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 |