FDA Adverse Event
Injury
Summary report: N
SENSUS HEALTHCARE SRT-100
MDR report key: 8746054
·
Received June 28, 2019
Report
- Report Number
- 3008513398-2019-00001
- Event Type
- Injury
- Date Received
- June 28, 2019
- Date of Event
- June 2, 2019
- Report Date
- June 3, 2019
- Manufacturer
- SENSUS HEALTHCARE, INC
- Product Code
- JAD
- PMA / PMN Number
- K123985
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- 003
Narratives
Additional Manufacturer Narrative · 1
THE SRT-100 SYSTEM USED TO DELIVER THERAPY OPERATED WITHIN ITS NORMAL DESIGN PARAMETERS. NO ISSUES ASSOCIATED WITH THIS SYSTEM HAVE BEEN NOTED DURING THE INITIAL REVIEW MANUFACTURING TESTING, INSPECTION, INSTALLATION, AND SERVICING RECORDS. THE DEVICE HAS BEEN MAINTAINED AND AN INSPECTION BY SERVICE PERSONNEL SHOWED THE DEVICE OPERATING WITHIN NORMAL PARAMETERS WITH NO ANOMALIES.
Description of Event or Problem · 1
ON (B)(6) 2019, A PATIENT CONTACTED SENSUS HEALTHCARE VIA THE GENERAL WEB INQUIRY FORM ON OUR WEBSITE. THE PATIENT STATED THEY HAD RECEIVED SRT TREATMENT ON THEIR RIGHT CALF TO TREAT SQUAMOUS CELL CARCINOMA. PATIENT DEVELOPED A WOUND/SORE AT THE SITE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 540033 | SENSUS HEALTHCARE SRT-100 | SYSTEM, THERAPEUTIC, X-RAY | JAD | SENSUS HEALTHCARE, INC | SRT-100 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 76 YR | Other |