LEKSELL GAMMA KNIFE ICON 1016200

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-04-01 for LEKSELL GAMMA KNIFE ICON 1016200 manufactured by Elekta Instrument Ab.

Event Text Entries

[42067000] Investigation is ongoing.
Patient Sequence No: 1, Text Type: N, H10


[42067001] It has been reported there may be an offset in stereotactic references - a possible 1. 6mm difference found in some icon images.
Patient Sequence No: 1, Text Type: D, B5


[51522065] A root cause analysis was conducted involving extensive calibration and measurements. The investigation concludes that the shift is caused by a skewed g-frame caused by asymmetric and high tension in the g-frame attachment screws in combination with extended posts. Multiple use error must occur for the cause to happen. The use errors are deemed unusual since the correct g-frame training and usage is detailed in the ifu and the fiducial error is clearly displayed to the lgp user.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9612186-2016-00004
MDR Report Key5540856
Date Received2016-04-01
Date of Report2016-07-22
Date of Event2016-03-14
Date Mfgr Received2016-07-22
Date Added to Maude2016-04-01
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 FDA3
Event Location3
Manufacturer ContactPMS
Manufacturer StreetLINAC HOUSE FLEMING WAY
Manufacturer CityCRAWLEY, WEST SUSSEX RH109RR
Manufacturer CountryUK
Manufacturer PostalRH10 9RR
Manufacturer G1ELEKTA INSTRUMENT AB
Manufacturer StreetPO BOX 7593
Manufacturer CitySTOCKHOLM, SE10393
Manufacturer CountrySW
Manufacturer Postal CodeSE103 93
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameLEKSELL GAMMA KNIFE ICON
Generic NameSYSTEM, RADIATION THERAPY, RADIONUCLIDE, PRODUCT CODE: IWB
Product CodeIWB
Date Received2016-04-01
Model Number1016200
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerELEKTA INSTRUMENT AB
Manufacturer AddressPO BOX 7593 STOCKHOLM, SE10393 SW SE103 93


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2016-04-01

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