(92 days)
ACHIEVA family consists of diagnostic devices that produce cross-sectional images, spectroscopy images and/or spectra in any orientation of the internal structure of the whole body. These images when interpreted by a trained physician, yield information that may assist in diagnosis.
The ACHIEVA family is the successor of the predicate Intera Achieva family release 1-series. The design of ACHIEVA family is based on the same software platform and hardware technology as its predicate device. All MR system parts of the ACHIEVA family have the same appearance. The ACHIEVA family is extended with enhancements and new functionalities for contrast enhanced MRA techniques and faster scanning techniques. Furthermore it is extended with SENSE Body wrap coil RF-coil and extension of multi-nuclei spectroscopy with 3T coils.
This document is a 510(k) summary for the Philips Medical Systems ACHIEVA family of Magnetic Resonance Diagnostic Devices (MRDD). It details the device's general information, predicate device, indications for use, and a statement of substantial equivalence.
Based on the provided text, here's a breakdown of the requested information:
1. Table of acceptance criteria and the reported device performance:
The document primarily focuses on substantial equivalence to a predicate device rather than presenting specific performance metrics against pre-defined acceptance criteria. The core assertion is that "The ACHIEVA family does not induce any other risks than already indicated for its predicate device with the same safety and effectiveness." This implies that the acceptance criteria are met by virtue of being equivalent to the already cleared predicate device.
Therefore, a table of specific numerical acceptance criteria and reported device performance from this document cannot be directly constructed as those details are not provided. The "performance" reported is essentially that it is substantially equivalent to the predicate.
2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective):
The document does not provide any details on a specific test set, sample size, or data provenance as it relies on substantial equivalence. There is no mention of a particular study with a test set.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience):
This information is not available in the document as no specific test set or study requiring ground truth establishment is described.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set:
This information is not available in the document as no specific test set or study requiring adjudication is described.
5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:
This document describes a Magnetic Resonance Diagnostic Device (MRDD), which is an imaging system, not an AI-assisted diagnostic tool. Therefore, an MRMC comparative effectiveness study regarding human reader improvement with AI assistance is not applicable and not mentioned.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:
This document describes an imaging device, not an algorithm, so a standalone algorithm-only performance study is not applicable and not mentioned.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.):
This information is not available in the document as no specific study involving ground truth establishment is described. The basis for clearance is substantial equivalence to a predicate device.
8. The sample size for the training set:
This information is not available in the document as no machine learning algorithm development with a training set is described.
9. How the ground truth for the training set was established:
This information is not available in the document as no machine learning algorithm development with a training set is described.
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Image /page/0/Picture/0 description: The image shows a handwritten alphanumeric string. The string is "KO4 3147". The characters are written in black ink on a white background.
FEB 1 5 2005
Page 1 of 2
510(k) SUMMARY OF SAFETY AND EFFECTIVENESS
The following information is being submitted in accordance with the requirements of 21 CFR 807.92.
General information
| Company Name: | Philips Medical Systems Nederland BV |
|---|---|
| Address: | Veenpluis 4-6Best, Netherlands, 5684 PC |
| Registration No.: | 1217116 |
| Contact person: | Lynn HarmerManager, regulatory SubmissionsTel: (425) 487-7312Fax: (425) 487-8666Lynn.Harmer@Philips.com |
| Date Prepared: | 9 November 2004 |
| Device (Trade) Name: | ACHIEVA family |
| Classification Name: | Magnetic Resonance Diagnostic Device (MRDD) |
| Classification: | Class II |
| Product code: | LNH |
| Performance standards: | NEMA voluntary standards, FDA MR DiagnosticDevice Guidance, UL and IEC 601 appropriate safetystandards and/or draft standards are used. |
Predicate Device(s):
The Philips Medical Systems ACHIEVA is the successor of the already cleared (predicate device) INTERA ACHIEVA family release 1-series (ref.K031815).
Indications for use:
The ACHIEVA family consists of diagnostic devices that produce cross-sectional images, spectroscopy images and/or spectra in any orientation of the internal structure of the whole body. These images when interpreted by a trained physician, yield information that may assist in diagnosis.
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Device description:
The ACHIEVA family is the successor of the predicate Intera Achieva family release 1-series.
The design of ACHIEVA family is based on the same software platform and hardware technology as its predicate device. All MR system parts of the ACHIEVA family have the same appearance.
The ACHIEVA family is extended with enhancements and new functionalities for contrast enhanced MRA techniques and faster scanning techniques. Furthermore it is extended with SENSE Body wrap coil RF-coil and extension of multi-nuclei spectroscopy with 3T coils.
General Safety and Effectiveness
The ACHIEVA family does not induce any other risks than already indicated for its predicate device with the same safety and effectiveness.
Substantial Equivalence
It is the opinion of Philips Medical Systems that the Philips ACHIEVA family is substantially equivalent to its predicate device Intera Achieva.
End
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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an emblem featuring a stylized eagle with its wings spread, superimposed over three wavy lines, which likely represent water. The logo is rendered in black and white.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
FEB 1 5 2005
Mr. Lynn T. Harmer Manger, Regulatory Submissions Phillips Medical Systems North America 22100 Bothell Evert Highway Post Office Box 3003 98141-3003 BOTHELL WA 98021-8431
Re: K043147 Trade/Device Name: Achieva Family Regulatory Number: 21 CFR 892.1000 Regulation Name: Magnetic resonance diagnostic device Regulatory Class: II Product Code: 90 LNH Dated: January 10, 2005 Received: January 12, 2005
Dear Mr. Harmer:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced wore 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 the enerosate) to te enactment date of the Medical Device Amendments, or to devices that have been May 20, 1770, the characterith 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 do not require approvisions of the Act. The general controls provisions of the Act active, subjoct 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 de rise to be subject to such additional controls. Existing major regulations affecting your Applo rary, It may of only 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 awrised of early ination 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 caran states and roganding, but not limited to registration and listing (21 CFR Part 807); labeling Act 3 requirements, morements practice requirements as set forth in the quality systems (QS) (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
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This letter will allow you to begin marketing your device as described in your Section 510(k) I his letter will anow you to begin marketing of substantial equivalence of your device to a legally premarket nothleadon: "The PDP Intentige of our 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 acried for your are 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 |
| Other | 240-276-0100 |
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Arso, picaso note the regulation on your responsibilities under the Act from the 807.77). Tou may ooually cater general and Consumer Assistance at its toll-free number (800) DIVISION of 301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsmaldsmamain.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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510(k) Number (if known):
Device Name :
ACHIEVA family
K04 3147
Indication For Use :
ACHIEVA family consists of diagnostic devices that produce cross-sectional images, spectroscopy images and/or spectra in any orientation of the internal mages, spootroboopy integre these images when interpreted by a trained physician, yield information that may assist in diagnosis.
Prescription Use _____________________________________________________________________________________________________________________________________________________________ (Per 21 CFR 801.109)
Over-The-Counter Use _________________________________________________________________________________________________________________________________________________________ OR
( PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Namenc Brogdon
(Division Sign-Off)
Division of Reproductive, Abdominal,
and Radiological Devices
510(k) Number K043147
§ 892.1000 Magnetic resonance diagnostic device.
(a)
Identification. A magnetic resonance diagnostic device is intended for general diagnostic use to present images which reflect the spatial distribution and/or magnetic resonance spectra which reflect frequency and distribution of nuclei exhibiting nuclear magnetic resonance. Other physical parameters derived from the images and/or spectra may also be produced. The device includes hydrogen-1 (proton) imaging, sodium-23 imaging, hydrogen-1 spectroscopy, phosphorus-31 spectroscopy, and chemical shift imaging (preserving simultaneous frequency and spatial information).(b)
Classification. Class II (special controls). A magnetic resonance imaging disposable kit intended for use with a magnetic resonance diagnostic device only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.