ACUITY H77

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05,06 report with the FDA on 2011-07-26 for ACUITY H77 manufactured by Varian Medical Systems Uk Ltd..

Event Text Entries

[20394017] Although, there was no reported injury in this case, the available info suggests a possible malfunction of the device. Though still under investigation, varian has determined that a mdr is appropriate as this possible malfunction, should it recur, could potentially cause serious injury. Add'l f/u to this mdr is expected upon completion of the investigation.
Patient Sequence No: 1, Text Type: N, H10


[20413541] The customer called due to a cbct second reconstruction problem. After performing a cbct triple scan, the reconstruction displayed images are shorter, as compared to the first reconstructed image; specifically, the bottom or lower-half portion of the second reconstructed images is missing. No error message is displayed. There was no serious injury reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number8020711-2011-00009
MDR Report Key2231316
Report Source01,05,06
Date Received2011-07-26
Date of Report2011-06-28
Date of Event2011-06-28
Date Mfgr Received2011-06-28
Device Manufacturer Date2008-05-01
Date Added to Maude2012-06-15
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationBIOMEDICAL ENGINEER
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMICHEL PIGNATARO, MGR.
Manufacturer Street911 HANSEN WAY M/S C-255
Manufacturer CityPALO ALTO CA 94304
Manufacturer CountryUS
Manufacturer Postal94304
Manufacturer Phone6504246471
Manufacturer G1VARIAN MEDICAL SYSTEMS UK LTD.
Manufacturer StreetGATWICK RD.
Manufacturer CityCRAWLEY, WEST SUSSEX HR109RG
Manufacturer CountryUK
Manufacturer Postal CodeHR10 9RG
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameACUITY
Generic NameACCELERATOR, LINEAR, MEDICAL
Product CodeKPQ
Date Received2011-07-26
Model NumberH77
ID NumberV2.2.9.0
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerVARIAN MEDICAL SYSTEMS UK LTD.
Manufacturer AddressUK


Patients

Patient NumberTreatmentOutcomeDate
10 2011-07-26

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