Recall StatusOpen, Classified
Date Initiated2025-08-05
Product Quantity810 (350 U.S. and 460 O.U.S.)
Reason for Recall
Due to a software issue, there is a potential image error of the Region of Interest for expansion/contraction for HFP (Head First Prone), FFS (Feet First Supine) and FFP (Feet First Prone) orientations.
Firm Action
On 08/05/2025, the firm sent via FedEx an "Urgent Medical Device Correction" Letter informing customers of a software issue affecting the Pinnacle3 Radiation Therapy Planning System performing Advanced Region of Interest (ROI) Expansion and Contraction that results in a potential shift of the intended ROI. The software assumes the patient is always in the Head First Supine (HFS) position when transposing the Advanced Expansion to alternate positions.
Customers are instructed to:
-When using the Advanced ROI Expansion and Contraction feature in Pinnacle3, only use the Head First Supine (HFS) patient orientation.
-Ensure that relevant clinical staff, including physicians, physicists, and dosimetrists, are informed about the potential for directional errors in ROI expansion/contraction under certain orientation conditions.
-Customers may continue to use your system(s) in accordance with the intended use and by following the recommendations above.
-Circulate this notice to all users of this device so that they are aware of the potential issue. -Retain this letter with their system(s) until a solution is installed on your system; ensure the letter is in a place likely to be seen/viewed.
-Complete and return the updated attached response form to Philips promptly and no
later than 30 days from receipt of this letter via email to:
[email protected].
Note: If customers have returned a response form already in reply to the initial customer letter, complete and sign this updated response form and return to Philips.
Philips will provide a label to be affixed to the device that provides instruction to use the HFS position only.
A Philips representative will contact you to schedule a time for a Field Service Engineer (FSE) to visit your site to attach /affix the label to the workstation (Reference 2025-EI-TPS-002).
Questions-contact your local Philips representative: For North America, contact Philips Customer Care Center at 1-800-722-9377.
Root Cause
Software design
Distribution Pattern
U.S Nationwide distribution including in the states of AL, AR, AZ, CA, CO, CT, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, and WV.
Related FDA 510(k) Records
Devices referenced by this recall via K-numbers.
Official Source
View FDA Recall →Source: FDA Enforcement Report / Recall database. Always confirm against the official FDA record.