K Number
K152899
Date Cleared
2015-10-30

(29 days)

Product Code
Regulation Number
892.1550
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Philips Lumify Diagnostic Ultrasound System is intended for diagnostic ultrasound imaging in B (2D), Color Doppler, and Combined (B + Color) modes. It is indicated for diagnostic ultrasound imaging and fluid flow analysis in the following applications:

  • Fetal/Obstetric Abdominal Urology Gynecological Cardiac Fetal Echo Small Organ Musculo-skeletal Peripheral Vessel Carotid
    Lumify is intended for use in environments where bealthcare is provided by healthcare professionals, with the exception of home, ambulance, or air.
Device Description

Lumify with the L12-4 transducer is a mobile, general purpose, software controlled, diagnostic ultrasound system. Its function is to acquire ultrasound data and to display the data in various modes of operation. Lumify supports wireless network connectivity to allow the user to export ultrasound images.

The Lumify Diagnostic Ultrasound System includes:

  • o A commercial off-the-shelf Android device (COTS)
  • o Philips ultrasound software running as an app on the off-the-shelf device
  • o The C5-2 Curved linear array USB transducer
  • o The L12-4 Linear array USB transducer

Eumify provides customers with a smaller, lower cost, and more easily leveraged ultrasound system.

AI/ML Overview

The provided document is a 510(k) premarket notification for the Philips Lumify Diagnostic Ultrasound System. It details the device's indications for use and compares it to predicate devices to establish substantial equivalence. However, it does not contain explicit acceptance criteria or a study dedicated to proving the device meets specific performance criteria in terms of accuracy or efficacy.

The document claims that the Lumify system "introduces no new indications for use, modes, features, or technologies relative to the predicate devices (Nuvis/ClearVue) that require clinical testing. The clinical safety and effectiveness of ultrasound systems with these characteristics are well accepted for both predicate and subject devices." This means that the regulatory submission primarily relies on the equivalency to previously cleared devices rather than providing a new performance study.

Therefore, the following information cannot be extracted from the provided text:

  • A table of acceptance criteria and reported device performance (as no specific performance metrics are given for a new study).
  • Sample size used for a test set.
  • Data provenance for a test set.
  • Number of experts used to establish ground truth.
  • Qualifications of experts.
  • Adjudication method for a test set.
  • Whether a multi-reader multi-case (MRMC) comparative effectiveness study was done.
  • Effect size of human reader improvement with AI assistance (as this is an ultrasound system, not an AI-assisted diagnostic tool in this context, and no such study is mentioned).
  • Whether a standalone performance study was done.
  • The type of ground truth used for a performance study.
  • Sample size for the training set.
  • How ground truth for the training set was established.

Information that can be extracted related to criteria and studies, though not a performance study as requested:

1. Acceptance Criteria and Reported Device Performance:

The primary "acceptance criterion" for this 510(k) submission appears to be demonstrating substantial equivalence to predicate devices. The performance data presented are non-clinical, focusing on compliance with safety and technical standards rather than clinical accuracy for specific diagnostic tasks.

Criterion TypeAcceptance Standard (implied)Device Performance (reported)
Safety and EMCCompliance with relevant IEC and ISO standardsComplies with IEC 60601-1, IEC 60601-1-2, IEC 60601-2-37, and ISO 10993.
Quality SystemAdherence to quality assurance measures during design and developmentRisk Analysis, Product Specifications, Design Reviews, Verification and Validation measures applied.
Clinical EfficacyEquivalence to predicate devices for intended uses."Introduces no new indications for use, modes, features, or technologies relative to the predicate devices... The clinical safety and effectiveness... are well accepted..."
Indications for UseAligns with or expands upon predicate device indications.Matches or adds indications previously cleared with K133833 (Nuvis) and K120321 (ClearVue L12-4). See detailed tables in {3}, {4}, {5}.

2. Study/Test Information (Non-Clinical):

The document mentions "non-clinical performance data" for regulatory compliance, not a clinical performance study.

  • Test Set/Sample Size & Provenance: Not applicable for a clinical performance study for this submission. The "tests" mentioned are for compliance with standards.
  • Experts and Adjudication: Not applicable, as no clinical performance study for diagnostic accuracy is described. The "experts" would be those testing compliance with the listed engineering and safety standards.
  • MRMC Study: No MRMC study was done, as the submission explicitly states no clinical testing was required due to substantial equivalence.
  • Standalone Performance: No standalone clinical performance study was done for diagnostic accuracy. Performance relies on the established safety and efficacy of the predicate devices.
  • Ground Truth: Not applicable in the context of a clinical performance study, as none was performed. For the non-clinical tests, ground truth refers to the specifications and requirements of the standards being met.
  • Training Set (for algorithms): Not applicable. The document describes a medical device, not an AI/algorithm being trained on a dataset.
  • Ground Truth for Training Set: Not applicable.

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Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the circle is an abstract symbol that resembles three human profiles facing to the right, with flowing lines connecting them.

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

October 30, 2015

Philips Healthcare, Inc. % Mr. Mark Job Responsible Third Party Official Regulatory Technology Services LLC 1394 25th Street, NW BUFFALO MN 55313

Re: K152899

Trade/Device Name: Philips Lumify Diagnostic Ultrasound System Regulation Number: 21 CFR 892.1550 Regulation Name: Ultrasonic pulsed doppler imaging system Regulatory Class: II Product Code: IYN, IYO, ITX Dated: October 21, 2015 Received: October 22, 2015

Dear Mr. Job:

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 Ochs

Robert Ochs, Ph.D. 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

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement below.

510(k) Number (if known)

K152899 Device Name

Philips Lumify Diagnostic Ultrasound System

Indications for Use (Describe)

Philips Lumify Diagnostic Ultrasound System is intended for diagnostic ultrasound imaging in B (2D), Color Doppler, and Combined (B + Color) modes. It is indicated for diagnostic ultrasound imaging and fluid flow analysis in the following applications:

  • Fetal/Obstetric Abdominal Urology Gynecological Cardiac Fetal Echo Small Organ Musculo-skeletal Peripheral Vessel Carotid
    Lumify is intended for use in environments where bealthcare is provided by healthcare professionals, with the exception of home, ambulance, or air.
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."

FORM FDA 3881 (8/14)

Page 1 of 1

PSC Publishing Survices (201) 443-6740 E.F

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DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM

510(k) Number:

Device name: Lumify Diagnostic Ultrasound System

Intended Use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Clinical ApplicationMode of Operation
General(Track IOnly)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined(Specify)See belowOther*(Specify)
OphthalmicOphthalmic
Fetal/ObstetricPPP
AbdominalPPP
Intraoperative(vascular/epicardial)
Intraoperative (Neuro)
Laparoscopic
FetalImaging& OtherPediatric
Small Organ (thyroid,scrotum, prostate, breast)NNN
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Intra-luminal
Musculo-skel(conventional)NNN
Musculo-skel (superficial)NNN
Other (Urology)PPP
Other (Gynecology)PPP
Cardiac Adult
CardiacCardiac Pediatric
Trans-esoph. (Cardiac)
Other (Intracardiac)
Other (Fetal Echo)PPP
PeripheralVesselPeripheral vesselNNN
Other (Carotid)NNN

N= new indication; P= previously cleared by FDA; E= added under Appendix E

Combined mode: B+Color
Previous submission: K133833

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of Center for Devices and Radiological Health, Office of In Vitro Diagnostics

Prescription Use (Per 21 CFR 801.109)

{4}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM

510(k) Number:
Device name: C5-2
Intended Use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:
Clinical ApplicationMode of Operation
General(Track IOnly)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined(Specify)See belowOther*(Specify)
OphthalmicOphthalmic
Fetal/ObstetricPPP
AbdominalPPP
Intraoperative(vascular/epicardial)
Intraoperative (Neuro)
Laparoscopic
FetalImaging& OtherPediatric
Small Organ (thyroid,scrotum, prostate, breast)
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Intra-luminal
Musculo-skel(conventional)
Musculo-skel (superficial)
Other (Urology)PPP
Other (Gynecology)PPP
Cardiac Adult
CardiacCardiac Pediatric
Trans-esoph. (Cardiac)
Other (Intracardiac)
Other (Fetal Echo)PPP
PeripheralVesselPeripheral vessel
Other (Carotid)

N= new indication; P= previously cleared by FDA; E= added under Appendix E

Combined mode: B+Color
Previous submission: K133833

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of Center for Devices and Radiological Health, Office of In Vitro Diagnostics

Prescription Use (Per 21 CFR 801.109)

{5}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM

510(k) Number:
Device name:L12-4
Intended Use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:
Clinical ApplicationMode of Operation
General(Track IOnly)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined(Specify)See belowOther*(Specify)
OphthalmicOphthalmic
FetalImaging& OtherFetal/Obstetric
AbdominalNNN
Intraoperative(vascular/epicardial)
Intraoperative (Neuro)
Laparoscopic
Pediatric
Small Organ (thyroid,scrotum, prostate, breast)PPP
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Intra-luminal
Musculo-skel(conventional)PPP
Musculo-skel (superficial)PPP
Other (Urology)
Other (Gynecology)
CardiacCardiac Adult
Cardiac Pediatric
Trans-esoph. (Cardiac)
Other (Intracardiac)
Other (Fetal Echo)
PeripheralVesselPeripheral vesselPPP
Other (Carotid)PPP

N= new indication; P= previously cleared by FDA; E= added under Appendix E

Combined mode: B+Color
Previous submission: (K120321)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of Center for Devices and Radiological Health, Office of In Vitro Diagnostics

Prescription Use (Per 21 CFR 801.109)

{6}------------------------------------------------

Philips Ultrasound, Inc.Quality, Regulatory and SustainabilityTraditional 510(k)Doc. ID:238367
Lumify Diagnostic Ultrasound SystemRevision:A
with theL12-4 TransducerDoc. date:2015 Sep 02
Page:51 of 121

510(k) Summary of Safety and Effectiveness

This summary of safety and effectiveness is provided as part of the Premarket Notification in compliance with 21CFR. Part 807, Subpart E, Section 807.92

  1. Submitter's name, address, telephone number, contact person

Penny Greco Philips Healthcare, Inc. Regulatory Affairs Specialist 3000 Minuteman Road Andover, MA 01810-6302 Tel: (978) 659-4615 Fax (978) 975-7324

Date prepared: September 2, 2015

  1. Name of the device, including the trade or proprietary name if applicable, the common or usual name, and the classification name, if known:
Common/Usual Name:Diagnostic ultrasound system and transducers
Proprietary Name:Lumify
Classification:Class II
21 CFR Section892.1550892.1560892.1570Classification NameSystem, Imaging, Pulsed Doppler, UltrasonicSystem, Imaging, Pulsed Echo, UltrasonicTransducer, Ultrasonic, diagnosticProduct Code90 IYN90 IYO90 ITX
3) Substantially Equivalent DevicesPrimary Predicate DeviceNuvis Diagnostic Ultrasound System K133833 01/17/2014

Reference Device ClearVue Diagnostic Ultrasound System K120321 02/17/2012

  1. Device Description

Lumify with the L12-4 transducer is a mobile, general purpose, software controlled, diagnostic ultrasound system. Its function is to acquire ultrasound data and to display the data in various

{7}------------------------------------------------

Philips Ultrasound, Inc.Quality, Regulatory and SustainabilityTraditional 510(k)Lumify Diagnostic Ultrasound Systemwith theL12-4 TransducerDoc. ID:238367
Revision:A
Doc. date:2015 Sep 02
Page:52 of 121

modes of operation. Lumify supports wireless network connectivity to allow the user to export ultrasound images.

The Lumify Diagnostic Ultrasound System includes:

  • o A commercial off-the-shelf Android device (COTS)
  • o Philips ultrasound software running as an app on the off-the-shelf device
  • o The C5-2 Curved linear array USB transducer
  • o The L12-4 Linear array USB transducer

Eumify provides customers with a smaller, lower cost, and more easily leveraged ultrasound system.

5) Intended Use

The Lumify Diagnostic Ultrasound System is intended for diagnostic ultrasound imaging in B (2D), Color Doppler, and the Combined Mode (B+Color). The device is indicated for diagnostic ultrasound imaging and fluid flow analysis in the following applications: Fetal/Obstetric, Abdominal, Urology, Gynecological, Cardiac Fetal, Small Organ, Muskulosketel (Conventional & Superficial), Peripheral Vessel, Carotid.

Lumify is intended for use in environments where healthcare is provided by healthcare professionals for the diagnosis of patients, with the exception of home, ambulance and air.

5) Technological comparison to predicate devices

Lumify is a Track 3 system that employs the same fundamental scientific technology as that cleared with K133833. The primary difference between Lumify submitted as Nuvis (K133833) and Lumify submitted with this 510(k) is the addition of the L12-4 transducer (K120321). The additional Lumify indications for use were cleared with the Clear Vue L12-4 (K12032). The L12-4 is the same as the ClearVue L12-4 with equivalent indications for use, but with minor modifications including USB connectivity (same as the C5-2 K133833).

6) Determination of Substantial Equivalence

Non-clinical performance data

Non-clinical tests relied on in this premarket notification submission for a determination of substantial equivalence include tests which show compliance with the following standards:

  • · IEC 60601-1: Medical electrical equipment. General requirements for basic safety and essential performance

{8}------------------------------------------------

Philips Ultrasound, Inc.Quality, Regulatory and SustainabilityTraditional 510(k)Lumify Diagnostic Ultrasound Systemwith theL12-4 TransducerDoc. ID:238367
Revision:A
Doc. date:2015 Sep 02
Page:53 of 121
  • o IEC 60601-1-2: Medical Electrical Equipment - Part 1-2: General Requirements for Safety - Collateral standard: Electromagnetic Compatibility - Requirements and Tests
  • IEC 60601-2-37: Medical electrical equipment. Particular requirements for the safety 0 of ultrasonic medical diagnostic and monitoring equipment
  • ISO 10993: Biological evaluation of medical devices. O

Quality assurance measures applied to the system design and development include, but were not limited to:

  • Rick Analysis o
  • Product Specifications 0
  • Design Reviews O
  • Verification and Validation 0

Summary of Clinical Tests

Lumify introduces no new indications for use, modes, features, or technologies relative to the predicate devices (Nuvis/ClearVue) that require clinical testing. The clinical safety and effectiveness of ultrasound systems with these characteristics are well accepted for both predicate and subject devices.

7) Conclusions

Lumify is substantially equivalent to the predicates identified above.

Lumify is essentially the same as Nuvis (K133833) but with the L12-4 transducer (K120321) and additional indications.

514 Performance Standards

There are no Sec. 514 performance standards for this device.

Prescription Status

This is a prescription device. The prescription device statement appears in the labeling,

Sterilization Site(s) Not applicable. No components supplied sterile.

Track This is a Track 3 system

§ 892.1550 Ultrasonic pulsed doppler imaging system.

(a)
Identification. An ultrasonic pulsed doppler imaging system is a device that combines the features of continuous wave doppler-effect technology with pulsed-echo effect technology and is intended to determine stationary body tissue characteristics, such as depth or location of tissue interfaces or dynamic tissue characteristics such as velocity of blood or tissue motion. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II.