K Number
K161976
Device Name
Ziehm Solo FD
Manufacturer
Date Cleared
2016-10-06

(80 days)

Product Code
Regulation Number
892.1650
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Ziehm Solo FD is intended for use in providing medical imaging for adults and pediatric populations, using pulsed and continuous fluoroscopic imaging. The device provides contactless fluoroscopic image capture, temporarily storing, and display of digital subtraction of cine loops during diagnostic, interventional and surgical procedures. Examples of clinical application may include pediatric, cholangiography, endoscopic, lithotripsy, orthopedic, neurologic, vascular, cardiac, angiographic, critical care, and emergency room fluoroscopy procedures. The visualization of such anatomical structures assists the clinical outcome. At the discretion of a physician, the device may be used for other imaging applications. This device does not support direct radiographic film exposures and is not intended for use in performing mammography.

Device Description

The Ziehm Solo FD mobile fluoroscopy system is comprised of a mobile stand with a C-Profile shaped support with both a mono-block high voltage generator assembly and Flat Panel image receptor. These attach to either end of a C-Profile providing a fixed SID. The device performs 2D medical imaging using 4 axes of manual movement and one vertical axes of motorized movement. Additionally the device has the option of additional motorized axes of rotational movement for the (A-Axes C-profile motorization of the single A-axes provides the user an alternative for visualizing anatomical structures when performing certain procedures such as but not limited to working with lithotripsy procedures. A user touch screen provides for concise user selectable anatomical programs and X-ray technique control. Integrated highresolution flat panel display monitors directly mounted on the horizontal arm of the mobile stand providing the clinician with a precise angle for visualization of live fluoroscopic images of the patient's anatomy. This visualization helps to localize regions of pathology for surqical procedures. The mobile stand supports both a cable bound and optional wireless fluoroscopic footswitch. The Wireless footswitch operation allows for optimum positioning for the surgeon by removing the cable on the floor. The optional interface panel of the Ziehm Solo FD provides connection of peripheral devices such as external monitors, thermal video printers, and image storage devices (USB, DVD) and DICOM fixed wire and wireless network interfaces.

AI/ML Overview

The provided document is a 510(k) summary for the "Ziehm Solo FD" mobile fluoroscopic X-ray system. It describes the device, its intended use, and a comparison to predicate devices, focusing on the substantial equivalence argument.

However, the document does not contain information about acceptance criteria for device performance, nor details of a study that proves the device meets specific performance criteria through a rigorous clinical or non-clinical evaluation with a defined test set, expert involvement, or adjudication methods.

The document discusses:

  • Non-Clinical Test Data Summary: It states that verification/validation testing was successfully conducted on the Ziehm Solo FD, including internal functional specifications (software) and nonclinical image comparisons involving flat panel display images from the new device and the predicate Ziehm Vision² FD (K073346). It also mentions compliance with FDA requirements for diagnostic X-ray systems (e.g., leakage radiation, peak tube potential, fluoroscopic entrance exposure rates, beam-limiting alignment) and voluntary safety standards (IEC standards).
  • Image Quality Metrics: It lists several physical characteristics of the X-ray image receptor and system performance, such as DQE (70%), resolution (4 lp/mm), dynamic range (68 dB), and grayscale (16 bit). These are technical specifications rather than acceptance criteria for a study.

Therefore, based solely on the provided text, I cannot answer the questions regarding acceptance criteria and the study that proves the device meets them because such detailed information is not present in this 510(k) summary.

The summary indicates that the device's substantial equivalence is based on:

  1. Direct modifications to cleared predicate devices.
  2. Compliance with engineering design controls and quality management systems.
  3. Verification and Validation testing to internal functional specifications (including software).
  4. Nonclinical image comparisons between the new device and a predicate device.
  5. Compliance with relevant FDA guidance documents and federal performance standards for X-ray fluoroscopic equipment, as well as voluntary safety standards (e.g., IEC standards).

The document is primarily focused on demonstrating substantial equivalence to predicates for regulatory approval, rather than reporting a clinical performance study with detailed acceptance criteria and ground truth establishment methods for a specific indication leveraging AI or advanced image analysis algorithms that would typically require such a study.

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

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

October 6, 2016

Ziehm Imaging Gmbh % Mr. Richard L. Westrich Director of Regulatory Affairs and Quality Assurance Ziehm Imaging, Inc. 6280 Hazeltine National Drive ORLANDO FL 32822

Re: K161976 Trade/Device Name: Ziehm Solo FD Regulation Number: 21 CFR 892.1650 Regulation Name: Image-intensified fluoroscopic x-ray system Regulatory Class: II Product Code: OWB, JAA, OXO Dated: July 15, 2016 Received: July 18, 2016

Dear Mr. Westrich:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours.

Robert Ochs

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

Enclosure

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Indications for Use

510(k) Number (if known) K161976

Device Name Ziehm Solo FD

Indications for Use (Describe)

The Ziehm Solo FD is intended for use in providing medical imaging for adults and pediatric populations, using pulsed and continuous fluoroscopic imaging. The device provides contactless fluoroscopic image capture, temporarily storing, and display of digital subtraction of cine loops during diagnostic, interventional and surgical procedures. Examples of clinical application may include pediatric, cholangiography, endoscopic, lithotripsy, orthopedic, neurologic, vascular, cardiac, angiographic, critical care, and emergency room fluoroscopy procedures. The visualization of such anatomical structures assists the clinical outcome. At the discretion of a physician, the device may be used for other imaging applications. This device does not support direct radiographic film exposures and is not intended for use in performing mammography.

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

X 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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U.S. Food and Drug Administration Center for Devices and Radiological Health Document Mail Center -W066-G609 10903 New Hampshire Avenue Silver Spring, MD 20993-0002

Volume 005 510 (k) Summary

Sep 15, 2016

In accordance with 21 CFR §807.92 the following 510(k) summary information is provided:

Submitter Address:Ziehm Imaging GmbHDonaustrasse 3190451 NurembergGermanyPhone: + 49.911.2172-219Fax: +49.911.2172-390
Primary Contact Person /Agent:Richard L. WestrichDirector of Requlatory Affairs and Quality AssuranceZiehm Imaging, Inc.Phone: (407) 615-8560 Ext 140Fax: (470) 615-8561Cell Phone: (909) 262 9930
Secondary Contact Person:Stefan FiedlerDirector QM/RAZiehm Imaging GmbHPhone: + 49.911. 2172-219Fax: +49.911.2172-390

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Device (Trade Name):Ziehm Solo FD
510(k) NumberK161976
Common /Usual Names:Mobile Fluoroscopic C-Arm
Classification(s)21CFR 892.1650
Classification Names:Image-intensified fluoroscopic x-ray system
Device:Interventional fluoroscopic x-ray system
Product Code:OWB, OXO, JAA
Predicate Device:Ziehm Solo (K092438)
Classification(s)21CFR 892.1650
Classification Names:Image-intensified fluoroscopic x-ray system
Device:Interventional fluoroscopic x-ray system
Product Code:OWB, OXO, JAA
Predicate Device:Ziehm Vision² FD (K073346)
Classification(s)21CFR 892.1650
Classification Names:Image-intensified fluoroscopic x-ray system
Device:Interventional fluoroscopic x-ray system
Product Code:OWB, JAA, JAK

General Description: The Ziehm Solo FD mobile fluoroscopy system is comprised of a mobile stand with a C-Profile shaped support with both a mono-block high voltage generator assembly and Flat Panel image receptor. These attach to either end of a C-Profile providing a fixed SID. The device performs 2D medical imaging using 4 axes of manual movement and one vertical axes of motorized movement. Additionally the device has the option of additional motorized axes of rotational movement for the (A-Axes C-profile motorization of the single A-axes provides the user an alternative for visualizing anatomical structures when performing certain procedures such as but not limited to working with lithotripsy procedures. A user touch screen provides for concise user selectable anatomical programs and X-ray technique control. Integrated highresolution flat panel display monitors directly mounted on the horizontal arm of the mobile stand providing the clinician with a precise angle for visualization of live

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Image /page/5/Picture/0 description: The image shows the logo for Ziehm Imaging. The logo consists of a stylized globe with a human figure inside, followed by the text "ziehmimaging" in a teal color. The text is written in a sans-serif font and appears to be slightly faded.

fluoroscopic images of the patient's anatomy. This visualization helps to localize regions of pathology for surqical procedures. The mobile stand supports both a cable bound and optional wireless fluoroscopic footswitch. The Wireless footswitch operation allows for optimum positioning for the surgeon by removing the cable on the floor. The optional interface panel of the Ziehm Solo FD provides connection of peripheral devices such as external monitors, thermal video printers, and image storage devices (USB, DVD) and DICOM fixed wire and wireless network interfaces.

Indications for Use: The Ziehm Solo FD is intended for use in providing medical imaging for adults and pediatric populations, using pulsed and continuous fluoroscopic imaging. The device provides contactless fluoroscopic image capture, temporarily storing, and display of digital subtraction, and acquisition of cine loops during diagnostic, interventional and surgical procedures. Examples of clinical application may include pediatric, cholangiography, endoscopic, urologic, lithotripsy, orthopedic, neurologic, vascular, cardiac, angiographic, critical care, and emergency room fluoroscopy procedures. The visualization of such anatomical structures assists the clinician in the clinical outcome. At the discretion of

a physician, the device may be used for other imaging applications. This device does not support direct radiographic film exposures and is not intended for use in performing mammography.

Summary of Technological The comparisons of the predicate devices show the Characteristics: scientific and technology characteristics of the Ziehm Solo FD are substantial equivalence to that of the predicate devices.

DifferencesFeatures/TechnologySubject DeviceZiehm Solo FD(K161976)Predicate DeviceZiehm Solo(K092438)Predicate DeviceZiehm Vision2 FD(K073346)
Mobile fluoroscopic c-armYesYesYes
Classification21CFR 892.165021CFR 892.165021CFR 892.1650
Mobile stand user touch controlpanelYes, same designYes, same designYes, same design
X-ray generator and tubehousing assembly monoblocktechnologyYes, samemonoblock design,stationary anodetubeYes, samemonoblock design,stationary anodetubeSimilar monoblockdesign,stationary anodetube
KV Range 40-110 kVYesYesYes
KV Optional Range 40-120 kVYesYesNo
Max power output2.4 kW has the ability to providehigher mA at lower kV levelsallowing shorter pulse widths atvariable frame rates to increasethe image quality of movingobjects by reducing oreliminating the movement during2.0 kWOptional 2.4 kW2.0 kWNo2.0 kWNo
each single pulse.Collimator/beam limiter shuttersYes, same designAsymmetric SlotNo, IRIS with SlotCollimator forcircular imagereceptorYes, same designAsymmetric Slot
Pre CollimatorSquareRoundSquare
Virtual collimationYesYesYes
X-ray Image ReceptorSSXI/CMOS20.5 cm x 20.5 cmI.I./cesium iodideØ 23 cm or Ø 31cmSSXI/Amorphoussilicon20 cm x 20 cm
Flat Panel Detector (SSXI)YesNoYes
FPD FOVSquare FOVRound FOVSquare FOV
Pixel Size$100 _\text{μm}$N/A$194 \text{ μm}$
Detector Matrix2,048 x 2,048 pixelsN/A1,024 x 1,024pixels
Camera MatrixNA1,024 x 1,024 pixelsNA
Grayscale:16 bit (65,536shades of gray)12 bit (4,096shades of gray)16 bit (65,536shades of gray)
Dynamic range68 dBN/A for imageintensifier devices94 dB
DQE70 %65 %77 %
System resolution4 lp/mm5.2-6.8 lp/mm2.4 lp/mm
ZAIP (Ziehm Adaptive ImageProcessing)Adaptive noise filteradapts to thephysicalcharacteristics ofthe input signalNo,recursive noisefilteringAdaptive noisefilter adapts to thephysicalcharacteristics ofthe input signal
Removable anti-scatter gridYesYesNo
AERC Dose control systemSimilar design andcontrolSimilar design andcontrolSimilar designand control
Image Post ProcessingYes, same designYes, same designYes, same design
DICOM functionality includingRSDRYes, same designYes, same designYes, same design
TFT Flat Screen DisplaysYesYesYes
Orbital movement165°Geometry with newFlat Panel required135°135°
SID109 cmGeometry withnew Flat Panelrequires largerSID95 cm111 cm
Motorized AngulationYes, optionalYes, optionalNo
Option to dismantle thedevice in several modulesVariant"Portable"Variant"Portable"No
Monitor CartOptional"ViewingStation"Optional"ViewingStation"MandatoryMonitor Cart

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Summary of Non-Clinical Test Data:

Ziehm Solo FD is based on the direct modifications to cleared predicate devices Ziehm Solo (K092438) and Ziehm Vision2 FD (K073346); The design changes were completed in accordance with Ziehm Imaging GmbH Quality Management System Design Controls and Engineering, standards compliance, and Verification and Validation testing were successfully conducted on the Ziehm Solo FD. Further compliance testing for the modified device to all FDA requirements as stated in "Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices" as applicable including software requirements and software risk hazards was done.

Tests performed on the Ziehm Solo FD, demonstrated that the device is safe and effective, performs comparably to the predicate devices, and substantially equivalent to the predicate devices.

Tests included verification/validation testing to internal functional specifications (including software) and nonclinical image comparisons involving flat panel display images taken with the new device and the predicate device Ziehm Vision2 FD (K073346). Documentation

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provided in this submission demonstrates compliance of the modified device Ziehm Solo FD to all FDA requirements stated in "A Guide for the Submission of Initial Reports on Diagnostic X-Ray Systems and Their Major Components" as applicable. This includes but is not limited to leakage radiation of diagnostic source assembly, peak tube potential (kV), tube current mA, fluoroscopic entrance exposure rates, and beam-limiting alignment to device image receptor. Further, this performance testing confirmed that the Ziehm Solo FD complies with 21 CFR 1020.30-32 Federal Performance Standards for X-Ray Fluoroscopic equipment and with relevant voluntary safety standards for Electrical Safety and Electromaqnetic Compatibility testing, specifically IEC standards listed in the table below. With regard to the flat panel detector (SSXI), test documentation provided in this submission demonstrates compliance of the modified device Ziehm Solo FD to "Guidance for the Submission of 510(k)'s for Solid State X-ray Imaging Devices". This includes but is not limited to DQE, resolution, image quality of comparative sets of images, dynamic range, beam alignment, dose rates, frame rate, geometry, and resolution to predicate device.

The verification/validation activities successfully confirmed device requirements have been fulfilled, system functionality is consistent with the user needs, intended uses, and the Ziehm Solo FD device correctly performs as designed, and raises no new questions regarding either safety or effectiveness.

Therefore, when compared to the predicate devices the Ziehm Solo FD supports a determination of substantial equivalence to the predicate devices.

FDA/CDRHFrom 3626 (1/14)"A Guide for the Submission of Initial Reports on Diagnostic X-Ray Systems and Their Major Components"
21 CFR 1020.30-32Federal Performance Standard for Diagnostic X-ray Systems.
MDD 93/42/EECAnnex II of the European Medical Devices Directive (MDD)93/42/EEC.
EN ISO 13485Medical devices - Quality management systems -Requirements for regulatory purposes

Compliance Standards:

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AAMI/ANSI ES60601-1Medical Electrical Equipment -- Part 1: General Requirementsfor Basic Safety and Essential Performance (IEC 60601-1:2005, mod)Date: 2010Conformance Standard #19-5
IEC 60601-1Medical Electrical Equipment, General Requirements for SafetyEdition 3.0 (+Corr.1+Corr.2), Date: 2005-12-15
IEC 60601-1-2Medical Electrical Equipment, General Requirements forSafety, Electromagnetic CompatibilityEdition 3.0, Date: 2007-03-30,Conformance Standard #19-1
IEC 60601-1-3Medical Electrical Equipment, Radiation Protection inDiagnostic X-ray EquipmentEdition 2.0, Date: 2008-01-22Conformance Standard #12-210
IEC 60601-2-43Medical electrical equipment, Part 2-43: Particularrequirements for basic safety and essential performance of X-ray equipment for interventional proceduresEdition 2.0, Date: 2010-03-25Conformance Standard #12-202
IEC 60601-2-54Medical electrical equipment, Part 2-54: Particularrequirements for the basic safety and essential performanceof X-ray equipment for radiography and radioscopyEdition 1.0, Date: 2009-06-29Conformance Standard #12-274
IEC 60825-1Safety of laser products, Equipment Safety, requirements, anduser guideEdition 2.0, Date: 2007-03-30Conformance Standard #12-273
ISO 14971Medical devices - Application of risk management to medicaldevicesEdition 2.0, Date: 2007-03-01Conformance Standard #5-40
  • Ziehm Imaging GmbH considers the Ziehm Solo FD to be Conclusion: as safe, as effective, and performs substantially equivalent to the predicate device Ziehm Vision² FD (K073346) and Ziehm Solo (K092438) in accordance with its labeling.
    End of 510(k) Summary

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Richard A. Fiene

Richard L. Westrich Official Agent and Correspondent for Ziehm Imaging GmbH. Ziehm Imaging Inc, 6280 Hazeltine National Drive Orlando, Fl. 32822

§ 892.1650 Image-intensified fluoroscopic x-ray system.

(a)
Identification. An image-intensified fluoroscopic x-ray system is a device intended to visualize anatomical structures by converting a pattern of x-radiation into a visible image through electronic amplification. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II (special controls). An anthrogram tray or radiology dental tray intended for use with an image-intensified fluoroscopic x-ray system only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9. In addition, when intended as an accessory to the device described in paragraph (a) of this section, the fluoroscopic compression device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.