Recall StatusTerminated
Date Initiated2014-08-18
Date Terminated2015-07-30
Product Quantity512 affected devices
Reason for Recall
Due to user error, the 4DITC can improperly allow users to clear a safety interlock imposed by the 4DITC on behalf of Varian's Bar Code Conical Verification system from the BrainLab's ExacTract console when it is used with BCCV.
Firm Action
Varian issued an Urgent Medical Device Correction Notification letter dated August 19, 2014, to all affected sites. The letter informed users of the specific product and versions numbers as well as the issue. A list of third party systems that perform verification and communicate authorizations via ADI are included in Table 1 of the letter. The issue is only now to occur with the ExacTract positioning system in combination with a C-Series HE linac BCCV.
User recommended actions are provided for users using auxiliary devices requiring ADI interface and for users performing SRS/SBRT.
Varian has developed a fix for the issue and customer service representatives will be contacting all affected sites to schedule installation.
A copy of the correction letter is to be kept with the most current labeling and all personnel who work in the radiotherapy department should be made aware of the content of the letter.
The recall Return response form is to be completed and returned.
Questions may be directed to 1-888-827-4265 for US and Canada. Contact information is also provided for other areas of the world.
Root Cause
Software design
Distribution Pattern
Worldwide Distribution - USA (nationwide) and Internationally to Argentina, Brazil, Canada, Chili, China, Columbia, Czech Republic, France, Georgia, Germany, hong Kong, Hungary, India, Indonesia, Ireland, Israel, Italy, Japan, Latvia, Lithuania, Macau, Malaysia, Mexico, Netherland,s Portugal, Qutar, Russia, Singapore, Slovenia, South Korea, Spain, Sri Lanka, Switzerland, Taiwan, Thailand, Ukraine and United Kingdom.
Official Source
View FDA Recall →Source: FDA Enforcement Report / Recall database. Always confirm against the official FDA record.