K Number
K063130
Device Name
APLIO XG DIAGNOSTIC ULTRASOUND SYSTEM, MODEL SSA-790A, VERSION 1.0
Date Cleared
2006-11-02

(20 days)

Product Code
Regulation Number
892.1550
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Aplio XG System is intended to be used for the following types of studies: feta, abdominal, intraoperative, pediatric, small organs, neonatal cephalic, adult cephalic, cardiac, transrectal, transvaginal, transesophageal, peripheral vascular and muscoloskeletal (both conventional and superficial.
Device Description
The Aplio XG Ultrasound System is a mobile system. It is a Track 3 device that employs a wide array of probes that include flat linear array, convex linear array, and sector array with a frequency range of 2 MHz to 12 MHz
More Information

Not Found

No
The document explicitly states "Mentions AI, DNN, or ML: Not Found" and provides no other indication of AI/ML technology.

No
The "Intended Use / Indications for Use" section lists various types of imaging studies (e.g., fetal, abdominal, cardiac), indicating that the device is for diagnostic purposes, not therapeutic intervention.

Yes
The device is described as an Ultrasound System and its predicate device (K032281) is explicitly named "ToshibaSSA-770 Aplio Version 5.5 Diagnostic Ultrasound", directly indicating its diagnostic purpose.

No

The device description explicitly states it is a "mobile system" and employs "a wide array of probes," which are hardware components. The 510(k) summary describes a physical ultrasound system, not a software-only device.

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

Here's why:

  • Intended Use: The intended use describes the system being used for various types of in vivo (within a living organism) studies using ultrasound. This includes imaging of fetuses, organs, and body parts.
  • Device Description: The description confirms it's an ultrasound system, which is a medical imaging device used to visualize internal structures of the body.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens (like blood, urine, or tissue) outside of the body to provide information about a physiological or pathological state.

IVD devices are specifically designed to perform tests on samples taken from the human body to diagnose diseases or conditions. This device is clearly intended for direct imaging of the body.

N/A

Intended Use / Indications for Use

The Aplio XG System is intended to be used for the following types of studies: fetal, abdominal, intraoperative, pediatric, small organs, neonatal cephalic, adult cephalic, cardiac, transrectal, transvaginal, transesophageal, peripheral vascular and muscoloskeletal (both conventional and superficial.

Product codes (comma separated list FDA assigned to the subject device)

90-IYN, 90-IYO, 90-ITX

Device Description

The Aplio XG Ultrasound System is a mobile system. It is a Track 3 device that employs a wide array of probes that include flat linear array, convex linear array, and sector array with a frequency range of 2 MHz to 12 MHz

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Ultrasonic Pulsed Doppler Imaging System, Ultrasonic Pulsed Echo Imaging System

Anatomical Site

fetal, abdominal, intraoperative, pediatric, small organs (thyroid, parathyroid, breast, scrotum and penis), neonatal cephalic, adult cephalic, cardiac, transrectal, transvaginal, transesophageal, peripheral vascular, musculosketal (superficial and conventional)

Indicated Patient Age Range

pediatric, neonatal, adult

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)

Not Found

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K032281

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 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.

0

Toshiba America Medical Systems, Inc.

Image /page/0/Picture/1 description: The image shows a handwritten string of characters, "K063130". The characters are written in a simple, slightly slanted style. The "K" is capitalized and the "0" is smaller and slightly raised. The remaining digits, "63130", are written in a consistent size and style.

510(k) Summary of Safety and Effectiveness (21 CFR 807.92)

Submitter's Name:Toshiba America Medical Systems, Inc.
Address:P.O. Box 2068,
2441 Michelle Drive
Tustin, CA 92781-2068NOV - 2 2000
Contact:Paul Biggins, Senior Regulatory Affairs Manager
Telephone No.:(714) 730-5000
Device Proprietary Name:SSA-790A, Aplio™ XG Version 1.00
Common Name:Ultrasound Imaging System
Classification:
Regulatory Class:II
Review Category:Tier II
  • Ultrasonic Pulsed Doppler Imaging System Product Code: 90-IYN . (21 CFR 892.1550)
  • Ultrasonic Pulsed Echo Imaging System Product Code: 90-IYO . (21 CFR 892.1560)
  • Diagnostic Ultrasonic Transducer Product Code: 90-ITX . (21 CFR No. 892 1570)

Identification of Predicate Devices:

Toshiba America Medical System believes that this device is substantially equivalent to the following device:

ToshibaSSA-770 Aplio Version 5.5 Diagnostic Ultrasound, K032281

Device Description:

The Aplio XG Ultrasound System is a mobile system. It is a Track 3 device that employs a wide array of probes that include flat linear array, convex linear array, and sector array with a frequency range of 2 MHz to 12 MHz

Intended Use:

The Aplio XG System is intended to be used for the following types of studies: feta, abdominal, intraoperative, pediatric, small organs, neonatal cephalic, adult cephalic, cardiac, transrectal, transvaginal, transesophageal, peripheral vascular and muscoloskeletal (both conventional and superficial.

Safety Considerations:

This device is designed and manufactured in conjunction with the Quality System Regulations IEC-60601 (applicable portions), and IEC 60601-1-2 (applicable portions, IEC60601-2-37 (applicable portions), and the AIUM-NEMA UD2 Output Measurement Standard as applied to Track Ultrasound Systems and the AIUM-NEMA UD3 Output Display Standard.

1

Image /page/1/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized image of three human profiles facing right, with flowing lines representing hair or movement.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Toshiba Medical Systems Corporation c/o Mr. Mark Job Responsible Third Party Official Regulatory Technology Services LLC 1394 25th Street, N.W. BUFFALO MN 55313

NOV - 2 2006

Re: K063130

Trade Name: SSA-790A, Aplio™ XG Version 1.00 Regulation Number: 21 CFR §892.1550 Regulation Name: Ultrasonic pulsed doppler imaging system Regulatory Class: II Product Code: IYN, IYO and ITX Dated: October 10, 2006 Received: October 13, 2006

Dear Mr. Job:

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 SSA-790A, Aplio™ XG Version 1.00 System, as described in your premarket notification:

Transducer Model Numbers

PVT-375BT PVT-661VT PLT-1202S PC-20M PET-510MB PST-25BT PLT-604AT

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.

2

Page 2 - Mr. Mark Job

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.

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 Schuping, Sc.D., at (240) 276- 3666.

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

Enclosures

3

System X_ Transducer________________________________________________________________________________________________________________________________________________________ Model_ SSA-790A 510(k) Number(s) 063130

Clinical ApplicationBTHIMColor DopplerPowerDynamic FlowTDIPWCWCHI 2DCHI Dynamic FlowCombined (Specify)
Ophthalmic
FetalNNNNNNNN
AbdominalNNNNNNNNN
Intraoperative (Specify)NNNNNNN
Intraoperative
Neurological
PediatricNNNNNNNNNN
Small Organ (Specify)*NNNNNNN
Neonatal CephalicNNNNNNNNN
Adult CephalicNNNNNNNNN
CardiacNNNNNNNNNNN
TransesophagealNNNNNNNN
TransrectalNNNNNNNN
TransvaginalNNNNNNNN
Transurethral
Intravascular
Peripheral VascularNNNNNNN
Laparoscopic
Musculo-skeletal
SuperficialNNNNNNN
Musculo-skeletal
ConventionalNNNNNNN

N= new indication; P = Previously Cleared by FDA; E = Added under Appendix E (LTF)

Additional Comments: Combined Modes: B/M; B/PWD; BDF/PWD; BDF/MDF; BDF/MDF/PWD;B-TDI; M-TDI; 2D/CWD; BDF/CWD; CHI/2D; FEV/2D; CHI/BDF; FEI/BDF

  • : For example: thyroid, parathyroid, breast, scrotum and penis

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

Prescription Use (Per 21 CFR 801.109)

Nancy Brogdon

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

11

4

062130

Transducer X System __ Model__PVT-375BT 510(k) Number(s)

Mode of Operation B THI M Color Power Dynamic TDI PW CW CHI CHI Combined Clinical Application Flow 2D (Specify) Doppler Dynamic Flow Ophthalmic P P P P P P Fetal P P P P P P P P P Abdominal P Intraoperative (Specify) Intraoperative Neurological P P P P P P Pediatric P P Small Organ (Specify)* Neonatal Cephalic Adult Cephalic Cardiac Transesophageal Transrectal Transvaginal Transurethral Intravascular Peripheral Vascular Laparoscopic Musculo-skeletal Superficial Musculo-skeletal Conventional

N= new indication; P = Previously Cleared by FDA; E = Added under Appendix E (LTF)

Combined Modes: B/M; B/PWD; Additional Comments: BDF/PWD; BDF/MDF; BDF/MDF/PWD;B-TDI; M-TDI; 2D/CWD; BDF/CWD; CHI/2D; FEI/2D; CHI/BDF; FEI/BDF; FEI/BDF

510(k) for this transducer K041499

(PLEASE DO NOT WRITE BELOW THIS LINE . CONTINUE ON OTHER PAGES IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

Nancy Chozdon

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

Diagnostic Ultrasound Indications For Use Form

5

Transducer X System _______________________________________________________________________________________________________________________________________________________________________ PVT-661VT Model_________________________________________________________________________________________________________________________________________________________________________ 510(k) Number(s) 063120

Mode of Operation
Clinical ApplicationBTHIMColor DopplerPowerDynamic FlowTDIPWCWCHI 2DCHI Dynamic FlowCombined (Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Specify)
Intraoperative
Neurological
Pediatric
Small Organ (Specify)*
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
TransrectalPPPPPPPP
TransvaginalPPPPPPPP
Transurethral
Intravascular
Peripheral Vascular
Laparoscopic
Musculo-skeletal
Superficial
Musculo-skeletal
Conventional

N= new indication; P = Previously Cleared by FDA; E = Added under Appendix E (LTF)

Additional Comments: Combined Modes: B/M; B/PWD; BDF/PWD; BDF/MDF; BDF/MDF/PWD;B-TDI; M-TDI; 2D/CWD; BDF/CWD; CHI/2D; FEI/2D; CHI/BDF; FEVBDF; FEVBDF

510(k) for this transducer K041499

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

Prescription Use (Per 21 CFR 801.109)

Nancy C. Hodgson

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

Diagnostic Ultrasound Indications For Use Form

6

Transducer X System System Model___ PLT-1202S

510(k) Number(s)

Mode of Operation TDI PW B THI M Color Power Dynamic ('W CHI CHI Combined Clinical Application Doppler Flow 2D Dynamic (Specify) Flow Ophthalmic Fetal Abdominal Intraoperative (Specify) E E E E F E E Intraoperative Neurologica! Pediatric Small Organ (Specify)* E E E E E E E Neonatal Cephalic Adult Cephalic Cardiac Transesophageal Transrectal Transvaginal Transurethral Intravascular Peripheral Vascular E E E E E E E Laparoscopic Musculo-skeletal E E E E భా শু E Superficial Musculo-skeletal E E E E כד E E Conventional

000 3

N= new indication; P = Previously Cleared by FDA; E = Added under Appendix E (LTF)

Additional Comments: Combined Modes: B/M; B/PWD; BDF/PWD; BDF/MDF; BDF/MDF/PWD;B-TDI; M-TDI; 2D/CWD; BDF/CWD; CHI/2D; FEI/2D; CHI/BDF; FEI/BDF; FEI/BDF

510(k) for this transducer K041499

(PLEASE DO NOT WRITE BELOW THIS LINE · CONTINUE ON OTHER PAGES IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

Nancy C. brygdon

(Division Sign-Off) Division of Reproductive, Abdomin and Radiological Devices E ! Prs) Number _

Diagnostic Ultrasound Indications For Use Form

7

System _______________________________________________________________________________________________________________________________________________________________________ Transducer X Model_ PC-20M 510(k) Number(s)

Mode of Operation
Clinical ApplicationBTHIMColor
DopplerPowerDynamic
FlowTDIPWCWCHI
2DCHI
Dynamic
FlowCombined
(Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Specify)
Intraoperative
Neurological
PediatricP
Small Organ (Specify)*
Neonatal Cephalic
Adult Cephalic
CardiacP
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral VascularP
Laparoscopic
Musculo-skeletal
Superficial
Musculo-skeletal
Conventional

663130

N= new indication; P = Previously Cleared by FDA; E = Added under Appendix E (LTF)

Additional Comments: Combined Modes: B/M; B/PWD; BDF/PWD; BDF/MDF; BDF/MDF/PWD;B-TDI; M-TDI; 2D/CWD; BDF/CWD; CHI/2D; FEI/2D; CHI/BDF; FEI/BDF; FEI/BDF

510(k) for this transducer K041499

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

Prescription Use (Per 21 CFR 801.109)

anar (Division Sign-Off) Donsion of Reproductive, Abdominal, ··············································································································································································

" = (k) Number _______________________________________________________________________________________________________________________________________________________________

8

Transducer X System _ Model_ PET-510MB__ 510(k) Number(s)

K06 3130

Mode of Operation
Clinical ApplicationBTHIMColor DopplerPowerDynamic FlowTDIPWCWCHI 2DCHI Dynamic FlowCombined (Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Specify)
Intraoperative
Neurological
Pediatric
Small Organ (Specify)*
Neonatal Cephalic
Adult Cephalic
Cardiac
TransesophagealPPPPPPPP
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral Vascular
Laparoscopic
Musculo-skeletal
Superficial
Musculo-skeletal
Conventional
N= new indication; P = Previously Cleared by FDA; E = Added under Appendix E (LTF)
Additional Comments: Combined Modes: B/M; B/PWD;
BDF/PWD; BDF/MDF; BDF/MDF/PWD;B-TDI; M-TDI; 2D/CWD; BDF/CWD;
CHI/2D; FEI/2D; CHI/BDF; FEI/BDF

CHI/2D; FEI/2D; CHI/BDF; FEI/BDF; FEI/BDF

510(k) for this transducer K041499

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

Prescription Use (Per 21 CFR 801.109)

Nancy C. Hogdon

(Division Sign-Offy Cousion of Reproductive, Abdominal, ... . Tadınloğical Devices 5 1 0,k) Number ______________________________________________________________________________________________________________________________________________________________

9

3130

System _______________________________________________________________________________________________________________________________________________________________________ Transducer X PST-25BT_ Model_ 510(k) Number(s)

| Clinical Application | B | THI | M | Color
Doppler | Power | Dynamic
Flow | TDI | PW | CW | CHI
2D | CHI
Dynamic
Flow | Combined
(Specify) |
|----------------------------------|---|-----|---|------------------|-------|-----------------|-----|----|----|-----------|------------------------|-----------------------|
| Ophthalmic | | | | | | | | | | | | |
| Fetal | | | | | | | | | | | | |
| Abdominal | E | E | E | E | E | E | E | E | E | | | E |
| Intraoperative (Specify) | | | | | | | | | | | | |
| Intraoperative | | | | | | | | | | | | |
| Neurological | | | | | | | | | | | | |
| Pediatric | E | E | E | E | E | E | E | E | E | | | E |
| Small Organ (Specify)* | | | | | | | | | | | | |
| Neonatal Cephalic | E | E | E | E | E | E | E | E | E | | | E |
| Adult Cephalic | E | E | E | E | E | E | E | E | E | | | E |
| Cardiac | E | E | E | E | E | E | E | E | E | E | | E |
| Transesophageal | | | | | | | | | | | | |
| Transrectal | | | | | | | | | | | | |
| Transvaginal | | | | | | | | | | | | |
| Transurethral | | | | | | | | | | | | |
| Intravascular | | | | | | | | | | | | |
| Peripheral Vascular | | | | | | | | | | | | |
| Laparoscopic | | | | | | | | | | | | |
| Musculo-skeletal | | | | | | | | | | | | |
| Superficial | | | | | | | | | | | | |
| Musculo-skeletal
Conventional | | | | | | | | | | | | |

N= new indication; P = Previously Cleared by FDA; E = Added under Appendix E (LTF)

Combined Modes: B/M; B/PWD; Additional Comments: BDF/PWD; BDF/MDF; BDF/MDF/PWD;B-TDI; M-TDI; 2D/CWD; BDF/CWD; CHI/2D; FEI/2D; CHI/BDF; FEVBDF; FEVBDF

Letter to file against K041499

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON OTHER PAGES IF NEEDE!D) Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use (Per 21 CFR 801.109)

Nancy Brogdon

(Division Sign-Off) Firelon of Reproductive, anningical Devices - Copy Number ________________________________________________________________________________________________________________________________________________________________

10

Transducer_X System _ PLT-604AT Model 510(k) Number(s)

Kole3130

Mode of Operation
Clinical ApplicationBTHIMColor
DopplerPowerDynamic
FlowTDIPWCWCHI
2DCHI
Dynamic
FlowCombined
(Specify)
Ophthalmic
Fetal
Abdominal
Intraoperative (Specify)
Intraoperative
Neurological
Pediatric
Small Organ (Specify)*PPPPPPPP
Neonatal Cephalic
Adult Cephalic
Cardiac
Transesophageal
Transrectal
Transvaginal
Transurethral
Intravascular
Peripheral VascularPPPPPPPP
Laparoscopic
Musculo-skeletal
SuperficialPPPPPPPP
Musculo-skeletal
ConventionalPPPPPPPP

N= new indication; P = Previously Cleared by FDA; E = Added under Appendix E (LTF)

Combined Modes: B/M; B/PWD; Additional Comments: BDF/PWD; BDF/MDF; BDF/MDF/PWD;B-TDI; M-TDI; 2D/CWD; BDF/CWD; CHI/2D; FEI/2D; CHI/BDF; FEI/BDF; FEI/BDF

510(k) for this transducer K041499

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

Prescription Use (Per 21 CFR 801.109)

Nancy C Broadon

(Division Sign-Off) Asion of Reproductive, A lon only of Devices ു Number ----