FDA Adverse Event Malfunction Summary report: N

SYSTEM, APPLICATOR, RADIONUCLIDE, MANUAL

MDR report key: 23943694 · Received January 2, 2026

Report

Report Number
MW5181568
Event Type
Malfunction
Date Received
January 2, 2026
Report Date
November 10, 2025
Manufacturer
CIVCO MEDICAL INSTRUMENTS CO., INC.
Product Code
IWJ
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
MA, US
Reporter Occupation
UNKNOWN
Health Professional
*

Narratives

Description of Event or Problem · 0

IT WAS REPORTED THAT CIVCO FLOOR MOUNT SYSTEM NEEDED TO BE REPLACED DUE TO AN ISSUE WITH THE PELICAN CASE. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
13950 SYSTEM, APPLICATOR, RADIONUCLIDE, MANUAL SYSTEM, APPLICATOR, RADIONUCLIDE, MANUAL IWJ CIVCO MEDICAL INSTRUMENTS CO., INC. 610-974

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other