On April 20, 2011, the NRC issued a Notice of Violation to the Community Hospitals of Indiana for a Severity Level III violation involving the failure to fully implement procedures to provide high confidence that a brachytherapy treatment was in accordance with the written directive as required by 10 CFR 35.41(a). Specifically, on September 30, 2010, an authorized medical physicist missed a step in the procedure that established the starting position for the high dose remote afterloader brachytherapy treatment. The failure to implement this step resulted in a medical event.