K Number
K090349
Device Name
CLEARVUE PRONE BREAST TREATMENT TABLE
Date Cleared
2009-03-09

(26 days)

Product Code
Regulation Number
892.5050
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
ClearVue, a breast radiation therapy patient support, is an accessory for medical linear accelerator radiation therapy systems. ClearVue is intended to be used to position and reposition patients for breast radiation therapy. ClearVue may be used with CT and MR scanners to acquire images for radiation therapy planning.
Device Description
ClearVue is a prone-breast table top attachment, which allows for multi-angle access to the treatment anatomy. This device is compatible with mainstream linear accelerators as well as compatible with most existing CT scanners. ClearVue is placed on top of the existing treatment or imaging modality couch. ClearVue does not have motors for mechanical motion. ClearVue is compatible with both left and right breast patients by the use of variable inserts. An optional support cushion is used should one find it necessary to tilt the patient. ClearVue passes through a standard CT opening with the patient on top (these range from 70 to 85 cm in diameter). The distance between the layer on which the patient rests and the layer which rests on the therapy system couch is 18 to 30 cm to accommodate most breast sizes. The table is made from carbon-fiber to minimize thickness and radiation absorption. A soft, cushion lining is attached to the patient layer for comfort.
More Information

No
The device description focuses on the mechanical design and materials of a patient support system, with no mention of software, algorithms, or data processing that would indicate AI/ML. The "Mentions AI, DNN, or ML" and "Description of the training set..." sections are explicitly marked as "Not Found".

No
The device is an accessory used for positioning and repositioning patients during breast radiation therapy, which is a therapeutic procedure. However, the device itself does not directly treat or diagnose a disease or condition; it facilitates the delivery of the therapy.

No

Explanation: The ClearVue is described as an accessory for positioning and repositioning patients during radiation therapy and for image acquisition for planning. It does not perform any diagnostic function such as detecting, diagnosing, or monitoring a disease.

No

The device description clearly describes a physical table top attachment made of carbon-fiber with physical components like variable inserts and an optional support cushion. It is a hardware accessory.

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

Here's why:

  • IVD devices are used to examine specimens (like blood, urine, or tissue) taken from the human body to provide information about a person's health. They are used in vitro (outside the body).
  • ClearVue is a patient support device used in vivo (within the body) during medical procedures (radiation therapy and imaging). It is used to position and support the patient, not to analyze biological samples.

The description clearly states its purpose is to position and reposition patients for breast radiation therapy and imaging, which are procedures performed directly on the patient.

N/A

Intended Use / Indications for Use

ClearVue Prone Breast Treatment Table, a breast radiation therapy patient support, is an accessory for medical linear accelerator radiation therapy systems. ClearVue is intended to be used to position and re-position patients for breast radiation therapy. Clear Vue may be used with CT and MR scanners to acquire images for radiation therapy planning.

Product codes

IYE

Device Description

ClearVue is a prone-breast table top attachment, which allows for multi-angle access to the treatment anatomy. This device is compatible with mainstream linear accelerators as well as compatible with most existing CT scanners. ClearVue is placed on top of the existing treatment or imaging modality couch. ClearVue does not have motors for mechanical motion. ClearVue is compatible with both left and right breast patients by the use of variable inserts. An optional support cushion is used should one find it necessary to tilt the patient. ClearVue passes through a standard CT opening with the patient on top (these range from 70 to 85 cm in diameter). The distance between the layer on which the patient rests and the layer which rests on the therapy system couch is 18 to 30 cm to accommodate most breast sizes. The table is made from carbon-fiber to minimize thickness and radiation absorption. A soft, cushion lining is attached to the patient layer for comfort.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

CT, MR

Anatomical Site

Breast

Indicated Patient Age Range

Not Found

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)

K905007

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 892.5050 Medical charged-particle radiation therapy system.

(a)
Identification. A medical charged-particle radiation therapy system is a device that produces by acceleration high energy charged particles (e.g., electrons and protons) intended for use in radiation therapy. This generic type of device may include signal analysis and display equipment, patient and equipment supports, treatment planning computer programs, component parts, and accessories.(b)
Classification. Class II. When intended for use as a quality control system, the film dosimetry system (film scanning system) included as an accessory to the device described in paragraph (a) of this section, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

0

KC90349

·

MAR - 9 2009

:

510(k) Summary

Date preparedFebruary 10, 2008
510(k) OwnerOrbital Therapy, LLC
8 Alfred Circle
Bedford, MA 01730
Phone: 508-202-7224
Fax: 508-371-3434
ContactNatalya Koshnitsky, Manager, Regulatory Affairs
Trade nameClearVue Prone Breast Treatment Table
Common nameBreast radiation therapy patient support
Classification NameMedical charged-particle radiation therapy system
Regulation:21 CFR 892.5050
Product code:IYE
Predicate deviceBionix RT-6025 Prone Breast System, which was cleared to market
in 510(k) # K905007
Device descriptionClearVue is a prone-breast table top attachment, which allows for
multi-angle access to the treatment anatomy. This device is
compatible with mainstream linear accelerators as well as
compatible with most existing CT scanners. ClearVue is placed on
top of the existing treatment or imaging modality couch. ClearVue
does not have motors for mechanical motion. ClearVue is
compatible with both left and right breast patients by the use of
variable inserts. An optional support cushion is used should one
find it necessary to tilt the patient. ClearVue passes through a
standard CT opening with the patient on top (these range from 70 to
85 cm in diameter). The distance between the layer on which the
patient rests and the layer which rests on the therapy system couch
is 18 to 30 cm to accommodate most breast sizes. The table is
made from carbon-fiber to minimize thickness and radiation
absorption. A soft, cushion lining is attached to the patient layer for
comfort.

Y ﮩﺴ

:

1

Intended use

Clear Vue Prone Breast Treatment Table, a breast radiation therapy patient support, is an accessory for medical linear accelerator radiation therapy systems. ClearVue is intended to be used to position and re-position patients for breast radiation therapy. Clear Vue may be used with CT and MR scanners to acquire images for radiation therapy planning.

Comparison to the predicate device

CharacteristicClearVueBionix RT-6025
Connection to
accelerator patient
tableRests on table with
high friction feet to
prevent movement.
An optional fixture
locks to the table.Locks to table
Prone position for
breast treatmentSameSame
Patient cushionCushioned body and
head supportMassage-style face
cushion supports the
head with openings
for air flow.
Contralateral breast
protectionSameSame
Comfortable foam
support during
treatmentSameSame
Height7" to 12"9"
Weight28 pounds18 pounds

Conclusion

The Clear Vue is substantially equivalent to the Bionix RT-6025 Prone Breast System with respect to intended use, safety, and effectiveness.

2

Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized caduceus symbol, which features a staff with a snake entwined around it, and three horizontal bars above it. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the symbol.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAR - 9 2009

Orbital Therapy, LLC % Mr. Chas Burr President Chas Burr Q/R Services, Inc. 11 Mystic Avenue WINCHESTER MA 01890

Re: K090349

Trade/Device Name: ClearVue Prone Breast Treatment Table Regulation Number: 21 CFR 892.5050 Regulation Name: Medical charged-particle radiation therapy system Regulatory Class: II Product Code: IYE Dated: February 10, 2009

Received: February 11, 2009

Dear Mr. Burr:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration. Iisting 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 (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.

3

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 Section 510(k) premarket notification. The FDA finding os 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 892.xxx(Radiology)(240) 276-0120
Other(240) 276-0100

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometrics' (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufactures. 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.suppot/index.html.

Sincerely yours,

Janine M. Morris

anine M. Morris Acting Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

4

Indications for Use

510(k) Number (if known): K 090349

Device Name: ClearVue Prone Breast Treatment Table

Indications for Use:

ClearVue, a breast radiation therapy patient support, is an accessory for medical linear accelerator radiation therapy systems. ClearVue is intended to be used to position and reposition patients for breast radiation therapy. ClearVue may be used with CT and MR scanners to acquire images for radiation therapy planning.

Prescription Use X (Part 21 CFR 801 Subpart D)

AND/OR

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

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Hulin Perner

(Division Sign-Off) Division of Reproductive, Abdominal, and Radiological Devices

10(k) Number

ClearVue 510(k)

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