K Number
K042023
Date Cleared
2004-08-25

(28 days)

Product Code
Regulation Number
892.1680
Reference & Predicate Devices
N/A
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The indications for use of the Fuji Computed Radiography (FCR) ClearView CS Image Reader with initials frials (1) processing of diagnostic x-ray images of the human body, and associating patient and exam identification with the images.

Device Description

A Fuil Computed Radiography (FCR) system typically consists of an image reader (IR), patient ID terminal, imaging plates (IPs), IP cassettes, interface board, positioning monitor, laser printer for hard copy output, and optionally an image workstation, optical disk file, and network interface. This notification is for the image reader and associated imaging plates (IPs). IPs are used as twodimensional radiation detectors in place of radiographic film and intensifying screens to capture a portion of the projected x-ray patient image. In the image reader, the captured image data is associated electronically with patient and exam identification data and the latent image is read by laser emission by the phenomenon of photostimulable luminescence. The photostimulated fuminescence is then collected, sampled, and digitized. The image data is then digitally processed according to exam and user-specified parameters and may be displayed on a CRT monitor to confirm patient positioning, printed by a hard copy device (such as laser printer, or dry printer), or output to a workstation, optical disk file, or other destination. The device performs no lossy compression of image data.

FCR ClearView CS consists of an Image Reader and Imaging Plates of various sizes and types (described below). The Image Reader is casselle-based. The IP is placed into a cassette and exposed using standard x-ray equipment. The cassette containing the exposed image plate is then manually inserted into the ClearView CS Image Reader. The image reader automatically removes the IP from the cassette and moves the IP to the reading position where it is scanned by a laser beam. The luminescence from the IP is then converted to an electrical signal by a pholoelectron multiplier

AI/ML Overview

The provided text does not contain a detailed study description with acceptance criteria and a comprehensive report of device performance against these criteria. Instead, it is a 510(k) Summary for the Fuji Computed Radiography (FCR) ClearView CS Image Reader, which focuses on device description, intended use, and substantial equivalence to predicate devices. It does not include information about clinical studies, expert-established ground truth, sample sizes for training or test sets, or comparative effectiveness with human readers.

Therefore, I cannot provide the requested information in the format of a table or answer the specific questions about acceptance criteria, study details, or performance metrics from the given text.

The closest information related to performance is a comparison of technical characteristics between the FCR ClearView CS and predicate devices, as shown in the table on page 1. This table lists various parameters like image recording, patient identification, reading method, laser type, sampling raster, gray scale, physical dimensions, weight, throughput, and processing time. However, these are technical specifications, not acceptance criteria for clinical performance or outcomes, nor is there a report on how the device performed against any such criteria.

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K042 023

Image /page/0/Picture/2 description: The image shows the Fujifilm logo. The logo consists of the word "FUJIFILM" in bold, black letters, with a smaller black graphic to the left. Below the wordmark is the text "I&I-Imaging & Information" in a smaller font size.

FUJIFILM MEDICAL SYSTEMS USA, INC.

419 WEST AVENUE STAMFORD, CT 06902 Telephone: 203/324-2000 Fax: 203/353-0926

510(K) Summary

In accordance with the requirements of the Safe Medical Device Act, FUJIFILM Medical Systems, USA, Inc. herewith submits a 510(K) summary of safety and effectiveness for the following device.

SUBMITTER NAME / ADDRESS:FUJIFILM Medical Systems, USA, Inc.419 West AvenueStamford, CT 06902
CONTACT PERSON / TEL NO:Frank GianelliRegulatory Coordinator
DATE SUMMARY PREPARED:June 29, 2004
ESTABLISHMENT NO .:2443168
TRADE/PROPRIETARY NAME:Fuji Computed Radiography (FCR) ClearView CSImage Reader (CR-IR363)
COMMON/USUAL NAME:Computed Radiography Image Reader
CLASSIFICATION NAME:Solid State X-Ray Imager
CLASS/PANEL:Class II, 90-MQB, 21CFR 892.1650
PREDICATE DEVICE(S):FCR 9000HQ Image ReaderFCR 5501D Image ReaderFCR 9000 Image Reader

DEVICE DESCRIPTION:

A Fuil Computed Radiography (FCR) system typically consists of an image reader (IR), patient ID terminal, imaging plates (IPs), IP cassettes, interface board, positioning monitor, laser printer for hard copy output, and optionally an image workstation, optical disk file, and network interface. This notification is for the image reader and associated imaging plates (IPs). IPs are used as twodimensional radiation detectors in place of radiographic film and intensifying screens to capture a portion of the projected x-ray patient image. In the image reader, the captured image data is associated electronically with patient and exam identification data and the latent image is read by laser emission by the phenomenon of photostimulable luminescence. The photostimulated fuminescence is then collected, sampled, and digitized. The image data is then digitally processed according to exam and user-specified parameters and may be displayed on a CRT monitor to confirm patient positioning, printed by a hard copy device (such as laser printer, or dry printer), or output to a workstation, optical disk file, or other destination. The device performs no lossy compression of image data.

FCR ClearView CS consists of an Image Reader and Imaging Plates of various sizes and types (described below). The Image Reader is casselle-based. The IP is placed into a cassette and exposed using standard x-ray equipment. The cassette containing the exposed image plate is then manually inserted into the ClearView CS Image Reader. The image reader automatically removes the IP from the cassette and moves the IP to the reading position where it is scanned by a laser beam. The luminescence from the IP is then converted to an electrical signal by a pholoelectron multiplier

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PARAMETERFCR 3000FCR 5501DFCR 9000MQFCR ClearView CS
Image RecordingDigital Data (from Console)Digital Data (from Console)Digital Data (from Console)Digital Data (from Console)
Patient Identification
Recording MethodPhotostimulable LuminescencePhotostimulable LuminescencePhotostimulable LuminescencePhotostimulable Luminescence
No. of Imaging Plates/Cassette SlotsFour Cassette slots!Two Built-in Imaging PlatesOne Cassette slotOne Cassette slot
Image plate types and sizesST-VI 14"×17",14"×14",10"×12",8"×10"ST-55BD 460×510 mm (usable area)ST-VN 14"×17",14"×14",10"×12",8"×10"ST-VN 14"×17",14"×14",10"×12",8"×10"HR-V 18"x10"
Image Reading
Reading MethodHR-V 24cm×30cm,18cm×24cmHR-V 24cm×30cm,18cm×24cmHR-V 24cm×30cm,18cm×24cmHR-BD 24cm×30cm,18cm×24cm
ReadingRaster Scan (ST/HR), RasterScan with dual-sidedetector(HR-80)Raster Scan with dual-sidedetectorRaster ScanRaster Scan
Reading LaserLaser Diodes (660 nm)Laser Diodes (680 nm)Laser Diodes (675 nm)Laser Diodes (675 nm)
Sampling Raster10 bits (1024 gray levels)10 bits (1024 gray levels)10 bits (1024 gray levels)10 bits (1024 gray levels)
Gray ScaleIP Reading Area Pixels/mmIP Reading Area Pixels/mmIP Reading Area Pixels/mmIP Reading Area Pixels/mm
ST-VI 14"×17" 10ST-VI 14"×14" 10ST-VI 10"×12" 10ST-VI 8"×10" 10HR-V 24cm×30cm 10HR-V 18cm×24cm 10HR-BD 24cm×30cm 20HR-BD 18cm×24cm 20ST-55BD 17x17 in 10ST-55BD 14x17 in. 10ST-55BD 14x14 in. 10ST-55BD 10x12 in. 10ST-55BD 8x10 in 10ST-55BD 18x43 cm 10ST-VN 14"×17" 10ST-VN 14"×14" 10ST-VN 10"×12" 10ST-VN 8"×10" 10HR-V 8"×10" 10ST-VN 14"×17" 5ST-VN 14"×14" 5ST-VN 10"×12" 6.7ST-VN 8"×10" 10HR-V 8"×10" 10
Physical
WxHxD (mm)655×740×1480 mm1170×800×1800950×750×1760 mm950×750×1760 mm
Weight (kg)285 kg540 kg350 kg350 kg
Throughput (Approximate)122 IP's/hr150 IP's/hr75 IP's/hr110 IP's/hr
Processing Time -14"×14" IP53 seconds88 seconds142 seconds105 seconds

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Image /page/2/Picture/0 description: The image is a black and white logo for the Department of Health & Human Services USA. The logo consists of a stylized image of an eagle with its wings spread, enclosed within a circular border. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" is written around the border of the circle.

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

FUJIFILM Medical Systems USA, Inc. % Mr. William J. Sammons Project Engineer Underwriters Laboratories, Inc. 12 Laboratory Drive, P.O. Box 13995 Research Triangle Park, NC 27709-3995

AUG 23 2013

Re: K042023

Trade/Device Name: Fuii Computed Radiography (FCR) Clear View CS Image Reader (CR-IR363) Regulation Number: 21 CFR 892.1680 Regulation Name: Stationary x-ray system Regulatory Class: II Product Code: MQB Dated: August 10, 2004 Received: August 11, 2004

Dear Mr. Sammons:

This letter corrects our substantially equivalent letter of August 25, 2004.

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 of

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medical device-related adverse events) (21 CFR 803); and good manufacturing practice requirements as set forth in the quality systems (QS) 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

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

Enclosure

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Indications For Use

510(k) Number (if known): K042023

Device Name: FCR ClearView CS Image Reader (CR-IR363)

Indications For Use:

The indications for use of the Fuji Computed Radiography (FCR) ClearView CS Image The Intolcations for abover the identification, capture, digitization, capture, digitization, and Reader with initials frials (1)
processing of diagnostic x-ray images of the human body, and associating patient and exam identification with the images.

Prescription Use _ X (Part 21 CFR 801 Subpart D) ANDIOR

Over-The-Counter Use (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Daniel A. Seymore


ivision of Reproductive, Abdominal, and Radiological De 510(k) Number

Page _1_of _1 Page A2-2

§ 892.1680 Stationary x-ray system.

(a)
Identification. A stationary x-ray system is a permanently installed diagnostic system intended to generate and control x-rays for examination of various anatomical regions. 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). A radiographic contrast tray or radiology diagnostic kit intended for use with a stationary 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.