ENS 47952

v t e ENS Event
05:00 Apr 10, 2012
Title	Agreement State Report - Stuck Source in Catheter
Event Description	The following the received via e-mail: On May 23, 2012, the Agency [State of Texas] was notified by the licensee that on April 10, 2012, while the licensee was performing a routine quality assurance test using a beta catheter system device, the 50.2 milliCurie Strontium-90 source train jammed as it began to move from the transfer device to the test catheter. The source train was lodged near the transfer device exit port and could not be returned to the home position. After a few failed attempts to retract the source train, the applicator and phantom were covered with a lead apron, and the manufacturer's Radiation Safety Officer was notified. A manufacturer's technician arrived at the licensee's Hot Lab the morning of April 11, 2012. The technician was not able to return the source to the shielded position. The device was returned to the manufacturer's facility for analysis. Since this fault occurred during routine quality assurance testing, no patient was involved in the procedure. The manufacturer inspected the catheter and found a deformation in the catheter that would have interfered with the source movement. The source was leak tested, and the results indicated that the source was not leaking. The source train has been removed from service. Additional information will be provided as it is received in accordance with SA - 300. TX Incident # I-8956

ENS 47952 +/-
Where
The Methodist Hospital Houston, Texas (NRC Region 4)
License number:	00457
Organization:	Texas Department Of Health
Reporting

Agreement State
Time - Person (Reporting Time:+1043.63 h43.485 days <br />6.212 weeks <br />1.43 months <br />)
Opened:	Art Tucker 16:38 May 23, 2012
NRC Officer:	Joe O'Hara
Last Updated:	May 23, 2012
47952 - NRC Website
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