K Number
K030745
Device Name
GAMMAMED 212 AND 232 SOURCE ASSEMBLY
Date Cleared
2003-03-12

(2 days)

Product Code
Regulation Number
892.5730
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Gammamed Model 212 and 232 source assembly is designed to be used in conditions typically associated with hospitals and medical facilities for the treatment of cancerous tumors.
Device Description
The Gammamed 212 and 232 Source Assemblies are brachytherapy sources that are used in conjunction with Gammamed remote afterloaders. The Gammamed 212 Source Assembly is used in conjunction with the Gammamed 12i or 12it temote afterloader. The Gammamed 232 Source Assembly is used with either the Gammamed Plus or Gammamed 3/24 afterloader.
More Information

Not Found

No
The summary describes a brachytherapy source assembly and its use with remote afterloaders, with no mention of AI or ML technologies.

Yes
The device is used for "treatment of cancerous tumors," indicating a therapeutic purpose.

No

Explanation: The device is described as a brachytherapy source used for the "treatment of cancerous tumors," indicating a therapeutic rather than diagnostic purpose.

No

The device description clearly states it is a "source assembly" and a "brachytherapy source," which are physical components used in conjunction with remote afterloaders, indicating it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use clearly states the device is for the "treatment of cancerous tumors" and is used in "hospitals and medical facilities." This describes a therapeutic device used directly on a patient, not a device used to examine specimens (like blood, tissue, etc.) outside the body to diagnose or monitor a condition.
  • Device Description: The description identifies the device as "brachytherapy sources" used with "remote afterloaders." Brachytherapy is a form of radiation therapy where a radioactive source is placed inside or next to the area requiring treatment. This is a therapeutic procedure, not a diagnostic one.
  • Lack of IVD Indicators: The document does not mention any activities typically associated with IVDs, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Providing diagnostic information
    • Using reagents or assays

Therefore, the Gammamed Model 212 and 232 source assembly is a therapeutic medical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The Gammamed Model 212 and 232 source assembly is designed to be used in conditions typically associated with hospitals and medical facilities for the treatment of cancerous tumors.

Product codes (comma separated list FDA assigned to the subject device)

90 KXK

Device Description

The Gammamed 212 and 232 Source Assemblies are brachytherapy sources that are used in conjunction with Gammamed remote afterloaders. The Gammamed 212 Source Assembly is used in conjunction with the Gammamed 12i or 12it temote afterloader. The Gammamed 232 Source Assembly is used with either the Gammamed Plus or Gammamed 3/24 afterloader.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

hospitals and medical facilities

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

Not Found

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

Not Found

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K891131

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 892.5730 Radionuclide brachytherapy source.

(a)
Identification. A radionuclide brachytherapy source is a device that consists of a radionuclide which may be enclosed in a sealed container made of gold, titanium, stainless steel, or platinum and intended for medical purposes to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy.(b)
Classification. Class II (special controls). A prostate seeding kit intended for use with a radionuclide brachytherapy source only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

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Image /page/0/Picture/0 description: The image shows the logo for Varian Medical Systems. The logo consists of the word "VARIAN" in a bold, sans-serif font, with a stylized "I" that has a dot above it. Below the word "VARIAN" is the phrase "medical systems" in a smaller, sans-serif font. The logo is simple and clean, and it conveys a sense of professionalism and innovation.

K030745

Varian Medical Systems, Inc. 3100 Hansen Way Palo Alto, CA 94304-1038 IISA tel +1 650 493 4000 www.varian.com

The following information is provided following the format of 21 CFR 807.92 for the Gammamed 212 and 232 Source Assembly

MAR 1 2 2003

1. Submitter:Varian Medical Systems
3100 Hansen Way M/S H055
Palo Alto, CA 94304-1129
Contact Name: Vy Tran
Phone: (650) 424-5731
Fax: (650) 842-5040
Email: vy.tran@varian.com
Date: March 7, 2003
  1. Device Name: Gammamed 212 and 232 Source Assembly
Classification Name:Radionuclide brachytherapy source
Common/Usual Name:Gammamed 212 and 232 Source Assembly
Proprietary Name:Gammamed 212 and 232 Source Assembly
  1. Equivalent Device: Gammamed 12i, K891131

  2. Device Description: The Gammamed 212 and 232 Source Assemblies are brachytherapy sources that are used in conjunction with Gammamed remote afterloaders. The Gammamed 212 Source Assembly is used in conjunction with the Gammamed 12i or 12it temote afterloader. The Gammamed 232 Source Assembly is used with either the Gammamed Plus or Gammamed 3/24 afterloader.

  3. Statement of Intended Use: The Gammamed Model 212 and 232 source assemblies are designed for use in medical brachytherapy applications.

  4. Comparison to substantially equivalent devices:

Features / ProductsGAMMAMED 12iGAMMAMED 212GAMMAMED 232
DeviceFDA approvalK891131PendingPending
IsotopeIr-192Ir-192Ir-192
Nominal Activity370 GBq (10 Ci)370 GBq (10 Ci)370 GBq (10 Ci)
Active dimensions Ø x length0.6 x 4.0 mm0.6 x 3.5 mm0.6 x 3.5 mm
cable length2100 mm2100 mm2100 mm
cable diameter1.1 mm1.1 mm0.9 mm
manufacturing processelectron beamlaser weldinglaser welding

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Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 1 2 2003

Ms. Vy Tran Manager, Regulatory Affairs Varian Medical Systems, Inc. 3100 Hansen Way PALO ALTO CA 94304-1038

Re: K030745

Trade/Device Name: Gammamed 212 and 232 Source Assembly Regulation Number: 21 CFR $892.5730 Regulation Name: Radionuclide brachytherapy source Regulatory Class: II Product Code: 90 KXK Dated: March 7, 2003 Received: March 10, 2003

Dear Ms. Tran:

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 either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. 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 Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (sections 531-542 of the Act); 21 CFR 1000-1050.

2

This letter will allow you to begin marketing your device as described in your 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 Part 801), please contact the Office of Compliance at one of the following numbers, based on the regulation number at the top of this letter:

8xx.1xxx(301) 594-4591
876.2xxx, 3xxx, 4xxx, 5xxx(301) 594-4616
884.2xxx, 3xxx, 4xxx, 5xxx, 6xxx(301) 594-4616
892.2xxx, 3xxx, 4xxx, 5xxx(301) 594-4654
Other(301) 594-4692

Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely yours,

Nancy C Brogdon

Nancy C. Brogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Image /page/3/Picture/0 description: The image shows the logo for Varian Medical Systems. The logo consists of the word "VARIAN" in a serif font, with a stylized "I" that resembles a person. Below the word "VARIAN" are the words "medical systems" in a smaller, sans-serif font. The logo is simple and professional, and it conveys a sense of innovation and technology.

Varian Medical Systems, Inc. 3100 Hanson Way Palo Alto, CA 94304-1038 USA tel +1 650 493 4000 www.varian.com

Statement of Indications for Use

510(k) Number (if known):

K030745

Device Name:

The Gammamed Model 212 and 232 source assembly

Indications For Use:

The Gammamed Model 212 and 232 source assembly is designed to be used in conditions typically associated with hospitals and medical facilities for the treatment of cancerous tumors.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use X (Per 21 CFR 801.109)

OR

Over-The-Counter Use (Optional Format 1-2-96)

David R. Lyman

(Division Sign-Off) Division of Reproductive, Abdominal, and Radiological Devices

510(k) Number K030745