K Number
K051754
Device Name
ORTHOSCAN, ORTHOSCAN HD
Manufacturer
Date Cleared
2005-08-09

(41 days)

Product Code
Regulation Number
892.1650
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The OrthoScan mobile c-arm is designed to provide the physician with general fluoroscopic visualization of the patient including but not limited to, surgical orthopedic procedures and critical and emergency care procedures.
Device Description
The OrthoScan is a mini C-arm mobile imaging system. The OrthoScan is used for processing and capturing live fluoroscopic images. Interfaces are provided for external peripheral devices such as controls, thermal printers, video cassette recorders and DICOM. The device is compatible with NTSC video outputs and 100 Base T Ethernet.
More Information

GE/OEC Medical Systems series 6800 mini view digital mobile imaging device, Hologic/FluoroScan Imaging System Premier Encore mobile imaging device

Not Found

No
The summary mentions "algorithms" for image processing but does not explicitly mention AI, ML, or related terms, nor does it provide details about training or test data sets typically associated with AI/ML development.

No
The device is described as an imaging system used for "general fluoroscopic visualization of the patient." Its purpose is to acquire images, not to treat a condition or restore function.

No.
The document describes the device as an imaging system used for real-time visualization (fluoroscopy) during medical procedures, rather than for diagnosing a condition or disease. Its output is images for "general fluoroscopic visualization," not diagnostic interpretations.

No

The device description explicitly states it is a "mini C-arm mobile imaging system" and mentions hardware components like interfaces for external peripheral devices, NTSC video outputs, and Ethernet, indicating it is a hardware device with integrated software.

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

Here's why:

  • Intended Use: The intended use clearly states "general fluoroscopic visualization of the patient" for procedures like surgical orthopedic and critical/emergency care. This involves imaging inside the patient's body.
  • Device Description: The description confirms it's a "mini C-arm mobile imaging system" used for "processing and capturing live fluoroscopic images." This is an imaging device, not a device that analyzes samples taken from the body.
  • IVD Definition: In Vitro Diagnostics are devices used to examine specimens (like blood, urine, tissue) taken from the human body to provide information about a person's health. This device does not do that.

The OrthoScan is a medical imaging device used for visualizing internal structures of the body using fluoroscopy.

N/A

Intended Use / Indications for Use

The OrthoScan mobile c-arm is designed to provide the physician with general fluoroscopic visualization of the patient including, but not limited to, surgical orthopedic procedures and critical and emergency care procedures. The intended users of this product are doctors surgeons, radiologists and technologists who will use this product in a hospital or clinical environment. It is anticipated that the majority of user will be orthopedic doctors, podiatrists and pediatricians, among others.

Product codes

JAA, IZL

Device Description

The OrthoScan is a mini C-arm mobile imaging system. The OrthoScan is used for processing and capturing live fluoroscopic images. Interfaces are provided for external peripheral devices such as controls, thermal printers, video cassette recorders and DICOM. The device is compatible with NTSC video outputs and 100 Base T Ethernet.

The OrthoScan has the following physical characteristics:

  • All components are contained in one mobile workstation .
  • An articulating arm is attached to the workstation and extends out from the main . support to position the x-ray imaging components.
  • All mechanical positioning of the workstation and articulating arm is manual . (non-motorized).
  • Power ratings are between 90VAC and 260 VAC and 3A to 6A. The system is . powered by a detachable power cord.
  • System power is isolated from input power by an isolation transformer. .
  • Internal x-ray generator produces voltages up to 80 kVp. .
  • Fluoroscopic operation:
  • --- 40 to 80 kVp
  • --- 20 to 100 uA (.020 to .100 mA)
  • --- Automatic Exposure Rate Control
  • Major components of the system include:
  • --- Video monitor
  • --- Input isolation transformer
  • --- Circuitry for digital processing and x-ray control
  • --- High voltage power supply
  • --- X-ray tube
  • --- Image Intensifier

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Fluoroscopic X-ray

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

The intended users of this product are doctors, surgeons, radiologists and technologists who will use this product in a hospital or clinical environment. It is anticipated that the majority of users will be orthopedic doctors, podiatrists and pediatricians, among others. It is anticipated that this product will be used on a daily basis by such users. Users must be schooled in their medical fields and the use of x-ray equipment. They will be trained by OrthoScan specialists and/or qualified site personnel in the proper use of this product. The device labeling stipulates that only properly trained persons may operate this equipment.

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)

GE/OEC Medical Systems series 6800 mini view digital mobile imaging device, Hologic/FluoroScan Imaging System Premier Encore mobile imaging device

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 892.1650 Image-intensified fluoroscopic x-ray system.

(a)
Identification. An image-intensified fluoroscopic x-ray system is a device intended to visualize anatomical structures by converting a pattern of x-radiation into a visible image through electronic amplification. 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). An anthrogram tray or radiology dental tray intended for use with an image-intensified fluoroscopic 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. In addition, when intended as an accessory to the device described in paragraph (a) of this section, the fluoroscopic compression device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

0

AUG 9 - 2005

thoscan .............................................................................................................................................................................. of Or � 651754

510 (k) Summary

This summary of 510 (k) safety and effectiveness information is being submitted in This Sunmal y of 510 (x) Sareery and SMDA 1990 and 21 CFR, Part 807.92.

| Date:
Name of Submitter: | June 14, 2005
OrthoScan, Inc.
Suite 900
8585 E. Hartford Dr.
Scottsdale, AZ 85255
480-503-8010 |
|-----------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Corresponding Official: | Arlen Issette
Chief Executive Officer |
| Device Proprietary Name: | OrthoScan, OrthoScan-HD |
| Classification Name: | System, X-ray, Fluoroscopic, Image-Intensified |
| Common/Usual Name: | OrthoScan Imaging System |
| Substantial equivalence: | The OrthoScan is substantially equivalent to the
following systems which are currently marketed: |
| | 1. GE/OEC Medical Systems series 6800
mini view digital mobile imaging device.

  1. Hologic/FluoroScan Imaging System
    Premier Encore mobile imaging device |
    | Similarities/Differences: | Refer to the attached Specification Comparison,
    (Similarities/Differences). This chart compares the
    functional characteristics of the OrthoScan with
    these similar devices which are currently marketed. |
    | Intended Use: | The OrthoScan mobile c-arm is designed to provide
    the physician with general fluoroscopic
    visualization of the patient including, but not
    limited to, surgical orthopedic procedures and
    critical and emergency care procedures. |

1

orthoScanHD

The intended users of this product are doctors, User Characteristics: surgeons, radiologists and technologists who will use this product in a hospital or clinical environment. It is anticipated that the majority of users will be orthopedic doctors, podiatrists and pediatricians, among others. It is anticipated that this product will be used on a daily basis by such users. Users must be schooled in their medical fields and the use of x-ray equipment. They will be trained by OrthoScan specialists and/or qualified site personnel in the proper use of this product. The device labeling stipulates that only properly trained persons may operate this equipment. The OrthoScan is a mini C-arm mobile imaging General Description: system. The OrthoScan is used for processing and capturing live fluoroscopic images. Interfaces are provided for external peripheral devices such as controls, thermal printers, video cassette recorders and DICOM. The device is compatible with NTSC video outputs and 100 Base T Ethernet. A number of algorithms are used in the image processing functions performed by the system. A detailed description of these algorithms is provided in the image processor functions specification attached hereto as Attachment A. The descriptions and formal definitions of these types of algorithms are well known. References on the subject would include:

Jain. Anil K., Fundamentals if Digital Image Processing, Prentice Hall, Inc. 1989. Castleman, Kenneth R., Digital Image Processing, Prentice Hall, Inc., 1979.

2

orthoscan H

The OrthoScan has the following physical characteristics:

  • All components are contained in one mobile workstation .
  • An articulating arm is attached to the workstation and extends out from the main . support to position the x-ray imaging components.
  • All mechanical positioning of the workstation and articulating arm is manual . (non-motorized).
  • Power ratings are between 90VAC and 260 VAC and 3A to 6A. The system is . powered by a detachable power cord.
  • System power is isolated from input power by an isolation transformer. .
  • Internal x-ray generator produces voltages up to 80 kVp. .
    • Fluoroscopic operation:
    • --- 40 to 80 kVp
    • --- 20 to 100 uA (.020 to .100 mA)
    • --- Automatic Exposure Rate Control
  • Major components of the system include: ●
    • --- Video monitor
    • --- Input isolation transformer
    • --- Circuitry for digital processing and x-ray control
    • --- High voltage power supply
    • --- X-ray tube
    • --- Image Intensifier

Standards:

In addition to complying with the Federal Performance Standard for Diagnostic X-ray Imaging Systems (21 CFR Part 1020.30-32), the OrthoScan mobile C-arm is designed in accordance with guidelines established in the following standards:

NFPA 99, Standard for Health Care facilities NFPA 70, National Electrical Code UL 187, Standard for X-ray Equipment CSA-C22.2 No. 601.1-M90, Medical Electrical Equipment IEC 601-1, Medical Electrical Equipment, General Requirements for Safety IEC 601-1-2, Medical Electrical Equipment, General Requirements for Safety, Electromagnetic Compatibility IEC 601-1-3, Medical Electrical Equipment, Radiation Protection in Diagnostic X-ray Equipment IEC 601-2-7, Medical Electrical Equipment, Safety of HV/X-av Generators 93/42/eec - Annex 1, Essential Requirements of the European Union Medical Device Directive

3

Image /page/3/Picture/0 description: The image shows the logo for OrthoScanHD. The logo consists of a series of dots arranged in a grid pattern, followed by the word "OrthoScanHD" in a stylized font. The letters are bold and have a slightly futuristic look. There is a small black circle below the letters.

This concludes this 510 (k) Summary.

Attachment: OrthoScan Specification Comparison to Competitive Systems.

4

Image /page/4/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the department's name around the perimeter. Inside the circle is a stylized image of an eagle with three lines extending from its head, representing the department's mission to protect the health of all Americans.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 9 - 2005

Ms. Arlen Issette American C-Arm, Inc., a.k.a. OrthoScan, Inc. 8585 E, Hartford Drive, Suite 900 SCOTTSDALE AZ 85255

Re: K051754

Trade/Device Name: OrthoScan, OrthoScan HD Regulation Number: 21 CFR 892.1650 Regulation Name: Image-intensified fluoroscopic x-ray system Regulation Number: 21 CFR 892.1720 Regulation Name: Mobil x-ray system Regulatory Class: II Product Code: JAA and IZL Dated: July 27, 2005 Received: July 27, 2005

Dear Ms. Issette:

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.

5

This letter will allow you to begin marketing your device as described in your Section 510(k) rms letter watification. The FDA finding of substantial equivalence of your device to a legally premativel notified on " 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 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

6

Indications for Use

510(k) Number (if known): 尾০51754 Not Available

Device Name:

OrthoScan, OrthoScan HD

Indications for Use:

The OrthoScan mobile c-arm is designed to provide the physician with general fluoroscopic visualization of the patient including but not limited to, surgical orthopedic procedures and critical and emergency care procedures.

The intended users of this product are doctors surgeons, radiologists and technologists who will use this product in a hospital or clinical environment. It is anticipated that the majority of user will be orthopedic doctors, podiatrists and pediatricians, among others.

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

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

David R. Legum

(Division Sign-Off) Division of Reproductive. Abdominal, and Padlological Devices 511)(k, Number

OrthoScan B-1

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