K Number
K062315
Device Name
SUPERDIMENSION/BRONCHUS PREMIUM 2
Date Cleared
2006-09-08

(30 days)

Product Code
Regulation Number
892.1750
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Indicated for displaying images of the tracheobronchial tree to aid the physician in guiding endoscopic tools in the pulmonary tract. It does not make a diagnosis and is not an endoscopic tool.
Device Description
The superDimension/Bronchus Premium is a device that guides a bronchoscope and bronchial tool to a target in or adjacent to the bronchial tree on a path indicated by CT scan, and visualizes target and the interior of the tree. It has been modified to permit connection to PACS and import of PET/CT image data. Other minor improvements have been made also.
More Information

Not Found

No
The summary explicitly states "no new technology is used" and there are no mentions of AI, ML, or related terms. The device's function is described as guiding based on CT/PET/CT data, which is typical for image-guided navigation systems without necessarily employing AI/ML for the core guidance logic.

No.
The device's intended use is to display images and aid in guiding endoscopic tools, which are diagnostic and procedural assistance functions, not direct therapeutic action or treatment.

No
Explanation: The "Intended Use / Indications for Use" section explicitly states, "It does not make a diagnosis." The device is intended to aid in guiding endoscopic tools and visualizing the tracheobronchial tree, not for diagnostic purposes.

No

The device description explicitly states it "guides a bronchoscope and bronchial tool" and "visualizes target and the interior of the tree," implying interaction with and control of hardware components (bronchoscope, tools, visualization system), which is not characteristic of a software-only medical device. The performance studies also mention testing the "entire system," further suggesting hardware components are involved.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to make a diagnosis or to monitor a patient's health.
  • Device Function: The description clearly states the device's intended use is to display images of the tracheobronchial tree to aid the physician in guiding endoscopic tools. It explicitly says it does not make a diagnosis.
  • Input Data: The input data is imaging data (CT and PET/CT scans), not biological samples.
  • Anatomical Site: The device interacts with the pulmonary tract and tracheobronchial tree, which are internal anatomical structures, not samples taken from the body.

Therefore, the superDimension/Bronchus Premium is a medical device used for image-guided navigation during bronchoscopy, not an in vitro diagnostic test.

N/A

Intended Use / Indications for Use

The superDimension/Bronchus Premium 2 is intended to image the upper airways and tracheobronchial tree to aid the physician in guiding endoscopic tools in the pulmonary tract. It does not make a diagnosis and is not a bronchial tool.

Indicated for displaying images of the tracheobronchial tree to aid the physician in guiding endoscopic tools in the pulmonary tract. It does not make a diagnosis and is not an endoscopic tool.

Product codes

JAK

Device Description

The superDimension/Bronchus Premium is a device that guides a bronchoscope and bronchial tool to a target in or adjacent to the bronchial tree on a path indicated by CT scan, and visualizes target and the interior of the tree. It has been modified to permit connection to PACS and import of PET/CT image data. Other minor improvements have been made also.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

CT scan, PET/CT

Anatomical Site

upper airways and tracheobronchial tree, pulmonary tract

Indicated Patient Age Range

Not for pediatric use.

Intended User / Care Setting

Not Found

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)

Non - clinical tests: The superDimension/Bronchus Premium 2 satisfies the requirements of EN60601-1 and EN 60601-1-2. The entire system has had extensive bench testing.
Clinical tests: Since no new technology is used, clinical tests are not required.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K052852

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 892.1750 Computed tomography x-ray system.

(a)
Identification. A computed tomography x-ray system is a diagnostic x-ray system intended to produce cross-sectional images of the body by computer reconstruction of x-ray transmission data from the same axial plane taken at different angles. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II.

0

superDimension Ltd. Special 510(k)

SEP - 8 2006

Modification to super/Dimension Bronchus Premium 2 510(k) Summary July 26, 2006

1. Submitter Information

Name: superDimension Ltd.

Address:

8 Hamenofim St., POB 2045 Herzliya 46120 Israel

Tel. +972-(0)9-971-3700 Fax +972-(0)9-971-3701

Contact person:

Dr. George Myers (Official Correspondent) Medsys Inc. 377 Route 17 S Hasbrouck Heights, NJ 07604 Tel.: 201-727-1703 Fax: 201-727-1708

Date prepared: July 26, 2006

2. Name of Device

Trade Name: superDimension/Bronchus Premium 2 Common Name: Bronchoscope Classification name: System, x-ray, tomography, computed

3. Equivalent legally- marketed devices:

superDimension/Bronchus Premium, K052852

4. Description

The superDimension/Bronchus Premium is a device that guides a bronchoscope and bronchial tool to a target in or adjacent to the bronchial tree on a path indicated by CT scan, and

1

visualizes target and the interior of the tree. It has been modified to permit connection to PACS and import of PET/CT image data. Other minor improvements have been made also.

5. Intended Use

The superDimension/Bronchus Premium 2 is intended to image the upper airways and tracheobronchial tree to aid the physician in guiding endoscopic tools in the pulmonary tract. It does not make a diagnosis and is not a bronchial tool

6. Performance Data

Non - clinical tests

The superDimension/Bronchus Premium 2 satisfies the requirements of EN60601-1 and EN 60601-1-2. The entire system has had extensive bench testing.

Clinical tests

Since no new technology is used, clinical tests are not required.

7. Conclusion

The superDimension/Bronchus Premium is safe and effective for its intended use.

2

Image /page/2/Picture/0 description: The image shows the logo for the Department of Health & Human Services - USA. The logo is a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an abstract symbol resembling an eagle or bird in flight, composed of three curved lines.

Food and Drug Administration 9200 Corporate Blvd. Rockville MD 20850

SEP - 8 2006

George H. Myers, Sc.D. Official Correspondent Medsys, Inc. 377 Route 17 S HASBROUCK HGTS NJ 07604

Re: K062315

Trade/Device Name: superDimension/Bronchus Premium 2 Regulation Number: 21 CFR §892.1750 Regulation Name: Computed tomography x-ray system Regulatory Class: II Product Code: JAK Dated: August 8, 2006 Received: August 9, 2006

Dear Mr. Myers:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your boower to see is substantially equivalent (for the indications for referented in the enclosure) to legally marketed predicate devices marketed in interstate commerce ass stated in the entrebute) was ment 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 nate (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 therefore, mainer 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 11 your de rise to such additional controls. Existing major regulations affecting your Apployally, It the J oe book of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Image /page/2/Picture/10 description: The image is a circular logo or seal. The text "1906 - 2006" is at the top of the logo. The letters "FDA" are in the center of the logo. The word "Centennial" is below the letters "FDA". Three stars are below the word "Centennial".

romoting Public He

3

Page 2 -

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 Erth 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.

This letter will allow you to begin marketing your device as described in your Section 510(k) 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 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.xxx(Gastroenterology/Renal/Urology)240-276-0115
21 CFR 884.xxx(Obstetrics/Gynecology)240-276-0115
21 CFR 894.xxx(Radiology)240-276-0120
Other240-276-0100

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/cdrlv/industry/support/index.html.

Sincerely yours,

Nancy C. Hogdon

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

Enclosure

4

superDimension Bronchus Premium 2 Page 4-1

Ko 6 2315 Indications for Use

510(k) Number (if known):

Device Name: superDimension/Bronchus Premium 2

Indications For Use:

Indicated for displaying images of the tracheobronchial tree to aid the physician in guiding endoscopic tools in the pulmonary tract. It does not make a diagnosis and is not an endoscopic tool.

Not for pediatric use.

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

Over-The-Counter Use (21 CFR 807 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

David A. Legmann

(Division Sign Off Division of Repand Radiological Penna 510(k) Number