inforMED
MalfunctionIXI

AXXENT FLEXISHIELD MINI

Received Jun 16, 2011 · Event occurred May 31, 2011

Report 3005594788-2011-00024 · MDR key 2176045

Device

Generic name

Beam Blocks For Radiation Therapy

Manufacturer

Xoft, Inc.

Model number

F5300

Catalog number

F5300

Product problems

  • Nonstandard Device
  • Device Contamination with Chemical or Other Material

Patient

60 YR

  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

DEVICE HAS NOT BEEN RETURNED. COMPANY IS COLLECTING FURTHER INFO TO ASCERTAIN THIS EVENT. THIS MDR IS RELATED TO MDR 3005594788-2011-00001.

Description of Event or Problem

DURING SIX MONTH FOLLOW-UP OF INTRA-OPERATIVE RADIATION TREATMENT OF THE BREAST, THE MAMMOGRAM SHOWED POWDERY MATERIAL ON AND NEAR THE TREATMENT SITE. INCIDENT DID NOT RESULT IN A PT INJURY.

Remedial action

  • Recall