Monmouth Medical Center, Amendment Request dtd 06/06/2005 ...

MONMOUTH MEDICAL CENTER

An afiliate of the Saint Barnabas Health Care System -r")r !, ' 4 ) . G',! 9. > Q .? ; . I ) . i L 6 1 L-

RONALD J. DEL MAURO Pmsiderit and Chief Executive Officer Saint Barnabas Health Care System

FRANK J.VOZOS, MD, FACS Executive Director

Moiunouth Medical Center

Fax: (732) 923-7511 (732) 923-7504

June 6,2005

Michelle Beardsly Senior Health Physicist U. S. Nuclear Regulatory Commission Region I 475 Allendale Road King of Prussia, PA 9 1406- 14 1 5

RE: License No. 29-081 13-03 630 I 70 I Dear Ms. Beardsley:

This letter is to support the application and approval of Dr. Gin-Weigh Wu as an authorized Medical Physicist (AMP) for HDR Remote Afterloading Devices in the department of Radiation Oncology of Monmouth Medical Center, Long Branch, New Jersey. Dr. Gin-Weigh Wu has been employed in radiation oncology as a physicist performing routine quality assurance work on external beam machines since May 2003. He has also been, under direct supervision, receiving training in HDR remote aflerloading-devices. We would like to add Dr. Wu to our NRC license as an authorized medical physicist for HDR remote afterloading devices.

Dr. Wu meets the qualifications of 10 CFR: 35.961(c).

1. Dr. Wu graduated with a Ph.D. degree in Nuclear Engineering and Radiological Sciences from the University of Missouri-Columbia with emphasis on the nuclear and medical usage and projects.

2. Dr. Wu has worked in the department of Radiation Oncology at Monmouth Medical Center as a trainee under three AMPs (Jack Yang, Thomas Piccoli, and Hansen Chen) during the past two years. He has been supervised to perform the quality assurance procedures, and most importantly, the emergency procedures in managing the Ir-193 HDR source from Nucletron Corp. (See attached documentation.)

I 37M I NMSWRGMI MATERIALS002

300 SECOND AVENUE LONG BRANCH, NEW JERSEY 07740 rn (732) 222-5200

Saint Barnabas Health Care System - New Jersey's health care system.

3. He has been directly supervised for over 100 HDR treatments. He is very familiar with clinical procedures (more than 100 cases) and meets the regulations in 10 CFR 961 (c).

His level of competency has also been approved by our senior management and our radiation safety committee members.

Please feel fiee to contact us at 732.923.68 1 1, should you need additional information or have any questions.

Sincerely;

Thomas Piccoli, DABR JMYang, PhD., DABR William Arnold Medical PhysicistRSO Chief Medical Physicist Vice President, Operations

Radiation Oncology

Gin-Weieh Wu

Tel:

Education:

Ph.D. M.S. B.S.

in Nuclear Engineering Erom University of Missouri - Columbia (Aug., 1995) in Nuclear Engineering Erom University of Missouri - Columbia (May, 1990) in Nuclear Science Erom National Tsing Hua University, Taiwan (May, 1984)

Work Experience:

2003 -- present Research Associate Department of Radiation Oncology Monmouth medical Center, Long Branch, NJ

Be responsible or participate in all special physics projects and clinical physics services, including 3-D conformal External Beam Radiation Therapy (3DCRT) and Intensity Modulated Radiation Therapy (IMRT), High Dose Rate Brachytherapy (HDR), Prostate Seed Implants (PSI), Sterotactic Radiosurgery (SRS), IMRT verification, weekly chart checking, overseeing patient simulation and treatment setups, simulatodlinear accelerator QA (accelerator testing, brachytherapy source calibration, equipment acceptance testing, Daily/ monthly/ annual quality assurance checkout test). Experience with SIEMENS linear accelerators (PRIMUS & ONCOR), ADAC’S ~ ~ i n n a c l e & P~IMRT planning system(V.6.5 & V.7.4), Nucletron PLAT0 Brachytherapy Planning System V.3.3.2, VARIAN VariSeed V7.0,, RIT system and IMPAC/ LANTIS R&V system, Sun Nuclear’s Daily QA, Profile & MapCheck system.

1999 - 2003 Project Leader for AT&T End-To-End Service Delivery Project / Integrated Solutions Inc. (As a AT&T Contractor of Business Process /IT Application Performance Analysis, Monitoring & Optimization District in AT&T LABS at Middletown, NJ)

* Business Process Analysis for AT&T End-To-End Service Delivery -- By developing data analysis methodology and tools working with PM’s Process Modeling and Simulation S o b a r e (Win NT, Win 2000 platform), the team build ETE Service Delivery Process Simulation Model (including FR, PL, HSSD, ATM, IP, etc . . .) and associated analysis capabilities to target investment strategies and anticipate/ plan for DMOQ /KPI performance under different business scenarios, which include ITB investment, US0 volume changes, Resource Headcount changes, Bottleneck & performance analysis, etc . . . .

*OneVu Network Management System for HP 9000 N-Class Server (HP/UX 1 1 .O platform) -- By using JAVA 1.2, CORBA(VisiBroker 4.5 Java Version), C O M A Notification Service (PrismTech’s OpenFusion 2.5 Java Version), XML(JDOM), JDBC(Oracle9i), and database status trackinglpolling technologies, ONEVU provided a Java CORBA ClientBerver Network Management System tools for the AT&T new Competitive Network Initiative (CNI) Network to integrate Ciena’s Intelligent Optical Switch (10s) and Cisco’s Multi-Service Platform (MSP)

PERSONAL INFORYAnON WAS REMOVED BY h‘X NO COPY OF THIS INFORMATION

WAS RETAINED BY THE NRC. I 1

Gin-Weieh Wu

Element management System (EMSs) into AT&T Operations Support System(O0S). It not only provided a real-time view of the entire network inventory of Ciena’s Intelligent Optical Switch and Cisco’s Multi-Service Platform EMS, but also provided a focal point to communicate with EMS’S for service provisioning purpose.

1996 - 1999 Software Engineer (America Online(AOL)/SPRYNET Internet Division, Bellevue, WA)

* CompuServe/SPRYNET 32 Bit Registration Wizard -- By using C &C++ programming,, developed a 32 bit Remote Access Maintenance Protocol(RAMP) client software application that resides on a Microsoft Windows PC and communicates with a remote server computer to sign-up a user with a SPRYNET Internet access account and E-MAIL account.

1988 - 1996 Research Assistant - MURR (Missouri University Research Reactor), Columbia, MO

* On-line Neutron Noise Surveillance Expert System -- Developed a C software application which combined with Hybrid Expert System by using a Statistical Pattern Recognition model to perform an on-line effective surveillance model for statistical monitoring of Reactor Neutron Flux signal pattern similarity based on Euclidian distance similarity measurement.

* Determination of Hydrogen in steel by Neutron Scattering Designed and conducted experiments in the Neutron Scattering experiment, and developed a new Monte Carlo statistical computer model using FORTRAN and C to theoretically duplicate a statistical trials for determination of Hydrogen in steel by neutron scattering.

1986 - 1988

Research Assistant Institute of Nuclear Engineering, National Tsing Hua University, Taiwan

* Dropped Rod Accident in the Nuclear Power Plant -- Developed a statistical computer model with FORTRAN Programming to simulate and Analyze the Dropped Rod Accident in the PWR Nuclear Power Plant.

Award:

1995 Superior Graduate Achievement Award

The program is sponsored by the Graduate student Association of UMC and recognizes graduate students for excellence in the areas of academics, teaching, research and extension.

References:

Available upon request.

PERSONAL INFORMATION WAS REMOVED BY NRC. NO COPY OF THIS INFORMATION

WAS RETAINED BY THE NRC.

Field Training Report I of 1 NUC-T331 US41

This is to acknowledge the receipt of your letter/application dated

la60 5 , and to inform you that the initial processing which includes an administrative review has been performed.

kmeudhw-k Jq 4 08 113-~U There were no administrative omissions. Your application was assigned to a technical reviewer. Please note that the technical review may identify additional omissions or require additional information.

Please provide to this office within 30 days of your receipt of this card

A copy of your action has been forwarded to our License Fee & Accounts Receivable Branch, who will contact you separately if there is a fee issue involved.

Your action has been assigned Mail Control Number 1 3 7Aq 1 . When calling to inquire about this action, please refer to this control number. You may call us on (610) 337-5398, or 337-5260.

NRC FORM 532 (RI)

(6-98)

Sincerely, Licensing Assistance Team Leader

BETWEEN :

License Fee Management Branch, ARM

Regional Licensing Sections and

(FOR LFMS USE) INFORMATION FROM LTS _ _ _ _ - - - - - - _ _ _ _ _ _ _ _ _ _

: Program Code: 02230 : Status Code: 0 : Fee Category: 7C : Exp. Date: 20060331 : Fee Comments: : Decom Fin Assur Reqd: N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LICENSE FEE TRANSMITTAL

A. REGION z 1. APPLICATION ATTACHED

Applicant/Licensee: MONMOUTH MEDICAL CENTER Received Date: 20050624 Docket No : 3017015 Control No.: 137241

Action Type: Amendment License No.: 29-08113-03

2. FEE ATTACHED Amount : Check No. :

3. COMMENTS

Signed Date

B. LICENSE FEE MANAGEMENT BRANCH (Check when milestone 03 is entered /-/I

1. Fee Category and Amount:

2. Correct Fee Paid. Application may be processed f o r : Amendment Renewal License

3 . OTHER

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