K Number
K101751
Device Name
VARIAN UNIQUE SINGLE ENERGY LINEAR ACCELERATOR
Date Cleared
2010-08-10

(49 days)

Product Code
Regulation Number
892.5050
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The UNIQUE is intended to provide stereotactic radiosurgery and precision radiotherapy for lesions, tumors and conditions anywhere in the body when radiation treatment is indicated. The UNIQUE is indicated for stereotactic radiosurgery and precision radiotherapy for lesions, tumors and conditions anywhere in the body when radiation treatment is indicated.
Device Description
The UNIQUE is a Single Energy Linear Accelerator and includes modifications to the previously cleared Varian Trilogy. The UNIQUE provides additional features, safety improvements, and usability improvements. UNIQUE is supported by the following Varian accessories: RPM Respiratory Gating (063270), PortalVision (K091209), 4D Integrated Treatment Console (K091132), Millennium Multi-Leaf Collimator (K050442).
More Information

Not Found

No
The summary does not mention AI, ML, or related terms, and the device description focuses on hardware modifications and existing accessories.

Yes
The device is intended to provide stereotactic radiosurgery and precision radiotherapy, which are forms of treatment for lesions, tumors, and conditions, indicating a therapeutic purpose.

No
The device description and intended use clearly state that the UNIQUE is a linear accelerator used for "stereotactic radiosurgery and precision radiotherapy," which are treatment modalities, not diagnostic ones. There is no mention of it being used to detect, identify, or determine the nature of a disease or condition.

No

The device description explicitly states it is a "Single Energy Linear Accelerator" and includes modifications to a previously cleared linear accelerator (Varian Trilogy), indicating it is a hardware device.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening.
  • Device Description and Intended Use: The description clearly states the device is a "Single Energy Linear Accelerator" used for "stereotactic radiosurgery and precision radiotherapy." This involves delivering radiation to treat lesions, tumors, and conditions within the body.
  • Lack of Specimen Analysis: There is no mention of the device analyzing any biological specimens taken from the patient.

This device is a therapeutic device used for delivering radiation treatment, not a diagnostic device that analyzes samples.

N/A

Intended Use / Indications for Use

The UNIQUE is intended to provide stereotactic radiosurgery and precision radiotherapy for lesions, tumors and conditions anywhere in the body when radiation treatment is indicated.

The UNIQUE is indicated for stereotactic radiosurgery and precision radiotherapy for lesions, tumors and conditions anywhere in the body when radiation treatment is indicated.

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

90 IYE

Device Description

The UNIQUE is a Single Energy Linear Accelerator and includes modifications to the previously cleared Varian Trilogy. The UNIQUE provides additional features, safety improvements, and usability improvements. UNIQUE is supported by the following Varian accessories: RPM Respiratory Gating (063270), PortalVision (K091209), 4D Integrated Treatment Console (K091132), Millennium Multi-Leaf Collimator (K050442).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

anywhere in the body

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.

Varian Trilogy K072916

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

§ 892.5050 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

K101757

510(k) Summary

The information below is provided for the UNIQUE, following the format of 21 CFR 807.92.

AUG 1 0 2010

  • Varian Medical Systems 1. Submitter: 3100 Hansen Way, M/S E110 Palo Alto, CA 94304 Contact Name: Vy Tran Phone: 650/424.5731 Fax: 650/842.5040 E-mail: vy.tran@varian.com
2. Name of the Device:UNIQUE
Trade / Proprietary Names:UNIQUE
Common or Usual Names:Single Energy Linear Accelerator
Classification Name:Medical Charged Particle Radiation Therapy System
21 CFR §892.5050
Class II
Product Code:90 IYE
    1. Predicate Device: Varian Trilogy K072916
    1. Description of the Device:

,

The UNIQUE is a Single Energy Linear Accelerator and includes modifications to the previously cleared Varian Trilogy. The UNIQUE provides additional features, safety improvements, and usability improvements. UNIQUE is supported by the following Varian accessories: RPM Respiratory Gating (063270), PortalVision (K091209), 4D Integrated Treatment Console (K091132), Millennium Multi-Leaf Collimator (K050442).

    1. Intended Use Statement
      The UNIQUE is intended to provide stereotactic radiosurgery and precision radiotherapy for lesions, tumors and conditions anywhere in the body when radiation treatment is indicated.
    1. Indications for Use Statement
      The UNIQUE is indicated for stereotactic radiosurgery and precision radiotherapy for lesions, tumors and conditions anywhere in the body when radiation treatment is indicated.

1

7. Substantial Equivalence

The UNIQUE is substantially equivalent to the predicate device, the Varian Trilogy.

The functionality of the UNIQUE is equivalent to the functionality of the Varian Trilogy in safety and effectiveness. Varian design control procedures applied to the development of the UNIQUE include requirements reviews, risk analysis, and verification and validation testing. The results of verification and validation activities demonstrate that the acceptance criteria have been met.

Compared with the predicate device, the Varian Trilogy, the basic operation is the same. Operational differences are described in the Instructions for Use for the UNIQUE.

Substantial Equivalence Table

The table below illustrates the substantial equivalence between the UNIQUE and the predicate device, the Varian Trilogy (K072916).

The intended use for both devices is to provide stereotactic radiosurgery and precision radiotherapy for lesions, tumors and conditions anywhere in the body when radiation treatment is indicated.

ItemTrilogy - K072916UNIQUE
C-Series Software: improvements for
usability and safety, as well as support for
additional featuresC-Series 7.7C-Series 8.0
Photon Energy (MV) available4-25 MV6 MV
Selectable Number of Photon BeamsTwoOne
Dose Rates50-600 MU/min (1000 SRS rate)100 - 600 MU/min (No SRS rate)
Maximum standard treatment field size40cm x 40cm40cm x 40cm
Electron TreatmentYesNo
Arc Treatments: Standard and RapidArc
where gantry rotation speed and dose rate
are varied.YesYes
Non-arc photon treatment mode
programmable MU maximum dose999 MU1999 MU
Patient Support surface: Exact CouchYesYes
Patient support surface: Exact couch
pedestal with IGRT couch top for improved
MV imagingNoYes
Drive mechanismDirect DriveClutch
Treatment Beam generationKlystronMagnetron
Support for External System Gating
Interface "EXGI" (K072916) - export of
beam information to external devicesNoYes

510(k) Summary UNIQUE - Varian Medical Systems

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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 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 with three stylized lines forming its body and wings.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

AUG 1 0 2010

Ms. Vy Tran Official Correspondent Varian Medical Systems, Inc. 3100 Hansen Way PALO ALTO CA 94304-1038

Re: K101751

Trade/Device Name: UNIQUE Regulation Number: 21 CFR 892.5050 Regulation Name: Medical charged-particle radiation therapy system Regulatory Class: II Product Code: IYE Dated: June 18, 2010 Received: June 22, 2010

Dear Ms. Tran:

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.

If your device is classified (see above) into class II (Special Controls), it may be subject to such additional controls. Existing major regulations affecting your device can be found in Title 21, Code of Federal Regulations (CFR), Parts 800 to 895. 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 Parts 801 and 809); medical device reporting (reporting of

3

medical device-related adverse events) (21 CFR 803); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820). 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 Parts 801 and 809), please contact the Office of In Vitro Diagnostic Device Evaluation (21 CLT Allis 101 and 5450. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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 tolli the (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Donald J. Trump

Donald J. St.Pierre Acting Director Division of Radiological Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

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K101751

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![Image of Varian medical systems logo](image.png)

Varian Medical Systems, Inc. 3100 Hansen Way Palo Alto, CA 94304-1038 USA Tel +1 650 493 4000 www.varian.com

# Indications for Use

AUG 1 0 2010

510(k) Number (if known):

Device Name: UNIQUE

Indications for Use:

1 1

The UNIQUE is indicated for stereotactic radiosurgery and precision radiotherapy for lesions, tumors and conditions anywhere in the body when radiation treatment is indicated.

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 In Vitro Diagnostic Devices (OIVD)

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(Division Sign-Off)

(Division Sign-Off) Division of Radiological Devices Office of In Vitro Diagnostic Device Evaluation and Safety

510K [K101751](https://510k.innolitics.com/search/K101751)

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