K Number
K162583
Device Name
ALOKA LISENDO 880
Manufacturer
Date Cleared
2016-11-17

(63 days)

Product Code
Regulation Number
892.1550
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
ALOKA LISENDO 880 is intended for use by trained personnel (doctor, sonographer, etc.) for the diagnostic ultrasound evaluation of Fetal, Abdominal, Pediatric, Small Organ (Spec.), Intra-operative (Spec.), Neonatal Cephalic, Musculo-skel. (Convent./Superfic.), Peripheral vessel, Cardiac Adult, Cardiac Pediatric, Trans-esophageal (card), Adult Cephalic clinical applications. The Modes of Operation are B mode, PW mode (Pulsed Wave Doppler), CW mode (Continuous Wave Doppler), Color Doppler, Power Doppler (Color Flow Angiography), TDI (Tissue Doppler Imaging), 3D Imaging, 4D Imaging.
Device Description
An ultrasound diagnostic system with the following features: - Ultrasound transducer(s) to generate the transmitted ultrasound energy and detect the reflected echoes - Ultrasound transducer accessories (standard and optional) to maximize functional usage of transducer(s) in various modes of operation - A computer system - to control the transducer and analyze the signals resulting from the reflected echoes - A video monitor with optional image recorder to display the computed image or derived Doppler data
More Information

No
The 510(k) summary does not mention AI, ML, or any related terms like deep learning or neural networks. The description focuses on standard ultrasound technology components and signal processing.

No
The device is described as an "ultrasound diagnostic system" and its intended use is for "diagnostic ultrasound evaluation," indicating it is used for diagnosis, not treatment.

Yes
The "Intended Use / Indications for Use" section explicitly states that the device is "intended for use by trained personnel (doctor, sonographer, etc.) for the diagnostic ultrasound evaluation". This clearly indicates its diagnostic function.

No

The device description explicitly lists hardware components such as ultrasound transducers, a computer system, and a video monitor, indicating it is a hardware-based ultrasound system, not software-only.

Based on the provided information, the ALOKA LISENDO 880 is not an In Vitro Diagnostic (IVD) device.

Here's why:

  • Intended Use: The intended use clearly states that the device is for "diagnostic ultrasound evaluation" of various anatomical sites and clinical applications. This involves using ultrasound energy to create images and analyze physiological data within the patient's body.
  • Device Description: The description details components like transducers, a computer system to analyze signals from reflected echoes, and a video monitor to display images. These are characteristic of an in-vivo imaging system, not a device that analyzes samples outside the body.
  • Input Imaging Modality: The input modality is Ultrasound, which is an in-vivo imaging technique.
  • Anatomical Site: The listed anatomical sites are all locations within the human body.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, urine, tissue, etc.) or performing tests on these samples outside of the body, which are the defining characteristics of an IVD device.

In summary, the ALOKA LISENDO 880 is an ultrasound diagnostic system used for imaging and evaluating structures and functions within the patient's body, making it an in-vivo diagnostic device, not an in-vitro diagnostic device.

N/A

Intended Use / Indications for Use

ALOKA LISENDO 880 is intended for use by trained personnel (doctor, sonographer, etc.) for the diagnostic ultrasound evaluation of Fetal, Abdominal, Pediatric, Small Organ (Spec.), Intra-operative (Spec.), Neonatal Cephalic, Musculo-skel. (Convent./Superfic.), Peripheral vessel, Cardiac Adult, Cardiac Pediatric, Trans-esophageal (card), Adult Cephalic clinical applications.

The Modes of Operation are B mode, PW mode (Pulsed Wave Doppler), CW mode (Continuous Wave Doppler), Color Doppler, Power Doppler (Color Flow Angiography), TDI (Tissue Doppler Imaging), 3D Imaging, 4D Imaging.

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

IYN, IYO, ITX

Device Description

An ultrasound diagnostic system with the following features:

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

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Ultrasound

Anatomical Site

Fetal, Abdominal, Pediatric, Small Organ (Spec.), Intra-operative (Spec.), Neonatal Cephalic, Musculo-skel. (Convent./Superfic.), Peripheral vessel, Cardiac Adult, Cardiac Pediatric, Trans-esophageal (card), Adult Cephalic

Indicated Patient Age Range

Fetal, Pediatric, Neonatal, Adult

Intended User / Care Setting

trained personnel (doctor, sonographer, etc.)

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

No clinical performance studies were required. Non-clinical testing was conducted, which included evaluation of acoustic output, biocompatibility, cleaning & disinfection effectiveness, electromagnetic compatibility, electrical and mechanical safety. The device was found to conform to applicable medical device safety standards.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K134016

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

K142368

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 892.1550 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.

0

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

November 17, 2016

Hitachi, Ltd. % Ms. Angela Van Arsdale RA/QA Manager Hitachi Aloka Medical America, Inc. 10 Fairfield Boulevard WALLINGFORD CT 06492-5903

Re: K162583

Trade/Device Name: ALOKA LISENDO 880 Regulation Number: 21 CFR 892.1550 Regulation Name: Ultrasonic pulsed doppler imaging system Regulatory Class: II Product Code: IYN, IYO, ITX Dated: September 29, 2016 Received: September 30, 2016

Dear Ms. Van Arsdale:

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

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

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

1

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

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

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

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

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

Sincerely yours.

Michael D'Hara

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

2

Indications for Use

510(k) Number (if known) K162583

Device Name ALOKA LISENDO 880

Indications for Use (Describe)

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

ALOKA LISENDO 880 is intended for use by trained personnel (doctor, sonographer, etc.) for the diagnostic ultrasound evaluation of Fetal, Abdominal, Pediatric, Small Organ (Spec.), Intra-operative (Spec.), Neonatal Cephalic, Musculo-skel. (Convent./Superfic.), Peripheral vessel, Cardiac Adult, Cardiac Pediatric, Trans-esophageal (card), Adult Cephalic clinical applications.

The Modes of Operation are B mode, PW mode (Pulsed Wave Doppler), CW mode (Continuous Wave Doppler), Color Doppler, Power Doppler (Color Flow Angiography), TDI (Tissue Doppler Imaging), 3D Imaging, 4D Imaging.

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.

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

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

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

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

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

3

Device Name: ALOKA LISENDO 880

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(SpeOther**
(Spec.)
OphthalmicOphthalmic
FetalPPPPPPP
Fetal Imaging
& OtherAbdominalPaPaPaPaPaPaPa
Intra-operative (Spec.)PbPbPbPbPbPbPb
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)PdPdPdPdPdPdPd
Neonatal CephalicPPPPPPP
Adult CephalicPPPPPPP
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)PgPgPgPgPgPgPg
Musculo-skel. (Convent.)PPPPPPP
Musculo-skel. (Superfic.)PPPPPPP
Intra-luminal
Other (Wound)
Other (Gynecological)
Cardiac AdultPPPPPPP
CardiacCardiac PediatricPPPPPPP
Trans-esophageal (Adult/Pediatric)PgPgPgPgPgPgPg
Other (spec.)
PeripheralPeripheral vesselPPPPPPP
VesselOther (spec.)
Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:
--------------------------------------------------------------------------------------------------

N = new indication; P = previously cleared in K134016, K142368

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW **Power Doppler (Color Flow Angiography). Tissue Doppler Imaging, Free Angular M-mode, 3D 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, and 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

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

Prescription Use Only (Per 21 CFR 801.109)

(PLEASE DO NOT 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 Diagnostics and Radiological Health 510(k)

Page 2 of 17

4

Device Name: ALOKA LISENDO 880 Transducer: C251 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(SpeOther**
(Spec.)
OphthalmicOphthalmic
FetalPPPPPPP
Fetal Imaging
& OtherAbdominalPaPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)PdPdPdPdPdPdPd
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (Wound)
Other (Gynecological)
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (Adult/Pediatric)
Other (spec.)
Peripheral
VesselPeripheral vessel
Other (spec.)

N = new indication; P = previously cleared in K134016

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW ** Power Doppler (Color Flow Angiography), Tissue Doppler Imaging, Free Angular M-mode

Additional Comments:

Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis). Subscript "a":

Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

(PLEASE DO NOT 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 Diagnostics and Radiological Health 510(k)

Page 3 of 17

5

Device Name: ALOKA LISENDO 880 Transducer: C252 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(Spe)Other**
(Spec.)
OphthalmicOphthalmic
FetalPPPPPPP
Fetal Imaging
& OtherAbdominalPaPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)PdPdPdPdPdPdPd
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (Wound)
Other (Gynecological)
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (Adult/Pediatric)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.)

N = new indication; P = previously cleared in K134016

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW ** Power Doppler (Color Flow Angiography), Tissue Doppler Imaging, Free Angular M-mode

Additional Comments:

Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis). Subscript "a":

Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

(PLEASE DO NOT 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 Diagnostics and Radiological Health 510(k)

Page 4 of 17

6

Device Name: ALOKA LISENDO 880 Transducer: C35 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(SpeOther**
(Spec.)
OphthalmicOphthalmic
FetalPPPPPPP
Fetal Imaging
& OtherAbdominalPaPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)PdPdPdPdPdPdPd
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (Wound)
Other (Gynecological)
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (Adult/Pediatric)
Other (spec.)
Peripheral
VesselPeripheral vessel
Other (spec.)

N = new indication; P = previously cleared in K134016

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW ** Power Doppler (Color Flow Angiography), Tissue Doppler Imaging, Free Angular M-mode

Additional Comments:

Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis). Subscript "a":

Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

(PLEASE DO NOT 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 Diagnostics and Radiological Health 510(k)

Page 5 of 17

7

Device Name: ALOKA LISENDO 880 Transducer: C42K Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Clinical Application Mode of Operation B M PWD CWD Color Other** General Specific Combined* (Track I only) (Tracks I & III) Doppler (Spe (Spec.) Ophthalmic Ophthalmic Fetal Fetal Imaging Abdominal & Other Intra-operative (Spec.) Pb Pb Pb Pb Pb Pb Intra-operative (Neuro.) Laparoscopic Pediatric Small Organ (Spec.) Pd Pd Pd Pd Pd Pd Neonatal Cephalic P P P P P P Adult Cenhalic Trans-rectal Trans-vaginal Trans-urethral Trans-esoph. (non-Card.) Musculo-skel. (Convent.) Musculo-skel. (Superfic.) Intra-luminal Other (Wound) Other (Gynecological) Cardiac Adult Cardiac Cardiac Pediatric Trans-esophageal (Adult/Pediatric) Other (spec.) Peripheral vessel Peripheral Vessel Other (spec.) N = new indication; P = previously cleared in K134016

  • Combination of each operating mode, B, M, PWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/CFM-M, CFM-B/PW ** Power Doppler (Color Flow Angiography), Free Angular 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, and penis.

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

Includes imaging for Cavernous/Non-Cavernous wounds Subscript "h"

Prescription Use Only (Per 21 CFR 801.109)

(PLEASE DO NOT 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 Diagnostics and Radiological Health 510(k)

Page 6 of 17

8

Device Name: ALOKA LISENDO 880 Transducer: L34 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(Spec.)Other**
(Spec.)
OphthalmicOphthalmic
Fetal
Fetal Imaging
& OtherAbdominalPaPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)PdPdPdPdPdPdPd
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPPP
Musculo-skel. (Superfic.)
Intra-luminal
Other (Wound)
Other (Gynecological)
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (Adult/Pediatric)
Other (spec.)
Peripheral
VesselPeripheral vesselPPPPPPP
Other (spec.)

N = new indication; P = previously cleared in K134016

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW **Power Doppler (Color Flow Angiography), Free Angular M-mode

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 and laparoscopic procedures). Subscript "b":

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

(PLEASE DO NOT 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 Diagnostics and Radiological Health 510(k)

Page 7 of 17

9

Device Name: ALOKA LISENDO 880 Transducer: L441 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(SpeOther**
(Spec.)
OphthalmicOphthalmic
Fetal
Fetal Imaging
& OtherAbdominalPaPaPaPaPaPaPa
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)PdPdPdPdPdPdPd
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)PPPPPPP
Musculo-skel. (Superfic.)PPPPPPP
Intra-luminal
Other (Wound)
Other (Gynecological)
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (Adult/Pediatric)
Other (spec.)
Peripheral
VesselPeripheral vesselPPPPPPP
Other (spec.)

N = new indication; P = previously cleared in K134016, K142368

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW **Power Doppler (Color Flow Angiography), Free Angular 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, and 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

Prescription Use Only (Per 21 CFR 801.109)

(PLEASE DO NOT 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 Diagnostics and Radiological Health 510(k)

Page 8 of 17

10

Device Name: ALOKA LISENDO 880 Transducer: L64

Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows: Clinical Application Mode of Operation B M PWD CWD Color Other** General Specific Combined* (Track I only) (Tracks I & III) Doppler (Spe (Spec.) Ophthalmic Ophthalmic Fetal Fetal Imaging Abdominal Pa Pa Pa Pa Pa Pa Pa & Other Intra-operative (Spec.) Intra-operative (Neuro.) Laparoscopic Pediatric P P P P P P P Small Organ (Spec.) Pd Pd Pd Pd Pd Pd Pd Neonatal Cephalic Adult Cenhalic Trans-rectal Trans-vaginal Trans-urethral Trans-esoph. (non-Card.) Musculo-skel. (Convent.) P P P P P P P P Musculo-skel. (Superfic.) P P P P P P Intra-luminal Other (Wound) Other (Gynecological) Cardiac Adult Cardiac Cardiac Pediatric Trans-esophageal (Adult/Pediatric) Other (spec.) Peripheral vessel P P P P P P P Peripheral Vessel Other (spec.)

N = new indication; P = previously cleared in K134016, K142368

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW ** Power Doppler (Color Flow Angiography), Free Angular 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, and penis.

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

Includes imaging for Cavernous/Non-Cavernous wounds Subscript "h"

Prescription Use Only (Per 21 CFR 801.109)

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Page 9 of 17

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Device Name: ALOKA LISENDO 880 Transducer: MXS1 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(Spec.)Other**
(Spec.)
OphthalmicOphthalmic
FetalPPPPPPP
Fetal Imaging
& OtherAbdominalPPPPPPP
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)
Neonatal Cephalic
Adult CephalicPPPPPPP
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (Wound)
Other (Gynecological)
CardiacCardiac AdultPPPPPPP
Cardiac PediatricPPPPPPP
Trans-esophageal (Adult/Pediatric)
Other (spec.)
Peripheral
VesselPeripheral vesselPPPPPPP
Other (spec.)

N = new indication; P = previously cleared in K134016

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW ** Power Dopler (Color Flow Angiography), Tissue Doppler Imaging, Free Angular M-mode, 3D Imaging

Additional Comments:

Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis). Subscript "a":

Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures)

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

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Page 10 of 17

12

Device Name: ALOKA LISENDO 880 Transducer: MXS2ESLL Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

intended use. Diagnostic ultrasound imaging of fluid flow analysis of the human body as follows.

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(SpeOther**
(Spec.)
OphthalmicOphthalmic
Fetal
Fetal ImagingAbdominal
& 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.)PgPgPgPgPgPgPg
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (Wound)
Other (Gynecological)
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (Adult/Pediatric)PgPgPgPgPgPgPg
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.)

N = new indication; P = previously cleared in K134016, K142368

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW ** Power Dopler (Color Flow Angiography), Tissue Doppler Imaging, Free Angular M-mode, 3D Imaging

Additional Comments:

Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis). Subscript "a":

Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript g. For Adult and pediatric patients.

Subscript “h.” Includes imaging for Cavernous/Naso

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

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Page 11 of 17

13

Device Name: ALOKA LISENDO 880 Transducer: S121 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(SpeOther**
(Spec.)
OphthalmicOphthalmic
FetalPPPPPPP
Fetal ImagingAbdominalPPPPPPP
& OtherIntra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)
Neonatal Cephalic
Adult CephalicPPPPPPP
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (Wound)
Other (Gynecological)
Cardiac AdultPPPPPPP
CardiacCardiac PediatricPPPPPPP
Trans-esophageal (Adult/Pediatric)
Other (spec.)
PeripheralPeripheral vesselPPPPPPP
VesselOther (spec.)

N = new indication; P = previously cleared in K134016

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW ** Power Doppler (Color Flow Angiography), Tissue Doppler Imaging, Free Angular M-mode

Additional Comments:

Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis). Subscript "a":

Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

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Page 12 of 17

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Device Name: ALOKA LISENDO 880 Transducer: S31 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

intended use. Diagnostic ultrasound imaging of fluid flow analysis of the human body as follows:

Clinical ApplicationMode of Operation
-----------------------------------------

| | Clinical Application
Mode of Operation | | | | | | | |
|---------------------------|-------------------------------------------|---|---|-----|-----|------------------|-------------------|--------------------|
| General
(Track I only) | Specific
(Tracks I & III) | B | M | PWD | CWD | Color
Doppler | Combined*
(Spe | Other**
(Spec.) |
| Ophthalmic | Ophthalmic | | | | | | | |
| | Fetal | | | | | | | |
| Fetal Imaging
& Other | Abdominal | P | P | P | P | P | P | P |
| | Intra-operative (Spec.) | | | | | | | |
| | Intra-operative (Neuro.) | | | | | | | |
| | Laparoscopic | | | | | | | |
| | Pediatric | P | P | P | P | P | P | P |
| | Small Organ (Spec.) | | | | | | | |
| | Neonatal Cephalic | P | P | P | P | P | P | P |
| | Adult Cephalic | | | | | | | |
| | Trans-rectal | | | | | | | |
| | Trans-vaginal | | | | | | | |
| | Trans-urethral | | | | | | | |
| | Trans-esoph. (non-Card.) | | | | | | | |
| | Musculo-skel. (Convent.) | | | | | | | |
| | Musculo-skel. (Superfic.) | | | | | | | |
| | Intra-luminal | | | | | | | |
| | Other (Wound) | | | | | | | |
| | Other (Gynecological) | | | | | | | |
| | Cardiac Adult | P | P | P | P | P | P | P |
| Cardiac | Cardiac Pediatric | P | P | P | P | P | P | P |
| | Trans-esophageal (Adult/Pediatric) | | | | | | | |
| | Other (spec.) | | | | | | | |
| Peripheral
Vessel | Peripheral vessel | | | | | | | |
| | Other (spec.) | | | | | | | |

N = new indication; P = previously cleared in K134016

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW ** Power Doppler (Color Flow Angiography), Tissue Doppler Imaging, Free Angular M-mode

Additional Comments:

Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis). Subscript "a":

Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

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

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Page 13 of 17

15

Device Name: ALOKA LISENDO 880 Transducer: S3ESEL Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Intended use. Diagnostic ultrasound imaging of fluid flow analysis of the human body as follows.

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(SpeOther**
(Spec.)
OphthalmicOphthalmic
Fetal
Fetal Imaging
& OtherAbdominal
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
Pediatric
Small Organ (Spec.)
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)PgPgPgPgPgPgPg
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (Wound)
Other (Gynecological)
Cardiac Adult
CardiacCardiac Pediatric
Trans-esophageal (Adult/Pediatric)PgPgPgPgPgPgPg
Other (spec.)
Peripheral
VesselPeripheral vessel
Other (spec.)

N = new indication; P = previously cleared in K134016, K142368

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW ** Power Doppler (Color Flow Angiography), Tissue Doppler Imaging, Free Angular M-mode

Additional Comments:

Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis). Subscript "a":

Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures)

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

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Page 14 of 17

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Device Name: ALOKA LISENDO 880 Transducer: S42 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(SpeOther**
(Spec.)
OphthalmicOphthalmic
Fetal
Fetal Imaging
& OtherAbdominalPPPPPPP
Intra-operative (Spec.)
Intra-operative (Neuro.)
Laparoscopic
PediatricPPPPPPP
Small Organ (Spec.)
Neonatal CephalicPPPPPPP
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skel. (Convent.)
Musculo-skel. (Superfic.)
Intra-luminal
Other (Wound)
Other (Gynecological)
Cardiac AdultPPPPPPP
CardiacCardiac PediatricPPPPPPP
Trans-esophageal (Adult/Pediatric)
Other (spec.)
PeripheralPeripheral vessel
VesselOther (spec.)

N = new indication; P = previously cleared in K134016

  • Combination of each operating mode, B, M, PWD, CWD and Color Doppler. B/B, B/M, B/PW, CFM-B/CFM-M, CFM-B/PW ** Power Doppler (Color Flow Angiography), Tissue Doppler Imaging, Free Angular M-mode

Additional Comments:

Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amniocentesis). Subscript "a":

Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

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Page 15 of 17

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Device Name: ALOKA LISENDO 880 Transducer: UST-2265-2 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

intended use. Diagnostic ultrasound imaging of fluid flow analysis of the human body as follows.

Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(SpeOther**
(Spec.)
OphthalmicOphthalmic
Fetal
Fetal ImagingAbdominal
& 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 (Wound)
Other (Gynecological)
Cardiac AdultP
CardiacCardiac PediatricP
Trans-esophageal (Adult/Pediatric)
Other (spec.)
PeripheralPeripheral vesselP
VesselOther (spec.)

N = new indication; P = previously cleared in K134016, K142368

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":

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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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18

Device Name: ALOKA LISENDO 880 Transducer: UST-2266-5 Intended use: Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows:

intended use. Diagnostic ultrasound imaging or fluid flow analysis of the human body as follows.

Clinical ApplicationMode of Operation
-----------------------------------------
Clinical ApplicationMode of Operation
General
(Track I only)Specific
(Tracks I & III)BMPWDCWDColor
DopplerCombined*
(SpeOther**
(Spec.)
OphthalmicOphthalmic
Fetal Imaging
& OtherFetal
Abdominal
Intra-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 (Wound)
Other (Gynecological)
CardiacCardiac AdultP
Cardiac Pediatric
Trans-esophageal (Adult/Pediatric)
Other (spec.)
Peripheral
VesselPeripheral vesselP
Other (spec.)

N = new indication; P = previously cleared in K134016

** Power Doppler (Color Flow Angiography), Tissue Doppler Imaging, Free Angular M-mode, 3D Imaging

Additional Comments:

Subscript "a": Includes imaging for guidance of percutaneous biopsy of abdominal organs and structures (including amnocentesis).

Subscript "b": Includes imaging of organs and structures exposed during surgery (excluding neurosurgery and laparoscopic procedures).

Subscript "c": Includes thyroid, parathyroid, breast, scrotum, and 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

Subscript "f": Includes imaging for guidance of trans-vaginal biopsy.

For Adult and pediatric patients Subscript "g":

Subscript "h" Includes imaging for Cavernous/Non-Cavernous wounds

Prescription Use Only (Per 21 CFR 801.109)

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19

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. Healthcare Business Unit 2-16-1, Higashi-Ueno, Taito-ku Tokyo 110-0015 JAPAN

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

Date Prepared: September 9, 2016

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

Device Proprietary Name - ALOKA LISENDO 880 Common name - Diagnostic Ultrasound System and Transducers Classification name - System, Imaging, Pulsed Doppler, Ultrasonic Classification: Class II 90-IYN 892.1550 Ultrasonic Pulsed Imaging System Product Code: 90-IYO 892.1560 Ultrasonic Pulsed Echo Imaging System 90-ITX 892.1570 Diagnostic Ultrasound Transducer

    1. Legally Marketed Predicate Device(s): ARIETTA70 (K134016)
    1. 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
  • O A computer system - to control the transducer and analyze the signals resulting from the reflected echoes
  • A video monitor with optional image recorder to display the computed image or derived Doppler data O
    1. Indication for Use:

ALOKA LISENDO 880 is intended for use by trained personnel (doctor, sonographer, etc.) for the diagnostic ultrasound evaluation of Fetal, Abdominal, Pediatric, Small Organ (Spec.), Intra-operative (Spec.), Neonatal Cephalic, Musculo-skel. (Convent. /Superfic.), Peripheral vessel, Cardiac Pediatric, Transesoph. (non-Card.), Trans-esophageal (card.), Adult Cephalic clinical applications.

The Modes of Operation are B mode, M mode (Pulsed Wave Doppler), CW mode (Continuous Wave Doppler), Color Doppler (Color Flow Angiography), TDI (Tissue Doppler Imaging), 3D Imaging, 4D Imaging.

20

predicate device:

6. Comparison to
--------------------

| | SUBJECT DEVICE:
ALOKA LISENDO 880 | PREDICATE DEVICE:
ARIETTA 70 (K134016) |
|--------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| INDICATION FOR USE | ALOKA LISENDO 880 is intended for use by trained personnel (doctor, sonographer, etc.) for the diagnostic ultrasound evaluation of Fetal, Abdominal, Pediatric, Small Organ (Spec.), Intra-operative (Spec.), Neonatal Cephalic, Musculo-skel. (Convent./Superfic.), Peripheral vessel, Cardiac Adult, Cardiac Pediatric, Trans-esoph. (non-Card), Trans-esophageal (card), Adult Cephalic clinical applications. | The ARIETTA 70/ ARIETTA V70/ ARIETTA S70 is intended for use by trained personnel (doctor, songrapher, etc.) for the diagnostic ultrasound evaluation of Abdominal, Cardiac, Intra-operative, Fetal, Pediatric, Small Organ, Peripheral vessel, Biopsy, Trans-rectal, Trans-vaginal, Musculoskeletal, Neonatal Cephalic, Adult Cephalic, Endloscopy, Intra-luminal, Gynecology, Urology and Laparoscopic clinical applications. |
| | The Modes of Operation are B mode, M mode, PW mode (Pulsed Wave Doppler), CW mode (Continuous Wave Doppler), Color Doppler, Power Doppler, Amplitude Doppler (Color Flow Angiography), TDI (Tissue Doppler Imaging), 3D Imaging, 4D Imaging. | The Modes of Operation are B mode, M mode, PW mode (Pulsed Wave Doppler), CW mode (Continuous Wave Doppler), Color Doppler, Amplitude Doppler (Color Flow Angiography), TDI (Tissue Doppler Imaging), 3D Imaging, 4D Imaging, Real Time Tissue Elastography, and Real Time Virtual Sonography |
| TRACK | 3 | 3 |
| PROBE TYPES | Convex, Linear, Sector and Other | Convex, Linear, Sector, 4D and Other |
| MODES | B, M, PW, CW and combinations of | B, M, PW, CW and combinations of |

APPLICABLE SOFTWARE FEATURE COMPARISION
SUBJECT DEVICE:
ALOKA LISENDO 880PREDICATE DEVICE:
ARIETTA 70 (K134016)
FEATURE:YESYES
PHYSIOLOGICAL SIGNAL DISPLAYYESYES
DICOMYESYES
DICOM SRYESYES
DICOM QRYESYES
PICTURE IN PICTUREYESYES
FREEHAND 3DYESYES
REAL-TIME 3DYESYES
3D STICYESYES
AUTOMATED IMT MEASUREMENTYESYES
AUTOMATED NT MEASUREMENTYESYES
ET (ETRACKING / ECHO TRACKINGYESYES
FMD (FLOW DILATION)YESYES
WI (WAVE INTENSITY)YESYES
EFV(EXTENDED FIELD OF VIEW)YESYES
STRESS ECHOYESYES
HI REZ / AIPYESYES
EyeballEFYESYES
DSD (DYNAMIC SLOW MOTION DISPLAY)YESYES
CHI/CHEYESYES
MARKING ASSIST DISPLAYYESYES
REAL-TIME DOPPLER AUTO TRACEYESYES
SPATIAL COMPOUNDYESYES
FAM (FREE ANGULAR M-MODE)YESYES
MEASUREMENT FUNCTIONYESYES
DUAL DOPPLERYESYES
TRAPEZOIDYESYES
TDIYESYES

COLOR FLOW

YES

APPLICABLE SOFTWARE FEATURE COMPARISION

YES

21

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.
    1. Clinical testing:
      None required
    1. Conclusions:
      The ALOKA LISENDO 880 Diagnostic Ultrasound scanner is substantially equivalent in safety and effectiveness to the predicate device:
  • . The subject and predicate device are both indicated for diagnostic ultrasound 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.

  • 트 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) systems have connectable probes that are designed to be re-usable and provide instructions for cleaning, disinfection, and sterilization in the Ultrasound system and transducer manuals.

END OF SUMMARY