RecallDepth

RefleXion X1 Radiotherapy System Model RXM1000 Software version 2.1.19-3 Radiation therapy system is a device that combines the functionality of an emission computed tomography detection system and a linear accelerator.

This recall is currently active, issued May 30, 2024. It was issued by Reflexion Medical, Inc..

Company
Reflexion Medical, Inc.
Recall Initiated
April 16, 2024
Posted
May 30, 2024
Recall Number
Z-1933-2024
Quantity
7 systems
Firm Location
Hayward, CA
Official Source
View on FDA website ↗

Reason for Recall

A potential dose error exists for patients treated with an out of session SCINTIX partial fraction.

Distribution

U.S.: CA, CT, NJ, OR, PA and TX No O.U.S.

Lot / Code Info

Model Number: RXM1000 UDI Codes that includes system serial numbers: (01)00860003983812(11)230504(21)X11001 (01)00860003983812(11)230518(21)X11002 (01)00860003983812(11)230505(21)X11003 (01)00860003983812(11)230530(21)X11004 (01)00860003983812(11)230811(21)X11006 (01)00860003983812(11)230410(21)X11007 (01)00860003983812(11)230803(21)X11008

Root Cause

Software design

Action Taken

On 04/29/2024, the firm sent an "Urgent: Medical Device Recall Safety Notification" via email to customer informing them that during internal dosimetric testing of SCINTIX OOS partials in periodic tracking mode, it was observed that the delivered dose error of the full fraction can exceed 5% with respect to the upper bound of one or more static volumes within the DVH in the plan (non-tracked, non-target volumes in the patient frame of reference, i.e., the planning CT). This was determined to be the result of a software defect associated with completing interrupted. Customers are instructed to: 1. Notify all clinical staff of this recall 2. Utilized the Clinical Guidance Document that is include with this notification. For questions or concerns - contact Service and Support at 650-239-9070 or email support@reflexion.com

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