K Number
K160559
Date Cleared
2016-10-18

(232 days)

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

The Noblus™ Ultrasound Diagnostic System is intended for use by trained personnel (doctor, sonographer, etc.) for the diagnostic ultrasound evaluation of Abdominal, Cardiac, Intra-operative (Spec.), Intra-operative (Neuro.), Transesophageal (Cardiac) - Adult/Pediatric, Wound (Cavernous/Non-Cavernous), Fetal, Pediatric, Small Organ, Peripheral vessel, Biopsy, Trans-rectal, Musculoskeletal (Convent. / Superfic.), Neonatal Cephalic, Adult Cephalic, Endoscopy, Intra-luminal, Gynecology, Urology, and Laparoscopic clinical applications.

The modes of Operation of the Hitachi Noblus™ Ultrasound Diagnostic System are B mode, M mode (Pulse Wave Doppler), CW mode (Continuous Wave Doppler), Color Doppler (Color Flow Angiography), TDI (Tissue Doppler Imaging), 3D Imaging, 4D Imaging, and Real Time Tissue Elastography.

Device Description

An ultrasound diagnostic system with the following features:

  • Ultrasound transducer(s) to generate the transmitted ultrasound energy and detect the reflected echoes O
  • Ultrasound transducer accessories (standard and optional) to maximize functional usage of transducer(s) O in various modes of operation
  • A computer system to control the transducer and analyze the signals resulting from the reflected echoes O
  • A video monitor with optional image recorder to display the computed image or derived Doppler data O
AI/ML Overview

The provided text is related to a 510(k) premarket notification for the NOBLUS™ Ultrasound Diagnostic System. It primarily focuses on the device's intended use and comparison to a predicate device, rather than detailed acceptance criteria and study results for device performance. Therefore, I can only extract limited information relevant to your request.

Here's what can be gathered:

1. Table of Acceptance Criteria and Reported Device Performance:

The document lists "FDA Track" and "Transmit Channel" as comparative characteristics, implying these were evaluated, though specific acceptance criteria values or performance metrics are not explicitly stated in a tabular format as you requested. The comparison indicates the devices performed equivalently.

CharacteristicAcceptance Criteria (Implied)Reported Device Performance (Subject Device)
FDA TrackWithin FDA limits1 probe / 3 probes (with Probe extension unit)
Transmit ChannelSufficient for operation64
Acoustic LevelBelow Track 3 FDA limitsBelow Track 3 FDA limits
BiocompatibilityConforms to ISO 10993-1Conforms to ISO 10993-1
Cleaning & DisinfectionEffectiveness demonstratedEffectiveness demonstrated
Electromagnetic CompatibilityConforms to applicable standardsConforms to applicable standards
Electrical & Mechanical SafetyConforms to applicable standardsConforms to applicable standards
Quality System ComplianceConforms to FDA 21 CFR 820Conforms to FDA 21 CFR 820

2. Sample size used for the test set and the data provenance:

The document states "No new hazards were identified with the subject device and its transducers have been evaluated..." and "No new safety or effectiveness questions are raised related to these changes." This phrasing indicates that evaluations were performed, but no specific sample size for a test set or data provenance (e.g., country of origin, retrospective/prospective) is provided. The evaluation appears to be based on design, materials, and compliance with standards rather than clinical data from a test set.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

Since no clinical testing necessitating a test set and ground truth establishment is mentioned, this information is not available in the provided text. The evaluation method described focuses on engineering and regulatory compliance.

4. Adjudication method for the test set:

Not applicable, as no clinical test set requiring adjudication is mentioned.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

Not applicable. The device is an ultrasound diagnostic system, not an AI-assisted diagnostic tool for human readers. The document does not mention any AI capabilities or comparative effectiveness studies of this nature.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done:

Not applicable. The device is an ultrasound diagnostic system, which inherently involves human operation and interpretation. The document does not describe any standalone algorithm performance testing.

7. The type of ground truth used:

Not explicitly stated for performance evaluation as the evaluation methods lean towards engineering and regulatory compliance. For the broader context of diagnostic ultrasound, the "ground truth" would generally be established by definitive diagnostic methods (e.g., pathology, surgical findings, clinical follow-up) for the conditions being diagnosed. However, these are not directly referenced as part of this device's "study" for acceptance criteria.

8. The sample size for the training set:

Not applicable. This is a medical device submission for an ultrasound system, not an AI/machine learning model that typically requires a training set.

9. How the ground truth for the training set was established:

Not applicable, as there is no training set mentioned for an AI/machine learning model.

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Image /page/0/Picture/1 description: The image is a logo for the U.S. Department of Health & Human Services. The logo features a stylized image of three human profiles facing to the right, with flowing lines suggesting movement or connection. The profiles are arranged in a way that they appear to be layered or overlapping. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the image.

December 6, 2016

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

Hitachi Medical Corporation % Ms. Angela Van Arsdale RA/QA Manager Hitachi Aloka Medical America, Inc. 10 Fairfield Blvd. WALLINGFORD CT 06492

Re: K160559

Trade/Device Name: NOBLUS™ Ultrasound Diagnostic System Regulation Number: 21 CFR 892.1550 Regulation Name: Ultrasonic pulsed doppler imaging system Regulatory Class: II Product Code: IYN, IYO, ITX Dated: October 13, 2016 Received: October 14, 2016

Dear Ms. Van Arsdale:

This letter corrects our substantially equivalent letter of October 18, 2016.

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

{1}------------------------------------------------

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. 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/ResourcesforYou/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

Jeff Rothen

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

Enclosure

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Indications for Use

510(k) Number (if known)

Device Name

NOBLUSTM Ultrasound Diagnostic System

Indications for Use (Describe)

The Noblus™ Ultrasound Diagnostic System is intended for use by trained personnel (doctor, sonographer, etc.) for the diagnostic ultrasound evaluation of Abdominal, Cardiac, Intra-operative (Spec.), Intra-operative (Neuro.), Transesophageal (Cardiac) - Adult/Pediatric, Wound (Cavernous/Non-Cavernous), Fetal, Pediatric, Small Organ, Peripheral vessel, Biopsy, Trans-rectal, Musculoskeletal (Convent. / Superfic.), Neonatal Cephalic, Adult Cephalic, Endoscopy, Intra-luminal, Gynecology, Urology, and Laparoscopic clinical applications.

The modes of Operation of the Hitachi Noblus™ Ultrasound Diagnostic System are B mode, M mode (Pulse Wave Doppler), CW mode (Continuous Wave Doppler), Color Doppler (Color Flow Angiography), TDI (Tissue Doppler Imaging), 3D Imaging, 4D Imaging, and Real Time Tissue Elastography.

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.

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Transducer:All connectable probes
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
FetalPPPPPPP
AbdominalPaPaPaPaPaPaPa
Intra-operative (Spec.)PbPbPbPbPbPb
Intra-operative (Neuro.)NNNNNN
LaparoscopicPPPPPP
PediatricPPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal CephalicPPPPPPP
Fetal ImagingAdult CephalicPPPPPPP
& OtherTrans-rectalPePePePePePe
Trans-vaginalPfPfPfPfPfPf
Trans-urethral
Trans-esoph. (non-Card.)PgPgPgPgPgPg
Musculo-skel. (Convent.)PPPPPP
Musculo-skel. (Superfic.)PPPPPP
Intra-luminal
Other (spec.) - WoundPhPhPhPhPhPh
Other (spec.) - GynecologicalPPPPPP
Other (spec.) - EndoscopyPPPPPP
Other (spec.) -
Cardiac AdultPPPPPPP
CardiacCardiac PediatricPPPPPPP
Trans-esophageal (card.)PgPgPgPgPgPgPg
Other (spec.)
PeripheralPeripheral vesselPPPPPPP
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M, CFM-B/PW,TDI-B/B. TDI-B/M, TDI-B/PW* Amplitude Doppler (Color Flow Angiography), Tissue Doppler Imaging, 3D Imaging, 4D Imaging, Omni Directional M mode, Wide View,Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

Noblus

System:

(PLEASE DO NO WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

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

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:C221
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
Fetal Imaging& OtherFetal
AbdominalPPPPPP
Intra-operative (Spec.)PbPbPbPbPbPb
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
CardiacCardiac Adult
Cardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

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

System:Noblus
Transducer:C22K
Intended use:Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
Fetal
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)PbPbPbPbPbPb
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign – Off)
Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:________________________________________________________________________________________________________________________________________________________________

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

System:Noblus
Transducer:C22P
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationGeneral(Track I only)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmicFetalPPPPPP
AbdominalPaPaPaPaPaPa
Fetal Imaging& OtherIntra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
CardiacCardiac Adult
Cardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N= new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health

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

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:C22T
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
AbdominalPPPPPP
Intra-operative (Spec.)PbPbPbPbPbPb
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N= new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M, CFM-B/PW,
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign – Off)
Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

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

System:Noblus
Transducer:C25
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
FetalPPPPPP
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHIER PAGE IF NEEDED)

{9}------------------------------------------------

System:Noblus
Transducer:C251
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
FetalPPPPPP
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

(PLEASE DO NO WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign — Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{10}------------------------------------------------

System:Noblus
Transducer:C35
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
FetalPPPPPP
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M, CFM-B/PW,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View,
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

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(Division Sign – Off)
Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{11}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:C41
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
AbdominalPPPPPP
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PcPcPcPcPcPc
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPP
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vesselPPPPPP
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, CFM-B/CFM-B/CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View,
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds
Prescription Use Only (per 21 CFR 801.109)

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(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health

{12}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:C41B
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColor DopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
FetalPPPPPP
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectalPePePePePePe
Trans-vaginalPfPfPfPfPfPf
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
CFM-B/PW* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

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Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{13}------------------------------------------------

System:Noblus
Transducer:C41L47RP
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectalPePePePePePe
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
CFM-B/PW* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Real Time Tissue Elastography
Additional Comments:Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "b":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

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(Division Sign - Off) Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{14}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:C41V
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorCombined*Other**
(Track I only)(Tracks I & III)Doppler(Spec.)(Spec.)
OphthalmicOphthalmic
FetalPPPPPP
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectalPePePePePePe
Trans-vaginalPfPfPfPfPfPf
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - GynecologicalPPPPPP
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

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(Division Sign – Off)
Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{15}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:C41V1
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
FetalPPPPPP
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectalPePePePePePe
Trans-vaginalPfPfPfPfPfPf
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - GynecologicalPPPPPP
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

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(Division Sign - Off) Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:________________________________________________________________________________________________________________________________________________________________ ---

{16}------------------------------------------------

System:Noblus
Transducer:C42
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)PbPbPbPbPbPb
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal CephalicPPPPPP
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)PPPPPP
PeripheralPeripheral vesselPPPPPP
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

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(Division Sign - Off) Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{17}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:C42K
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColor DopplerCombined* (Spec.)Other** (Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)PbPbPbPbPbPb
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds
Duranamissioner Iln.I.1000 21 CED 901 1001

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(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health

{18}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:C42T
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)PbPbPbPbPbPb
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N= new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparossopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

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(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health
510(k) Number:

{19}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:CC41R
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
FetalPPPPPP
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectalPePePePePePe
Trans-vaginalPfPfPfPfPfPf
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

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(Division of Radiological Health 510(k) Number:___

{20}------------------------------------------------

System:NoblusDIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
Transducer:EUP-B512
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationSpecific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
General(Track I only)
OphthalmicOphthalmic
FetalPPPPPP
AbdominalPaPaPaPaPaPa
Fetal Imaging& OtherIntra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
CardiacCardiac Adult
Cardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M, CFM-B/PW,CFM-B/PW**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging
Additional Comments:
Subscript "a": Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c": Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d": Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e": Includes imaging for guidance of trans-rectal biopsy.
Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g": For Adult and Pediatric patients.
Subscript "h": Includes imaging for Cavernous/Non-Cavernous wounds

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(Division Sign - Off)
Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{21}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:EUP-B715
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Mode of Operation
Clinical ApplicationSpecific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
General(Track I only)(Tracks I & III)
OphthalmicOphthalmic
FetalPPPPPP
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

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(Division Sign - Off) Office of Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{22}------------------------------------------------

System:Noblus
Transducer:EUP-C715
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
FetalPPPPPP
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N= new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED)

(Division of Radiological Health
Office of In Vitro Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{23}------------------------------------------------

System:Noblus
Transducer:EUP-CC531S
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of OperationOther**
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
FetalPPPPPP
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectalPePePePePePe
Trans-vaginalPfPfPfPfPfPf
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{24}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:EUP-L53L
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColor DopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
Fetal
AbdominalPPPPPP
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PcPcPcPcPcPc
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPP
Musculo-skel. (Superfic.)PPPPPP
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vesselPPPPPP
Other (spec.) -
N= new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

1:

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:________________________________________________________________________________________________________________________________________________________________

{25}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:EUP-L74M
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
Fetal
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPP
Musculo-skel. (Superfic.)PPPPPP
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vesselPPPPPP
VesselOther (spec.) -
N= new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Office of In Vitro Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number: _______________________________________________________________________________________________________________________________________________________________

.

{26}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:EUP-053T
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificColorCombined*Other**
(Track I only)(Tracks I & III)BMPWDCWDDoppler(Spec.)(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)PbPbPbPbPbPb
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign – Off) – Off)
Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{27}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:EUP-054J
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)PPPPPP
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPP
Musculo-skel. (Superfic.)PPPPPP
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vesselPPPPPPP
VesselOther (spec.) -
N= new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health

{28}------------------------------------------------

System:Noblus
Transducer:EUP-0732T
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)PbPbPbPbPbPb
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED)

(Division of Radiological Health
Office of In Vitro Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:__

{29}------------------------------------------------

System:Noblus
Transducer:EUP-OL334
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of OperationCombined*(Spec.)Other **(Spec.)
General(Track I only)Specific(Tracks I & III)BMPWDCWDColorDoppler
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
LaparoscopicPPPPPP
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health
510(k) Number: _________________________________________________________________________________________________________

{30}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:EUP-R54AW-19, -33
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectalPPPPPP
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign – Off)
Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{31}------------------------------------------------

System:Noblus
Transducer:L34
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
Fetal
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPP
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vesselPPPPPP
Other (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Contrast Ime Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health

8

{32}------------------------------------------------

System:Noblus
Transducer:L43K
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorCombined*Other**
(Track I only)(Tracks I & III)Doppler(Spec.)(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)PbPbPbPbPbPb
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M, CFM-B/CFM-M, CFM-B/PW,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

్రాప్ట్

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

:

(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:___

{33}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:L44
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPP
Musculo-skel. (Superfic.)PPPPPP
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vesselPPPPPP
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

.

{34}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:L441
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColor DopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
Fetal
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPP
Musculo-skel. (Superfic.)PPPPPP
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vesselPPPPPP
Other (spec.) -
N= new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign – Off)
Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:________________________________________________________________________________________________________________________________________________________________

{35}------------------------------------------------

System:Noblus
Transducer:L44LA
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorCombined*Other**
(Track I only)(Tracks I & III)Doppler(Spec.)(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)PPPPPP
Intra-operative (Neuro.)
LaparoscopicPPPPPP
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, CFM-B/CFM-B/CFM-B/CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign – Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{36}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:L44LA1
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificColorCombined*Other **
(Track I only)(Tracks I & III)BMPWDCWDDoppler(Spec.)(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)PPPPPP
Intra-operative (Neuro.)
LaparoscopicPPPPPP
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N= new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{37}------------------------------------------------

System:Noblus
Transducer:L55
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other **(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPP
Musculo-skel. (Superfic.)PPPPPP
Intra-luminal
Other (spec.) - WoundPhPhPhPhPhPh
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vesselPPPPPP
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
**Amplitude Doppler (Color Flow Angiography, Omni Directional M mode, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{38}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:L64
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColor DopplerCombined*Other **
(Track I only)(Tracks I & III)(Spec.)(Spec.)
OphthalmicOphthalmic
Fetal
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPP
Musculo-skel. (Superfic.)PPPPPP
Intra-luminal
Other (spec.) - WoundPhPhPhPhPhPh
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vesselPPPPPP
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Omni Directional M mode, Wide View, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health
510(k) Number:

{39}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:R41R
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificMPWDCWDColorCombined*Other **
(Track I only)(Tracks I & III)BDoppler(Spec.)(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectalPPPPPP
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, CFM-B/CFM-B/CFM-B/CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Includes imaging for Cavernous/Non-Cavernous wounds
Subscript "h":

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED)

(E

{40}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:S21
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorCombined*Other **
(Track I only)(Tracks I & III)Doppler(Spec.)(Spec.)
OphthalmicOphthalmic
FetalPPPPPPP
AbdominalPPPPPPP
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult CephalicPPPPPPP
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac AdultPPPPPPP
CardiacCardiac PediatricPPPPPPP
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vesselPPPPPPP
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW, TDI-B/B. TDI-B/M, TDI-B/PW
** Amplitude Doppler (Color Flow Angiography), Tissue Doppler Imaging, 3D Imaging, Omni Directional M mode, Contrast Imaging
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign – Off)
Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:________________________________________________________________________________________________________________________________________________________________ -

{41}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:S211
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationSpecific(Tracks I & III)Mode of Operation
General(Track I only)BMPWDCWDColor DopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
FetalPPPPPPP
AbdominalPPPPPPP
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult CephalicPPPPPPP
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
CardiacCardiac AdultPPPPPPP
Cardiac PediatricPPPPPPP
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vesselPPPPPPP
Other (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW, TDI-B/B. TDI-B/M, TDI-B/PW
**Amplitude Doppler (Color Flow Angiography), Tissue Doppler Imaging, 3D Imaging, Omni Directional M mode, Contrast Imaging
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off)
Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health
510(k) Number:

{42}------------------------------------------------

Mode of Operation
System:Noblus
Transducer:S31
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationSpecific(Tracks I & III)BMPWDCWDColor DopplerCombined*(Spec.)Other**(Spec.)
General(Track I only)
OphthalmicOphthalmic
Fetal
AbdominalPPPPPPP
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)
Neonatal CephalicPPPPPPP
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
CardiacCardiac AdultPPPPPPP
Cardiac PediatricPPPPPPP
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW,TDI-B/B. TDI-B/M, TDI-B/PW
**Amplitude Doppler (Color Flow Angiography), Tissue Doppler Imaging, 3D Imaging, Omni Directional M mode
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division of Radiological Health
Office of In Vitro Division of Radiological Health
Office of In Vitro Diagnostic and Radiological Health 510(k) Number:________________________________________________________________________________________________________________________________________________________________

{43}------------------------------------------------

System:Noblus
Transducer:S31KP
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationSpecific(Tracks I & III)Mode of Operation
General(Track I only)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)NNNNNN
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M, CFM-B/PW**Amplitude Doppler (Color Flow Angiography), Omni Directional M mode
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

(PLEASE DO NO WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostics and Radiological Health (OIR)

(Division Sign - Off) Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health
510(k) Number:__________________________________________________________________________________________________________

{44}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:S3ESS/S3ESL
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)PgPgPgPgPgPgPg
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)PgPgPgPgPgPgPg
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M, CFM-B/PW,
CFM-B/PW, TDI-B/B. TDI-B/M, TDI-B/PW
** Amplitude Doppler (Color Flow Angiography), Tissue Doppler Imaging, 3D Imaging, Omni Directional M mode
Additional Comments:Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "a":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "b":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "d":Includes imaging for guidance of trans-rectal biopsy.
Subscript "e":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "f":
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

ા ગુજરાત રાજ્યના ઉ

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{45}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
--------------------------------------------------
System:Noblus
Transducer:S3ESEL
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Mode of OperationClinical Application
GeneralSpecificBMPWDCWDColorCombined*Other**
(Track I only)(Tracks I & III)Doppler(Spec.)(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)PgPgPgPgPgPgPg
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)PgPgPgPgPgPgPg
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW, TDI-B/B. TDI-B/M, TDI-B/PW
** Amplitude Doppler (Color Flow Angiography), Tissue Doppler Imaging, 3D Imaging, Omni Directional M mode
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

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{46}------------------------------------------------

Mode of Operation
System:Noblus
Transducer:S3ESL1
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationSpecific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
General(Track I only)Ophthalmic
OphthalmicFetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)PgPgPgPgPgPgPg
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)PgPgPgPgPgPgPg
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW, TDI-B/B. TDI-B/M, TDI-B/PW
**Amplitude Doppler (Color Flow Angiography), Tissue Doppler Imaging, 3D Imaging, Omni Directional M mode
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

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Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{47}------------------------------------------------

System:Noblus
Transducer:VC34A
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecific(Tracks I & III)BMPWDCWDColorDopplerCombined*(Spec.)Other **(Spec.)
(Track I only)
OphthalmicOphthalmic
FetalPPPPPP
AbdominalPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPP
Small Organ (Spec.)PdPdPdPdPdPd
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 4D Imaging, Omni Directional M mode
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

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{48}------------------------------------------------

System:Noblus
Transducer:UST-2265-2
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorCombined*Other **
(Track I only)(Tracks I & III)Doppler(Spec.)(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminalOther (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - Endoscopy
Other (spec.) -
Cardiac AdultP
CardiacCardiac PediatricP
Trans-esophageal (card.)
Other (spec.)P
PeripheralPeripheral vesselP
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

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{49}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:EB-1970UK
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificPWDCWDColorCombined*Other **
(Track I only)(Tracks I & III)BMDoppler(Spec.)(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal ImagingAdult Cephalic
& OtherTrans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - EndoscopyPPPPPP
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, CFM-B/CFM-B/CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "d":
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.Includes imaging for guidance of trans-vaginal biopsy.
Subscript "f":For Adult and Pediatric patients.
Subscript "g":
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

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Division of Radiological Health Office of In Vitro Diagnostic and Radiological Health 510(k) Number:___ -

{50}------------------------------------------------

System:Noblus
Transducer:EG-3270UK
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - EndoscopyPPPPPP
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N = new indication. P = previously cleared in K142368
* Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,
CFM-B/PW
** Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

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{51}------------------------------------------------

DIAGNOSTIC ULTRASOUND INDICATIONS FOR USE FORM
System:Noblus
Transducer:EG-3670URK
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined*(Spec.)Other**(Spec.)
(Track I only)(Tracks I & III)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - Gynecological
Other (spec.) - EndoscopyPPPPPP
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N= new indication. P = previously cleared in K142368*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

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510(k) Number: _________________________________________________________________________________________________________

{52}------------------------------------------------

System:Noblus
Transducer:EG-3870UTK
Intended use: Diagnostic ultrasound imaging or fluid flow analysis if the human body as follows:
Clinical ApplicationMode of Operation
General(Track I only)Specific(Tracks I & III)BMPWDCWDColor DopplerCombined*(Spec.)Other**(Spec.)
OphthalmicOphthalmic
Fetal
Abdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Fetal Imaging& OtherAdult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (spec.) - Wound
Other (spec.) - GynecologicalPP
Other (spec.) - EndoscopyPPPPPP
Other (spec.) -
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (card.)
Other (spec.)
PeripheralVesselPeripheral vessel
Other (spec.) -
N= new indication. P = previously cleared in K142368*Combination of each operating mode, B, M, PWD, and Color Doppler; B/B, B/M, B/PW, B/CW, CFM-B/CW, CFM-B/CFM-B, CFM-B/CFM-M,CFM-B/PW
**Amplitude Doppler (Color Flow Angiography), 3D Imaging, Wide View, Contrast Imaging, Real Time Tissue Elastography
Additional Comments:
Subscript "a":Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis).
Subscript "b":Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).
Subscript "c":Includes thyroid, parathyroid, breast, scrotum, penis.
Subscript "d":Includes thyroid, parathyroid, breast, scrotum, penis and imaging for guidance of biopsy.
Subscript "e":Includes imaging for guidance of trans-rectal biopsy.
Subscript "f":Includes imaging for guidance of trans-vaginal biopsy.
Subscript "g":For Adult and Pediatric patients.
Subscript "h":Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (per 21 CFR 801.109)

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Office of In Vitro Diagnostic and Radiological Health 510(k) Number:_

{53}------------------------------------------------

510(k) Summary of Safety and Effectiveness in accordance with 21 CFR Part 807, Subpart E, Section 807.92.

21 CFR 807.92, Subsection a

  1. Submitter's Information

Hitachi Aloka Medical America, Inc. 10 Fairfield Boulevard Wallingford, CT 06492-5903 On behalf of HITACHI, LTD 2-16-1, Higashi-Ueno, Taito-ku Tokyo, 110-0015, JAPAN

Primary Contact Person: Angela Van Arsdale R.A. / Q.A. Manager Telephone: (203) 269-5088 Ext: 346 Fax Number: (203) 269-6075

Date Prepared: October 17, 2016

  1. Device / Common / Classification Name / Classification / Product Code:

Device Proprietary Name – NOBLUS™ Ultrasound Diagnostic System Common name - Ultrasound Diagnostic System and Transducers Classification name - System, Imaging, Pulsed Doppler, Ultrasonic Classification: Class II Product Code: 90-IYN 892.1550 Ultrasonic Pulsed Imaging System 90-IYO 892.1560 Ultrasonic Pulsed Echo Imaging System 90-ITX 892.1570 Diagnostic Ultrasound Transducer

    1. Legally Marketed Predicate Device(s):
      Noblus™ Ultrasound Diagnostic System (K142368)

4. Device Description:

An ultrasound diagnostic system with the following features:

  • Ultrasound transducer(s) to generate the transmitted ultrasound energy and detect the reflected echoes O
  • Ultrasound transducer accessories (standard and optional) to maximize functional usage of transducer(s) O in various modes of operation
  • A computer system to control the transducer and analyze the signals resulting from the reflected echoes O
  • A video monitor with optional image recorder to display the computed image or derived Doppler data O

{54}------------------------------------------------

  1. Indication for Use:

The Hitachi Noblus™ Ultrasound Diagnostic System is intended for use by trained personnel (doctor, sonographer, etc.) for the diagnostic ultrasound evaluation of Abdominal, Cardiac, Intra-operative (Spec.), Intra-operative (Neuro), Trans-esophageal (Cardiac) – Adult/Pediatric, Wound (Cavernous/Non-Cavernous/Non-Cavernous), Fetal, Pediatric, Small Organ, Peripheral vessel, Biopsy, Trans-rectal, Musculoskeletal (Convent. / Superfic.), Neonatal Cephalic, Endoscopy, Intra-luminal, Gynecology, Urology, and Laparoscopic clinical applications.

The modes of Operation of the Hitachi Noblus™ Ultrasound Diagnostic System are B mode, M mode (Pulse Wave Doppler), CW mode (Continuous Wave Doppler), Color Doppler, Amplitude Doppler (Color Flow Angiography), TDI (Tissue Doppler Imaging), 3D Imaging, and Real Time Tissue Elastography

    1. Comparison to predicate device:
      The Hitachi NOBLUS™ Ultrasound Diagnostic System is equivalent to the predicate devices the Hitachi Noblus (K142368). The NOBLUS™ has been modified to include an additional indication, additional probes / accessories and new materials of manufacture that fall within predicate material specifications. The subject and predicate devices are Track III systems.
Predicate DeviceNoblus(K142368)Subject DeviceNoblus
Intended Use:The Hitachi Noblus™ Ultrasound DiagnosticSystem is intended for use by trained personnel(doctor, sonographer, etc.) for the diagnosticultrasound evaluation of Abdominal, Cardiac,Intra-operative (Spec.), Trans-esophageal(Cardiac/Non-Cardiac) - Adult/Pediatric, Wound(Cavernous/Non-Cavernous), Fetal, Pediatric,Small Organ, Peripheral vessel, Biopsy, Trans-rectal, Trans-vaginal, Musculoskeletal (Convent./ Superfic.), Neonatal Cephalic, Adult Cephalic,Endoscopy, Intra-luminal, Gynecology, Urology,and Laparoscopic clinical applications.The Hitachi Noblus™ Ultrasound DiagnosticSystem is intended for use by trained personnel(doctor, sonographer, etc.) for the diagnosticultrasound evaluation of Abdominal, Cardiac,Intra-operative (Spec.), Intra-operative (Neuro),Trans-esophageal (Cardiac/Non-Cardiac) -Adult/Pediatric, Wound (Cavernous/Non-Cavernous), Fetal, Pediatric, Small Organ,Peripheral vessel, Biopsy, Trans-rectal, Trans-vaginal, Musculoskeletal (Convent. / Superfic.),Neonatal Cephalic, Adult Cephalic, Endoscopy,Intra-luminal, Gynecology, Urology, andLaparoscopic clinical applications.
The Modes of Operation of the Noblus™Ultrasound Diagnostic System are B mode, Mmode, PW mode (Pulse Wave Doppler), CWmode (Continuous Wave Doppler), ColorDoppler, Amplitude Doppler (Color FlowAngiography), TDI (Tissue Doppler Imaging),3D Imaging, 4D Imaging, and Real Time TissueElastography.The Modes of Operation of the Noblus™Ultrasound Diagnostic System are B mode, Mmode, PW mode (Pulse Wave Doppler), CWmode (Continuous Wave Doppler), ColorDoppler, Amplitude Doppler (Color FlowAngiography), TDI (Tissue Doppler Imaging),3D Imaging, 4D Imaging, and Real Time TissueElastography.
FDA Track:1 probe / 3 probes (with Probe extension unit)1 probe / 3 probes (with Probe extension unit)
Probes:Convex, Linear, Sector, 4D, Other, EUSConvex, Linear, Sector, 4D, Other, EUS
Transmit Channel:6464
Display Modes:Combinations ofB, B/B, B/M, M, B/PW, PW, CW, B/CW, CFM-B/CW, CFM-B, CFM-B/CFM-B, CFM-B/CFM-M, CFM-M, CFM-B/PW, TDI-B,TDI-B/B,TDI-B/M, TDI-M,TDI-B/PW,TDI-PWCombinations ofB, B/B, B/M, M, B/PW, PW, CW, B/CW, CFM-B/CW, CFM-B, CFM-B/CFM-B, CFM-B/CFM-M, CFM-M, CFM-B/PW, TDI-B,TDI-B/B,TDI-B/M, TDI-M,TDI-B/PW,TDI-PW

{55}------------------------------------------------

21 CFR Part 807.92, Section b

1. Non-clinical Testing

No new hazards were identified with the subject device and its transducers have been evaluated for acoustic output, biocompatibility, cleaning & disinfection effectiveness, electromagnetic compatibility, as well as electrical and mechanical safety, and have been found to conform to applicable medical device safety standards.

2. Clinical testing:

None required

3. Conclusions:

The Noblus™ Ultrasound Diagnostic scanner is substantially equivalent in safety and effectiveness to the predicate device;

  • . The subject and predicate device(s) are both indicated for ultrasound Diagnostic imaging and fluid flow analysis.
  • . The subject and predicate device(s) have the same gray scale and Doppler capabilities.
  • . The subject and predicate device(s) have the same essential technology for imaging, Doppler functions, and signal processing.
  • . The subject and predicate device(s) have acoustic level below the Track 3 FDA limits.
  • . The subject and predicate device(s) are manufactured in accordance to FDA 21 CFR 820 Quality System Regulations.
  • . The subject and predicate device(s) are designed and manufactured to the same electrical and physical safety standards.
  • . The subject and predicate device(s) are manufactured with materials that have been tested in accordance to ISO 10993-1; all biocompatibility testing has been conducted in accordance to each component material characterization, type of body contact, and duration contact risk profile.
  • . The subject and predicate device(s) are designed to be re-usable and provide instructions for cleaning, disinfection, and sterilization in the Ultrasound system and transducer manuals.

END OF SUMMARY

§ 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.