MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2019-04-24 for EXABALTE 4000 SYS940352 manufactured by Insightec Ltd.
[142875231]
The system technical performance during treatment was thoroughly reviewed;no technical issues were found. No system malfunction occurred. All sonication parameters were within the normal ranges with no exceptional usage.
Patient Sequence No: 1, Text Type: N, H10
[142875232]
On (b)(6) 2018, insightec was notified, that patient who was treated on (b)(6) 2018 experienced mild right leg ataxia on the same day as his left thalamotomy for essential tremor. The physician reported an improvement on patient condition since the day of treatment, but the condition still present. No side effect has been observed during and after the treatment nor reported. The patient had significant tremor relief after the treatment. At this time, there is no additional information.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9615058-2018-00008 |
| MDR Report Key | 8543362 |
| Report Source | COMPANY REPRESENTATIVE,HEALTH |
| Date Received | 2019-04-24 |
| Date of Report | 2018-11-06 |
| Date of Event | 2018-09-26 |
| Date Mfgr Received | 2018-10-06 |
| Device Manufacturer Date | 2016-12-08 |
| Date Added to Maude | 2019-04-24 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MR IDAN COHEN |
| Manufacturer Street | 5 NACHUM HETH STREET |
| Manufacturer City | TIRAT CARMEL, 39120 |
| Manufacturer Country | IS |
| Manufacturer Postal | 39120 |
| Manufacturer G1 | INSIGHTEC LTD |
| Manufacturer Street | 5 NACHUM HETH STREET |
| Manufacturer City | TIRAT CARMEL, 39120 |
| Manufacturer Country | IS |
| Manufacturer Postal Code | 39120 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | EXABALTE 4000 |
| Generic Name | MR GUIDED FOCUSED ULTRASOUND SYSTEM |
| Product Code | POH |
| Date Received | 2019-04-24 |
| Model Number | 4000 |
| Catalog Number | SYS940352 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | INSIGHTEC LTD |
| Manufacturer Address | 5 NACHUM HETH STREET TIRAT CARMEL, 39120 IS 39120 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Deathisabilit | 2019-04-24 |