On October 10, 2008, a Notice of Violation was issued for three Severity Level III violations. The first violation involved a failure to meet 10 CFR 35.41(b)(2) requirement. Specifically, the licensee did not develop and implement written procedures to provide high confidence that each medical administration is in accordance with the written directive, in that the procedures did not address response to high dose rate (HDR) device error messages. The second violation involved a failure to ensure an authorized user (AU) was physically present during initiation of a patient treatment. During continuation of the patient treatment, neither the AU, nor a physician under the supervision of an AU, was physically present. Specifically, the AU was working with another patient in another room and was not involved in the investigation and resolution of an HDR device error message that was received during the patient treatment. The third violation involved a failure to report a medical event as required by 10CFR 35.3045(a)(1)(iii)&(3). Specifically, for an HDR fractional treatment that resulted in a dose delivered to a portion of the treatment site that differed from the prescribed dose by more than 50 rem, and the fractionated dose that differed from the prescribed dose, for a single fraction, by more than 50%, the licensee personnel did not provide a verbal or written report to the NRC in a timely manner.