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