ProForm™ Head and Neck Extension MTIL6679

GUDID 00841439114193

ProForm™ XLE (1518mm): For Use with Universal Couchtop™

MEDTEC, INC.

Indexed-immobilization patient positioning system

• Primary Device ID: 00841439114193
• NIH Device Record Key: 553464b3-476f-4a77-9636-32d44dbb682c
• Commercial Distribution Status: In Commercial Distribution
• Brand Name: ProForm™ Head and Neck Extension
• Version Model Number: MTIL6679
• Catalog Number: MTIL6679
• Company DUNS: 103977526
• Company Name: MEDTEC, INC.
• Device Count: 1
• DM Exempt: true
• Pre-market Exempt: false
• MRI Safety Status: Labeling does not contain MRI Safety Information
• Human Cell/Tissue Product: false
• Device Kit: false
• Device Combination Product: false
• Single Use: false
• Lot Batch: true
• Serial Number: true
• Manufacturing Date: true
• Expiration Date: false
• Donation Id Number: false
• Contains Natural Rubber Latex: false
• Labeled No Natural Rubber Latex: false
• RX Perscription: true
• OTC Over-The-Counter: false

Customer Support Contacts

• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com
• Phone: +1(712)737-8688
• Email: radiotherapy.complaints@civcort.com

Device Identifiers

Device Issuing Agency	Device ID
GS1	00841439114193 [Primary]

FDA Pre-market Approvals/Notifications & deNovo

• Premarket Notification: K180021

FDA Product Code

• IYE: Accelerator, linear, medical

Sterilization

• Steralize Prior To Use: false
• Device Is Sterile: false

Device Entry Metadata

• Public Version Status: New
• Device Record Status: Published
• Public Version Number: 1
• Public Version Date: 2022-10-24
• Device Publish Date: 2022-10-14

On-Brand Devices [ProForm™ Head and Neck Extension]

• 00841439112700: Extension and cushion guide for use with Universal Couchtop™
• 00841439114223: ProForm™ XXLE (1648mm): For Use with Universal Couchtop™
• 00841439114216: ProForm™ XSE (935mm): For Use with Universal Couchtop™
• 00841439114209: ProForm™ SE (995mm): For Use with Universal Couchtop™
• 00841439114193: ProForm™ XLE (1518mm): For Use with Universal Couchtop™
• 00841439114186: ProForm™ ME (1048mm): For Use with Universal Couchtop™