FDA Adverse Event Injury Summary report: N

SENSUS HEALTHCARE SRT-100

MDR report key: 8927119 · Received August 23, 2019

Report

Report Number
3008513398-2019-00003
Event Type
Injury
Date Received
August 23, 2019
Date of Event
July 25, 2019
Report Date
August 23, 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

THE DOCTOR CONTACTED SENSUS ON (B)(6) 2019 BECAUSE SHE HAD RECENTLY BECOME AWARE OF A PATIENT WHO EXPERIENCED A BREAKDOWN IN THE TREATMENT AREA. THE DOCTOR STATED THAT UPON FIRST EXHIBITING THESE SIGNS, THE PATIENT WAS STILL UNDERGOING TREATMENT. THE PATIENT WAS GIVEN A BREAK AND THE DOCTOR THAT SHE HAD SOUGHT MEDICAL ATTENTION FOR THE WOUND. THE PATIENT DID NOT RETURN TO COMPLETE THE REMAINDER OF THEIR TREATMENTS. SENSUS CLINICAL SUPPORT TEAM WAS NOTIFIED AND CONTACTED THE DOCTOR FOR MORE DETAILS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
720221 SENSUS HEALTHCARE SRT-100 SYSTEM, THERAPEUTIC, X-RAY JAD SENSUS HEALTHCARE, INC SRT-100

Patients

Seq Age Sex Outcome Treatment
1 78 YR Other