K Number
K101628
Device Name
KOWA NONMYD WX
Manufacturer
Date Cleared
2011-01-26

(230 days)

Product Code
Regulation Number
886.1120
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
KOWA nonmyd WX is intended for use with plane and stereo retinal image capturing without mydriatic. The retinal image can be stored to an image filing device through serial interface.
Device Description
The KOWA nonmyd WX is a retinal camera without mydriatic. Plane retinal image capturing function, that is normal image capturing, is equipped and furthermore, stereo image capturing function is done. The stereo images are able to take simultaneously in shingle shot, as these images are captured without image/parallax shifts. The KOWA nonmyd WX consists of a device body and external digital SLR camera, Single-Lens Reflex camera. The KOWA nonmed WX uses Xenon flash lamp as an image capturing light and Infrared LED lamp as an observation light. The KOWA nonmyd WX can be sued even in case which pupil has not been completely dilated in plane image capture mode, if it is more than 3.7mm in diameter. The KOWA nonmyd WX is equipped with a USB port to be able to transfer images to a computer. The KOWA nonmyd WX is designed to be able to link up to a filling system (KOWA portable VK-2), which can manage the digital images.
More Information

Not Found

No
The summary describes a retinal camera for image capture and storage, with no mention of AI/ML for image analysis or processing.

No
The device is a retinal camera used for image capturing, not for treating a disease or condition.

No

Explanation: The device is described as a retinal camera for image capturing and storage, without any mention of functionalities for analyzing these images to diagnose conditions.

No

The device description explicitly states it consists of a device body and an external digital SLR camera, and uses Xenon flash and Infrared LED lamps, indicating it is a hardware device with imaging capabilities.

Based on the provided information, the KOWA nonmyd WX is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD definition: In vitro diagnostics are tests performed on samples such as blood, urine, or tissue that have been taken from the human body to detect diseases, conditions, or infections.
  • KOWA nonmyd WX function: The KOWA nonmyd WX is a retinal camera that captures images of the retina. It is used for imaging the inside of the eye, which is an in-vivo process (within the living body), not an in-vitro process (outside the living body).
  • Intended Use: The intended use clearly states "retinal image capturing," which is an imaging procedure, not a diagnostic test performed on a sample.

Therefore, the KOWA nonmyd WX falls under the category of medical imaging devices, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

KOWA nonmyd WX is intended for use with plane and stereo retinal image capturing without mydriatic. The retinal image can be stored to an image filing device through serial interface.

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

HKI, NFJ

Device Description

The KOWA nonmyd WX is a retinal camera without mydriatic. Plane retinal image capturing function, that is normal image capturing, is equipped and furthermore, stereo image capturing function is done. The stereo images are able to take simultaneously in shingle shot, as these images are captured without image/parallax shifts.

The KOWA nonmyd WX consists of a device body and external digital SLR camera, Single-Lens Reflex camera.

The KOWA nonmed WX uses Xenon flash lamp as an image capturing light and Infrared LED lamp as an observation light.

The KOWA nonmyd WX can be sued even in case which pupil has not been completely dilated in plane image capture mode, if it is more than 3.7mm in diameter.

The KOWA nonmyd WX is equipped with a USB port to be able to transfer images to a computer.
The KOWA nonmyd WX is designed to be able to link up to a filling system (KOWA portable VK-2), which can manage the digital images.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Retinal

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): 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.

K053026, K973533

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

§ 886.1120 Ophthalmic camera.

(a)
Identification. An ophthalmic camera is an AC-powered device intended to take photographs of the eye and the surrounding area.(b)
Classification. Class II (special controls). The device, when it is a photorefractor or a general-use ophthalmic camera, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 886.9.

0

K101628

owar Kowa Company. Ltd.

ELECTRONICS & OPTICS DIVISION 4-14, NIHONBASHI-HONCHO 3-CHOME, CHUO-KU, TOKYO 103-8433 JAPAN TEL: +81-(0)3-3279-7646 FAX: +81-(0)3-3279-7621

510(k) Summary

JAN 26 201

Submitter information: Applicant:

Kowa Company, Ltd. 4-14, Nihonbashi-honcho 3-Chome Chuo-ku, Tokyo, 103-8433 Japan Phone: +81-3-3279-7646 +81-3-3279-7621 Fax:

Contact:

Date summary prepared:

June 9, 2010

Satohiko Takanashi, PE

Device identification:

Device trade name: Classification name: Product code:

KOWA nonmyd WX Camera, Ophthalmic, AC-powered HKI, NFJ

Identification of predicate devices:

Kowa Company believes that this device is substantially equivalent to: KOWA nonmyd 7 manufactured by Kowa, 510(k)# K053026, Nidek 3-DX/3-DXF Stereo Disc/Fundus Cameras manufactured by Nidek, 510(k)# K973533.

Device description:

The KOWA nonmyd WX is a retinal camera without mydriatic. Plane retinal image capturing function, that is normal image capturing, is equipped and furthermore, stereo image capturing function is done. The stereo images are able to take simultaneously in shingle shot, as these images are captured without image/parallax shifts.

The KOWA nonmyd WX consists of a device body and external digital SLR camera, Single-Lens Reflex camera.

The KOWA nonmed WX uses Xenon flash lamp as an image capturing light and Infrared LED lamp as an observation light.

The KOWA nonmyd WX can be sued even in case which pupil has not been completely dilated in plane image capture mode, if it is more than 3.7mm in diameter.

The KOWA nonmyd WX is equipped with a USB port to be able to transfer images to a computer.

1

The KOWA nonmyd WX is designed to be able to link up to a filling system (KOWA portable VK-2), which can manage the digital images.

Intended use:

KOWA nonmyd WX is intended for use with plane and stereo retinal image capturing without mydriatic. The retinal image can be stored to an image filing device through serial interface.

Technical characteristics:

Electrical safety

To guarantee Electrical safety, IEC60601-1 test was performed. The nonmyd WX met all requirements of the standard.

Electromagnetic compatibility

To guarantee Electromagnetic compatibility, IEC60601-1-2 test was performed. The nonmyd WX met all requirements of the standard.

Optical safety

To guarantee Optical safety, evaluation based on ISO15004-2 was performed. The nonmyd WX met all requirements of Group 1 instrument in the standard.

Software evaluation

To make sure Software validity of the nonmyd WX embedded software and filing software, evaluation based on FDA guidance, Guidance for the content of premarket submissions for software contained in medical devices, 2005, was performed. The levels of concern of these software items are minor.

The validation of these software items is performed as a part of system function test. All functions are tested and confirmed good working to required items.

Biocompatibility

To guarantee biocompatibility, biocompatibility assessment was performed. All materials were used the same of the other legally marked devices in US.

Risk Management

The nonmyd WX was evaluated in accordance with ISO14971: 2007, and met to all requirements of standard. The risk management of the device was deemed satisfactory. Remaining risks will be noted in the user manual, so users will be able to avoid them.

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Conclusion

COWA nonmyd WX is equipped with the fundamental technology to the predicate device for retinal image capturing and also deliver the equivalent level of safety. Therefore, it is concluded that there is no difference in the basic functions and safety between KOWA nonmyd WX and the predicate device.

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Image /page/3/Picture/1 description: The image shows the seal of the Department of Health & Human Services USA. The seal is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter. In the center of the seal is an abstract image of an eagle.

Food and Drug Administration 10903 New Hampshire Avenue Document Mail Center - WO66-G609 Silver Spring, MD 20993-0002

Kowa Co. Ltd. c/o Mr. Satohiko Takanashi 4-14, Nihonbashi-honcho 3-chome Chuo-ku Tokyo, 103-8433 Japan

Re: K101628

Trade/Device Name: Kowa nonmyd WX Regulation Number: 21 CFR 886.1120 Regulation Name: Ophthalmic camera Regulatory Class: II Product Code: HKI Dated: October 13, 2010 Received: October 14, 2010

JAN 2 6 2011

Dear Mr. Takanashi:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic

4

product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638 2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Kesia Alexander

Malvina B. Eydelman, M.D. Director Division of Ophthalmic, Neurological, and Ear. Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if know):______________________________________________________________________________________________________________________________________________________ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Device Name: KOWA nonmyd WX

Indications for Use:

KOWA nonmyd WX is intended for use with plane and stereo retinal image capturing without mydriatic. The retinal image can be stored to an image filing device through serial interface.

X Prescription Use_ (Part 21 CFR 801 Subpart D)

Over-The-Counter Use_ AND/OR (21 CFR 801 Subpart C)

(PLEASE DO WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of Device

Feson.

(Division Sign-Off) (Division of Ophthalmic, Neurological and Ear, Nose and Throat Devices

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