K Number
K043122
Device Name
SMD 21500 OR DSB-2103-D-5MP-5M PIXEL GRAYSCALE FLAT PANEL DISPLAY
Manufacturer
Date Cleared
2005-02-09

(89 days)

Product Code
Regulation Number
892.2050
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The SMD 21500 / DSB-2103-D-5MP device is intended to be used in displaying and viewing digital images for review by trained medical practitioners. It is especially designed for digital mammography applications.
Device Description
The SMD 21500 / DSB-2103-D-5MP is a grayscale diagnostic medical display
More Information

Not Found

No
The summary describes a medical display device and does not mention AI, ML, or any related technologies in its description, intended use, or performance studies.

No
The device is a display for viewing digital images, specifically for digital mammography applications, for review by trained medical practitioners. It does not perform any therapeutic function.

Yes
The device is described as a "grayscale diagnostic medical display" and is intended for "displaying and viewing digital images for review by trained medical practitioners," especially for "digital mammography applications." These uses clearly align with the definition of a diagnostic device.

No

The device is described as a "grayscale diagnostic medical display," which is a hardware component used for viewing medical images. While it processes digital images, the core device is a physical display, not solely software.

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

Here's why:

  • Intended Use: The intended use is "displaying and viewing digital images for review by trained medical practitioners." This describes a device used for visualizing medical images, not for performing tests on biological samples to diagnose conditions.
  • Device Description: It's described as a "grayscale diagnostic medical display." This reinforces its function as a display device.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Using reagents or assays
    • Providing a diagnostic result based on the analysis of a sample

The device is a medical display intended for viewing images, which is a different category of medical device than an IVD.

N/A

Intended Use / Indications for Use

The SMD 21500 / DSB-2103-D-5MP device is intended to be used in displaying and viewing digital images for review by trained medical practitioners. It is especially designed for digital mammography applications.

Product codes

90LLZ

Device Description

The SMD 21500 / DSB-2103-D-5MP is a grayscale diagnostic medical display

Mentions image processing

System, Image Processing

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

trained medical practitioners

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)

Barco Coronis 5MP HD (K041508)

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 892.2050 Medical image management and processing system.

(a)
Identification. A medical image management and processing system is a device that provides one or more capabilities relating to the review and digital processing of medical images for the purposes of interpretation by a trained practitioner of disease detection, diagnosis, or patient management. The software components may provide advanced or complex image processing functions for image manipulation, enhancement, or quantification that are intended for use in the interpretation and analysis of medical images. Advanced image manipulation functions may include image segmentation, multimodality image registration, or 3D visualization. Complex quantitative functions may include semi-automated measurements or time-series measurements.(b)
Classification. Class II (special controls; voluntary standards—Digital Imaging and Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture and Television Engineers (SMPTE) Test Pattern).

0

K04322

FEB - 9 2005 510(k) Summary

Date of Application:November 1, 2004
Manufacturer:Siemens AG
A&D SE DT - Display Technologies
84 Siemensallee
Karlsruhe, Germany 76187
Contact Information:George Scott
Marketing Manager, U.S.
Siemens Display Technologies
Ph: 303-604-6760
Fax: 303-664-0727
Email: george.scott@siemens.com
Classification Name:System, Image Processing
Common/Usual Name:Image Display Device, Medical Imaging
Proprietary Name/Model:SMD 21500 or DSB-2103-D-5MP - 5M Pixel
Grayscale Flat Panel Display
Device Ordering Codes:6GF6201-4Cxxx (where xxx represents
specific customer version)
Classification Number:21 CFR 892.2050/Procode 90LLZ
Substantial Equivalence:Barco Coronis 5MP HD (K041508)
Device Description:The SMD 21500 / DSB-2103-D-5MP is a
grayscale diagnostic medical display
Intended Use:The SMD 21500 / DSB-2103-D-5MP device is
intended to be used in displaying and viewing
digital images for review by trained medical
practitioners. It is especially designed for
digital mammography applications.
Technological Characteristics:The SMD 21500 / DSB-2103-D-5MP device is
a high-resolution display with electronic
capabilities for evaluation of high-resolution
medical images.
(See separate comparison chart to predicate
device)

:

1

Image /page/1/Picture/11 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 wing. The eagle is enclosed in a circle with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

FEB - 9 2005

Siemens AG % Mr. George Scott Marketing Manager Siemens Energy & Automation, Inc. Power Control Division 515 Courtney Way, Suite A LAFAYETTE CO 80026

Re: K043122 Trade/Device Name: SMD 21500 / DSB-2103-D-5MP 5M Pixel Grayscale Flat Panel Display Regulation Number: 21 CFR 892.2050 Regulation Name: Picture archiving and communications system Regulatory Class: II Product Code: 90 LLZ Dated: January 18, 2005 Received: January 18, 2005

Dear Mr. Scott:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced we have reviewed your corned 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 the enorolours) to teening time Medical Device Amendments, or to devices that have been May 20, 1770, the charactering 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 do not require approvince of the Act. The general controls provisions of the Act. The Act de not, subject to the general 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 (Premarket n your as the to be subject to such additional controls. Existing major regulations affecting your Apploval), It they of Subject 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 I rease of advisor 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 I caraf statues and regularing, 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) (21 CFR Part 807), 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 Section 510(k) rins letter will and will be region mading of substantial equivalence of your device to a legally premaired notification: "Thesults 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 If you desire specific at not of the following numbers, based on the regulation number at the top of this letter:

21 CFR 876.xxxx(Gastroenterology/Renal/Urology)240-276-0115
21 CFR 884.xxxx(Obstetrics/Gynecology)240-276-0115
21 CFR 892.xxxx(Radiology)240-276-0120
Other240-276-0100

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Also, prease note the regaration on your responsibilities under the Act from the 807.77). Tou may oouall carees, International and Consumer Assistance at its toll-free number (800) DIVISION of Shian Hamanavia 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

3

Statement of Indications for Use

Ko43122 510(k) Number:

Device Name:

Indications for Use:

SMD 21500 / DSB-2103-D-5MP — 5M Pixel Grayscale Flat Panel Display

The SMD 21500 / DSB-2103-D-5MP device is intended to be used in displaying and viewing digital images for review by trained medical practitioners. It is especially designed for digital mammography applications.

Prescription Use

David B. Lonsman

(Division Sign-Off) Productive, Sign-Off)
Division of Reproductive, Abdominal, 5 100 Radiological Devices 5 10(k) Number