K Number
K150165
Device Name
GC85A
Date Cleared
2015-04-02

(66 days)

Product Code
Regulation Number
892.1680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The GC85A Digital X-ray Imaging System is intended for use in generating radiographic images of human anatomy by a qualified/trained doctor or technician. This device is not intended for mammographic applications.
Device Description
The GC85A digital X-ray imaging system consists of High voltage generator (HVG), Ceiling Suspension, X-ray tube, Collimator, Detector, AEC, DAP, CIB(Control Interface Box), Wall Stand, Patient Table, Collimator, Detector, Remote controller, Grid, Foot switch, Barcode scanner and Auto-stitching stand. This system is used to capture images by transmitting X-ray to a patient's body. The X-ray passing through a patient's body is sent to the detector and then converted into electrical signals. These signals go through the process of amplification and digital data conversion in the signal process device before being sent to the S-Station (Operation Software) and saved in DICOM file, a standard for medical imaging. The captured images are sent to the Picture Archiving & Communication System (PACS) server, and can be used for reading images.
More Information

Not Found

No
The document describes a standard digital X-ray imaging system and its components. There is no mention of AI, ML, or any related technologies in the intended use, device description, or performance studies. The image processing described is standard digital conversion and amplification.

No
This device is an X-ray imaging system, used for diagnosis by generating radiographic images, not for therapy.

No

The device is described as an X-ray imaging system that generates radiographic images. While these images are used by doctors for diagnosis, the device itself is focused on image acquisition and processing rather than directly performing a diagnosis or providing diagnostic interpretations. Its purpose is to produce images that are then "used for reading images" by a qualified professional.

No

The device description explicitly lists numerous hardware components (High voltage generator, X-ray tube, Detector, etc.) that are integral to the device's function. While it includes software (S-Station), it is part of a larger hardware system.

Based on the provided information, the GC85A Digital X-ray Imaging System is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • IVD devices are used to examine specimens taken from the human body. The intended use of the GC85A is to generate radiographic images of human anatomy by transmitting X-rays through the patient's body. This is an in vivo (within the living body) process, not an in vitro (in glass, or outside the living body) process.
  • The device description clearly outlines the components and process of capturing X-ray images of a patient. It describes the interaction of X-rays with the patient's body and the subsequent processing of the signals to create an image. This is consistent with diagnostic imaging, not laboratory testing of specimens.

Therefore, the GC85A Digital X-ray Imaging System falls under the category of medical imaging devices, not IVD devices.

N/A

Intended Use / Indications for Use

The GC85A Digital X-ray Imaging System is intended for use in generating radiographic images of human anatomy by a qualified/trained doctor or technician. This device is not intended for mammographic applications.

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

KPR

Device Description

The GC85A digital X-ray imaging system consists of High voltage generator (HVG), Ceiling Suspension, X-ray tube, Collimator, Detector, AEC, DAP, CIB(Control Interface Box), Wall Stand, Patient Table, Collimator, Detector, Remote controller, Grid, Foot switch, Barcode scanner and Auto-stitching stand.

This system is used to capture images by transmitting X-ray to a patient's body.

The X-ray passing through a patient's body is sent to the detector and then converted into electrical signals. These signals go through the process of amplification and digital data conversion in the signal process device before being sent to the S-Station (Operation Software) and saved in DICOM file, a standard for medical imaging. The captured images are sent to the Picture Archiving & Communication System (PACS) server, and can be used for reading images.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Digital X-ray

Anatomical Site

human anatomy

Indicated Patient Age Range

Not Found

Intended User / Care Setting

qualified/trained doctor or technician.

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)

Non-clinical data: The proposed detectors show curves and measurements of MTF and DQE that do not differ from the predicate device.
Clinical data: Clinical images were obtained in accordance with FDA guidance for the submission of 510(k)'s for Solid State X-ray Imaging Devices. They were evaluated by a professional radiologist and found to be equivalent to the predicate device.

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.

K140334

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

§ 892.1680 Stationary x-ray system.

(a)
Identification. A stationary x-ray system is a permanently installed diagnostic system intended to generate and control x-rays for examination of various anatomical regions. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II (special controls). A radiographic contrast tray or radiology diagnostic kit intended for use with a stationary x-ray system only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

0

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized image of three human profiles facing to the right, stacked on top of each other.

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

April 2, 2015

Samsung Electronics Co., Ltd. % Chulsin Kim Regulatory Affairs Manager 129, Samsung-ro, Yeongtong-gu Suwon-si, Gyeonggi-do 443-742 REPUBLIC OF KOREA

Re: K150165

Trade/Device Name: GC85A Regulation Number: 21 CFR 892.1680 Regulation Name: Stationary x-ray system Regulatory Class: II Product Code: KPR Dated: January 23, 2015 Received: January 26, 2015

Dear Chulsin Kim:

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

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

K150165

Device Name GC85A

Indications for Use (Describe)

The GC85A Digital X-ray Imaging System is intended for use in generating radiographic images of human anatomy by a qualified/trained doctor or technician. This device is not intended for mammographic applications.

Type of Use (Select one or both, as applicable)
☑ Prescription Use (Part 21 CFR 801 Subpart D)☐ Over-The-Counter Use (21 CFR 801 Subpart C)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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."

3

Image /page/3/Picture/1 description: The image shows the Samsung logo. The logo consists of the word "SAMSUNG" in white, bold, sans-serif font. The word is set against a blue, oval-shaped background that is tilted slightly. The logo is simple and modern, and it is easily recognizable.

510(k) Premarket Notification - Traditional

Section 5: 510(k) Summary

This summary of 510(k) safety and effectiveness information is being submitted accordance with requirements of 21 CFR 807.92

    1. Date: January 23, 2015
    1. Submitter
    • Company Name: SAMSUNG ELECTRONICS Co., Ltd. A.
    • B. Address: 129, Samsung-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 443-742, Republic of Korea

3. Primary Contact Person

  • A. Name: KIM, CHULSIN
  • B. Title: Regulatory Affairs Manager
  • C. Phone Number: +82-31-200-7661
  • FAX Number: +82-31-200-1199 D. E-Mail: chulsin.kim@samsung.com

4. Secondary Contact Person

  • Name: Ninad Gujar A.
  • B. Title: Regulatory Affairs Manager
  • C. Phone Number: 978-564-8503
  • D. FAX Number: 978-750-6677 E-Mail: ngujar@samsungneurologica.com

5. Proposed Device

  • A. Trade Name: GC85A
  • B. Device Name: GC85A
  • C. Common Name: Digital Diagnostic X-ray System
  • Classification Name: System, X-ray, Stationary D.
  • Product Code: KPR ட்.
  • F. Regulation: 21 CFR 892.1680

6. Predicate Device

  • A. Manufacturer: SAMSUNG ELECTRONICS Co., Ltd.
  • B. Trade Name: XGEO GC80
  • C. Classification Name: System, X-ray, Stationary
  • D. Product Code: KPR
  • E. 510(k) Number: K140334
  • 510(k) Decision Date: May 28, 2014 F.

7. Device Description

The GC85A digital X-ray imaging system consists of High voltage generator (HVG), Ceiling

4

Image /page/4/Picture/1 description: The image shows the Samsung logo. The word "SAMSUNG" is written in white, bold, sans-serif font. The text is set against a blue, rounded, rectangular background.

510(k) Premarket Notification - Traditional

Suspension, X-ray tube, Collimator, Detector, AEC, DAP, CIB(Control Interface Box), Wall Stand, Patient Table, Collimator, Detector, Remote controller, Grid, Foot switch, Barcode scanner and Auto-stitching stand.

This system is used to capture images by transmitting X-ray to a patient's body.

The X-ray passing through a patient's body is sent to the detector and then converted into electrical signals. These signals go through the process of amplification and digital data conversion in the signal process device before being sent to the S-Station (Operation Software) and saved in DICOM file, a standard for medical imaging. The captured images are sent to the Picture Archiving & Communication System (PACS) server, and can be used for reading images.

8. Intended Use

The GC85A Digital X-ray Imaging System is intended for use in generating radiographic images of human anatomy by a qualified/trained doctor or technician. This device is not intended for mammographic applications.

9. Summary of Technological characteristic of the proposed device compared with the predicate device

The proposed GC85A adds new detectors and modify wall stand to the predicate device, and it does not have significant change in materials, energy source or technological characteristics compared to the predicate device, XGEO GC80 (K140334). Comparisons of the following technological characteristics were assessed and the results demonstrate the substantial equivalence to the predicates.

SpecificationPredicate DeviceProposed DeviceDiscussion
Device NameXGEO GC80GC85A
ManufacturerSAMSUNG ELECTRONICSSAMSUNG ELECTRONICS
510(k) NumberK140334N/A
AppearancesSame
Intended UseThe XGEO GC80 digital X-rayThe GC85A digital X-raySame
imaging system is intended forimaging system is intended for
use in generating radiographicuse in generating radiographic
images of human anatomy by aimages of human anatomy by
qualified/trained doctor ora qualified/trained doctor or
technician. This device is nottechnician. This device is not
intended for mammographicintended for mammographic
applications.applications.
Manufacturer ContentsXGEO GC80 (K140334)GC85ADiscussion
---------------------------------------------------------------

5

Image /page/5/Picture/1 description: The image features the SAMSUNG logo. The logo is displayed in white text against a blue background. The text is bold and slightly angled.

510(k) Premarket Notification - Traditional

Manufacturer ContentsXGEO GC80 (K140334)GC85ADiscussion
(1)High Voltage Generator
TypeHigh FrequencyHigh FrequencySame
Max. Power80kW82kWDifference(1)
Output
RANGETube Voltage40-150kV40-150kVSame
Tube Current10-1000mA10-1000mASame
Exposure
Time1msec-6.3sec1msec-10secDifference(2)
AEC
(Automatic Exposure Control)YesYes
APR (Anatomically
Programmed Radiography)YesYesSame
Manufacturer ContentsXGEO GC80 (K140334)GC85ADiscussion
(2)Ceiling Suspension
Moving
Range
(mm)Longitudinal1680~4180
(Varies with room size)1680~4180
(Varies with room
size)Same
Lateral1030~3030
(Varies with room size)1030~3030
(Varies with room
size)Same
Vertical18401800Difference(3)
Vertical Tube Moving methodMotorizedMotorizedSame
Tube Assembly Rotation-157 ~ +183-157 ~ +183Same
Brake locking MethodElectromagneticElectromagneticSame
Automatic CenteringOOSame
Moving Rail TypeAl ExtrusionAl ExtrusionSame
Image PreviewOOSame
Display TypeColor LCDColor LCDSame
Control Switch TypeButton
  • Touch Screen | Button
  • Touch Screen | Same |
    | | With Table | O | O | Same |
    | Vertical Sync. | With Stand | O | O | Same |
Manufacturer ContentsXGEO GC80 (K140334)GC85ADiscussion
(3) Wall Stand
Vertical
MovementMechanismMotorized/ManualMotorizedDifference(4)
Range(mm)400~1800280~1850Difference(5)
Detector/tube servo couplingYesYesSame
DetectorTiltingMechanismMotorizedMotorizedSame

6

Image /page/6/Picture/1 description: The image shows the SAMSUNG logo in white text on a blue background. The logo is stylized with a slightly italicized font. The blue background is in the shape of an oval.

510(k) Premarket Notification - Traditional

Manufacturer ContentsXGEO GC80 (K140334)GC85ADiscussion
Range-20~+90-20~+90Same
AECConventionalConventionalSame
GridLines/cm84.685/92Difference(6)
Grid mechanismStationaryStationarySame
RemovabilityRemovableRemovableSame
Detector Support MountingFloorFloorSame
Patient Support DevicePatient handgrips, lateral support barPatient handgrips, lateral support barSame
Manufacturer ContentsXGEO GC80 (K140334)GC85ADiscussion
(4)Patient Table
Table TopSize(mm)2410 X 8122410 X 812Same
RangLateral±140±140Same
e
(mm)Longitudi
nal+480+480Same
Table heightMechanismDC Motor, Ball screwDC Motor, Ball screwSame
Range(mm)545 ~ 900545 ~ 900Same
Horizontal range of detector(mm)590688Difference(7)
AECConventionalConventionalSame
GridLines/cm84.685/92Difference(8)
Grid mechanismStationaryStationarySame
RemovabilityRemovableRemovableSame
Vertical Sync.OOSame
Control Switch TypeFoot switchFoot switchSame
Maximum Patient Weight(kg)350
(Static, Center load)350
(Static, Center load)Same
Manufacturer ContentsXGEO GC80 (K140334)GC85ADiscussion
(5)Collimator
Overall Size(mm)H212 X W300
X D179H212 X W300
X D179Same
Beam Limiting Blade
Moving MethodMotorized
/ManualMotorized
/ManualSame
Manual Operation MethodVolumeVolumeSame
Collimator Rotation±45±45Same
Beam Light SourceLEDLEDSame
Light Field Indicator TimerOOSame
Side LampOOSame

7

Image /page/7/Picture/1 description: The image shows the word "SAMSUNG" in white letters against a blue background. The font is bold and sans-serif. The logo is simple and recognizable, and the blue color is a signature of the brand.

510(k) Premarket Notification - Traditional

Manufacturer ContentsXGEO GC80 (K140334)GC85ADiscussion
Laser ModuleLaser ModuleSame
Field Size / SID DisplayColor LCDColor LCDSame

| Manufacturer

ContentsXGEO GC80 (K140334)GC85ADiscussion
(6) Detector
*NOTE: S4335-W, S4343-W were cleared with K140334.
NameS4335-WS4343-WS4335-WS4343-WS3025-W
Detector TypeCsICsICsICsICsISame
IndirectIndirectIndirectIndirectIndirectSame
Detector Area14"X17"
(345mmX42
5mm)17"X17"
(425mmX42
5mm)14"X17"
(345mmX42
5mm)17"X17"
(425mmX42
5mm)10"X12"
(245mmX29
5mm)Difference(9)
Number of pixels2466X30403036X30402466X30403036X30401750X2108
Pixel Pitch(um)140140140140140
High Contrast
Limiting
Resolution
(LP/mm)3.573.573.573.573.57Difference
(10)
CommunicationWired /
WirelessWired /
WirelessWired /
WirelessWired /
WirelessWired /
WirelessSame
NoDifferencesExplanation
(1)HVG Max PowerProposed medical device's HVG has higher max power than the predicate device's max power, and the higher max power does not contribute any adverse impacts to the device's safety and performance.
(2)HVG Exposure Time RangeProposed medical device's HVG maximum exposure time longer than the predicate device's one, and the longer exposure time does not contribute any adverse impacts to the device's safety and performance.
(3)Vertical moving range of Ceiling SuspensionProposed medical device's Vertical moving range of Ceiling Suspension has shorter than the predicate device's moving range, but the shorter moving range does not contribute any adverse impacts to the device's safety and performance.
(4)Vertical Movement Mechanism of Wall StandProposed medical device's Vertical Movement Mechanism of Wall Stand has a motorized method, while the predicate device's Vertical Movement Mechanism of Wall Stand has two methods as manual & motorized. The movement mechanism does not contribute any adverse impacts to the device's safety and performance.
(5)Vertical Moving range ofProposed medical device's Vertical Moving range of Wall Stand has

8

Image /page/8/Picture/1 description: The image shows the Samsung logo. The logo consists of the word "SAMSUNG" in white, set against a blue, rounded rectangular background. The font is sans-serif and bold, giving the logo a clean and modern appearance. The blue background provides a strong contrast, making the white text stand out.

510(k) Premarket Notification - Traditional

| | Wall Stand | longer than the predicate device's one, and the longer moving range
does not contribute any adverse impacts to the device's safety and
performance. |
|------|---------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| (6) | Grid line ( Wall stand ) | Proposed medical device's Line Pair of Grid installed in Wall Stand
has higher than the predicate device's one, and the higher line pair of
grid does not contribute any adverse impacts to the device's safety
and performance. |
| (7) | Horizontal range of
detector (Patient Table) | Proposed medical device's Horizontal Moving range of Detector
installed Patient Table has longer than the predicate device's one,
and the longer moving range does not contribute any adverse impacts
to the device's safety and performance. |
| (8) | Grid line (Patient Table) | Proposed medical device's Line Pair of Grid installed in Patient Table
has higher than the predicate device's one, and the higher line pair of
grid does not contribute any adverse impacts to the device's safety
and performance. |
| (9) | Detector Area | Proposed medical device's S3025-W detector has smaller area than
the predicate device's detectors while technical specification is
identical among them such as type & pixel pitch, and the smaller area
does not contribute any adverse impacts to the device's safety and
performance. |
| (10) | Number of pixels
Resolution and pixel pitch
of detector | Proposed medical device's S3025-W detector has smaller detector
area. Therefore, the proposed medical device's numbers of pixels is
smaller than the predicate device's detectors while pixel pitch is
identical among them, and the smaller number of pixels does not
contribute any adverse impacts to the device's safety and
performance. |

In non-clinical data, the proposed detectors show curves and measurements of MTF and DQE that do not differ from the predicate device. In clinical data, the proposed GC85A has been shown a substantially equivalent to the predicate device.

10. Safety, EMC and Performance Data

Electrical, mechanical, environmental safety and performance testing according to standard ES 60601-1, IEC 60601-1-2, IEC 60601-1-3, IEC 60601-2-28, IEC 60601-2-54, ISO14971, 21CFR1020.30 and 21CFR1020.31 were performed, and EMC testing was conducted in accordance with standard IEC 60601-1-2. Wireless function was tested and verified followed by guidance, Radio frequency Wireless Technology in Medical Devices. All test results were satisfying the standards.

11. Non-clinical data

Non-clinical testing data was provided in conformance to the FDA "Guidance for the Submission of 510(k)'s for Solid-State X-ray Imaging Devices", which includes MTF and DQE measurements as tested by IEC 62220-1. The proposed device shows no difference in non-clinical testing data such as MTF and DQE measurements from the predicate device.

9

Image /page/9/Picture/1 description: The image shows the Samsung logo. The logo consists of the word "SAMSUNG" in white, sans-serif font, set against a blue, elliptical background. The ellipse is tilted slightly, giving the logo a dynamic appearance.

510(k) Premarket Notification - Traditional

12. Clinical data

In clinical data, clinical images were obtained in accordance with FDA guidance for the submission of 510(k)'s for Solid State X-ray Imaging Devices. They were evaluated by a professional radiologist and found to be equivalent to the predicate device.

13. Conclusions

Clinical images were provided; these images were not necessary to establish substantial equivalence based on the modifications to the device but they provide further evidence in addition to the laboratory performance data to show that the complete system works as intended. These images were evaluated by a radiologist with equivalent U.S. board certification and found to be equivalent to the predicate device.

    1. Samsung Electronics Co., Ltd. will update and include in this summary any other information deemed seasonably necessary by the FDA