K Number
K050190
Device Name
APOLLO
Date Cleared
2005-03-25

(57 days)

Product Code
Regulation Number
892.1980
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The indication for use of the APOLLO is: radiology and fluoroscopy investigations when installed in conjunction with adequate image intensifier, image acquisition systems, X-ray generators and X-ray tubes.

Device Description

Remote controlled radiology table, collimator and spot film device

AI/ML Overview

I'm sorry, but the provided text does not contain the detailed information necessary to describe acceptance criteria and a study proving device performance as requested.

The document is a 510(k) summary for the APOLLO remote-controlled radiology table. It focuses on establishing substantial equivalence to a predicate device by comparing technical specifications and intended use.

Specifically, the document does NOT contain information on:

  • Acceptance Criteria for performance: It lists specifications of the device but not criteria against which its performance was measured to demonstrate safety and effectiveness.
  • A "study that proves the device meets the acceptance criteria": There is no description of a clinical trial, performance testing study, or any other formal study conducted to "prove" the device's performance against specific metrics.
  • Sample size or data provenance for a test set.
  • Number or qualifications of experts for ground truth.
  • Adjudication method.
  • Multi-Reader Multi-Case (MRMC) comparative effectiveness study.
  • Standalone algorithm performance.
  • Type of ground truth used.
  • Sample size for a training set.
  • How ground truth for a training set was established.

The document is primarily a comparison table of features between the APOLLO and its predicate device (Philips Omnidiagnost Eleva) to demonstrate substantial equivalence, a regulatory pathway that doesn't typically require extensive performance studies as might be seen for novel devices or AI solutions.

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Image /page/0/Picture/0 description: The image shows a logo for Villa Sistemi Medicali. The logo features a stylized letter 'V' above the company name. The text 'VILLA' is in a larger font size than 'SISTEMI MEDICALI', which is stacked below it.

MAR 2 5 2005

Koso190

Attachment 1 - 510 (k) SUMMARY

510(k) summary for APOLLO

Identification

ApplicantVilla Sistemi Medicali S.p.A.Via delle Azalee 3,20090 BUCCINASCO - Milan- ItalyRegistration Number: 8021091
Contact Persondr. Roberto Daglio – QA Director
Telephone (applicant)+ 39 02 48859233
Designated Agentin the USVeronica MeredithDel Medical Imaging11550 West King StreetFranklin ParkIllinois 60131Tel. 847-288-7000
Manufacturing siteVilla Sistemi Medicali S.p.A.Via delle Azalee 3,20090 BUCCINASCO - Milan - Italy

Trade name: APOLLO

Common name: APOLLO R/F remote controlled table

Classification:

The equipment is classified as a class II device since it is composed of the following three components:

radiological table (CFR892.1980): class I

spot film device (CFR892.1670): class II

X-ray beam limiting device (CFR 892-1610): class II

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150190

Substantial equivalent device: the APOLLO is defined as Substantially Equivalent (SE) to the Philips Medical Systems OMNIDIAGNOST ELEVA, manufactured by Philips Medical Systems and cleared by FDA with K032046

The following table compares the APOLI.O and the predicate device

APOLLOPhilips Omnidiagnost Eleva
Intended useRemote controlled radiologytable, collimator and spot filmdeviceRemote controlled radiologysystem inclusive of remotecontrolled table, collimator,spot film device, imageintensifier system
Working height (tabletop center tofloorplate)600 -1400 mm840 -1140 mm
Table tilt movement-90° - +90°-90° - +90°
Table tilt speed4.5 -6.5°/secVariable 2-4.5°/sec
Table top suspensionTwo sides suspensionSingle side (left or right)
Table top material2379x750 Plastic laminate orcarbon fiber2250 x 660 mm carbon fiber
Table top movementPatient remain stationaryduring all scan movmentsPatient remain stationaryduring all scan movments
Table top absorptionPlastic:<0.5mm AlCarbon fiber: <0.3 mm Al@ 100kV, HVL 2.7mm Al<= 1.1 mm Al eq.
ShapeCurved for max patientcomfort and autocenteringCurved for max patientcomfort and autocentering
Max patient weight150 kg200kg
Skin to film distance65 mm105 mm
Lateral scan distance-160 - +160 mm-160 - +160 mm
Lateral scan speed30 mm/secVariable 10 - 50 mm/sec
Longitudinal scandistance1600 mm1550 mm
Longitudinal scanspeed30 - 200 mm/secVariable 20-120 mm/sec
Table columnangulation-40° - +40°-40° - +40°
Table columnangulation speed11.2 °/secVariable 4°-8°/sec
Source image distanceContinuous variable between1000 and 1500 mmContinuous variable between1100 and 1500 mm
Tube rotationManual +/-180° with stops atManual -90° - +180° with
0°:+/-40°:+/-50°;+/-90°; 180°stops at 0°-40°-90°
Image intensifier lift32 mm in 0.8 sec32 mm in 0.8 sec
CollimatorSquare/rectangular.Iris optionalSquare/rectangular and Iris
Compressor movementMotorized and parkableMotorized and parkable
Compressor pressureAdjustable between 30 and150 N in steps of 5 NAdjustable between 40 and160 N
Automatic spot filmdevice
Cassette sizeFrom 13x18cm to 35x43From 20x20 to 35x43
Sudivisions1, 2, 3, 4 in line4, 6 in cross1, 2, 3. 4 in line4, 6 in cross
Load unload time2 sec2 sec
Preparation time forexposure0.8 sec (min)1.2 sec
Rapid sequenceyes6 exposure in 4 sec
Gridparkableparkable
Tomography
MovementArc- plan motion: at 45°, 30°,20°, 7°Linear at 40°, 20° or 8°
Layer height range0 - 300 mm with automaticlayer height increments10 - 250 with automatic layerheight increments
Sweep time2 sec:4 0 or 2.5 sec at 45°2.7 or 1.3 sec at 30°1.8 or 0.9 sec at 20°0.6 Or 0.3 sec at 7°2 speeds:3 0 or 1.5 sec at 40°1.5 or 0.75 sec at 20°0.6 or 0.3 sec at 8°

510(K) Summary for APOLLO

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K050130

Indication for use.

The indication for use of the APOLLO is: radiology and fluoroscopy investigations when installed in conjunction with adequate image intensifier, image acquisition systems, X-ray generators and X-ray tubes.

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Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is a staff with two snakes entwined around it, on the right side. On the left side, the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the caduceus symbol.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR 2 5 2005

Villa Sistemi Medicali S.p.A. % Ms. Veronica Meridith Official Correspondent Del Medical Imaging 11550 West King Street FRANKLIN PARK IL 60131 Re: K050190

Trade/Device Name: APOLLO Regulation Number: 21 CFR 892.1980 Regulation Name: Radiologic table Regulation Number: 21 CFR 892.1670 Regulation Name: Spot-film device Regulation Number: 21 CFR 892.1610 Regulation Name: Diagnostic x-ray beam-limiting device Regulatory Class: II Product Code: KXJ, IXL, and KPW Dated: January 25, 2005 Received: February 10, 2005

Dear Ms. Meridith:

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 (Premarket Approval), it may be subject to such 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.

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This letter will allow you to begin marketing your device as described in your Section 510(k) rms tetter wrification. 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 n Joan t the Office of Compliance at one 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 807.97). 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) 443-6597 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.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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K050190

Indication for use Statement 5.1.

510(k) Number:

Device Name: APOLLO

The indication for use of the APOLLO is: radiology and fluoroscopy investigations when installed in conjunction with adequate image intensifier, image acquisition systems, X-ray generators and X-ray tubes.

Prescription Use

Nancy C. Broodon

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ivision Sign-Off ivision of Reproduc d Radiological Devi

§ 892.1980 Radiologic table.

(a)
Identification. A radiologic table is a device intended for medical purposes to support a patient during radiologic procedures. The table may be fixed or tilting and may be electrically powered.(b)
Classification. Class II (special controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 892.9.