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U.S. Department of Health and Human Services

Class 2 Device Recall Cios Alpha

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  Class 2 Device Recall Cios Alpha see related information
Date Initiated by Firm April 17, 2020
Date Posted May 04, 2020
Recall Status1 Terminated 3 on August 25, 2020
Recall Number Z-2127-2020
Recall Event ID 85572
510(K)Number K181560  
Product Classification Interventional fluoroscopic x-ray system - Product Code OWB
Product Cios Alpha Image-Intensified Fluoroscopic X-Ray System, Model Numbers VA20-10308191 and VA30-10308194

The Cios Alpha and Cios Spin are a mobile X-Ray system designed to provide X-ray imaging of the anatomical structures of patient during clinical applications.
Code Information Serial Numbers: 11200 13288 13259 12339 13241 10019 12377 13219 12946 13232 13045 12618 12972 40109 40110 40073 40057 40013 40082 40093 40078 40107 40108 40111 40120 40126 40134 40135 40104 40074 40095 40076 40080 40058 40077 40081 40055 40054 40075 40125 40113 40102 40071 40061 40094 40124 40070 40103 40118 40119 40121 40084 40122 40123 40083 40062 40130 40116
Recalling Firm/
Manufacturer		 Siemens Medical Solutions USA, Inc
40 Liberty Blvd
Malvern PA 19355
For Additional Information Contact Meredith Adams
610-219-4834
Manufacturer Reason
for Recall		 The unplugging of the main cable on the monitor trolley from the X10 connector can cause an unsafe electrical voltage (up to 67,6 V DC) at the X10 connector. This can result in an electrical shock if the user or other persons touch the contact pins of the X10 connector.
FDA Determined
Cause 2		 Device Design
Action URGENT: MEDICAL DEVICE CORRECTION notification letters dated 4/17/20 were sent to customers. What is the impact to the operation of the system and what are the possible risks? There is no impact to the operation of the system, however, unplugging the main cable can cause an unsafe electrical voltage (up to 67,6 V DC) at the X10 connector which can result in an electrical shock if the user or other persons touch the contact pins of the X10 connector. How was the subject identified and what is the root cause? The issue was identified by the manufacturer during system assembly when the plug of the main cable was unplugged. The root cause is a design flaw in a generator component of the generator Polydoros M25 revision 04. What actions do we recommend urgently to mitigate possible risks? We strongly recommend that you do not unplug the main cable until the generator is repaired by a service engineer. How will the corrective action be implemented and what is the efficiency of the corrective actions? Siemens will correct the hardware error via Update Instruction AX028/20/S in which a Siemens Service Engineer will repair the generator at your site. Our service organization will contact you shortly to arrange a date to perform this corrective action. Please feel free to contact our service organization for an earlier appointment at 1-800-888-7436. Following the correction, the cause is eliminated, and any recurrence of this potential fault is prevented. Acknowledge Receipt of this Safety Advisory Notice Please review, understand, and confirm acknowledgement of the information and instructions outlined in this Urgent Safety Advisory Notice. By signing this document, you are acknowledging that you have read and understand the content therein.
Quantity in Commerce 58
Distribution US Nationwide Distribution to states of: AR, AZ, CA, FL, IL, IN, MA, MD, MI, MN, NC, NE, NH, NJ, NY, OH, OK, SC, TN, TX, UT, VA, WA, and Puerto Rico.
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 = OWB and Original Applicant = Siemens Medical Systems USA, Inc.
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