K Number
K173631
Device Name
Intelli-C
Manufacturer
Date Cleared
2018-07-11

(229 days)

Product Code
Regulation Number
892.1650
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Intelli-C is indicated for use as a multipurpose diagnostic X-ray system for universal radioscopic and fluoroscopic studies. With its C-arm and digital flat detector, it can perform a range of applications including interventional procedures, vascular procedures, specialized applications including angiographic studies of the entire body on adults and paediatrics. The Intelli-C system is only indicated for use by trained professionals. The Intelli-C is not intended for mammography studies.
Device Description
The Intelli-C device that we wish to bring to market is a multi-purpose - also sometimes known as a universal C-arm fluoroscopy system, designed for diagnostic medical imaging examinations, from barium studies to interventional and angiography studies. This type of device is typically used in departments with a single fluoroscopy installation that benefit from the versatility of multi-purpose systems that allow a wider range of examinations than a standard fluoroscopy unit. In larger departments such systems can provide backup for other fluoroscopy installations, for example in case of breakdown. As with most multi-purpose systems, the Intelli-C has the patient tabletop and C-arm assembly supported on a main column from which the complete unit can be elevated and tilted. The tabletop is supported only at the foot end providing good, all round access to the patient. The C-arm supports the X-ray tube and image detector assembly and patient coverage is achieved through a combination of C-arm movements and table top movements. The C-arm has angulation and rotational movements, and the source to detector distance is variable. The image detector can be positioned above or below the tabletop depending on the specific examination requirement. The control room control panel for gantry movements, imaging system, generator and collimator are located in the control room. To facilitate interventional studies to be performed on this type of system, most controls are duplicated on a mobile tableside control panel. The imaging system is normally connected to PACS and Hospital Information System, e.g. patient lists, through the hospital network. The Intelli-C device will be offered in two main variants: NRT REF No.: 03400000 Device name: Intelli-C, Right side suspended table NRT REF No.: 03400010 Device name: Intelli-C, Left side suspended table The main systems will be offered with a range of options and accessories as listed in section 11 of this application.
More Information

Not Found

No
The summary describes a standard X-ray system with mechanical and digital components, without mentioning any AI or ML capabilities.

No
The device is described as a "multipurpose diagnostic X-ray system" used for "radioscopic and fluoroscopic studies" and "diagnostic medical imaging examinations." Its stated purpose is for imaging, not for treating a condition, disease, or injury.

Yes
The "Intended Use / Indications for Use" section states: "The Intelli-C is indicated for use as a multipurpose diagnostic X-ray system." Additionally, the "Device Description" section mentions it is "designed for diagnostic medical imaging examinations".

No

The device description clearly outlines physical hardware components such as a C-arm, digital flat detector, patient tabletop, main column, X-ray tube, and control panels, indicating it is a hardware-based medical device with integrated software.

Based on the provided information, the Intelli-C device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, or tissue) to provide information about a person's health.
  • Intelli-C Function: The Intelli-C is an X-ray system that uses radiation to create images of the inside of the body. It directly interacts with the patient, not with specimens taken from the patient.
  • Intended Use: The intended use clearly states it's for "radioscopic and fluoroscopic studies," "interventional procedures," "vascular procedures," and "angiographic studies." These are all imaging procedures performed directly on the patient.

Therefore, the Intelli-C falls under the category of a medical imaging device, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Intelli-C is indicated for use as a multipurpose diagnostic X-ray system for universal radioscopic and fluoroscopic studies. With its C-arm and digital flat detector, it can perform a range of applications including interventional procedures, vascular procedures, specialized applications including angiographic studies of the entire body on adults and paediatrics.

The Intelli-C system is only indicated for use by trained professionals. The Intelli-C is not intended for mammography studies.

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

OWB, JAA

Device Description

The Intelli-C device that we wish to bring to market is a multi-purpose - also sometimes known as a universal C-arm fluoroscopy system, designed for diagnostic medical imaging examinations, from barium studies to interventional and angiography studies.

This type of device is typically used in departments with a single fluoroscopy installation that benefit from the versatility of multi-purpose systems that allow a wider range of examinations than a standard fluoroscopy unit. In larger departments such systems can provide backup for other fluoroscopy installations, for example in case of breakdown.

As with most multi-purpose systems, the Intelli-C has the patient tabletop and C-arm assembly supported on a main column from which the complete unit can be elevated and tilted. The tabletop is supported only at the foot end providing good, all round access to the patient.

The C-arm supports the X-ray tube and image detector assembly and patient coverage is achieved through a combination of C-arm movements and table top movements. The C-arm has angulation and rotational movements, and the source to detector distance is variable. The image detector can be positioned above or below the tabletop depending on the specific examination requirement.

The control room control panel for gantry movements, imaging system, generator and collimator are located in the control room. To facilitate interventional studies to be performed on this type of system, most controls are duplicated on a mobile tableside control panel. The imaging system is normally connected to PACS and Hospital Information System, e.g. patient lists, through the hospital network.

The Intelli-C device will be offered in two main variants:

  • NRT REF No.: 03400000, Device name: Intelli-C, Right side suspended table
  • NRT REF No.: 03400010, Device name: Intelli-C, Left side suspended table

The main systems will be offered with a range of options and accessories as listed in section 11 of this application.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray

Anatomical Site

entire body

Indicated Patient Age Range

adults and pediatrics

Intended User / Care Setting

trained professionals

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)

Not Found

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.

K033486

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.

Not Found

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

§ 892.1650 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.

0

Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo is in blue and includes the letters "FDA" in a square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION".

July 11th, 2018

NRT X-ray A/S % Mr. Kevin Walls Principal Consultant Regulatory Insight, Inc. 33 Golden Eagle Lane LITTLETON CO 80127

Re: K173631

Trade/Device Name: Intelli-C Regulation Number: 21 CFR 892.1650 Regulation Name: Image-intensified fluoroscopic x-ray system Regulatory Class: II Product Code: OWB, JAA Dated: June 30, 2018 Received: July 5, 2018

Dear Mr. Walls:

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. Iisting 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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) 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

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 comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Jeff Rogero

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)

K173631

Device Name Intelli-C

Indications for Use (Describe)

The Intelli-C is indicated for use as a multipurpose diagnostic X-ray system for universal radioscopic and fluoroscopic studies. With its C-arm and digital flat detector, it can perform a range of applications including interventional procedures, vascular procedures, specialized applications including angiographic studies of the entire body on adults and paediatrics.

The Intelli-C system is only indicated for use by trained professionals. The Intelli-C is not intended for mammography studies.

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)

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Image /page/3/Picture/0 description: The image shows the logo for NRT. The logo consists of a circular icon to the left of the letters "NRT". The circular icon is made up of concentric circles. The letters "NRT" are in a sans-serif font and are blue in color.

This summary document has been prepared to meet the conditions of 21 CFR 807.92.

Date of summary:

June 25, 2018

Submitter information:

| 510(k) owner: | NRT X-Ray A/S
Birkegaardsvej 16
8361 Hasselager
DENMARK |
|---------------------------------|------------------------------------------------------------------|
| Establishment Registration no.: | 1000188474 |
| Contact person: | Jan Malling, Quality Manager |
| Phone: | +4586283500 |
| E-mail: | jm@nrtxray.com |

New device:

Trade name:Intelli-C
Common name:Multi-purpose tilt C
Classification name:Interventional Fluoroscopic X-Ray System
Classification:Class II
CFR Section:892.1650
Product Code (primary):OWB
(secondary):JAA

Predicate device:

Trade name: Premarket Notification No.: Manufacturer:

GE Precision MPi K033486 NRT X-Ray A/S Birkegaardsvej 16 8361 Hasselager DENMARK

Device description for new device:

The Intelli-C device that we wish to bring to market is a multi-purpose - also sometimes known as a universal C-arm fluoroscopy system, designed for diagnostic medical imaging examinations, from barium studies to interventional and angiography studies.

This type of device is typically used in departments with a single fluoroscopy installation that benefit from the versatility of multi-purpose systems that allow a wider range of examinations than a standard fluoroscopy unit. In larger departments such systems can provide backup for other fluoroscopy installations, for example in case of breakdown.

4

Image /page/4/Picture/0 description: The image shows the logo for NRT. The logo consists of a circular icon on the left and the text "NRT" on the right. The circular icon is made up of concentric circles, and the text "NRT" is in a sans-serif font and is blue in color.

As with most multi-purpose systems, the Intelli-C has the patient tabletop and C-arm assembly supported on a main column from which the complete unit can be elevated and tilted. The tabletop is supported only at the foot end providing good, all round access to the patient.

The C-arm supports the X-ray tube and image detector assembly and patient coverage is achieved through a combination of C-arm movements and table top movements. The C-arm has angulation and rotational movements, and the source to detector distance is variable. The image detector can be positioned above or below the tabletop depending on the specific examination requirement.

The control room control panel for gantry movements, imaging system, generator and collimator are located in the control room. To facilitate interventional studies to be performed on this type of system, most controls are duplicated on a mobile tableside control panel. The imaging system is normally connected to PACS and Hospital Information System, e.g. patient lists, through the hospital network.

The Intelli-C device will be offered in two main variants:

NRT REF No.:Device name:
03400000Intelli-C, Right side suspended table
03400010Intelli-C, Left side suspended table

The main systems will be offered with a range of options and accessories as listed in section 11 of this application.

Electrical safety, EMC and QMS:

The Intelli-C device is tested to the below listed international standards, including FDA performance standards 21 CFR 1020.30, 31 and 32. Design and production controls are carried under a Quality Management System in compliance with 21 CFR 820 and ISO 13485 requirements.

StandardTitleRevisionDate
IEC 60601-1Medical electrical equipment –
Part 1: General requirements for basic safety and essential performance
(including US national differences)Edition 3.1(2012-08)
IEC 60601-1-2Medical electrical equipment –
Part 1-2: General requirements for basic safety and essential performance
Collateral standard: Electromagnetic disturbances - Requirements and testsEdition 4.0(2014-02)
IEC 60601-1-3Medical electrical equipment –
Part 1-3: General requirements for basic safety and essential performance
Collateral Standard: Radiation protection in diagnostic X-ray equipmentEdition 2.1(2013-04)
IEC 60601-2-43Medical electrical equipment –
Part 2-43: Particular requirements for basic safety and essential performance
of X-ray equipment for interventional proceduresEdition 2.0(2010-03)
IEC 60601-2-54Medical electrical equipment –
Part 2-54: Particular requirements for the basic safety and essential performance of X-ray equipment for radiography and radioscopyEdition 1.1(2015-04)

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Image /page/5/Picture/0 description: The image shows the logo for NRT. The logo consists of a circular design on the left and the letters "NRT" on the right. The circular design has concentric circles, and the letters "NRT" are in a sans-serif font. The logo is in blue.

Comparison with predicate device:

The Intelli-C and GE Precision MPi are very similar on all comparable parameters. The predicate device comparison in section 12 of this application, contains a detailed discussion of all differences between the Intelli-C and its predicate device, the GE Precision MPi.

For the purpose of this 510(k) Summary, please find a comparison of the Intended Use, Indications for Use, target population and selected technology aspects below:

Comparison table, Intended Use, Indications for Use and target population:

Intelli-CPrecision MPi
Intended use:The Intelli-C is an all-digital multipurpose tilt-C X-ray system, intended
for a multitude of diagnostic procedures, including: universal
radiographic, radioscopic and fluoroscopic diagnostic X-ray,
interventional procedures, vascular and non-vascular procedures, and
specialized applications including angiographic studies of the entire
body on adults and pediatrics.The GE Precision MPi is an all-digital multipurpose
tilt-C X-ray system, intended for a multitude of
diagnostic procedures, including: R&F, radiology,
fluoroscopy, interventional procedures, vascular
and non-vascular procedures, and specialized
applications including angiographic studies
Indications for
use:The Intelli-C is indicated for use as a multipurpose diagnostic X-ray
system for universal radiographic, radioscopic and fluoroscopic studies.
With its C-arm and digital flat detector, it can perform a range of
applications including interventional procedures, vascular and non-
vascular procedures, specialized applications including angiographic
studies of the entire body on adults and pediatrics.
The Intelli-C is not indicated for mammography studies.The GE Precision MPi is a multi-purpose system
that can perform general R&F, radiography,
fluoroscopy, interventional and angiography
procedures/applications.
Target
population:Adults and pediatricsAll, no limitations

Technological differences:

The Intelli-C is the successor to the predicate device, GE Precision MPi, which was also manufactured by NRT X-ray A/S. The main difference between the Intelli-C and the Precision MPi is the introduction of a digital flat panel detector (FPD). The FPD adds benefits such as improved patient access, lower patient radiation doses, and wider dynamic ranges when compared to the Image Intensifier, utilized in the predicate device.

The difference in other X-ray critical components from when the predicate device was produced are reflecting the current state-of-the-art developments from the manufacturers of X-ray High Voltage Generator, X-ray tube and Beam Limiting Device. As it can be seen from the comparison table below, the manufacturers of the X-ray critical components are the same as for the Precision MPI.

ComponentIntelli-CPrecision MPi
High Voltage
GeneratorModel:
Indico IQ, 80kW

Manufacturer:
Communications & Power Industries Canada Inc. | Model:
Indico 100, 100kW

Manufacturer:
Communications & Power Industries Canada Inc. |
| X-ray tube | Model:
G1592/B180 or G1092/B160

Manufacturer:
Varex Imaging Corporation | Model:
G1592/B180 or G1092/B160

Manufacturer:
Varex Imaging Corporation |

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Image /page/6/Picture/0 description: The image shows the logo for NRT. The logo consists of a circular icon to the left of the letters "NRT". The circular icon is made up of concentric circles, with the innermost circle being solid and the outer circles being broken into segments. The letters "NRT" are in a sans-serif font and are a similar color to the circular icon.

| Imaging system | Model:
Nexus DRF Digital X-ray Imaging System (with PaxScan 4343CB).
Manufacturer:
Varex Imaging Corporation | Model:
Platinum One Imaging System
Manufacturer:
Infimed Inc. (now Varex Imaging Corporation) |
|----------------|-----------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------|
| Collimator | Model:
R 806Q
Manufacturer:
Ralco S.R.L. | Model:
R 806ASFL
Manufacturer:
Ralco S.R.L. |

The Intelli-C is by no means an early mover into the FPD technology. We believe that the use of FPD technology is the state-of-the-art standard of today and since the majority of transitions from II to FPD took place years ago, we have decided to provide scientific literature that supports the transition from the II based systems to FPD systems. In this search we found the following peer reviewed articles, discussing the advantages and disadvantages using an FPD in place of an II:

Peer reviewed articles supporting FPD technology:

IDArticle titleAuthor(s)Published inAssessment remarks and conclusion
1AAPM/RSNA Physics Tutorial
for Residents: Physics of Flat-
Panel Fluoroscopy Systems
Survey of Modern Fluoroscopy
Imaging: Flat-Panel Detectors
versus Image Intensifiers and
MoreEdward Lee
Nickoloff,
DScradiographics.rsna.orgThe author concludes that Solid-state FPD image receptors
have better stability, lower radiation dose rates, and
improved dynamic range, and they eliminate glare and
geometric distortions such as vignetting and defocusing
effects. It is concluded that the fact that FPDs are smaller
than image intensifiers allows for more flexible positioning of
the angiography and cardiac fluoroscopy systems.
The few disadvantages of FPD systems include higher costs
and lower spatial resolution with very small and very large
FOVS.
2The design and imaging
characteristics of dynamic,
solid-state, flat-panel x-ray
image detectors for digital
fluoroscopy and fluorographyA.R. Cowen,
A.G. Davies,
M.U.
SivananthanThe Royal College of
Radiologists.
Published by Elsevier
Ltd.The authors conclude that the use of FPD technology brings
a range of advantages over the II-TV system such as more
stable performance, zero geometrical distortion and
vignetting, less physical dimensions with great versatility.

Materials and control elements used for the Intelli-C and the predicate device are comparable and not significantly different.

Conclusions:

We believe that the Intelli-C will perform as safe and as effective or better than the predicate device. We base our conclusions on the Substantial Equivalence Discussion and Literature summary, documenting the technological differences which include the digital x-ray receptor, user interfaces, x-ray generation component upgrades, and other minor modifications.

The use of a previously cleared digital x-ray receptor and adequate verification and validation testing results document adequate image quality and integration.

We do not see that new issues of safety or effectiveness are raised with the introduction of the Intelli-C Xray device.