K Number
K141536
Device Name
VIEWING CLIENT MOBILE
Date Cleared
2015-03-06

(269 days)

Product Code
Regulation Number
892.2050
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Viewing Client Mobile is a software application that is intended to be used by qualified medical professionals for the review of medical images derived from multiple modalities. Clinical reports can also be viewed using this device. The Viewing Client Mobile application can be used to perform image manipulation (for example, window width and level, zoom, pan, rotation) and measurement. It can display both lossless and lossy compressed images. For lossy images, the user must determine if the level of loss is acceptable for their purposes. The Viewing Client Mobile application provides wireless and portable access to medical images from only the following modalities: MRI, CT, X-ray and Ultrasound. It is not intended to replace a full workstation and should be used only when there is no access to one. The Viewing Client Mobile application must not be used for the primary interpretation of mammographic images.
Device Description
AXON Medical Technology Corp.'s Viewing Client Mobile is a viewer that facilitates the secure viewing of 2D, DICOM 3.0-compliant soft-copy imaging studies both within and without the Enterprise context. The product operates through an API. Viewing Client Mobile is used under mobile viewing conditions within the device's intended use. Viewing Client Mobile app runs on iOS platforms. Core measurement and image manipulation tools provided by the Viewing Client Mobile include zoom, pan, invert, W/L, Pixel Value/ Line/ Angle, ROI and CINE. The Viewing Client Mobile also supports multiseries and study display. The Viewing Client Mobile app operates on the iPad, a portable, "off-the-sheh" hardware device, used to wirelessly access medical images under mobile conditions, and is therefore more sensitive to factors not typical for reading room workstations (e.g. display condition, variable lighting, viewing angle, etc.). The user is therefore instructed to properly follow the operating instructions provided with the hardware device, utilize the Viewing Client Mobile's risk mitigation features and heed precautions related to safe device use.
More Information

Not Found

No
The document describes a mobile medical image viewer with standard image manipulation tools. There is no mention of AI, ML, or any features that would suggest the use of such technologies for image analysis, interpretation, or other functions beyond basic viewing and manipulation.

No
This device is a software application for viewing and manipulating medical images for diagnostic purposes, not for treating a specific medical condition.

No

Explanation: The device is explicitly stated as a viewer for medical images and is not intended for primary diagnosis, but rather for review and should not replace a full workstation. While clinical reports can be viewed, and it supports image manipulation for review, the key phrases "review of medical images" and "not intended to replace a full workstation" indicate it's not a primary diagnostic tool. The performance studies mention "diagnostic reads," but this refers to the quality of the images for such reads, not the device performing the diagnosis itself.

Yes

The device is described as a "software application" and a "viewer" that "runs on iOS platforms" (specifically the iPad, an "off-the-shelf hardware device"). While it requires hardware to function, the device itself is the software application, and the description focuses on the software's capabilities and performance on the hardware.

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

Here's why:

  • IVD definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, or tissue) to provide information for diagnosis, monitoring, or screening.
  • Device's intended use: The Viewing Client Mobile is a software application for viewing and manipulating medical images (MRI, CT, X-ray, Ultrasound) derived from multiple modalities. It is used by medical professionals for reviewing these images and clinical reports.
  • No mention of biological specimens: The description and intended use do not involve the analysis of any biological specimens from the human body. The device operates on medical images, which are generated by imaging equipment, not directly from patient samples.

Therefore, the Viewing Client Mobile falls under the category of medical imaging software, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Viewing Client Mobile is a software application that is intended to be used by qualified medical professionals for the review of medical images derived from multiple modalities. Clinical reports can also be viewed using this device.

The Viewing Client Mobile application can be used to perform image manipulation (for example, window width and level, zoom, pan, rotation) and measurement. It can display both lossless and lossy compressed images. For lossy images, the user must determine if the level of loss is acceptable for their purposes.

The Viewing Client Mobile application provides wireless and portable access to medical images from only the following modalities: MRI, CT, X-ray and Ultrasound. It is not intended to replace a full workstation and should be used only when there is no access to one.

The Viewing Client Mobile application must not be used for the primary interpretation of mammographic images.

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

LLZ

Device Description

AXON Medical Technology Corp.'s Viewing Client Mobile is a viewer that facilitates the secure viewing of 2D, DICOM 3.0-compliant soft-copy imaging studies both within and without the Enterprise context. The product operates through an API.

Viewing Client Mobile is used under mobile viewing conditions within the device's intended use. Viewing Client Mobile app runs on iOS platforms.

Core measurement and image manipulation tools provided by the Viewing Client Mobile include zoom, pan, invert, W/L, Pixel Value/ Line/ Angle, ROI and CINE. The Viewing Client Mobile also supports multiseries and study display.

The Viewing Client Mobile app operates on the iPad, a portable, "off-the-sheh" hardware device, used to wirelessly access medical images under mobile conditions, and is therefore more sensitive to factors not typical for reading room workstations (e.g. display condition, variable lighting, viewing angle, etc.). The user is therefore instructed to properly follow the operating instructions provided with the hardware device, utilize the Viewing Client Mobile's risk mitigation features and heed precautions related to safe device use.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

MRI, CT, X-ray and Ultrasound

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

qualified medical professionals

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)

Bench Testing was performed on all supported off-the-shelf mobile platforms to confirm the Viewing Client Mobile can be calibrated to provide optimal viewing conditions for performing diagnostic reads under prescribed illuminance ranges. The tests were performed in accordance with the test guidelines provided in AAPM Assessment of Display Performance for Medical Imaging Devices (2005). The Test plan was validated by an expert in luminance and illuminance testing and executed internally. Test equipment calibration is certified traceable to NIST. A total of seven tests were performed. In each case acceptance criteria was met. Furthermore, AXON Medical Technologies has conducted verification, and functional testing on Viewing Client Mobile software. In all cases, the software passed its performance requirements and met specifications.

A Clinical Testing Image Quality Demonstration study was performed by certified Radiologists using a variety of modalities, specifically MRI, CT, X-ray and Ultrasound, under different environmental conditions. The radiologists conducted a side-by-side comparison of the predicate and Viewing Client Mobile to evaluate and compare the overall image quality of a series of representative patient images form the range of modalities supported by the device. All radiologists indicated that the image quality of Viewing Client Mobile was acceptable in terms of overall quality, sharpness and contrast and that it would enable diagnostic reads to be made confidently. No image artifacts were noted by the reviewers. Results of the clinical testing affirm the diagnostic image viewing capability of Viewing Client Mobile when used as indicated.

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.

K112930

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

§ 892.2050 Medical image management and processing system.

(a)
Identification. A medical image management and processing system is a device that provides one or more capabilities relating to the review and digital processing of medical images for the purposes of interpretation by a trained practitioner of disease detection, diagnosis, or patient management. The software components may provide advanced or complex image processing functions for image manipulation, enhancement, or quantification that are intended for use in the interpretation and analysis of medical images. Advanced image manipulation functions may include image segmentation, multimodality image registration, or 3D visualization. Complex quantitative functions may include semi-automated measurements or time-series measurements.(b)
Classification. Class II (special controls; voluntary standards—Digital Imaging and Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture and Television Engineers (SMPTE) Test Pattern).

0

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is an abstract symbol that resembles a stylized caduceus or a representation of human profiles.

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

March 6, 2015

AXON Medical Technologies Corp. % Mr. Chas Yu Quality Assurance Manager 18 Tanager Avenue, Suite 303 Toronto, Ontario M4G 3R1 CANADA

Re: K141536

Trade/Device Name: Viewing Client Mobile Regulation Number: 21 CFR 892.2050 Regulation Name: Picture archiving and communications system Regulatory Class: II Product Code: LLZ Dated: February 19, 2015 Received: March 2, 2015

Dear Mr. Yu:

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

1

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638 2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. 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 Industry and Consumer Education 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,

Robert A Ochs

Robert Ochs. Ph.D. Acting Director Division of Radiological Health Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K141536

Device Name Viewing Client Mobile

Indications for Use (Describe)

The Viewing Client Mobile is a software application that is intended to be used by qualified medical professionals for the review of medical images derived from multiple modalities. Clinical reports can also be viewed using this device.

The Viewing Client Mobile application can be used to perform image manipulation (for example, window width and level, zoom, pan, rotation) and measurement. It can display both lossless and lossy compressed images, the user must determine if the level of loss is acceptable for their purposes.

The Viewing Client Mobile application provides wireless and portable access to medical images from only the following modalities: MRI, CT, X-ray and Ultrasound. It is not intended to replace a full workstation and should be used only when there is no access to one.

The Viewing Client Mobile application must not be used for mammography.

Type of Use (Select one or both, as applicable)

2 Prescription Use (Part 21 CFR 801 Subpart D)

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

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

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Image /page/3/Picture/0 description: The image shows the logo for Axon Medical Technologies Corp. The logo consists of a blue abstract symbol on the left, followed by the word "axon" in black. Below the word "axon" is the text "Medical Technologies Corp." also in black. The abstract symbol is made up of four blue circles connected to a central white circle.

5 510(k) Summary [21 CFR 807.92(c)]

General Information 5.1

5.1.1 Manufacturer Information

AXON Medical Technologies Corp. 18 Tanager Avenue Suite 303 Toronto, Ontario Canada M4G 3R1 Email: peter.bak@axonmed.com Tel: (416) 421-2588 Fax: (416) 421-5603

5.1.2 FDA Registration No.

Pending Approval of first 510(k) submission.

5.1.3 Submitter Information

Chas Yu Manager, Quality Assurance Tel: (604) 679-0976 Email: chas.yu@axonmed.com

Date Summary Prepared: March 31st, 2014

5.1.4 Device Information

Trade Name: Viewing Client Mobile Common Name: Medical Image Processing Software Classification Name: Picture Archiving and Communication System (PACS), (21 CFR Part 892.2050, Product Code LLZ)

5.1.5 Predicate Devices

K112930 MobileMIM MIM Software Inc. (formerly MIMvista Corp.)

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Image /page/4/Picture/0 description: The image shows the logo for Axon Medical Technologies Corp. The logo consists of a blue abstract symbol resembling interconnected circles, followed by the word "axon" in a dark gray, sans-serif font. Below the word "axon" is the text "Medical Technologies Corp." in a smaller, lighter gray font.

5.2 Device Description

AXON Medical Technology Corp.'s Viewing Client Mobile is a viewer that facilitates the secure viewing of 2D, DICOM 3.0-compliant soft-copy imaging studies both within and without the Enterprise context. The product operates through an API.

Viewing Client Mobile is used under mobile viewing conditions within the device's intended use. Viewing Client Mobile app runs on iOS platforms.

Core measurement and image manipulation tools provided by the Viewing Client Mobile include zoom, pan, invert, W/L, Pixel Value/ Line/ Angle, ROI and CINE. The Viewing Client Mobile also supports multiseries and study display.

The Viewing Client Mobile app operates on the iPad, a portable, "off-the-sheh" hardware device, used to wirelessly access medical images under mobile conditions, and is therefore more sensitive to factors not typical for reading room workstations (e.g. display condition, variable lighting, viewing angle, etc.). The user is therefore instructed to properly follow the operating instructions provided with the hardware device, utilize the Viewing Client Mobile's risk mitigation features and heed precautions related to safe device use.

5.3 Intended Use/ Indications for Use

The Viewing Client Mobile is a software application that is intended to be used by qualified medical professionals for the review of medical images derived from multiple modalities. Clinical reports can also be viewed using this device.

The Viewing Client Mobile application can be used to perform image manipulation (for example, window width and level, zoom, pan, rotation) and measurement. It can display both lossless and lossy compressed images. For lossy images, the user must determine if the level of loss is acceptable for their purposes.

The Viewing Client Mobile application provides wireless and portable access to medical images from only the following modalities: MRI, CT, X-ray and Ultrasound. It is not intended to replace a full workstation and should be used only when there is no access to one.

The Viewing Client Mobile application must not be used for the primary interpretation of mammographic images.

5

Image /page/5/Picture/0 description: The image shows the logo for Axon Medical Technologies Corp. The logo consists of a blue abstract symbol on the left, followed by the word "axon" in black, and the words "Medical Technologies Corp." in a smaller font size below the word "axon". The abstract symbol appears to be four blue circles arranged in a square pattern.

Point of ComparisonViewing Client MobileMobile MIM
510(k) NumberK112930
Intended Use /
Indications for UseThe Viewing Client Mobile is a
software application that is intended
to be used by qualified medical
professionals for the review of
medical images derived from
multiple modalities. Clinical reports
can also be viewed using this device.

The Viewing Client Mobile
application can be used to perform
image manipulation (for example,
window width and level, zoom, pan,
rotation) and measurement. It can
display both lossless and lossy
compressed images. For lossy
images, the user must determine if
the level of loss is acceptable for
their purposes.

The Viewing Client Mobile
application provides wireless and
portable access to medical images
from only the following modalities:
MRI, CT, X-ray and Ultrasound. It is
not intended to replace a full
workstation and should be used only
when there is no access to one.

The Viewing Client Mobile
application must not be used for the
primary interpretation of
mammographic images. | The Mobile MIM software program
is used for the registration, fusion,
and/or display for diagnosis of
medical images from only the
following modalities: SPECT, PET,
CT, MRI, X-Ray and Ultrasound.

Mobile MIM can be used to review
images, contours, DVH, and
isodose curves from radiation
treatment plans. Mobile MIM can
be used to approve these plans.

Mobile MIM provides wireless and
portable access to medical images.
This device is not intended to
replace full workstations and
should be used only when there is
no access to a workstation.

This device is not to be used for
mammography. |
| Receive, Store, Display,
and Process Digital
Medical Images | Yes | Yes |
| Display of Clinical
Patient Data when no
access to a workstation | Yes | Yes |
| Image Fusion | No | Yes |
| Multiplanar
reconstruction (MPR) | No | Yes |
| Maximum Intensity
Projection (MIP) | No | Yes |
| Standardized Uptake
Value (SUV) | No | Yes |
| Distant Measurements | Yes | Yes |
| Window/ Level | Yes | Yes |
| Zoom/ Pan | Yes | Yes |
| User Authentication | Yes | Yes |
| Modalities | MRI, CT, X-Ray and Ultrasound | SPECT, PET, CT, MRI, X-Ray,
Ultrasound |
| Remote Handheld
Viewing Device | Yes | Yes |
| Operating Platform | Apple iOS | Apple iOS |
| Hardware
Requirements | iPad 3 and 4 (Apple iOS handheld
devices) | Apple iOS Handheld Devices |
| Installation
Requirements | Downloadable as app | Downloadable as app |
| Logging of Audit Trails | Yes | No |
| Ambient Light Display | Yes | Yes |

Technological Characteristics Comparison Table 5.4

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Image /page/6/Picture/0 description: The image shows the logo for Axon Medical Technologies Corp. The logo consists of a blue abstract symbol on the left, followed by the word "axon" in black, and the words "Medical Technologies Corp." in a smaller font below the word "axon". The abstract symbol is made up of four blue shapes arranged in a circular pattern.

7

Image /page/7/Picture/0 description: The image shows the logo for Axon Medical Technologies Corp. The logo consists of a blue abstract symbol on the left, followed by the word "axon" in black, and the words "Medical Technologies Corp." in a smaller font size below the word "axon". The abstract symbol appears to be a stylized representation of a neuron or a network, which is relevant to the company's focus on medical technologies.

Verification Tool
Support for radiation treatment plansNoYes

Performance Testing 5.5

Bench Testing was performed on all supported off-the-shelf mobile platforms to confirm the Viewing Client Mobile can be calibrated to provide optimal viewing conditions for performing diagnostic reads under prescribed illuminance ranges.

The tests were performed in accordance with the test guidelines provided in AAPM Assessment of Display Performance for Medical Imaging Devices (2005). The Test plan was validated by an expert in luminance and illuminance testing and executed internally. Test equipment calibration is certified traceable to NIST. A total of seven tests were performed. In each case acceptance criteria was met.

Furthermore, AXON Medical Technologies has conducted verification, and functional testing on Viewing Client Mobile software. In all cases, the software passed its performance requirements and met specifications.

5.6 Clinical Testing

An Image Quality Demonstration study was performed by certified Radiologists using a variety of modalities, specifically MRI, CT, X-ray and Ultrasound, under different environmental conditions. The radiologists conducted a side-by-side comparison of the predicate and Viewing Client Mobile to evaluate and compare the overall image quality of a series of representative patient images form the range of modalities supported by the device. All radiologists indicated that the image quality of Viewing Client Mobile was acceptable in terms of overall quality, sharpness and contrast and that it would enable diagnostic reads to be made confidently. No image artifacts were noted by the reviewers. Results of the clinical testing affirm the diagnostic image viewing capability of Viewing Client Mobile when used as indicated.

8

Image /page/8/Picture/0 description: The image shows the logo for Axon Medical Technologies Corp. The logo consists of a blue abstract symbol on the left, followed by the word "axon" in black, and the words "Medical Technologies Corp." in a smaller font below the word "axon". The abstract symbol is made up of four blue circles arranged in a square pattern.

Substantial Equivalence 5.7

The predicate comparison chart in tandem with the above consideration provides evidence in support of the determination that Viewing Client Mobile is substantially equivalent to K112930 MobileMIM Software Applications.

Viewing Client Mobile provides a portable diagnostic viewer of medical images substantially equivalent to K112930 MobileMIM. AXON is of the opinion that the Viewing Client Mobile does not introduce new safety or performance risks and is safe for commercial release.