On September 2, 2011, the NRC issued a Notice of Violation to Crittenton Hospital for a Severity Level III violation involving the failure to develop written procedures to provide high confidence that each administration was in accordance with the written directive as required by 10 CFR 35.41(a). Specifically, between September 2009 and January 2011, the licensee failed to address in its written procedure the need to verify that the step size used in the treatment plan was correctly translated into the high dose rate (HDR) remote afterloader unit. As a result, the device’s control unit default step size of 2.5 mm was used instead of the 5 mm used in the treatment planning system.