ZXT RADIATION THERAPY TREATMENT TABLE 9820952 NA

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2006-09-22 for ZXT RADIATION THERAPY TREATMENT TABLE 9820952 NA manufactured by Siemens Medical Solutions Usa, Inc..

Event Text Entries

[22181552] It was reported that the treatment table moved upwards without command from the operator. The system did display an error message to the user when the uncommanded movement occurred. However, the user cleared the error messages and continued to operate the system. The user's manual clearly states that when this error message occurs, the user should "remove the pt and call service". The investigation showed that this issue occurred due to a firmware malfunction. It is important to note that the red emergency stop button which halts all system movement remains functional if this problem occurs. Although this issue occurred during a pt treatment, there was no reported injury associated with this incident.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2910081-2006-00014
MDR Report Key871270
Report Source05,06
Date Received2006-09-22
Date of Report2004-10-21
Date of Event2004-10-21
Date Mfgr Received2004-10-21
Date Added to Maude2007-06-27
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Manufacturer ContactDAN TAKEMOTO
Manufacturer Street4040 NELSON AVE.
Manufacturer CityCONCORD CA 94520
Manufacturer CountryUS
Manufacturer Postal94520
Manufacturer Phone9256028192
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Remedial ActionRC
Previous Use Code3
Removal Correction Number2910081-06/26/06-001C
Event Type3
Type of Report3

Device Details

Brand NameZXT RADIATION THERAPY TREATMENT TABLE
Generic NameCOUCH, RADIATION THERAPY, POWERED
Product CodeJAI
Date Received2006-09-22
Model Number9820952
Catalog NumberNA
Lot NumberNA
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrY
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key851847
ManufacturerSIEMENS MEDICAL SOLUTIONS USA, INC.
Manufacturer Address4040 NELSON AVE. CONCORD CA 94520 US


Patients

Patient NumberTreatmentOutcomeDate
10 2006-09-22

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