This article walks you through every stage a case moves through, from creation to completion, and who acts at each one. It is for everyone who creates, plans, reviews or approves cases.
Knowing where a case is tells you what happens next and who is responsible for it. The current stage is shown as a status on the case card and in the case drawer.
The stages
Case Details: you create the case and enter the patient, surgery and case output details.
Awaiting Scan Files: the case exists, but no CT scan has been attached yet.
Pending and Segmenting: the scan is attached and the 3D models of the anatomy are being prepared.
Segmentation: the 3D anatomy is ready for you to review and confirm.
Reduction (fracture cases only, for example DRF): you move the fracture fragments back into alignment.
Landmarks: you review and adjust the anatomical reference points.
Surgery Planning: you review the plan, swap templates and move implants and cuts.
PSI Design: you review the patient-specific guide and adjust its type and parameters. Plan Only cases skip this stage.
Approve: the plan is reviewed and approved. The status reads Awaiting Approval, or Awaiting Final Review while a supervised case waits for back-office approval.
Ready for Production and In Production: for Plan and PSI cases, the approved PSI is produced. The case moves to In Production as soon as its output is downloaded, printed or validated.
Completed: the case is finished. Plan Only cases become Completed as soon as they are approved; Plan and PSI cases become Completed once every output pack has shipped.
Your approved output packs and files are on the Files tab of the case drawer. See Downloading Files & Plan Reports.
Who acts at each stage
What you can do on a case depends on your case role:
Approvers (Clinicians, Organization Admins and Organization Back Office in their own organization) can edit the plan, confirm or reject each step, and give the final approval with Approve Case.
Editors (Medical Assistants and Sales Reps in their own organization) can edit the plan and confirm or reject each step, but cannot give the final case approval.
Managers (Organization Supervisors in their own organization) can update case details and imaging, but cannot edit the plan.
Viewers (Technicians in their own organization) can view the case and download its files.
The back office (your Organization Back Office users or the CustoMED back-office team) steps in when a case needs review or a back-office approval.
People from outside the organization have the role they were given when the case was shared. See Sharing a Case with Others.
When a case is with the back office
A case goes to back-office review when, for example:
You reject a result and send it for review.
You approve a case in a Supervised or Viewer organization and it needs back-office approval.
In a Viewer organization, you confirm a step that the back office has not prepared yet.
While the back office works on a case, it is locked. Its card shows a lock icon, and inside the case you see a View Only and In Back Office badge. You can still view, share and approve, but you cannot edit until the back office sends the case back to you. When that happens, the collaborators the back office selects receive an email asking them to review the case.
Reopening an approved case
An approved case can be reopened when a change is needed. Only the back office can reopen a case, so contact your Organization Back Office or the CustoMED team. After reopening, the approved output packs stay locked as they are, and a new draft output pack is used for the changes. Earlier versions are kept.