BEAM MODULATOR

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00,05,06 report with the FDA on 2013-10-02 for BEAM MODULATOR manufactured by Elekta Limited.

Event Text Entries

[3766009] A physicist used a third party software to validate the leaf positions of the beam modulator and claims some of them to be more than 2mm out of position. Elekta are investigating
Patient Sequence No: 1, Text Type: D, B5


[11220246] The investigation into this incident is on-going at this time. Once the investigation is complete, elekta will forward additional information to the fda.
Patient Sequence No: 1, Text Type: N, H10


[26163366] This is a newly installed machine undergoing commissioning. The customer is using 3rd party software and elekta investigated the customers results. The manufacturer's investigation concluded that the root cause was a calibration error. The calibration is checked by the qa protocol used by the customer and is detectable prior to use. The system continues to meet the customer's specifications.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9617016-2013-00014
MDR Report Key3380380
Report Source00,05,06
Date Received2013-10-02
Date of Report2014-02-14
Date Mfgr Received2013-09-06
Date Added to Maude2014-01-08
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer StreetLINAC HOUSE FLEMING WAY
Manufacturer CityCRAWLEY, WEST SUSSEX RH109RR
Manufacturer CountryUK
Manufacturer PostalRH10 9RR
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBEAM MODULATOR
Generic NameBLOCK, BEAM-SHAPING, RADIATION THERAPY
Product CodeIXI
Date Received2013-10-02
OperatorPHYSICIST
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerELEKTA LIMITED
Manufacturer AddressLINAC HOUSE FLEMMING WAY CRAWLEY, WEST SUSSEX RH109RR UK RH10 9RR


Patients

Patient NumberTreatmentOutcomeDate
10 2013-10-02

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