K Number
K172356
Date Cleared
2017-09-15

(43 days)

Product Code
Regulation Number
892.1560
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The BladderScan® PRIME PLUS system is an ultrasound device intended to be used for measuring urine volume of the bladder non-invasively.

Device Description

The BladderScan" PRIME PLUS system provides non-invasive measurement of urinary bladder volume. The system calculates the bladder volume using patented neural network technology. Volume measurements made with this technology are based on a more complex, multifaceted image of the bladder.

Bladder volume, directional aiming with real-time feedback, battery status and usage rate indicators are displayed on the LCD display. The system operates using a battery which includes a charging cradle.

AI/ML Overview

The provided text describes the Verathon BladderScan® PRIME PLUS system, an ultrasound device for non-invasive measurement of bladder urine volume. However, the document explicitly states that "The BladderScan® PRIME PLUS System, subject of this submission, did not require clinical studies to support the determination of substantial equivalence." This means that a study proving the device meets acceptance criteria was not conducted or provided in this submission for the purpose of demonstrating substantial equivalence. Instead, the submission relies on the device's technological characteristics being substantially equivalent to a predicate device (BladderScan® PRIME System K153101).

Therefore, I cannot provide details about acceptance criteria and a study that proves the device meets them because such a study was not required for this 510(k) submission and is not described in the provided text.

The closest information available regarding performance is the "Measurement Accuracy" listed under the "Technological Characteristics and Performance" comparison table on page 6, which states:

  • Verathon BladderScan® PRIME PLUS System (This submission):
    • 0-100 mL = ±7.5 mL
    • 100-999 mL = ±7.5%
  • Predicate Verathon BladderScan® PRIME System (K153101):
    • ±15% ±15mL

This indicates that the new device has improved measurement accuracy compared to its predicate. However, this table is a
comparison of specifications, not a result of a new clinical study.

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Public Health Service

Image /page/0/Picture/2 description: The image is a seal for the Department of Health & Human Services - USA. The seal is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is a stylized image of three faces in profile, stacked on top of each other.

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

September 15, 2017

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

Re: K172356

Trade/Device Name: BladderScan® PRIME PLUS system Regulation Number: 21 CFR 892.1560 Regulation Name: Ultrasonic pulsed echo imaging system Regulatory Class: II Product Code: IYO, ITX Dated: September 5, 2017 Received: September 6, 2017

Dear Mr. Job:

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

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

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device

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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.

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 (DICE) 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 (DICE) 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,

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)

K172356

Device Name BladderScan® PRIME PLUS system

Indications for Use (Describe)

The BladderScan® PRIME PLUS system is an ultrasound device intended to be used for measuring urine volume of the bladder non-invasively.

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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Diagnostic Ultrasound Indications for Use Form

System: BladderScan® PRIME PLUS system Transducer: N/A

Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined(Specify)Other*(Specify)
(Track 1 Only)(Tracks 1 & 3)
OphthalmicOphthalmic
FetalImaging& OtherFetal
AbdominalP
Intra-operative (Specify)
Intra-operative (Neuro)
Laparoscopic
PediatricP
Small Organ (Specify)
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skeletal(Conventional)
Musculo-skeletal(Superficial)
Intravascular
Other (Specify)
CardiacCardiac Adult
Cardiac Pediatric
Intravascular (Cardiac)
Trans-esoph. (Cardiac)
Intra-cardiac
Other (Specify)
PeripheralVesselPeripheral vessel
Other (Bladder)P

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

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

  • Examples of other modes of operation may include: A-mode, Amplitude Doppler, 3-D Imaging, Harmonic Imaging, Tissue Motion Doppler, and Color Velocity Imaging

All items marked "P" were previously cleared in 510(k) K153101

Prescription Use (21 CFR 801.109)

(Division Sign-Off)
Division of Reproductive, Abdominal and
Radiological Devices
510(k) Number

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Diagnostic Ultrasound Indications for Use Form

System: BladderScan® Prime PLUS System Transducer: 2.49 MHz / 1.72 MHz

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

Clinical ApplicationMode of Operation
GeneralSpecificBMPWDCWDColorDopplerCombined(Specify)Other*(Specify)
(Track 1 Only)(Tracks 1 & 3)
OphthalmicOphthalmic
FetalImaging& OtherFetal
AbdominalP
Intra-operative (Specify)
Intra-operative (Neuro)
Laparoscopic
PediatricP
Small Organ (Specify)
Neonatal Cephalic
Adult Cephalic
Trans-rectal
Trans-vaginal
Trans-urethral
Trans-esoph. (non-Card.)
Musculo-skeletal(Conventional)
Musculo-skeletal(Superficial)
Intravascular
Other (Specify)
CardiacCardiac Adult
Cardiac Pediatric
Intravascular (Cardiac)
Trans-esoph. (Cardiac)
Intra-cardiac
Other (Specify)
PeripheralVesselPeripheral vessel
Other (Bladder)P

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

  • Examples of other modes of operation may include: A-mode, Amplitude Doppler, 3-D Imaging, Harmonic Imaging, Tissue Motion Doppler, and Color Velocity Imaging

All items marked "P" were previously cleared in 510(k) K153101

Prescription Use (21 CFR 801.109)

(Division Sign-Off) Division of Reproductive, Abdominal and Radiological Devices Radiological Bookscal Be
Verathon042 510(k) Number

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Image /page/5/Picture/0 description: The image contains the text "verathon.com". The text is in a light color, possibly white or light gray, against a green background. The text appears to be a website address.

Image /page/5/Picture/1 description: The image shows the logo for Verathon, a medical solutions company. The logo features a stylized "V" shape in green and blue, with the company name "VERATHON" in blue, bold letters. Below the company name is the tagline "Trusted and Enduring Medical Solutions" in a smaller font size. The logo is clean and professional, conveying a sense of trust and reliability.

510(k) Summary of Safety and Effectiveness

This summary of Safety and Effectiveness is provided as part of this Premarket Notification in compliance with 21 CFR 807, Subpart E, section 807.92.

Date Prepared: June 29, 2017

    1. Submitter's name, address, telephone number, contact person:
      Verathon Inc. 20001 North Creek Parkway Bothell, WA 98011 USA

Corresponding Official:

Mary K. Moore Vice President, Regulatory Affairs and Quality Assurance Phone: 425.629.5754 Email: Mary.Moore@verathon.com

Alternate Contact:

Swapna Chirala Regulatory Compliance Engineer, Regulatory Affairs and Quality Assurance Phone: 425.629.5582 Email: Swapna.Chirala@verathon.com

    1. Name of the device, including the trade or proprietary name if applicable, the common or usual name, and the classification name, if known:
Common Name:Diagnostic Ultrasound System with accessories
Proprietary/Trade name:BladderScan® PRIME PLUS system
Device Class:Class II
Review Panel:Radiology

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Image /page/6/Picture/1 description: The image shows the logo for Verathon, a medical solutions company. The logo features a stylized green and blue graphic to the left of the company name, which is written in blue, sans-serif font. Below the company name is the tagline "Trusted and Enduring Medical Solutions" in a smaller, sans-serif font.

Classification Information:

NameCFR SectionProduct Code
Ultrasonic Pulsed Echo Imaging System21 CFR 892.1560IYO
Diagnostic Ultrasound Transducer21 CFR 892.1570ITX

3. Identification of the predicate or legally marketed device:

BladderScan® PRIME System K153101

4. Device Description:

The BladderScan" PRIME PLUS system provides non-invasive measurement of urinary bladder volume. The system calculates the bladder volume using patented neural network technology. Volume measurements made with this technology are based on a more complex, multifaceted image of the bladder.

Bladder volume, directional aiming with real-time feedback, battery status and usage rate indicators are displayed on the LCD display. The system operates using a battery which includes a charging cradle.

5. Intended Use:

The BladderScan" PRIME PLUS System is an Ultrasound device intended to be used for measuring urine volume of the bladder non-invasively.

Clinical Application: Abdominal B-Mode (Bladder)

6. Technological Characteristics:

The BladderScan" PRIME PLUS system and the predicate are both Track 1 devices that employ the same fundamental technology. The comparison table is provided below.

Comparison CategoryVerathon BladderScan® PRIMEPLUS System(This submission)Predicate Verathon BladderScan®PRIME System(K153101)
Comparison Overview
FDA Ultrasound Guidance TrackIdentical to predicateTrack 1
Comparison CategoryVerathon BladderScan® PRIMEPLUS System(This submission)Predicate Verathon BladderScan®PRIME System(K153101)
Device Classification NameIdentical to predicateSystem, Imaging, Pulsed Echo,Ultrasonic
Intended Use/Indications ForUseIdentical to predicateThe BladderScan® Prime System isan ultrasound device intended tobe used for measuring the urinevolume in the bladder non-invasively.
ContraindicationsIdentical to predicateThe BladderScan® Prime System isnot intended for fetal use or for useon pregnant patients, patients withascites, or patients with open skinor wounds in the suprapubicregion.
Patient/User Characteristics
Target PopulationIdentical to predicateMale, Female, and Pediatricpatients
Anatomical SiteIdentical to predicateBladder
UsersIdentical to predicatePhysicians/Medical Professionals
Technological Characteristics and Performance
Patient Contact MaterialIdentical to predicateLexan Polycarbonate Plastic HP1-1H112 (colorant: PCM 84907 DarkGray 424C)
SterilityIdentical to predicateNon-sterile
Power SourceIdentical to predicateElectrical (Lithium-ion battery)
Energy DeliveredIdentical to predicateUltrasound
Measurement Accuracy$0-100mL = \pm7.5mL$$100-999 mL = \pm7.5%$$\pm 15% \pm 15mL$
Measurement RangeIdentical to predicate0 to 999 mL
Variable Acoustic OutputSettingsIdentical to predicateNo
Controls to Change AcousticOutput During ScanIdentical to predicateNo
Modes of OperationIdentical to predicateB-mode
Transducer TypeIdentical to predicateMechanical Sector Probe
Transducer DiameterIdentical to predicate13 mm
Number of ElementsIdentical to predicate1
Comparison CategoryVerathon BladderScan® PRIMEPLUS System(This submission)Predicate Verathon BladderScan®PRIME System(K153101)
Transducer Resonant FrequencyIdentical to predicate2.95 MHz
Nominal Acoustic OutputFrequenciesIdentical to predicate2.49 / 1.72 MHz
Sector AngleIdentical to predicate120 degrees
Number of Scan PlanesIdentical to predicate12
Design and Usability Features
PortableIdentical to predicateYes
DisplayIdentical to predicateLCD
Scan ButtonIdentical to predicateYes
Touchscreen OperationIdentical to predicateYes
Selectable Unit Orientation(Patient Right/Left)Identical to predicateYes
Live Scan ImageIdentical to predicateYes
Procedure Type selection onuser interfaceSingle mode of operationaccommodatingMale/Female/Small childMale/Female/Small Child modeselection screen and If female:Uterus or no uterus selection
CalibrationNo Calibration recommendedAnnual Calibration recommended
Data ConnectionsIdentical to predicateUSB, SD card
Attached PrinterIdentical to predicateYes
AccessoriesIdentical to predicatePrinter, battery, battery charger,power cord, mobile cart
Safety Standards
Acoustic Output: MaximumMechanical Index (MI)Identical to predicate0.424
Acoustic Output: MaximumThermal Index (TI)Identical to predicate≤ 1.0
Acoustic Output: Intensity,Spatial Peak Temporal Average(ISPTA)Identical to predicate≤ 1.0 mW/cm²
Acoustic Output: Intensity,Spatial Peak Pulse Average (ISPPA)Identical to predicate≤ 12.0 W/cm²
Biocompatibility StandardComplianceIdentical to predicateANSI/AAMI/ISO 10993-1:2009,ANSI/AAMI/ ISO 10993-5:2009, ISO10993-10:2010, ANSI/AAMI/ISO10993-12:2012
Comparison CategoryVerathon BladderScan® PRIMEPLUS System(This submission)Predicate Verathon BladderScan®PRIME System(K153101)
Electrical Safety StandardComplianceAAMI/ANSI ES 60601-1:2005/(R)2012 and A1:2012,IEC 60601-2-37:2007IEC 60601-1:2005, IEC 60601-2-37:2007
Electromagnetic CompatibilityStandard ComplianceIdentical to predicateIEC 60601-1-2: 2007

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Image /page/7/Picture/0 description: The image shows the logo for Verathon, a medical solutions company. The logo features a stylized green and blue graphic to the left of the company name, which is written in blue, sans-serif font. Below the company name is the tagline "Trusted and Enduring Medical Solutions" in a smaller font size.

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Image /page/8/Picture/0 description: The image contains the text "verathon.com". The text is in a sans-serif font and is light gray in color. The background is a light green color.

Image /page/8/Picture/1 description: The image shows the logo for Verathon, a medical solutions company. The logo features a stylized "V" shape in blue and green, followed by the word "VERATHON" in blue, all caps. Below the company name is the tagline "Trusted and Enduring Medical Solutions" in a smaller font.

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Image /page/9/Picture/0 description: The image shows the text "verathon.com". The text is written in a light color, possibly white or light green. The background is a darker shade of green. The text appears to be a website address.

Image /page/9/Picture/1 description: The image shows the logo for Verathon. The logo consists of a stylized green checkmark-like symbol on the left, followed by the word "VERATHON" in blue, all caps. Below the company name is the tagline "Trusted and Enduring Medical Solutions" in a smaller font size.

7. Determination of Substantial Equivalence:

Summary of Non-Clinical Tests:

The BladderScan" PRIME PLUS system has been evaluated for electrical, thermal, mechanical and EMC safety. Additionally, cleaning/disinfection, biocompatibility, and acoustic output have been evaluated, and the device has been found to conform to applicable voluntary medical device safety standards. Assurance of quality was established by employing the following elements for product development: Design Reviews, Risk Assessment, Development of Requirements and Software Verification, Hardware Verification, and Safety Compliance Verification. Patient contact materials are biocompatible.

The BladderScan" PRIME PLUS system is designed to comply with the following standards:

Reference No.Title
ISO 10993-1:2009ISO 10993-1:2009/R(2013) Biological Evaluation of Medical Devices. Part 1:Evaluation and Testing
ISO 10993-5:2009AAMI / ANSI / ISO 10993-5:2009/(R)2014, Biological Evaluation Of MedicalDevices - Part 5: Tests For In Vitro Cytotoxicity. (Biocompatibility)
ISO 10993-10:2010ISO 10993-10 Third Edition 2010-08-01, Biological Evaluation of MedicalDevices - Part 10: Test for Irritation and Skin Sensitization.(Biocompatibility)
ANSI/AAMI/ISO 10993-12:2012AAMI / ANSI / ISO 10993-12:2012, Biological Evaluation Of Medical Devices -Part 12: Sample Preparation And Reference Materials. (Biocompatibility)
IEC 60601-1:2005/A1:2012AAMI / ANSI ES60601-1:2005/(R)2012 And A1:2012, C1:2009/(R)2012 AndA2:2010/(R)2012 (Consolidated Text) Medical Electrical Equipment - Part 1:General Requirements For Basic Safety And Essential Performance (IEC60601-1:2005, Mod). (General II (ES/EMC))
IEC 60601-1-2:2007AAMI / ANSI / IEC 60601-1-2:2007(R)2012, Medical Electrical Equipment -Part 1-2: General Requirements for Basic Safety and Essential Performance– Collateral Standard: Electromagnetic Compatibility - Requirements andTests (Edition 3)

FDA Consensus Standards

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Image /page/10/Picture/0 description: The image shows the text "verathon.com". The text is written in a light color, possibly white or a light shade of green. The background is a solid, darker shade of green, providing contrast for the text to be visible.

Image /page/10/Picture/1 description: The image shows the logo for Verathon, a medical solutions company. The logo features a stylized checkmark symbol in blue and green, followed by the company name "VERATHON" in large, bold, blue letters. Below the company name is the tagline "Trusted and Enduring Medical Solutions" in a smaller font size.

IEC 60601-2-37:2007IEC 60601-2-37:2007 Medical Electrical Equipment. Part 2-37: ParticularRequirements for the Basic Safety and Essential Performance of UltrasonicMedical Diagnostic and Monitoring Equipment.
AIUM/NEMA UD-2:2004Standard for Real Time Display of Thermal and Mechanical Acoustic outputIndices on Diagnostic Ultrasound Equipment.
AIUM AOMS:2004Acoustic Output Measurement Standard for Diagnostic UltrasoundEquipment.
ISO 14971:2007AAMI / ANSI / ISO 14971:2007/(R) 2010 (Corrected 4 October 2007),Medical Devices - Applications of Risk Management to MedicalDevices. (General I (QS/RM))

Miscellaneous Standards

Reference No.Title
IEC 60601-1-6:2010/A1:2013IEC 60601-1-6 Edition 3.1 2013-10, Medical Electrical Equipment – Part 1-6:General Requirements for Basic Safety and Essential Performance –Collateral Standard: Usability. (General I (QS/RM))
AAMI HE 75:2009AAMI/ANSI HE75:2009/(R)2013, Human Factors Engineering – Design ofMedical Devices. (General I (QS/RM))
IEC 62366-1:2015
ISO 13485:2003ISO 13485:2003, Medical Devices Quality Management System -Requirements for Regulatory Purposes

Summary of Clinical Tests:

The BladderScan® PRIME PLUS System, subject of this submission, did not require clinical studies to support the determination of substantial equivalence.

8. Conclusion

The intended use and other key features are consistent with traditional clinical practice and FDA guidance. The BladderScan® PRIME PLUS system and the predicate device conform to applicable electro-medical device safety standards with compliance verified through independent evaluation. The BladderScan® PRIME PLUS system and the predicate meet FDA requirements for Track 1 devices, share indications for use, have biosafety equivalence and are manufactured using ISO 13485 quality management system. Verathon Inc. believes that the BladderScan" PRIME PLUS system is substantially equivalent with regard to safety and effectiveness to the legally marketed predicate device.

§ 892.1560 Ultrasonic pulsed echo imaging system.

(a)
Identification. An ultrasonic pulsed echo imaging system is a device intended to project a pulsed sound beam into body tissue to determine the depth or location of the tissue interfaces and to measure the duration of an acoustic pulse from the transmitter to the tissue interface and back to the receiver. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II (special controls). A biopsy needle guide kit intended for use with an ultrasonic pulsed echo imaging 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.