K Number
K023178
Device Name
INNOVA 4100
Date Cleared
2002-11-26

(64 days)

Product Code
Regulation Number
892.1650
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Digital Fluoroscopic Imaging System is indicated for use in generating fluoroscopic images of human anatomy for diagnostic and intervention angiography procedures. It is intended to replace fluoroscopic images obtained through the image intensifier technology. This device is not intended for mammography applications. The Digital Fluoroscopic Imaging System is indicated for use in diagnostic and interventional angiographic procedures of human anatomy. It is intended to replace image intensifier fluoroscopic systems in all diagnostic or interventionnal procedures. This device is not intended for mammography applications.
Device Description
The Digital Fluoroscopic Imaging System is designed to perform fluoroscopic x-ray examinations. The detector is comprised of amorphous silicon with a cesium iodide scintillator. The resulting digital image can be sent through a Fiber Channel link to an acquisition equipment then to network (in using DICOM) for applications such as post-processing, printing, viewing and archiving. Digital Fluoroscopic Imaging System consists of an angiographic monoplane positioner, a vascular table, an X-RAY system and a digital detector.
More Information

No
The summary describes a digital fluoroscopic imaging system that replaces older image intensifier technology. While it mentions digital image processing and networking (DICOM), there is no mention of AI, ML, deep learning, or any related concepts in the intended use, device description, or performance studies. The focus is on the digital acquisition and handling of images, not on AI/ML-driven analysis or processing.

No

The device is indicated for generating diagnostic images and is not described as providing a therapeutic effect or treatment.

Yes

The "Intended Use / Indications for Use" section explicitly states that the system is "indicated for use in generating fluoroscopic images of human anatomy for diagnostic and intervention angiography procedures" and "is indicated for use in diagnostic and interventional angiographic procedures of human anatomy." The "Summary of Performance Studies" also mentions "equivalent image diagnostic capability."

No

The device description explicitly lists hardware components such as a detector, positioner, vascular table, and X-RAY system, indicating it is not software-only.

Based on the provided text, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body (like blood, urine, or tissue) to provide information about a person's health.
  • Device Function: The description clearly states the device is a "Digital Fluoroscopic Imaging System" that generates "fluoroscopic images of human anatomy" using "fluoroscopic x-ray examinations." This is an imaging device that works externally to the body, not by analyzing samples taken from the body.
  • Intended Use: The intended use is for "generating fluoroscopic images of human anatomy for diagnostic and intervention angiography procedures." This involves visualizing internal structures using X-rays, not analyzing biological samples.

Therefore, the function and intended use of this device fall outside the scope of In Vitro Diagnostics.

N/A

Intended Use / Indications for Use

The Digital Fluoroscopic Imaging System is indicated for use in generating fluoroscopic images of human anatomy for diagnostic and intervention angiography procedures. It is intended to replace fluoroscopic images obtained through the image intensifier technology. This device is not intended for mammography applications.

Product codes

OWB, JAA

Device Description

The Digital Fluoroscopic Imaging System is designed to perform fluoroscopic x-ray examinations. The detector is comprised of amorphous silicon with a cesium iodide scintillator. The resulting digital image can be sent through a Fiber Channel link to an acquisition equipment then to network (in using DICOM) for applications such as post-processing, printing, viewing and archiving. Digital Fluoroscopic Imaging System consists of an angiographic monoplane positioner, a vascular table, an X-RAY system and a digital detector.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Fluoroscopic X-ray

Anatomical Site

Human anatomy

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

A clinical comparison study: 6 radiologists from 3 hospitals: Saint-Luke's Hosp. (Bethlehem, Pennsylvania - US), Saint-Francis Hospital, (Peoria, Illinois - US); Centre Paris Nord (Sarcelles - France) compared digital images recorded on Innova 2000 and Innova 4100 from 11 pairs of patient sequences and found that the digital images from the Innova 4100 had equivalent image diagnostic capability.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

  • Study Type: Clinical comparison study and non-comparative clinical evaluations.
  • Sample Size: 11 pairs of patient sequences for the comparative study.
  • AUC: Not Found
  • MRMC: Not Found
  • Standalone Performance: Not Found
  • Key Results: The digital images from the Innova 4100 had equivalent image diagnostic capability compared to Innova 2000. A non-comparative clinical evaluation of the Large Field of View (40 cm) image diagnostic capability has been conducted by the same group of radiologists as well. A non-comparative clinical evaluation of fluoroscopy in all FOV conducted in real time of the clinical procedures by three radiologists of Saint-Luke's.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K993037

Reference Device(s)

K971452, K020483

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 892.1650 Image-intensified fluoroscopic x-ray system.

(a)
Identification. An image-intensified fluoroscopic x-ray system is a device intended to visualize anatomical structures by converting a pattern of x-radiation into a visible image through electronic amplification. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II (special controls). An anthrogram tray or radiology dental tray intended for use with an image-intensified fluoroscopic x-ray system only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9. In addition, when intended as an accessory to the device described in paragraph (a) of this section, the fluoroscopic compression device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

0

Image /page/0/Picture/1 description: The image shows the General Electric (GE) logo. The logo consists of the letters "GE" intertwined within a circle. The logo is black and white and has a vintage look.

GE Medical Systems P.O. Box 414, W-709 Milwaukee, WI 53201

バロ23/チ8

510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

This 510(k) summary of safety and effectiveness information is submitted in accordance with the requirements of 21 CFR Part 807.87(h).

| Identification of Submitter: | Larry A. Kroger, Ph.D.
Senior Regulatory Programs Manager
GE Medical Systems
Tel. (414) 544-3894
Summary prepared: 17 September 2002 |
|---------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Identification of Product:
Classification Name:
Manufacturer: | Digital Fluoroscopic Imaging System
Stationary X-ray System
GE Medical Systems Europe
283, rue de la Minière
78530 Buc Cedex, France |
| Distributed by: | GE Medical Systems, Milwaukee, WI |
| Marketed Devices: | The Digital Fluoroscopic Imaging System is substantially
equivalent to the currently marketed cardiographic system
LCV+ Version 2 so-called Innova 2000 introduced in 2000
(K993037) that complies with the same or equivalent
standards. The collimator used (Siemens model # 0468264
G052G) was introduced in the Siemens angiographic device
Sireskop (version SX ou SD cleared under K971452) in
1997. The Review station used so-called Advantage
Workstation 4.1 was introduced in 2000 (K020483). |
| Device Description: | The Digital Fluoroscopic Imaging System is designed to
perform fluoroscopic x-ray examinations. The detector is
comprised of amorphous silicon with a cesium iodide
scintillator. The resulting digital image can be sent through a
Fiber Channel link to an acquisition equipment then to
network (in using DICOM) for applications such as post-
processing, printing, viewing and archiving. Digital
Fluoroscopic Imaging System consists of an angiographic
monoplane positioner, a vascular table, an X-RAY system and
a digital detector. |

1

Materials: All construction and materials are compliant with UL 187 for the existing parts of the product and with UL 2601 for the new parts.

  • Design: There are hardware and software redundancies to prevent from single point failures that could cause unintended motion.
    Energy Source: 480 VAC 50/60Hz.

Indications for Use: The Digital Fluoroscopic Imaging System is indicated for use in generating fluoroscopic images of human anatomy for diagnostic and intervention angiography procedures. It is intended to replace fluoroscopic images obtained through the image intensifier technology. This device is not intended for mammography applications.

Comparison with The 41 cm Digital Fluoroscopic Imaging System is Predicate: substantially equivalent to the 20 cm Fluoroscopic system socalled Innova 2000 (Originally Cleared as the LCV+ Version 2; K993037).

  • Summary of Studies: A clinical comparison study: 6 radiologists from 3 � hospitals: Saint-Luke's Hosp. (Bethlehem, Pennsylvania - US), Saint-Francis Hospital, (Peoria, Illinois - US); Centre Paris Nord (Sarcelles - France) compared digital images recorded on Innova 2000 and Innova 4100 from 11 pairs of patient sequences and found that the digital images from the Innova 4100 had equivalent image diagnostic capability.
    ◆ A non-comparative clinical evaluation of the Large Field of View (40 cm) image diagnostic capability has been conducted by the same group of radiologists as well.

◆ A non-comparative clinical evaluation of fluoroscopy in all FOV conducted in real time of the clinical procedures by three radiologists of Saint-Luke's.

Conclusions: GE considers the 41 cm Digital Fluoroscopic Imaging System to be equivalent with the predicate device. The 41 cm Digital Fluoroscopic Imaging System provides fluoroscopic images that result in equivalent diagnostic capabilities than the 20 cm images. The potential hazards, e.g., wrong measurements and misdiagnosis, are controlled by a risk management plan including:

  • · A hazard identification
  • · A risk evaluation
  • · A Software Development and Validation Process

2

Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three stripes forming its body and wings. The eagle is facing right, and its head is slightly tilted upwards. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" is arranged in a circular pattern around the eagle.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room - WO66-G609 Silver Spring, MD 20993-0002

JUL 3 Ú 2012

Larry A. Kroger, Ph.D. Senior Regulatory Programs Manager GE Medical Systems, Inc. P.O. Box 414, W-709 MILWAUKEE WI 53201

Re: K023178

Trade/Device Name: Innova 4100 Regulation Number: 21 CFR 892.1650 Regulation Name: Image-intensified fluoroscopic x-ray system Regulatory Class: II Product Code: OWB and JAA Dated: September 20, 2002 Received: September 23, 2002

Dear Dr. Kroger:

This letter corrects our substantially equivalent letter of November 26, 2002.

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into class II (Special Controls), it may be subject to such additional controls. Existing major regulations affecting your device can be found in Title 21, Code of Federal Regulations (CFR), Parts 800 to 895. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Parts 801 and 809); medical device reporting (reporting of

3

medical device-related adverse events) (21 CFR 803); and good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820). This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Parts 801 and 809), please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at (301) 796-5450. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely Yours,

Janine M. Morris

Acting Director Division of Radiological Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

4

STATEMENT OF INTENDED USE

510(k) Number (if known): _K

Device Name: Digital Fluoroscopic Imaging System - Innova 4100

Indications for Use

:

The Digital Fluoroscopic Imaging System is indicated for use in diagnostic and interventional angiographic procedures of human anatomy. It is intended to replace image intensifier fluoroscopic systems in all diagnostic or interventionnal procedures. This device is not intended for mammography applications.

. .

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801-109)

OR Over-The-Counter Use

Nancy C. Gardner

(Division Sign-Off)
Division of Reproductive, Abdominal,
and Radiological Devices
510(k) Number K023178