K Number
K061980
Date Cleared
2006-08-17

(35 days)

Product Code
Regulation Number
892.1550
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Ultrasound imaging or fluid flow analysis of the human body as follows: Abdominal, Intraoperative, Small Parts, Transcranial, OB/GYN, Cardiac, Intracardiac, Transesophageal, Pelvic, Neonatal/Adult Cephalic. Vascular, Intravascular, Musculoskeletal, Superficial Musculoskeletat, Great Vessel, and Peripheral Vascular applications.

Device Description

The Siemens Acuson X500 has been designed to meet the following product safety standards: UL 60601-1, Safety Requirements for Medical Equipment IEC 60601-2-37 Diagnostic Ultrasound Safety Standards CSA C22.2 No. 601-1, Safety Requirements for Medical Equipment AIUM/NEMA UD-3, 1998 Standard for Real Time Display of Thermal and Mechanical Acoustic Output Indices on Diagnostic Ultrasound Equipment . AIUM/NEMA UD-2, 1998 Acoustic Output Measurement Standard for Diagnostic Ultrasound 93/42/EEC Medical Devices Directive t Safety and EMC Requirements for Medical Equipment EN/IEC ୧୦୧01 - I . EN/IEC 60601-1-1 EN/IEC 60601-1-2 IEC 1157 Declaration of Acoustic Power l ISO 10993-1 Biocompatibility

AI/ML Overview

This is a 510(k) Pre-market Notification for the Siemens Acuson X500 Ultrasound System. It is an application for market clearance rather than a post-market study reporting performance against acceptance criteria. Therefore, the document does not contain the specific information required (acceptance criteria, specific study details proving performance against those criteria, sample sizes, expert qualifications, adjudication methods, MRMC studies, or standalone algorithm performance).

The "Performance Data" section states: "The X500 modifications are verified and validated according to the company's design control process." This indicates that internal testing was performed to ensure the device met its design specifications and regulatory requirements, but the details of these tests are not provided in this summary.

The tables provided are "Diagnostic Ultrasound Indications for Use Forms" for the main system and various transducers. These tables outline the intended uses and the modes of operation for which the device and its components are cleared, indicating what the device is designed to do, not how well it performs against specific metrics or what studies prove that performance.

Therefore, I cannot provide the requested information from this document. This document primarily serves as a declaration of substantial equivalence to a predicate device and outlines the intended uses of the various components of the ultrasound system.

{0}------------------------------------------------

Kobl980

SECTION 11

510(k) Summary

Sponsor:Siemens Medical Solutions USA, Inc.,Ultrasound Division1230 Shorebird WayP.O. Box 7393Mountain View, California 94039-7393
Contact Person:Sheila W. Pickering
Telephone: (650) 943 7187
Fax: (650) 943 7053
Submission Date:July 11, 2006
Device Name:Siemens Acuson X500 Ultrasound System
Common Name:Diagnostic Ultrasound System with Accessories
Classification:
Regulatory Class:II
Review Category:Tier II
Classification Panel:Radiology
Ultrasonic Pulsed Doppler Imaging SystemFR # 892.1550Product Code 90-IYN
Ultrasonic Pulsed Echo Imaging SystemFR # 892.1560Product Code 90-IYO
Diagnostic Ultrasound TransducerFR #892.1570Product Code 90-ITX

A. Legally Marketed Predicate Devices

The Siemens Acuson X500 Ultrasound system is substantially equivalent to the Siemens Sonoline G60S ultrasound system.

B. Device Description:

The Siemens Acuson X500 has been designed to meet the following product safety standards:

  • 트 UL 60601-1, Safety Requirements for Medical Equipment
  • 이 IEC 60601-2-37 Diagnostic Ultrasound Safety Standards
  • 요 CSA C22.2 No. 601-1, Safety Requirements for Medical Equipment
  • 트 AIUM/NEMA UD-3, 1998 Standard for Real Time Display of Thermal and Mechanical Acoustic Output Indices on Diagnostic Ultrasound Equipment
  • . AIUM/NEMA UD-2, 1998 Acoustic Output Measurement Standard for Diagnostic Ultrasound
  • 이 93/42/EEC Medical Devices Directive
  • t Safety and EMC Requirements for Medical Equipment
    • 트 EN/IEC ୧୦୧01 - I
    • . EN/IEC 60601-1-1
    • 트 EN/IEC 60601-1-2
  • 트 IEC 1157 Declaration of Acoustic Power
  • l ISO 10993-1 Biocompatibility

{1}------------------------------------------------

C. Intended Use

The Siemens Acuson X500 ultrasound imaging system is intended for the following applications: Abdominal, Intraoperative, Small Parts, Transcranial, OB/GYN, Cardiac, Intracardiac, Transesophageal, Pelvic, Neonatal/Adult Cephalic. Vascular, Intravascular, Musculoskeletal, Superficial Musculoskeletat, Great Vessel, and Peripheral Vascular applications.

D. Substantial Equivalence

The submission device is substantially equivalent to the predicate with regard to both intended use and technological characteristics.

E. Performance Data

The X500 modifications are verified and validated according to the company's design control process.

{2}------------------------------------------------

Image /page/2/Picture/1 description: The image shows the logo for the Department of Health & Human Services (HHS). The logo features a stylized eagle with three stripes forming its body and wings. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" are arranged in a circular pattern around the eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

AUG 1 7 2006

Sheila Pickering, Ph.D. Senior Director of Regulatory Affairs Siemens Medical Solutions USA, Inc. 1230 Shorebird Way P.O. Box 7393 MOUNTAIN VIEW CA 94039-7393

Re: K061980

Trade Name: Siemens Acuson X500TM Ultrasound System Regulation Number: 21 CFR 892.1550 Regulation Name: Ultrasonic pulsed doppler imaging system Regulation Number: 21 CFR 892.1560 Regulation Name: Ultrasonic pulsed echo imaging system Regulation Number: 21 CFR 892.1570 Regulation Name: Diagnostic ultrasonic transducer Regulatory Class: II Product Code: IYN, IYO, and ITX Dated: July 11, 2006 Received: July 17, 2006

Dear Dr. Pickering:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and we 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). 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.

This determination of substantial equivalence applies to the following transducers intended for use with the Siemens Acuson X500™ Ultrasound System, as described in your premarket notification:

Image /page/2/Picture/11 description: The image is a black and white circular logo for the FDA Centennial. The logo includes the letters "FDA" in a bold, stylized font, with the word "Centennial" written in cursive underneath. The years "1906 - 2006" are displayed above the FDA letters. The logo is surrounded by text that curves along the circle's edge, and there are three stars below the word "Centennial".

Protecting and Promoting Public Health

{3}------------------------------------------------

Transducer Model Number

C5-2 Convex Array
C6-2 Convex Array
C8-5 Convex Array
5.0C50+ Convex Array
C6-3 3D Mechanically Driven 3D Convex
Array
EV9-4 Convex Array Endovaginal
Endo-VII Mechanical Sector Endovaginal
Endo-V 3D Mechanical Sector Endovaginal
Ec9-4 Convex Array Endovaginal
BE9-4 Convex Array Endocavity
5.0L45 Linear Array
7.5L70 Linear Array
LB5-2 Linear Array
L10-5 Linear Array

VF13-5 Linear Array VF13-5SP Linear Array 7.5L50I Linear Array 7.5L50Q Linear Array 8L3 Linear Array C7F2 Curved Array Mechanical 3D LAP8-4 Laparoscopic P4-2 Phased Sector Array 5.0P10 Phased Array MPT7-4 Phased Sector Array TEE CW2 CW5 P9-4 Phased Sector Array CH5-2 Convex Array

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), 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 (OS) 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 determination of substantial equivalence is granted on the condition that prior to shipping the first device, you submit a postclearance special report. This report should contain complete information, including acoustic output measurements based on production line devices, requested in Appendix G, (enclosed) of the Center's September 30, 1997 "Information for Manufacturers Seeking Marketing Clearance of Diagnostic Ultrasound Systems and Transducers." If the special report is incomplete or contains unacceptable values (e.g., acoustic output greater than approved levels), then the 510(k) clearance may not apply to the production units which as a result may be considered adulterated or misbranded.

The special report should reference the manufacturer's 510(k) number. It should be clearly and prominently marked "ADD-TO-FILE" and should be submitted in duplicate to:

{4}------------------------------------------------

Food and Drug Administration Center for Devices and Radiological Health Document Mail Center (HFZ-401) 9200 Corporate Boulevard Rockville, Maryland 20850

This letter will allow you to begin marketing your device as described in your 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 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 from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html

If you have any questions regarding the content of this letter, please contact Ralph Shuping at (301) 594-1212.

Sincerely yours,

David h. Syzmm

Nancy C. Brogdon
Director, Division of Reproductive,
Abdominal and Radiological Devices
Office of Device Evaluation
Center for Devices and Radiological Health

Enclosure(s)

{5}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

Kob 11720

510(k) Number (if known):

Device Name:

SIEMENS ACUSON X500™ Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPPBMDCNote 2,3,4,5
AbdominalPPPPPPBMDCNote 2,3,4,5
Intraoperative (Note 6)PPPPPBMDCNote 3
Intraoperative NeurologicalPPPPPBMDCNote 2,3
PediatricPPPPPPBMDCNote 2,3,4,5
Small Organ (Note 1)PPPPPPBMDCNote 2,3,4,5
Neonatal CephalicPPPPPPBMDCNote 2,3
Adult CephalicPPPPPPBMDCNote 2
CardiacPPPPPPBMDCNote 2,7
TransesophagealPPPPPPBMDCNote 2,3,7
TransrectalPPPPPBMDCNote 2,3,4,5
TransvaginalPPPPPBMDCNote 2,3,4,5
Transurethral
Intravascular
Peripheral vesselPPPPPPBMDCNote 2,3,4,5
LaparoscopicPPPPPBMDCNote 3
Musculo-skeletal (Conventional)PPPPPPBMDCNote 2,3,4,5
Musculo-skeletal (Superficial)PPPPPPBMDCNote 2,3,4,5
Other (specify)

P = previously cleared by the FDA under # K052894) E = added under Appendix E.

Note 1 For example: breast, testes, thyroid, penis, prostate, etc.

Ensemble tissue harmonic imaging Note 2

  • Note 3 3D imaging
    Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

For example: abdominal, vascular Note 6

Note 7 Contrast agent imaging

Note 8 Virtual Format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

productive

{6}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

Koblito

510(k) Number (if known):

Device Name:

Intended Use:

C5-2 Convex Array Transducer for use with: SIEMENS ACUSON X500 Ultrasound System Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPBMDCNote 2,3,4,5,
AbdominalPPPPPBMDCNote 2,3,4,5,
Intraoperative Abdominal
Intraoperative Neurological
PediatricPPPPPBMDCNote 2,3,4,5,
Small Organ
Neonatal Cephalic
Adult Cephalic
Cardiac
Trans-esophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPBMDCNote 2,3,4,5,
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (Specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

For example: breast, testes, thyroid, penis, prostate, etc. Note l

Ensemble tissue harmonic imaging Note 2

  • Note 3 3D imaging
  • Note 4 B&W SieScape panoramic imaging
  • Power SieScape panoramic imaging Note 5
  • Note 6 For example: abdominal, vascular
  • Note 7 Contrast agent imaging
  • Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Daniel A. Hagerman

(Division Sign-Off) Division of Reproductive. Abde and Radiological Devic 510(k) Number _

{7}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

Koleli To

Device Name:

C6-2 Convex Array Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPBMDCNote2,3,4,5,7
AbdominalPPPPPBMDCNote2,3,4,5,7
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPBMDCNote2,3,4,5,7
Small Organ (Note 1)
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPBMDCNote2,3,4,5,7
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

For example: breast, testes, thyroid, penis, prostate, etc. Note l

Note 2 Ensemble tissue harmonic imaging

  • 3D imaging Note 3
    Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

Note 6 For example: abdominal, vascular

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David R. Lessem

(Division Sign-Off) Division of Reproductive, Abd and Radiological Devic 510(k) Number

Page 32 of 68

{8}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

KU61420 510(k) Number (if known):

Device Name:

Intended Use:

C8-5 Convex Array Transducer for use with: SIEMENS ACUSON X500 Ultrasound System Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
AbdominalPPPPPBMDCNote 3,4,5
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPBMDCNote 3,4,5
Small Organ (Note 1)PPPPPBMDCNote 3,4,5
Neonatal CephalicPPPPPBMDCNote 3,4,5
Adult Cephalic
CardiacEEEEEBMDCNote 3,4,5,7
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal (Conventional)PPPPPBMDCNote 3,4,5
Musculo-skeletal (Superficial)EEEEEBMDCNote 3,4,5
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note I For example: breast, testes, thyroid, penis, prostate, etc.

Ensemble tissue harmonic imaging Note 2

Note 3 3D imaging

B&W SieScape panoramic imaging Note 4

Note 5 Power SieScape panoramic imaging

For example: abdominal, vascular Note 6 Note 7

Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

  1. David La Heyman

(Division Sign-Off) Division of Reproductive, A and Radiological Devic 510(k) Number

{9}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known).

1661980 5.0C50+ Convex Array Transducer for use with: Device Name:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPPBMDCNote 3,4,5
AbdominalPPPPPPBMDCNote 3,4,5
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPPBMDCNote 3,4,5
Small Organ (Note 1)PPPPPPBMDCNote 3,4,5
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPPBMDCNote 3,4,5
Laparoscopic
Musculo-skeletal (Conventional)EEEEEEBMDCNote 3,4,5
Musculo-skeletal (Superficial)EEEEEEBMDCNote 3,4,5
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

For example: breast, testes, thyroid, penis, prostate, etc. Note 1

Note 2 Ensemble tissue harmonic imaging

  • Note 3 3D imaging
    Note 4 B&W SieScape panoramic imaging

Power SieScape panoramic imaging Note 5

Note 6 For example: abdominal, vascular

Contrast agent imaging Note 7

  • Note 8 Virtual Format
    (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

David A. Lyman

(Division Sign-Off) Division of Reproductive, Abdom and Radiological Devices 510(k) Number_

{10}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):K061150
Device Name:C6-3 3D Mechanically Driven 3D Convex Array Transducer for use with:SIEMENS ACUSON X500 Ultrasound System
Intended Use:Ultrasound imaging or fluid flow analysis of the human body as follows:
Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPBMDCNote 2,3,4,5
AbdominalPPPPPBMDCNote 2,3,4,5
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPBMDCNote 2,3,4,5
Small Organ (Note 1)
Neonatal CephalicEEEEEBMDCNote 2,3,4,5
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

For example: breast, testes, thyroid, penis, prostate, etc. Note I

Note 2 Ensemble tissue harmonic imaging

Note 3 3D imaging

Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

Note 6 For example: abdominal, vascular

Note 7 Contrast agent imaging Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

Daniel A. Lynn

(Division Sign-Off) Division of Reproductive, Ab and Radiological Device 510(k) Number

{11}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

14061960

510(k) Number (if known):

Device Name:

Intended Use:

EV9-4 Convex Array Endovaginal Transducer for use with: SIEMENS ACUSON X500 Ultrasound System Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPBMDCNote 2,3,4,5
Abdominal
Intraoperative (Note 6)
Intraoperative Neurological
Pediatric
Small Organ (Note 1)
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
TransrectalPPPPPBMDCNote 2,3,4,5
TransvaginalPPPPPBMDCNote 2,3,4,5
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

For example: breast, testes, thyroid, penis, prostate, etc. Note l

Note 2 Ensemble tissue harmonic imaging

  • Note 3 3D imaging
  • Note 4 B&W SieScape panoramic imaging

Power SieScape panoramic imaging Note 5

Note 6 For example: abdominal, vascular

Note 7 Contrast agent imaging

  • Note 8 Virtual format
    (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

Elmer A. Larson

(Division Sign-Off) Division of Reproductive, A and Radiological Devices 510(k) Number

Page 36 of 68

{12}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

1661180

Device Name:

Intended Use:

Endo-VII Mechanical Sector Endovaginal Transducer for use with: SIEMENS ACUSON X500 Ultrasound System Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPBMNote 3
Abdominal
Intraoperative Abdominal
Intraoperative Neurological
Pediatric
Small Organ (Note 1)
Neonatal CephalicPPBMNote 3
Adult Cephalic
Cardiac
Transesophageal
TransrectalPPBMNote 3
TransvaginalPPBMNote 3
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal Conventional
Musculo-skeletal Superficial
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note l For example: breast, testes, thyroid, penis, prostate, etc.

Ensemble tissue harmonic imaging Note 2

  • Note 3 3D imaging
  • Note 4 B&W SieScape panoramic imaging

Power SieScape panoramic imaging Note 5

Note 6 For example: abdominal, vascular

  • Note 7 Contrast agent imaging
  • Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

David R. Lygren

(Division Sign-Off) Division of Reproductive, Abdor and Radiological Devices 510(k) Number .

{13}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

Kobigro 510(k) Number (if known):

Device Name:

Intended Use:

Endo-V 3D Mechanical Sector Endovaginal Transducer for use with: SIEMENS ACUSON X500 Ultrasound System Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPBMNote 3
Abdominal
Intraoperative (Note 6)
Intraoperative Neurological
Pediatric
Small Organ (Note 1)
Neonatal CephalicPPBMNote 3
Adult Cephalic
Cardiac
Transesophageal
TransrectalPPBMNote 3
TransvaginalPPBMNote 3
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note I For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

  • Note 3 3D imaging
  • Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

For example: abdominal, vascular Note 6

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Usc (Per 21 CFR 801.109)

David Lynn

(Division Sign-Off) Division of Reproductive, Abe and Radiological Devices 510(k) Number

Page 38 of 68

{14}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

11:01750

EC9-4 Convex Array Endovaginal Transducer for use with: Device Name: SIEMENS ACUSON X500 Ultrasound System Ultrasound imaging or fluid flow analysis of the human body as Intended Use: follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPBMDCNote 2,3,4,5
Abdominal
Intraoperative Abdominal
Intraoperative Neurological
Pediatric
Small Organ (Note 1)
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
TransrectalPPPPPBMDCNote 2,3,4,5
TransvaginalPPPPPBMDCNote 2,3,4,5
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal Conventional
Musculo-skeletal Superficial
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note l For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

  • Note 3 3D imaging
  • Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

Note 6 For example: abdominal, vascular

  • Note 7 Contrast agent imaging
  • Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

David A. Ingram

(Division Sign-Off) Division of Reproductive, Ab and Radiological Devices 510(k) Number

{15}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

11061982

Device Name:

Intended Use:

BE9-4 Convex Array Endocavity Transducer for use with: SIEMENS ACUSON X500 Ultrasound System Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPBMDCNote 2,3,4,5
Abdominal
Intraoperative Abdominal
Intraoperative Neurological
Pediatric
Small Organ (Note 1)
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
TransrectalPPPPPBMDCNote 2,3,4,5
TransvaginalPPPPPBMDCNote 2,3,4,5
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal Conventional
Musculo-skeletal Superficial
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note l For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

  • Note 3 3D imaging
  • Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

  • Note 6 For example: abdominal, vascular
  • Note 7 Contrast agent imaging
  • Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

David Bro. Lyman

(Division Sign-Off) Division of Reproductive, Al and Radiological Devices 510(k) Number

{16}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

Device Name:

5.0L45 Linear Array Transducer for use with:

061960

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
AbdominalPPPPPPBMDCNote 2,3,4,5
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPPBMDCNote 2,3,4,5
Small Organ (Note 1)PPPPPPBMDCNote 2,3,4,5
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPPBMDCNote 2,3,4,5
Laparoscopic
Musculo-skeletal (Conventional)PPPPPPBMDCNote 2,3,4,5
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

For example: breast, testes, thyroid, penis, prostate, etc. Note 1

Note 2 Ensemble tissue harmonic imaging

Note 3 3D imaging

Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

Note 6 For example: abdominal, vascular

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David A. Segerson

(Division Sign-Off) Division of Reproductive, Abdomin and Radiological Devices 510(k) Number .

Page 41 of 68

{17}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

Device Name:

7.5L70 Linear Array Transducer for use with:

= 61980

SIEMENS ACUSON X500 Ultrasound System

Ultrasound imaging or fluid flow analysis of the human body as Intended Use: follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPBMDCNote 3,4,5
Small Organ (Note 1)PPPPPBMDCNote 3,4,5
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselEEEEEBMDCNote 3,4,5
Laparoscopic
Musculo-skeletal (Conventional)PPPPPBMDCNote 3,4,5
Musculo-skeletal (Superficial)PPPPPBMDCNote 3,4,5
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note l For example: breast, testes, thyroid, penis, prostate, etc.

Ensemble tissue harmonic imaging Note 2

Note 3 3D imaging

Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

Note 6 For example: abdominal, vascular

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

David A. Syme

(Division Sign-Off Division of Reproductive. Abd Page 42 of 68and Radiological Devices 510(k) Numbe

{18}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

follows:

510(k) Number (if known):K e 6 1120
Device Name:LB5-2 Linear Array Transducer for use with:
Intended Use:SIEMENS ACUSON X500 Ultrasound System
Ultrasound imaging or fluid flow analysis of the human body as
Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPBMDCNote 4,5
AbdominalPPPPPBMDCNote 4,5
Intraoperative Abdominal
Intraoperative Neurological
Pediatric
Small Organ
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal Conventional
Musculo-skeletal Superficial
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note I For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

Note 3 3D imaging

Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

Note 6 For example: abdominal, vascular

Note 7 Contrast agent imaging

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David A. Leggett

(Division Sign-Off) Division of Reproductive, Abdo and Radiological Devices 510(k) Number

Page 43 of 68

{19}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

Collico

Device Name:

L10-5 Linear Array Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
AbdominalPPPPPBMDCNote2,3,4,5,8
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPBMDCNote2,3,4,5,8
Small Organ (Note 1)PPPPPBMDCNote2,3,4,5,8
Neonatal CephalicPPPPPBMDCNote2,3,4,5,8
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPBMDCNote2,3,4,5,8
Laparoscopic
Musculo-skeletal (Conventional)PPPPPBMDCNote2,3,4,5,8
Musculo-skeletal (Superficial)PPPPPBMDCNote2,3,4,5,8
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note 1 For example: breast, testes, thyroid, penis, prostate, etc.

  • Note 2 Ensemble tissue harmonic imaging
  • Note 3 3D imaging

Note 4 B&W SieScape panoramic imaging

Power SieScape panoramic imaging Note 5

Note 6 For example: abdominal, vascular Contrast agent imaging

Note 7 Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (�@E)

Prescription Use (Per 21 CFR 801.109)

David A. Symm

Page 44 of 68

(Division Sign-Off) Division of Reproductive, Abdom and Radiological Devices 510(k) Number

{20}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known).

K. 61706

Device Name:

VF13-5 Linear Array Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPPBMDCNote 3,4,5,8
Small Organ (Note 1)PPPPPPBMDCNote 3,4,5,8
Neonatal CephalicPPPPPPBMDCNote 3,4,5,8
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPPBMDCNote 3,4,5,8
Laparoscopic
Musculo-skeletal (Conventional)PPPPPPBMDCNote 3,4,5,8
Musculo-skeletal (Superficial)PPPPPPBMDCNote 3,4,5,8
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note 1 For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

Note 3 3D imaging

B&W SieScape panoramic imaging Note 4

Note 5 Power SieScape panoramic imaging

Note 6 For example: abdominal, vascular

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David A. Syzmm

(Division Sign Division of Reproductive, A and Radiological Devices 510(k) Numb

Page 45 of 68

{21}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

16 - 619 70

Device Name:

VF13-5SP Linear Array Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Note 6)PPPPPBMDCNote 3,4,5,8
Intraoperative NeurologicalPPPPPBMDCNote 3,4,5,8
PediatricPPPPPBMDCNote 3,4,5,8
Small Organ (Note 1)PPPPPBMDCNote 3,4,5,8
Neonatal CephalicPPPPPBMDCNote 3,4,5,8
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPBMDCNote 3,4,5,8
Laparoscopic
Musculo-skeletal ConventionalPPPPPBMDCNote 3,4,5,8
Musculo-skeletal SuperficialPPPPPBMDCNote 3,4,5,8
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E

Note 1 For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

Note 3 3D imaging

B&W SieScape panoramic imaging Note 4

Note 5 Power SieScape panoramic imaging

For example: abdominal, vascular Note 6

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

Daniel h. Lyman

Page 46 of 68

(Division Sign-Off) Division of Reproductive, Abdor and Radiological Devices 510(k) Number _

{22}------------------------------------------------

Intended Use:

Diagnostic Ultrasound Indications for Use Form

X 661 150 510(k) Number (if known): Device Name:

7.5L50I Linear Array Transducer for use with: SIEMENS ACUSON X500 Ultrasound System Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
AbdominalPPPPPBMDCNote 3,4,5
Intraoperative (Note 6)PPPPPBMDCNote 3,4,5
Intraoperative Neurological
Pediatric
Small Organ (Note 1)PPPPPBMDCNote 3,4,5
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPBMDCNote 3,4,5
Laparoscopic
Musculo-skeletal ConventionalPPPPPBMDCNote 3.4,5
Musculo-skeletal Superficial
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

For example: breast, testes, thyroid, penis, prostate, etc. Note l

  • Ensemble tissue harmonic imaging Note 2
  • Note 3 3D imaging
  • Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

For example: abdominal, vascular Note 6

  • Note 7 Contrast agent imaging
  • Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David A. Symon

(Division Sign-Off Division of Reproductive, and Radiological Devices 510(k) Number

Page 47 of 68

{23}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

follows:

510(k) Number (if known):K061780
Device Name:7.5L50Q Linear Array Transducer for use with:
SIEMENS ACUSON X500 Ultrasound System ·
Intended Use:Ultrasound imaging or fluid flow analysis of the human body as
Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
AbdominalPPPPPBMDCNote 3,4,5
Intraoperative (Note 6)PPPPPBMDCNote 3,4,5
Intraoperative Neurological
Pediatric
Small Organ (Note 1)PPPPPBMDCNote 3,4,5
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPBMDCNote 3,4,5
Laparoscopic
Musculo-skeletal (Conventional)PPPPPBMDCNote 3,4,5
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E. .

Note l For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

Note 3 3D imaging

B&W SieScape panoramic imaging Note 4

Note 5 Power SieScape panoramic imaging

Note 6 For example: abdominal, vascular

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David A. Bergman

(Divesion Sign-Off) Division of Reproductive, Abdomi and Radiological Devices 510(k) Number ________________________________________________________________________________________________________________________________________________________________

Page 48 of 68

{24}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

1061980 510(k) Number (if known):

Device Name:

8L3 Linear Array Transducer for use with:

Siemens Acuson X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColor Velocity ImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
AbdominalNNNNNNNBMDCNote 2,3,4,5,8
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPPPBMDCNote 2,3,4,5,8
Small Organ (Note 1)PPPPPPPBMDCNote 2,3,4,5,8
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPPPBMDCNote 2,3,4,5,8
Laparoscopic
Musculo-skeletal (Conventional)PPPPPPPBMDCNote 2,3,4,5,8
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note 1 For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

Note 3 3D imaging

Note 4 B&W SicScape panoramic imaging

Note 5 Power SieScape panoramic imaging

Note 6 For example: abdominal, vascular

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David B. Heyman

(Division Sign-Off) Division of Reproductive, Abdon and Radiological Devices 510(k) Number ________________________________________________________________________________________________________________________________________________________________

Page 49 of 68

{25}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510 (k) Number (if known):

Kiiro

Device Name:

C7F2 Curved array mechanical 3D transducer for use with

Siemens Acuson X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalNNNNNBMDCNote 2,3,4,5,7
AbdominalPPPPPBMDCNote 2,3,4,5,7
IntraoperativeAbdominal
IntraoperativeNeurological
PediatricPPPPPBMDCNote 2,3,4,5,7
Small Organ
Neonatal Cephalic
Adult Cephalic
Cardiac
Trans-esophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPBMDCNote 2,3,4,5,7
Laparoscopic
Musculo-skeletalConventionalPPPPPBMDCNote 2,3,4,5,7
Musculo-skeletalSuperficial
Other (specify)

N = new indication; P = previously cleared by FDA K033196; E = added under Appendix E

Additional Comments:

Note 2 Ensemble tissue harmonic imaging

  • SieClear multi-view spatial compounding Note 3
  • Tissue Equalization Technology Note 4
  • 3-Scape real-time 3D imaging Note 5
  • B&W SieScape panoramic imaging Note 7

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David R. Ingram

Page 50 of 68

(Division Sian-Off) Division of Reproductive, Abd anc Badiological Devices 5 | (Xk) Number

{26}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):K061980
Device Name:LAP8-4 Laparoscopic Transducer for use with:SIEMENS ACUSON X500 Ultrasound System
Intended Use:Ultrasound imaging or fluid flow analysis of the human body as follows:
Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Note 6)PPPPPBMDCNote 3,4,5
Intraoperative Neurological
Pediatric
Small Organ (Note 1)
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vessel
LaparoscopicPPPPPBMDCNote 3,4,5
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note 1 For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

  • 3D imaging Note 3
    Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

For example: abdominal, vascular Note 6

Note 7 Contrast agent imaging

Virtual format Note 8

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David R. Sgammo

Page 51 of 68

(Division Sign-Off) Division of Reproductive. Abdom and Radiological Devices 510(k) Number

{27}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

Ke 61 14 82.

Device Name:

P4-2 Phased Sector Array Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPPBMDC
AbdominalPPPPPPBMDCNote 2,3
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPPBMDC
Small Organ (Note 1)
Neonatal Cephalic
Adult CephalicPPPPPPBMDCNote 2,3
CardiacPPPPPPBMDCNote 2,3,7
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skelctal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

For example: breast, testes, thyroid, penis, prostate, etc. Note l

  • Note 2 Ensemble tissue harmonic imaging
    Note 3 3D imaging

Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

  • Note 6 For example: abdominal, vascular
    Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David A. Sycom

(Division Sign-Off)
Division of Reproductive, Abdominal,
and Radiological Devices
510(k) Number K061980

Page 52 of 68

{28}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (ifknown):K-61170
Device Name:5.0P10 Phased Sector Array Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
OphthalmicBMDCNote 2
FetalPPPPPPPBMDCNote 2
AbdominalPPPPPPPBMDCNote 2
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPPPBMDCNote 2
Small Organ (Note 1)
Neonatal CephalicPPPPPPPBMDCNote 2
Adult Cephalic
CardiacPPPPPPPBMDCNote 2,7
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skelctal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

For example: breast, testes, thyroid, penis, prostate, etc. Note 1

Note 2 Ensemble tissue harmonic imaging

  • 3D imaging Note 3
    Note 4 B&W SieScape panoramic imaging

Power SieScape panoramic imaging Note 5

Note 6 For example: abdominal, vascular

Contrast agent imaging Note 7

Virtual format Note 8

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Daniel R. Lyman

(Division Sign-Off) Division of Reproductive, Abdo and Radiological Devices Page 53 of 68 1 Olki Number __

{29}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

11 261150

Device Name:

MPT7-4 Phased Sector Array TEE Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Note 6)
Intraoperative Neurological
Pediatric
Small Organ (Note 1)
Neonatal Cephalic
Adult Cephalic
Cardiac
TransesophagealPPPPPPBMDCNote 2,3,7
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note 1 For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

3D imaging Note 3

Note 4 B&W SieScape panoramic imaging

Note 5 Power SieScape panoramic imaging

For example: abdominal, vascular Note 6

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David A. Seymour

I hunsion Sion - Off) Devision of Reproductive. ann Badinlouical Devi 5 € 5K) (wiender

Page 54 of 68

{30}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

Kobla VC 510(k) Number (if known):

Device Name:

CW2 Continuous Wave Doppler Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Note 6)
Intraoperative Neurological
Pediatric
Small Organ (Note 1)
Neonatal Cephalic
Adult Cephalic
CardiacP
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vessel
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note 1 For example: breast, testes, thyroid, penis, prostate, etc.

  • Note 2 Ensemble tissue harmonic imaging
  • Note 3 3D imaging
  • B&W SieScape panoramic imaging Note 4
  • Power SieScape panoramic imaging Note 5
  • Note 6 For example: abdominal, vascular
  • Note 7 Contrast agent imaging
  • Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David A. Severson

(Division Sign-Off) Division of Reproductive, and Redusingical Don ないと思います。 この時はない

Page 55 of 68

{31}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known): Device Name:

Koc 1970

CW5 Continuous Wave Doppler Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Note 6)
Intraoperative Neurological
Pediatric
Small Organ (Note 1)
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophagcal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselP
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K040060; E = added under Appendix E.

Note 1 For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

3D imaging Note 3

Note 4 B&W SieScape panoramic imaging

Power SieScape panoramic imaging Note 5

Note 6 For example: abdominal, vascular

  • Note 7 Contrast agent imaging
    Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109

01.109)
David R. Lynn
(Division Sign-Off)

Division of Reproductive An and Radiological Device 51 Wirl Number

Page 56 of 68

{32}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known):

Kols1480

Device Name:

P9-4 Phased Sector Array Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
Ophthalmic
FetalPPPPPPBMDCNote 2
AbdominalPPPPPPBMDCNote 2
Intraoperative (Note 6)
Intraoperative NeurologicalPPPPPBMDCNote 2
PediatricPPPPPPBMDCNote 2
Small Organ (Note 1)PPPPPP
Neonatal CephalicPPPPPPBMDCNote 2
Adult CephalicPPPPPP
CardiacPPPPPPBMDCNote 2,7
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPPBMDCNote 2
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K050240; E = added under Appendix E.

Note I For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

Note 3 3D imaging

B&W SieScape panoramic imaging Note 4

Note 5 Power SieScape panoramic imaging

Note 6 For example: abdominal, vascular

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

Daniel R. Lypman

(Division Sion-Off) vision of Reproductive. Abdo o Radiological Devic E 1 (1/k) Niember

Page 57 of 68

{33}------------------------------------------------

Diagnostic Ultrasound Indications for Use Form

510(k) Number (if known): Device Name:

Kel. 980

CH5-2 Convex Array Transducer for use with:

SIEMENS ACUSON X500 Ultrasound System

Intended Use:

Ultrasound imaging or fluid flow analysis of the human body as follows:

Mode of Operation
Clinical ApplicationABMPWDCWDColorDopplerAmplitudeDopplerColorVelocityImagingCombined(Specify)Other(Specify)
OphthalmicPPPPPBMDCNote2,3,7,8
FetalPPPPPBMDCNote2,3,7,8
AbdominalPPPPPBMDCNote2,3,7,8
Intraoperative (Note 6)
Intraoperative Neurological
PediatricPPPPPBMDCNote2,3,7,8
Small Organ (Note 1)
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral vesselPPPPPBMDCNote2,3,7,8
Laparoscopic
Musculo-skeletal (Conventional)
Musculo-skeletal (Superficial)
Other (specify)

P = previously cleared by the FDA under # K043016; E = added under Appendix E.

Note I For example: breast, testes, thyroid, penis, prostate, etc.

Note 2 Ensemble tissue harmonic imaging

3D imaging Note 3

B&W SieScape panoramic imaging Note 4

Note 5 Power SieScape panoramic imaging

For example: abdominal, vascular Note 6

Note 7 Contrast agent imaging

Note 8 Virtual format

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

David A. Syammen

Page 58 of 68

(Division Sian-Off Division of Reproductive, Abde and Radiological Devices 510(k) Number ________________________________________________________________________________________________________________________________________________________________

§ 892.1550 Ultrasonic pulsed doppler imaging system.

(a)
Identification. An ultrasonic pulsed doppler imaging system is a device that combines the features of continuous wave doppler-effect technology with pulsed-echo effect technology and is intended to determine stationary body tissue characteristics, such as depth or location of tissue interfaces or dynamic tissue characteristics such as velocity of blood or tissue motion. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II.