RecallDepth

HexaPOD evo RT Couch Top (also known as HexaPOD evo Module), a component of the HexaPOD evo RT system. Product Usage: To support and aid in positioning a patient during radiation therapy

Company
Elekta, Inc.
Recall Initiated
May 16, 2018
Terminated
October 30, 2020
Recall Number
Z-2535-2018
Quantity
725 devices
Firm Location
Atlanta, GA

Reason for Recall

Upon completion of a 6D workflow, the HexaPOD evo Module may be in a tilted state if it is moved to the position used for 3D (non-iGUIDE) treatments resulting in incorrect patient positioning.

Distribution

Worldwide Distribution - US Distribution of the device was made nationwide. There was government distribution but no military distribution. Foreign distribution was made to Canada, Algeria, Argentina, Australia, Austria, Bangladesh, Belgium, Botswana, Brazil, Chile, China, Colombia, Czech Republic, Denmark, Egypt, Finland, France, Germany, Greece, Hong Kong, Hungary, India, Indonesia, Ireland, Israel, Italy, Japan, Kazakhstan, Democratic People's Republic of Korea, Malaysia, Mexico, Morocco, Netherlands, New Zealand, Peru, Poland, Portugal, Russian Federation, Saudi Arabia, Singapore, Slovenia, South Africa, Spain, Sweden, Switzerland, Taiwan, Sweden, Thailand, Turkey, United Kingdom, and Viet Nam.

Lot / Code Info

UDI 04056719001698.  Serial numbers: 42380, 42384, 42626, 03005, 42009, 42012, 42013, 42062, 42068, 42106, 42107, 42126, 42153, 42217, 42224, 42292, 42293, 42301, 42435, 42491, 42496, 42517, 42615, 42620, 42690, 42691, 42731, 03019, 42092, 42222, 42356, 42382, 42601, 42649, 42658, 42743, 42289, 03000, 42311, 42586, 42471, 03017, 03022, 42057, 42058, 42129, 42159, 42187, 42279, 02982, 02986, 02991, 42004, 42113, 42178, 42189, 42202, 42207, 42209, 42212, 42213, 42216, 42220, 42416, 42417, 42418, 42419, 42420, 42463, 42652, 42704, 42706, 02987, 03008, 03018, 42000, 42008, 42032, 42048, 42064, 42070, 42074, 42084, 42102, 42115, 42118, 42134, 42137, 42142, 42145, 42146, 42152, 42174, 42177, 42237, 42312, 42329, 42330, 42341, 42363, 42369, 42371, 42375, 42383, 42394, 42409, 42446, 42450, 42453, 42457, 42464, 42474, 42501, 42509, 42519, 42523, 42524, 42550, 42553, 42587, 42611, 42612, 42643, 42647, 42662, 42674, 42681, 42694, 42721, 42722, 42069, 03029, 42036, 42709, 42710, 42139, 42162, 42591, 42592, 42421, 42669, 42011, 03006, 42007, 42109, 42173, 42193, 42282, 42392, 42405, 42427, 42428, 42504, 42535, 42602, 42603, 42644, 42680, 42685, 02998, 03003, 03033, 42015, 42053, 42053, 42065, 42085, 42091, 42094, 42105, 42124, 42198, 42219, 42271, 42334, 42386, 42388, 42397, 42449, 42507, 42574, 42618, 42635, 42687, 42692, 03024, 42121, 42338, 42377, 42412, 42545, 42546, 42627, 42444, 42498, 03020, 42027, 42061, 42075, 42079, 42214, 42248, 42286, 42305, 42314, 42413, 42455, 42481, 42482, 42502, 42505, 42518, 42520, 42522, 42527, 42561, 42564, 42571, 42577, 42584, 42598, 42609, 42630, 42637, 42638, 42670, 42699, 42600, 42604, 42682, 42192, 42381, 02960, 02961, 02962, 02995, 03030, 42002, 42021, 42025, 42033, 42035, 42089, 42127, 42151, 42155, 42200, 42204, 42221, 42239, 42247, 42281, 42325, 42326, 42360, 42361, 42365, 42366, 42424, 42454, 42476, 42477, 42478, 42484, 42485, 42494, 42499, 42526, 42531, 42555, 42575, 42678, 42724, 42733, 42734, 02993, 02997, 03002, 03004, 03031, 42001, 42016, 42028, 42029, 42037, 42042, 42047, 42049, 42050, 42051, 42054, 42055, 42063, 42077, 42080, 42083, 42087, 42101, 42103, 42117, 42140, 42147, 42150, 42156, 42157, 42163, 42165, 42166, 42169, 42179, 42180, 42182, 42183, 42186, 42195, 42196, 42197, 42223, 42227, 42231, 42234, 42235, 42236, 42240, 42243, 42245, 42249, 42250, 42251, 42253, 42254, 42256, 42260, 42261, 42262, 42264, 42265, 42266, 42267, 42268, 42269, 42270, 42272, 42276, 42291, 42298, 42300, 42304, 42331, 42333, 42336, 42337, 42347, 42349, 42350, 42353, 42354, 42355, 42358, 42362, 42378, 42379, 42385, 42389, 42398, 42399, 42400, 42401, 42402, 42403, 42404, 42406, 42436, 42439, 42440, 42441, 42442, 42443, 42458, 42459, 42460, 42472, 42483, 42493, 42511, 42512, 42536, 42537, 42538, 42539, 42554, 42557, 42562, 42565, 42567, 42568, 42569, 42570, 42580, 42581, 42582, 42597, 42610, 42660, 42663, 42672, 42696, 42697, 42698, 42701, 42708, 42226, 42018, 42135, 42185, 42252, 42273, 42284, 42364, 42367, 42374, 42488, 42618, 42648, 42677, 42525, 42719, 42081, 42090, 42093, 42095, 42110, 42114, 42133, 42181, 42332, 42671, 42576, 02580, 02977, 03016, 42116, 42396, 42532, 42689, 42010, 42073, 42295, 42296, 42661, 42753, 42176, 42164, 42588, 42589, 42590, 42599, 02963, 03028, 42373, 02976, 02979, 02988, 03015, 03021, 03027, 42022, 42034, 42038, 42041, 42088, 42104, 42348, 42352, 42372, 42452, 42468, 42238, 42346, 42302, 42547, 42560, 42412, 42490, 42432, 42433, 42659, 42006, 42024, 42060, 42082, 42194, 42232, 42263, 42318, 42342, 42344, 42351, 42368, 42395, 42534, 42628, 42642, 42673, 42688, 42693, 42702, 42199, 42573, 42684, 42170, 02985, 42078, 42138, 42158, 42161, 42188, 42215, 42242, 42275, 42308, 42327, 42370, 42414, 42425, 42445, 42470, 03032, 42120, 42313, 42533, 42641, 42056, 42306, 42530, 42665, 42667, 42707, 02964, 02969, 02972, 02984, 42290, 42495, 42563, 42607, 42616, 42629, 42668, 42675, 42725, 42739, 02966, 02968, 02970, 02971, 02973, 02974, 02981, 02990, 02992, 02996, 03001, 03007, 03012, 03013, 03014, 03025, 03026, 42014, 42017, 42020, 42023, 42030, 42040, 42043, 42044, 42045, 42046, 42052, 42066, 42067, 42071, 42072, 42096, 42097, 42099, 42100, 42111, 42112, 42122, 42123, 42125, 42130, 42131, 42136, 42141, 42143, 42144, 42148, 42149, 42154, 42160, 42171, 42172, 42175, 42190, 42191, 42203, 42205, 42206, 42208, 42211, 42218, 42225, 42228, 42229, 42230, 42233, 42241, 42244, 42255, 42257, 42258, 42274, 42277, 42278, 42280, 42285, 42287, 42288, 42294, 42297, 42299, 42303, 42307, 42309, 42310, 42315, 42320, 42322, 42323, 42324, 42328, 42335, 42339, 42340, 42345, 42357, 42359, 42390, 42391, 42393, 42407, 42408, 42411, 42423, 42426, 42429, 42431, 42437, 42438, 42448, 42456, 42467, 42469, 42473, 42475, 42479, 42486, 42486, 42487, 42489, 42492, 42497, 42500, 42506, 42510, 42515, 42528, 42529, 42540, 42541, 42542, 42543, 42544, 42548, 42552, 42556, 42558, 42559, 42566, 42572, 42578, 42579, 42583, 42585, 42605, 42606, 42613, 42614, 42619, 42621, 42632, 42633, 42634, 42639, 42640, 42651, 42653, 42654, 42655, 42656, 42657, 42686, 42700, 42703, 42714, 42717, 42720, 42727, 42128, 42593, 42617, and 42625.

Root Cause

Under Investigation by firm

Action Taken

The letter from Elekta dated May 2018 was issued via email 5/16/2018 and was flagged "URGENT IMPORTANT FIELD SAFETY NOTIFICATION. The letter identified the affected product, problem and actions to be taken.

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