.DECIMAL RANGE COMPENSATOR

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-10-19 for .DECIMAL RANGE COMPENSATOR manufactured by .decimal.

Event Text Entries

[57933559] This notification reports a product malfunction associated with the. Decimal proton range compensator. No serious injury or death has occurred, but there is a potential for serious injury, if the event were to recur. A patient was placed in treatment position on a patient treatment couch to be treated by the mevion medical systems mevion s250. As the patient was lying on the treatment table, the range compensator, a product manufactured by decimal, separated from its mounting screws holding it to the clamp ring. This caused the range compensator to fall from it's mounting above the patient onto the patient's chest. This particular event did not result in a serious injury or death. However, if this event were to recur, under particular conditions, it could potentially result in a serious injury, as assessed below. The design team evaluated the potential harm that could result from recurrence of this issue. The results conclude: the range compensator is made of plastic or wax and can weigh as much as (b)(6) pounds in an extreme case. The greatest hazard posed would be a fully retracted compensator falling from above the patient onto their head. This would be a fall of 20 cm or less, with a resulting energy of 8 joules. If the impact is absorbed in 1 cm of stopping distance that would generate a force of (b)(6) newtons (b)(6) lbs of force). As some of the shock is transferred to the head support this is a reasonable worst case. This is enough force to cause lacerations and bruising, but not enough to cause a skull fracture in an adult patient. In pediatric patients the nose and clavicle are particularly fragile bones. These could conceivably suffer a fracture from such forces, but the trauma would be moderate and treatable. Other body parts would suffer less trauma as the impact would be dissipated over a greater distance. Such impact may require medical intervention, of a low to moderate nature.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3007087027-2016-00002
MDR Report Key6042414
Date Received2016-10-19
Date of Report2016-10-19
Date of Event2016-08-31
Date Added to Maude2016-10-19
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 ContactMR. THOM FARIS
Manufacturer Street300 FOSTER STREET
Manufacturer CityLITTLETON MA 01460
Manufacturer CountryUS
Manufacturer Postal01460
Manufacturer Phone9785401500
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand Name.DECIMAL RANGE COMPENSATOR
Generic NameRANGE COMPENSATOR
Product CodeIXI
Date Received2016-10-19
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
Manufacturer.DECIMAL
Manufacturer Address121 CENTRAL PARK PLACE SANFORD, FL 32771 US 32771


Patients

Patient NumberTreatmentOutcomeDate
10 2016-10-19

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