Agency] told [the licensee] that it would be investigating this event and that it will want to interview the radiographer and trainee. The Agency believes the calculated dose may be high but will follow-up during the investigation. Texas Incident #: 9691
The following report was received from the Texas Department of State Health Services (the Agency) via email: During an investigation, the Agency learned there had been a miscommunication in the dose the licensee reported for the radiographer trainee's hand. The dose was not 1456 rem. The licensee is working with a consultant to make both a hand and whole body dose calculation. With the information provided, it appears the calculated dose to the radiographer trainee's hand should be less than 10 rem, which is below the regulatory reporting limit. The licensee will continue to monitor the radiographer trainee's hand. More information will be provided as it is obtained in accordance with SA-300. Notified R4DO (Groom) NMSS (Rivera-Capella) and NMSS Events and INES (Milligan) via e-mail.
The following retraction information was obtained from the state of Texas via email: Miscommunication during initial incident reporting. Exposure was well below reporting requirement/no overexposure. Notified R4DO (Groom) and NMSS Event Notifications via email. |
| Where | |
|---|---|
| Acuren Inspection La Porte, Texas (NRC Region 4) | |
| License number: | LL01774 |
| Organization: | Texas Dept Of State Health Services |
| Reporting | |
| Agreement State | |
| Time - Person (Reporting Time:+82.32 h3.43 days <br />0.49 weeks <br />0.113 months <br />) | |
| Opened: | Robert Free 15:19 Jun 24, 2019 |
| NRC Officer: | Caty Nolan |
| Last Updated: | Aug 1, 2019 |
| 54128 - NRC Website | |
Acuren Inspection with Agreement State | |
WEEKMONTHYEARENS 541282019-06-21T05:00:00021 June 2019 05:00:00
[Table view]Agreement State En Revision Imported Date 8/2/2019 ENS 449562009-03-23T05:00:00023 March 2009 05:00:00 Agreement State Agreement State Report - Source Retraction Challenges ENS 419892005-09-13T20:00:00013 September 2005 20:00:00 Agreement State Agreement State Report Involving a Stolen/Recovered Industrial Radiography Camera 2019-06-21T05:00:00 | |