K Number
K042961
Device Name
SPY INTRA-OPERATIVE IMAGING SYSTEM: SP2000
Date Cleared
2005-01-19

(84 days)

Product Code
Regulation Number
892.1600
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For use in intra-operative visual assessment of the coronary vasculature and bypass grafts during coronary artery bypass (CABG) surgery.
Device Description
The SPYTM Intra-operative Imaging System: SP2000 is indicated for use for intraoperative visual assessment of the coronary vasculature and grafts during CABG surgery. The SPYTM system provides the surgeon with the capability to view, record and replay fluorescent images of blood vessels and bypass grafts of the heart. A laser light source is used to illuminate the heart surface. Indocyanine Green (ICG) is injected intravenously through the central venous line, bypass pump or cardioplegia line and, while coursing through the coronary arteries and grafts, the absorption of laser light causes excitation of the dye followed by emission of infrared energy. The result is a fluorescent image of the coronary vasculature. A CCD camera captures the image. These images are used to evaluate the integrity of the coronary vasculature and bypass grafts.
More Information

Not Found

No
The description focuses on the optical and imaging components of the device and does not mention any AI/ML capabilities or image processing beyond basic capture and display.

No
The device is used for visual assessment and evaluation, not for treating any condition.

Yes
The device is used for intra-operative visual assessment and evaluation of the integrity of coronary vasculature and bypass grafts, which are diagnostic purposes to determine the success and patency of the grafts.

No

The device description explicitly details hardware components like a laser light source and a CCD camera, and performance studies include testing against electrical and laser standards, indicating it is a hardware-based system with associated software.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used outside of the body (in vitro).
  • Device Function: The SPYTM Intra-operative Imaging System: SP2000 is used during surgery (intra-operative) to visualize the coronary vasculature and bypass grafts directly on the heart. It uses a laser and fluorescent dye to create images of the blood vessels within the body.
  • Intended Use: The intended use is for "intra-operative visual assessment of the coronary vasculature and bypass grafts during coronary artery bypass (CABG) surgery." This clearly describes a procedure performed on the patient's body during surgery.
  • Sample Type: The device does not analyze samples taken from the body. It interacts directly with the patient's internal anatomy.

Therefore, based on the definition of an IVD and the description of the device's function and intended use, the SPYTM Intra-operative Imaging System: SP2000 is not an In Vitro Diagnostic device. It is an imaging system used for direct visualization during surgery.

N/A

Intended Use / Indications for Use

For use in intra-operative visual assessment of the coronary vasculature and bypass grafts during coronary artery bypass (CABG) surgery.

Product codes

IZI

Device Description

The SPYTM Intra-operative Imaging System: SP2000 is indicated for use for intraoperative visual assessment of the coronary vasculature and grafts during CABG surgery. The SPYTM system provides the surgeon with the capability to view, record and replay fluorescent images of blood vessels and bypass grafts of the heart. A laser light source is used to illuminate the heart surface. Indocyanine Green (ICG) is injected intravenously through the central venous line, bypass pump or cardioplegia line and, while coursing through the coronary arteries and grafts, the absorption of laser light causes excitation of the dye followed by emission of infrared energy. The result is a fluorescent image of the coronary vasculature. A CCD camera captures the image. These images are used to evaluate the integrity of the coronary vasculature and bypass grafts.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Fluorescent Angiography

Anatomical Site

Coronary vasculature, bypass grafts of the heart

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Surgeon, intraoperative setting

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

Animal studies, human experience and in vitro testing were conducted to support the safe and effective use of the SPYTM system.

In Vitro Testing: Testing of the SPYTM system was completed in conformance with the following standards. The SPYTM system successfully met all of the requirements for these standards:

  1. Electrical per IEC 60601-1 and UL2601-1
  2. Electromagnetic Compatibility per IEC 60601-1-2
  3. Light Emitting Laser Products per 21 CFR 1040
  4. Safe Use of Lasers in Health Care Facilities per ANSI Z136.3
  5. American National Standard for Safe Use of Lasers per ANSI Z136.1

In Vivo Testing: Animal studies and human experience in 950 CABG procedures were completed to demonstrate safety and effectiveness.

  1. The exposure for the SPY™ system is 35 mW/cm2 which is far below the MPE of 327 mW/cm2 established by ANSI for exposure to the skin.
  2. Use of the SPYTM system does not cause any thermal damage to the heart tissue.
  3. There were no changes to the electrocardiograms or arterial pressures during and following SPYTM use.
  4. There were no acute or long-term cellular effects of using the SPYTM system.
  5. There were no acute or long-term renal or hepatic effects of using the SPYTM system.
  6. The image quality of the SPYTM system was equivalent to radiographic angiography.
  7. The SPYTM system was able to acquire excellent images of the entire vascular bed on each aspect of the heart.

Key Metrics

Not Found

Predicate Device(s)

K984545, K944261

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 892.1600 Angiographic x-ray system.

(a)
Identification. An angiographic x-ray system is a device intended for radiologic visualization of the heart, blood vessels, or lymphatic system during or after injection of a contrast medium. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II.

0

JAN 1 9 2005

K042961
p. 1/2

510(k) Summary

Common Name:Fluorescent Angiographic System
Classification:21 CFR 892.1600
Manufacturer:Novadaq Technologies Inc.
2585 Skymark Avenue
Suite 306
Mississauga, Ontario
Canada
L4W 4L5
905.629.3822
Contact Name:Rick Mangat
Vice President - Cardiac

Legally Marketed Predicate Devices:

The Novadaq SPY™ Intra-operative Imaging System: SP2000 is equivalent to two predicate devices.

The Philips Integra Series 2 Systems (K984545) is an Angiographic X-Ray System intended for use in acquiring diagnostic quality images during cardiac, angiographic, vascular, neurovascular, and interventional applications.

The Heidelberg Retinal Angiographic System (K944261) is also equivalent to the SPY™ system. The indication for use is to acquire images of the posterior segment of the eye and to analyze these images quantitatively for diagnostic purposes.

Device Description:

The SPYTM Intra-operative Imaging System: SP2000 is indicated for use for intraoperative visual assessment of the coronary vasculature and grafts during CABG surgery.

The SPYTM system provides the surgeon with the capability to view, record and replay fluorescent images of blood vessels and bypass grafts of the heart. A laser light source is used to illuminate the heart surface. Indocyanine Green (ICG) is injected intravenously through the central venous line, bypass pump or cardioplegia line and, while coursing through the coronary arteries and grafts, the absorption of laser light causes excitation of the dye followed by emission of infrared energy. The result is a fluorescent image of the coronary vasculature. A CCD camera captures the image. These images are used to evaluate the integrity of the coronary vasculature and bypass grafts.

6

1

Testing:

Animal studies, human experience and in vitro testing were conducted to support the safe and effective use of the SPYTM system.

In Vitro Testing:

Testing of the SPYTM system was completed in conformance with the following standards. The SPYTM system successfully met all of the requirements for these standards.

    1. Electrical per IEC 60601-1 and UL2601-1
    1. Electromagnetic Compatibility per IEC 60601-1-2
    1. Light Emitting Laser Products per 21 CFR 1040
    1. Safe Use of Lasers in Health Care Facilities per ANSI Z136.3
    1. American National Standard for Safe Use of Lasers per ANSI Z136.1

In Vivo Testing:

Animal studies and human experience in 950 CABG procedures were completed to demonstrate safety and effectiveness.

    1. The exposure for the SPY™ system is 35 mW/cm2 which is far below the MPE of 327 mW/cm2 established by ANSI for exposure to the skin.
    1. Use of the SPYTM system does not cause any thermal damage to the heart tissue.
    1. There were no changes to the electrocardiograms or arterial pressures during and following SPYTM use.
    1. There were no acute or long-term cellular effects of using the SPYTM system.
    1. There were no acute or long-term renal or hepatic effects of using the SPYTM system.
    1. The image quality of the SPYTM system was equivalent to radiographic angiography.
    1. The SPYTM system was able to acquire excellent images of the entire vascular bed on each aspect of the heart.

Conclusions:

The above testing demonstrates that the SPY™ Intra-operative Imaging System is safe and effective in imaging the coronary vasculature and bypass grafts intraoperatively and is equivalent to the predicate devices.

2

Public Health Service

Image /page/2/Picture/2 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized symbol that resembles three abstract shapes, possibly representing human figures or waves.

JAN 1 9 2005

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Novadaq Technologies Inc. c/o Mr. Rick Mangat Vice President - Cardiac 2585 Skymark Avenue, Suite 306 Mississauga, Ontario Canada L4W 4L5

Re: K042961

Trade Name: SPY™ Intra-operative Imaging System: SP2000 Regulation Number: 21 CFR 892.1600 Regulation Name: Angiographic X-Ray System Regulatory Class: II (two) Product Code: IZI Dated: November 23, 2004 Received: November 24, 2004

Dear Mr. Mangat:

We have reviewed your Section 510(k) premarket notification of intent to market the device to we nave reviewed your bection 910(t) processor is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the encrosule for regars mannetted to the Medical Device American be to commerce proc to May 20, 1776, the enasting with the provisions of the Federal Food. Drug.
devices that have been reclassified in accordance with the provisions of the UNAA devices that have been recalismed in acceranted will of a premarket approval application (PMA).
and Cosmetic Act (Act) that do not require approval of a premarket approval ap You may, therefore, market the device, subject to the general controls provisions of the Act. The You may, therefore, market the devrees, becaments for annual registration, listing of general controls provisions of the rest 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 il your device is classified (see above) ins. Existing major regulations affecting your device can
may be subject to such additional controls. Existing major and chick on ED may be subject to such additional controller Little 21, Parts 800 to 898. In addition, FDA may be found in the Oods of Pouchs concerning your device in the Federal Register.

3

Page 2 – Mr. Rick Mangat

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. 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 Part 801), please contact the Office of Compliance at (240) 276-0120. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97) you may obtain. 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,

Brimimer for

Bram D. Zuckerman, M.D. Director Division of Cardiovascular Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

Indications for Use

510(k) Number (if known): _K042961

Device Name: SPY™ Intra-operative Imaging System: SP2000

Indications For Use:

For use in intra-operative visual assessment of the coronary vasculature and bypass grafts during coronary artery bypass (CABG) surgery.

Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR

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)

B. Blummer Jr.

(División Sign-Off) Division of Cardiovascular Devices 510(K) Number K04096

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