MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-02-28 for VAGINAL CT / MR MULTI CHANNEL APPLICATOR SET manufactured by Nucletron B.v..
[139839459]
The manufacturer's investigation is on-going and further information will be provided once the investigation has been completed.
Patient Sequence No: 1, Text Type: N, H10
[139839460]
The customer reported that the vaginal tube for the 25, 30 and 25 mm set will not stay locked in place. Unfortunately a patient's vaginal cuff was perforated when the vaginal tube became dislodged.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9611894-2019-00001 |
| MDR Report Key | 8377997 |
| Date Received | 2019-02-28 |
| Date of Report | 2019-05-13 |
| Date of Event | 2019-01-31 |
| Date Mfgr Received | 2019-02-01 |
| Date Added to Maude | 2019-02-28 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | PMS |
| Manufacturer Street | LINAC HOUSE FLEMING WAY |
| Manufacturer City | CRAWLEY, WEST SUSSEX RH109RR |
| Manufacturer Country | UK |
| Manufacturer Postal | RH10 9RR |
| Manufacturer G1 | NUCLETRON B.V. |
| Manufacturer Street | WAARDGELDER 1 |
| Manufacturer City | VEENENDAAL 3905TH |
| Manufacturer Country | NL |
| Manufacturer Postal Code | 3905 TH |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | VAGINAL CT / MR MULTI CHANNEL APPLICATOR SET |
| Generic Name | SYSTEM, APPLICATOR, RADIONUCLIDE, REMOTE-CONTROLLED |
| Product Code | JAQ |
| Date Received | 2019-02-28 |
| Device Availability | Y |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | NUCLETRON B.V. |
| Manufacturer Address | WAARDGELDER 1 VEENENDAAL 3905TH NL 3905 TH |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-02-28 |