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U.S. Department of Health and Human Services

Class 2 Device Recall

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  Class 2 Device Recall see related information
Date Initiated by Firm August 09, 2013
Date Posted October 24, 2013
Recall Status1 Terminated 3 on April 10, 2014
Recall Number Z-0065-2014
Recall Event ID 66121
510(K)Number K023220  
Product Classification System, Applicator, Radionuclide, Remote-Controlled - Product Code JAQ
Product VARISOURCE Breast Template System for high-dose rate Brachytherapy.
***INSTRUCTIONS FOR USE*** Breast Bridge & Template System AL13011000 ***Manufacturer: Varian Medical Systems, Inc., 3100 Hansen Way, Palo Alto, CA 94304 USA
Code Information Lots #6078184-1, #6078184-2, #6078184-4
Recalling Firm/
Manufacturer
Varian Medical Systems, Inc.
700 Harris St Ste 109
Charlottesville VA 22903-4584
For Additional Information Contact Mark Kattmann
434-977-8495
Manufacturer Reason
for Recall
The recall was initiated after Varian Medical became aware the Lexan templates of the Breast Bridge Template System could become bent and turn opaque after steam sterilization.
FDA Determined
Cause 2
Nonconforming Material/Component
Action Urgent Medical Device Correction, Urgent Field Safety Notice were mailed by FedEx tracked delivery to all consignees on August 12, 2013.
Quantity in Commerce 3 sets
Distribution Worldwide distribution: US (nationwide) distribution in CA and in the country of India.
Total Product Life Cycle TPLC Device Report

1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
3 For details about termination of a recall see Code of Federal Regulations (CFR) Title 21 §7.55.
510(K) Database 510(K)s with Product Code = JAQ and Original Applicant = VARIAN MEDICAL SYSTEMS
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