Medical Device
Manufacturing
THE TRADE PAPER OF THE FACTORY FLOOR
Z-1892-2019Class II

PROBEAT-V, software versions 4.8.1S, and 5.1M Radiation therapy system

Hitachi High-Tech America, Inc. Radiation Therapy Division / initiated 2019-04-15 / Terminated / root cause: software

Hitachi America, Ltd., Power Systems Division began a recall of PROBEAT-V, software versions 4.8.1S, and 5.1M Radiation therapy system on . FDA classified it as Class II and gives the reason as "There is a potential for a discrepant target position when using 3D3D matching mode in PIAS (Positioning Image Analysis System) software installed in the PROBEAT-V, proton therapy systems". As of , the recall status on record is Terminated, and MDM tags the root cause as software.

Recall record

Recall number
Z-1892-2019
Classification
Class II
Status
Terminated
Initiated
Posted
Terminated
Recalling firm
Hitachi High-Tech America, Inc. Radiation Therapy Division
Product
PROBEAT-V, software versions 4.8.1S, and 5.1M Radiation therapy system.
Product code
LHN System, Radiation Therapy, Charged-Particle, Medical
Reason for recall
There is a potential for a discrepant target position when using 3D3D matching mode in PIAS (Positioning Image Analysis System) software installed in the PROBEAT-V, proton therapy systems.
Root cause tag
software
FDA root cause
Software design
Action
The firm informed affected user sites of the recall beginning on April 15, 2019, via an Engineering Document. The firm distributed updated Urgent Medical Device Recall letters in June 2019. The firm stated that the PIAS software would be replaced with the corrected version. Until the software was corrected, users were asked to take the following interim countermeasures: -Limit the number of treatment planning CT slices to odd numbers only. - Create treatment plan only in Head First condition for new patients. - Use the beam limiting device in full open in the lateral direction (same as before). Customers were asked to complete and return the customer response form to the firm. The firm stated that the software correction will be implemented from June 17 - 29, 2019.
Quantity in commerce
3
Distribution
Distributed to accounts located in AZ, MN, and TN. Foreign distribution to Japan.
Product codes and lots
2015B01, A01, A02

Enforcement reports

One row per recalled product line
FDA enforcement reports joined to recall event Z-1892-2019
Recall numberClassStatusVoluntary or mandatedReport dateClassified
Z-1892-2019Class IITerminatedVoluntary: Firm initiated