General Information

Participants

Sales Rep

Clinical Support Lead

Other MRI members

General Information
Date

Scanner

Patient position

Hospital

Software Version

Type of Procedure

Surgeon

MRI Tech

Target

Fellow(s)

Uni or Bilateral

Procedure (If you want to add note for your answer, just double click on the border)

Clearpoint product used

Is the Surgeon/Fellow trained to use product with completed -0079?

Is there a defined workflow and checklist for this procedure?

Was the workflow and checklist used during the procedure?

Where there deviations from the workflow and checklist during this procedure?

Were there any MR related scan issues?

Were there any Software issues?

Were there any product complaints during the procedure?

What info is there to pass along for the next case?

Action items to address?

Was there any discussion on potential next case or new use of product?

Procedure

Time (military)
Patient arrived to the MRI suite
Anesthesia, Patient Asleep, Foley, etc.
Patient pinned
Marking grid/Incision
SmartFrame build complete
Trajectory planning complete
Alignment complete
Insertion complete
Therapy complete (if applicable)
Out of Room
Total Time
Patient IN to OUT of room
Patient pinned to insertion
Initial Scanning and entry point planning
Surgical Time from Incision to complete build
Scanning and Target replanning
Time for Alignment
Anesthesia Time
Time for Therapy
Closing and out of room

ClearPoint Data

Left Side

Projected Error

Trajectory View

Actual Error

Trajectory View

Was bias compensation used?

Did bias compensation work?

What was the final 2D radial error after compensation?

How did you rule out other factors in order to use bias compensation?

Right Side

Projected Error

Trajectory View

Actual Error

Trajectory View

Was bias compensation used?

Did bias compensation work?

How did you rule out other factors in order to use bias compensation?

What was the final 2D radial error after compensation?

How did you rule out other factors in order to use bias compensation?

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.