K Number
K173639
Device Name
Luminos dRF Max, Luminos Agile Max, Uroskop Omnia Max, Multitom Rax
Date Cleared
2018-04-02

(129 days)

Product Code
Regulation Number
892.1650
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Luminos Agile Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, venography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients. Luminos Agile Max is not for mammography examinations. Luminos dRF Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, venography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients. Luminos dRF Max is not for mammography examinations. Multitom Rax is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, venography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients Multitom Rax is not for mammography examinations. Uroskop Omnia Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system is designed primarily for urological diagnosis and the support of urological therapeutic applications such as examinations and small interventions of the urogenital tract. The table supports endourological and minimal invasive surgery in urology as there are transurethral interventions (e.g. ureterorenoscopy (URS), double stent placement, cystoscopy. transurethral resection of bladder tumors (TURB), transurethral resection of the prostate (TURP)), percutaneous urological procedures (e.g. percutaneous nephrostomy (PCN), percutaneous nephrolitholapaxy (PCNL)), urological X-ray diagnosis (e.g. survey imaging of the kidney, ureter, and bladder (KUB), intravenous pyelogram (IVP), retrograde pyelography), micturition cystourethrogram (MCU), videourodynamics, laparoscopic procedures and minor open urological interventions. The system may be used on pediatric, adult and bariatric patients. Uroskop Omnia Max is not for mammography examinations.
Device Description
All four radiology imaging devices are stationary X-ray systems for radiography and fluoroscopy. They use the same X-ray generator, the same X-ray tube and similar collimators. They also share the same imaging and system control device: The Fluorospot Compact. The reason for this submission is the upgrade of all systems to the software VF10. This new software will bring the following new features to the devices: IEC 4th for EMC, Windows 10, Cybersecurity package, Pediatric package, Use hospital IT (e.g. RIS) on modality, 16 fps mode for 3D (Multitom Rax only), SSXI update. The image processing algorithms (Diamond View Plus) will be used for exposures without grid and fluoroscopy image processing algorithms will be enhanced and called "Clearview". Also the name suffix "Max" is being established as an addition to the product name of Luminos Agile, Luminos dRF and Uroskop Omnia.
More Information

Not Found

No
The summary describes software updates for existing X-ray systems, focusing on features like cybersecurity, Windows 10 compatibility, and enhanced image processing algorithms ("Clearview"). There is no mention of AI, ML, or related concepts like deep learning, neural networks, or training/test datasets for such algorithms. The performance studies focus on compliance with standards and comparison to predicate devices, not on the performance metrics typically associated with AI/ML algorithms (e.g., sensitivity, specificity, AUC).

No
The devices are primarily intended for visualizing anatomical structures and supporting diagnostic purposes, not for direct therapeutic treatment. While Uroskop Omnia Max "supports urological therapeutic applications," the device itself is for "examinations and small interventions," not directly providing therapy.

Yes

Explanation: The device is intended to visualize anatomical structures for medical applications, including diagnosis (e.g., "urological diagnosis" and "urological X-ray diagnosis"). Visualization of anatomical structures is a key part of the diagnostic process.

No

The device description explicitly states that the submission is for an upgrade to the software VF10 for four radiology imaging devices which are stationary X-ray systems. This indicates the software is part of a larger hardware system, not a standalone software-only device.

Based on the provided information, these devices are not IVDs (In Vitro Diagnostics).

Here's why:

  • Intended Use: The intended use of these devices is to visualize anatomical structures by converting an X-ray pattern into a visible image. This is a function of medical imaging equipment used for diagnosis and intervention within the body, not for testing samples outside the body.
  • Device Description: The devices are described as "stationary X-ray systems for radiography and fluoroscopy." This confirms their function as imaging devices.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring substances in biological samples
    • Providing information about a patient's health status based on laboratory tests

IVDs are used to perform tests on samples taken from the human body to provide information for diagnosis, monitoring, or screening. These devices are clearly designed for direct imaging of the body using X-rays.

N/A

Intended Use / Indications for Use

Luminos Agile Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients.

Luminos Agile Max is not for mammography examinations.

Luminos dRF Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients.

Luminos dRF Max is not for mammography examinations.

Multitom Rax is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients.

Multitom Rax is not for mammography examinations.

Uroskop Omnia Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system is designed primarily for urological diagnosis and the support of urological therapeutic applications such as examinations and small interventions of the urogenital tract. The table supports endourological and minimal invasive surgery in urology as there are transurethral interventions (e.g. ureterorenoscopy (URS), double stent placement, cystoscopy, transurethral resection of bladder tumors (TURB), transurethral resection of the prostate (TURP)), percutaneous urological procedures (e.g. percutaneous nephrostomy (PCN), percutaneous nephrolitholapaxy (PCNL)), urological X-ray diagnosis (e.g. survey imaging of the kidney, ureter, and bladder (KUB), intravenous pyelogram (IVP), retrograde pyelography), micturition cystourethrogram (MCU), videourodynamics, laparoscopic procedures and minor open urological interventions. The system may be used on pediatric, adult and bariatric patients.

Uroskop Omnia Max is not for mammography examinations.

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

OWB, JAA

Device Description

All four radiology imaging devices are stationary X-ray systems for radiography and fluoroscopy. They use the same X-ray generator, the same X-ray tube and similar collimators. They also share the same imaging and system control device: The Fluorospot Compact. The reason for this submission is the upgrade of all systems to the software VF10. This new software will bring the following new features to the devices:

  • IEC 4th for EMC
  • Windows 10
  • Cybersecurity package
  • Pediatric package
  • Use hospital IT (e.g. RIS) on modality
  • 16 fps mode for 3D (Multitom Rax only)
  • SSXI update

The image processing algorithms (Diamond View Plus) will be used for exposures without grid and fluoroscopy image processing algorithms will be enhanced and called "Clearview".

Also the name suffix "Max" is being established as an addition to the product name of Luminos Agile, Luminos dRF and Uroskop Omnia.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray

Anatomical Site

Gastrointestinal, cranial, skeletal, thoracic, lung, urogenital tract.

Urological diagnosis and support of urological therapeutic applications, (e.g. ureterorenoscopy (URS), double stent placement, cystoscopy, transurethral resection of bladder tumors (TURB), transurethral resection of the prostate (TURP)), percutaneous urological procedures (e.g. percutaneous nephrostomy (PCN), percutaneous nephrolitholapaxy (PCNL)), urological X-ray diagnosis (e.g. survey imaging of the kidney, ureter, and bladder (KUB), intravenous pyelogram (IVP), retrograde pyelography), micturition cystourethrogram (MCU), videourodynamics, laparoscopic procedures and minor open urological interventions.

Indicated Patient Age Range

Pediatric, adult and bariatric patients.

Intended User / Care Setting

Not Found

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)

Summary of Non-Clinical Test Data:
The devices operating with software VF10 comply with the voluntary standards as listed in Table 7. The Software VF10 design was completed in accordance with Siemens Quality Management System Design Controls and verification and validation testing were successfully conducted. Non-clinical performance data are provided for the updated detectors. All radiology and fluoroscopy systems use the same software. Certain features of the software are enabled or disabled depending on the system and its indications for use (i.e. 16 frames per second for Multitom Rax versus 8 frames per second for all other systems. The new IEC 4th edition has been applied for the compliance to the IEC 60601-1-2 electromagnetic compatibility standard.

The tests were performed on the new software VF10 demonstrating that the devices are safe and effective, perform comparably to the predicate devices, and are substantially equivalent to the predicate devices.

Documentation provided demonstrates compliance of the subject devices to all FDA requirements stated in the Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices, including results of verification/validation tests of software requirements and software risk hazards.

Performance testing confirmed that the five devices comply with 21 CFR 1020.30-32 Federal Performance Standards for X-Ray Fluoroscopic equipment.

The software VF10 controls solid state X-ray imagers (SSXI) that are similar in performance to the predicates. Performance data are provided according to the "Guidance for the Submission of 510(k)'s for Solid State X-ray Imaging Devices, issued on: September 1, 2016".

Together, the verification/validation activities successfully confirmed that the software requirements have been fulfilled and that system functionality is consistent with the user needs and intended uses. The VF10 software correctly performs as designed and raises no new questions regarding safety or effectiveness. Therefore, when compared to the predicate devices the devices with the new software VF10 support a determination of substantial equivalence.

Summary of Clinical Tests:
For the subject of this premarket submission, Siemens did not do an evaluation of the clinical image quality as x-ray technology; geometry and SSXI changes are minor.

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

Table 3: Comparison of Detector 4343-F Subject and Predicate

  • DQE; 200 nGy: 65 % at 0.05 lp/mm, 51 % at 1 lp/mm, 41 % at 2 lp/mm, 25 % at 3 lp/mm, 16 % at 3.4 lp/mm (Nyquist)
  • MTF: 66 % at 1 lp/mm, 35 % at 2 lp/mm, 19 % at 3 lp/mm, 15 % at 3.4 lp/mm (Nyquist)

Table 4: Comparison of Detector MAX wi-D Subject and Predicate

  • DQE; 2 μ Gy: 70 % at 0.05 lp/mm, 51 % at 1 lp/mm, 42 % at 2 lp/mm, 29 % at 3 lp/mm, 19 % at Nyquist
  • MTF: 63 % at 1 lp/mm, 35 % at 2 lp/mm, 19 % at 3 lp/mm, 12 % at Nyquist

Table 5: Comparison of Detector MAX mini Subject and Predicate

  • DQE; 2 μ Gy: 66 % at 0.05 lp/mm, 50 % at 1 lp/mm, 40 % at 2 lp/mm, 24 % at 3 lp/mm, 17 % at Nyquist
  • MTF: 61 % at 1 lp/mm, 31 % at 2 lp/mm, 15 % at 3 lp/mm, 12 % at Nyquist

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.

K111292, K062623, K101491, K152928

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 contains the logos of the Department of Health & Human Services and the Food and Drug Administration (FDA). The Department of Health & Human Services logo is on the left, and the FDA logo is on the right. The FDA logo is a blue square with the letters "FDA" in white, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue.

Siemens Medical Solutions USA, Inc. % Denise Adams, RAC Regulatory Affairs Specialist 40 Liberty Boulevard, 65-1A MALVERN PA 19355

April 2, 2018

Re: K173639

Trade/Device Name: Luminos Agile Max. Luminos dRF Max. Uroskop Omnia Max. Multitom Rax Regulation Number: 21 CFR 892.1650 Regulation Name: Image-intensified fluoroscopic x-ray system Regulatory Class: II Product Code: OWB, JAA Dated: March 9, 2018 Received: March 13, 2018

Dear Ms. Adams:

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 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 the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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,

Michael D. O'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

510(k) Number (if known)

K173639

Device Name Luminos Agile Max

Indications for Use (Describe)

Luminos Agile Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients.

Luminos Agile Max is not for mammography examinations.

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

3

510(k) Number (if known)

Device Name Luminos dRF Max

Indications for Use (Describe)

Luminos dRF Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients.

Luminos dRF Max is not for mammography examinations.

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.

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

4

510(k) Number (if known)

Device Name Multitom Rax

Indications for Use (Describe)

Multitom Rax is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients.

Multitom Rax is not for mammography examinations.

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.

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

5

510(k) Number (if known)

Device Name Uroskop Omnia Max

Indications for Use (Describe)

Uroskop Omnia Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system is designed primarily for urological diagnosis and the support of urological therapeutic applications such as examinations and small interventions of the urogenital tract. The table supports endourological and minimal invasive surgery in urology as there are transurethral interventions (e.g. ureterorenoscopy (URS), double stent placement, cystoscopy, transurethral resection of bladder tumors (TURB), transurethral resection of the prostate (TURP)), percutaneous urological procedures (e.g. percutaneous nephrostomy (PCN), percutaneous nephrolitholapaxy (PCNL)), urological X-ray diagnosis (e.g. survey imaging of the kidney, ureter, and bladder (KUB), intravenous pyelogram (IVP), retrograde pyelography), micturition cystourethrogram (MCU), videourodynamics, laparoscopic procedures and minor open urological interventions. The system may be used on pediatric, adult and bariatric patients.

Uroskop Omnia Max is not for mammography examinations.

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.

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

6

K173639 510(k) Summary: Software Update VF10 for Luminos Agile Max, Luminos dRF Max, Multitom Rax, Uroskop Omnia Max

Company:Siemens Medical Solutions USA, Inc.
40 Liberty Boulevard
Malvern, PA 19355

March 9, 2018 Date Prepared:

This 510(k) summary of safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR § 807.92.

    1. General Information: Importer / Distributor: Siemens Medical Solutions USA, Inc. 40 Liberty Boulevard Malvern, PA 19355 Establishment Registration Number: 2240869
      Location of Manufacturing Site: Siemens Healthcare GmbH Siemensstr. 1 91301 Forchheim, Germany Establishment Registration Number: 3004977335

2. Contact Person:

Denise Adams, RAC Regulatory Affairs Specialist Siemens Medical Solutions USA, Inc. 40 Liberty Boulevard, 65 - 1A Malvern, PA 19355 adams.denise@siemens-healthineers.com

Alternate Contact Person:

Patricia D. Jones Regulatory Affairs Specialist Siemens Medical Solutions USA, Inc. 40 Liberty Boulevard, 65 - 1A Malvern, PA 19355 patricia.d.jones@siemens-healthineers.com

7

3. Device Names and Classifications:

Trade Names: Luminos Agile Max Luminos dRF Max Uroskop Omnia Max Multitom Rax Product Code: OWB Secondary Product Code: JAA Classification Names: System, x-ray, fluoroscopic, image-intensified, Interventional fluoroscopic x-ray system Classification Panel: Radiology Regulation: 21 CFR §892.1650 Device Class: II

Table 1: Legally Marketed Predicate Devices
Trade NameLuminos AgileAXIOM Luminos dRFUroskop OmniaMultitom Rax
510(k) NumberK111292K062623K101491K152928
Device Classification NameSystem, x-ray, fluoroscopic, image-intensifiedinterventional fluoroscopic x-ray systemSystem, x-ray, fluoroscopic, image-intensifiedinterventional fluoroscopic x-ray system
Regulation Medical SpecialtyRadiologyRadiologyRadiologyRadiology
Review PanelRadiologyRadiologyRadiologyRadiology
Product CodeJAAOWBJAAOWB
Subsequent Product CodesIZIJAA, OXOMQBJAA
Regulation Number892.1650892.1650892.1650892.1650
Device Class2222

Table 1: Legally Marketed Predicate Devices 4.

5. Device Description:

All four radiology imaging devices are stationary X-ray systems for radiography and fluoroscopy. They use the same X-ray generator, the same X-ray tube and similar collimators. They also share the same imaging and system control device: The Fluorospot Compact. The reason for this submission is the upgrade of all systems to the software VF10. This new software will bring the following new features to the devices:

8

| Product
Name | IEC
4th
for
EMC | Windows
10 | Cyber-
security
package | Pediatric
package | Use
hospital
IT (e.g.
RIS) on
modality | 16
fps
mode
for
3D | SSXI
update |
|-------------------------|--------------------------|---------------|-------------------------------|----------------------|----------------------------------------------------|--------------------------------|----------------|
| Luminos
Agile Max | √ | √ | √ | √ | √ | | √ |
| Luminos
dRF Max | √ | √ | √ | √ | √ | | √ |
| Uroskop
Omnia
Max | √ | √ | √ | √ | √ | | √ |
| Multitom
Rax | √ | √ | √ | √ | √ | √ | √ |

Table 2: New Features

The image processing algorithms (Diamond View Plus) will be used for exposures without grid and fluoroscopy image processing algorithms will be enhanced and called "Clearview"

Also the name suffix "Max" is being established as an addition to the product name of Luminos Agile, Luminos dRF and Uroskop Omnia.

6. Indications for Use:

The Indications for use have been revised for clarity and alignment.

Luminos Agile Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, venography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients.

Luminos Agile Max is not for mammography examinations.

Luminos dRF Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, venography, arthrography, interventional radiology, digital angiography and digital subtraction

9

angiography (DSA). The system may be used on pediatric, adult and bariatric patients.

Luminos dRF Max is not for mammography examinations.

Multitom Rax is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system has medical applications ranging from gastrointestinal examinations to cranial, skeletal, thoracic and lung exposures as well as examinations of the urogenital tract. The unit may also be used in emergency applications, lymphography, endoscopy, myelography, venography, arthrography, interventional radiology, digital angiography and digital subtraction angiography (DSA). The system may be used on pediatric, adult and bariatric patients

Multitom Rax is not for mammography examinations.

Uroskop Omnia Max is a device intended to visualize anatomical structures by converting an X-ray pattern into a visible image. The system is designed primarily for urological diagnosis and the support of urological therapeutic applications such as examinations and small interventions of the urogenital tract. The table supports endourological and minimal invasive surgery in urology as there are transurethral interventions (e.g. ureterorenoscopy (URS), double stent placement, cystoscopy. transurethral resection of bladder tumors (TURB), transurethral resection of the prostate (TURP)), percutaneous urological procedures (e.g. percutaneous nephrostomy (PCN), percutaneous nephrolitholapaxy (PCNL)), urological X-ray diagnosis (e.g. survey imaging of the kidney, ureter, and bladder (KUB), intravenous pyelogram (IVP), retrograde pyelography), micturition cystourethrogram (MCU), videourodynamics, laparoscopic procedures and minor open urological interventions. The system may be used on pediatric, adult and bariatric patients.

Uroskop Omnia Max is not for mammography examinations.

7. Substantial Equivalence:

The new system software VF10 does not alter the fundamental indication for use nor does it change the technology being used for X-ray imaging. The devices remain within the same classification regulation for the same indication for use as the predicate devices. The new system software design was completed in accordance with Siemens Quality Management System Design Controls comparable to the processes available for the predicate devices. The scope of internationally recognized standards compliance was updated to the standards recognized at the time of the design of the new software. Verification and Validation testing were the same or similar to the testing being used with the predicate devices.

The new system software VF10 controls solid state X-ray imagers (SSXI) similar to the imagers being used with the predicate devices. The SSXIs have been improved for mechanical robustness.

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  • The edges of the mobile detectors were reinforced with steel caps to increase the ● mechanical robustness.
  • The handle of the MAX wi-D will not be coated anymore with white film and will . appear in a black carbon fiber look.

The following tables compare the performance changes of the detectors being used with the VF10 to the predicate detectors. The changed data are highlighted in bold letters.

Table 3: Comparison of Detector 4343-F Subject and Predicate
VE 20 / K152928VF 10 K173639
Fluoroscopy detectorPixium 4343-FPixium 4343-F
Field of view (Max)42 cm x 42.6cm42.0 cm x 42.5 cm
Matrix sizeUp to 2840 x 2874 pixelUp to 2840 x 2874 pixel
DQE; 200 nGy65 % at 0.05 lp/mm65 % at 0.05 lp/mm
51 % at 1 lp/mm51 % at 1 lp/mm
41 % at 2 lp/mm41 % at 2 lp/mm
25 % at 3 lp/mm25 % at 3 lp/mm
16 % at 3.4 lp/mm (Nyquist)16 % at 3.4 lp/mm (Nyquist)
MTF66 % at 1 lp/mm66 % at 1 lp/mm
35 % at 2 lp/mm35 % at 2 lp/mm
19 % at 3 lp/mm19 % at 3 lp/mm
16 % at 3.4 lp/mm (Nyquist)15 % at 3.4 lp/mm (Nyquist)

Table 3: Comparison of Dotoctor 4343-F Subject and Prodicate

Table 4: Comparison of Detector MAX wi-D Subject and Predicate

Mobil Rad detectorVE 20 / K152928VF 10
Siemens NameMAX wi-DMAX wi-D
Trixell namePixium 3543 EZhPixium 3543 EZh
Dimensions34.9 cm x 42.5 cm34.8 cm x 42.4 cm
Matrix size2356 x 28722350 x 2866
DQE; 2 μ Gy66 % at 0.05 lp/mm70 % at 0.05 lp/mm
50 % at 1 lp/mm51 % at 1 lp/mm
40 % at 2 lp/mm42 % at 2 lp/mm
24 % at 3 lp/mm29 % at 3 lp/mm
17 % at Nyquist19 % at Nyquist
MTF61 % at 1 lp/mm63 % at 1 lp/mm
31 % at 2 lp/mm35 % at 2 lp/mm
15 % at 3 lp/mm19 % at 3 lp/mm
12 % at Nyquist12 % at Nyquist

Table 5: Comparison of Detector MAX mini Subject and Predicate

Mobil Rad detectorVE 20 / K152928VF 10
Siemens NameMAX miniMAX mini
Trixell namePixium 2430EZPixium 2430EZ

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| Dimensions (active

area)28.4 cm x 22.8 cm28.4 cm x 22.5 cm
Matrix size1920 x 15381920 x 1520
DQE; 2 $\mu$ Gy66 % at 0.05 lp/mm66 % at 0.05 lp/mm
50 % at 1 lp/mm50 % at 1 lp/mm
40 % at 2 lp/mm40 % at 2 lp/mm
24 % at 3 lp/mm24 % at 3 lp/mm
17 % at Nyquist17 % at Nyquist
MTF61 % at 1 lp/mm61 % at 1 lp/mm
31 % at 2 lp/mm31 % at 2 lp/mm
15 % at 3 lp/mm15 % at 3 lp/mm
12 % at Nyquist12 % at Nyquist

Summary of Technological Characteristics of the Subject Device as Compared 8. with the Predicate Devices:

The subject devices with the new software VF10 use the same X-ray generator, the same X-ray tube and the similar SSXI with the same digital imaging system and similar image processing software as the predicate devices. There are no changes in the patient environment or the type of user interface.

The following table compares the main performance data of the subject devices with the predicate devices to substantiate equivalence of the subject device and predicate devices.

| | Subject Devices | Predicate Devices | Compariso
n/
Comments |
|------------------------------------------------|---------------------------------------------------------------------------|---------------------------------------------------------------------|---------------------------------------------------------|
| Feature | Luminos Agile Max
Luminos dRF Max
Uroskop Omnia Max
Multitom Rax | Luminos Agile
AXIOM Luminos dRF
Uroskop Omnia
Multitom Rax | |
| X-ray | | | |
| Generator | Polydoros
65/80 kW | Polydoros
65/80 kW | |
| X-ray tube | OPTITOP
150/40/80/HC-100 | OPTITOP
150/40/80/HC-100 | X-ray |
| Collimator | Digital Multileaf
Collimator N | Digital Multileaf
Collimator N | Imaging |
| Air kerma | Kerma X | Kerma X | |
| X-ray techniques | Radiography
Pulsed fluoroscopy
DSA and series
exposure | Radiography
Pulsed fluoroscopy
DSA and series
exposure | components
are the same |
| Organ programs | X-ray parameters
Imaging processing
parameters | X-ray parameters
Imaging processing
parameters | |
| Testing | | | |
| IEC Compliance
for 60601-1-2
EMC | IEC 4th edition | IEC 3rd edition | Testing
according to
current IEC
test scope |
| Digital Imaging | | | |
| Fluoroscopic
SSXI integrated
into system | Trixell Pixium 5100
Max Dynamic =
4343F-4 | Trixell Pixium 5100
Max Dynamic =
4343F-3 | Image Chain
is similar to
predicate
devices. |
| SSXI for Rad
imaging | Trixell Pixium
MAX wi-D =
3543EZh
MAX mini = 2430EZ | Trixell Pixium
MAX wi-D =
3543EZh
MAX mini = 2430EZ | Detector
Performance
data
according To
SSXI |
| Digital imaging
system | Fluorospot Compact | Fluorospot Compact | guidance are
provided |
| Image processing | Diamond View Plus
Clearview | Diamond View Plus
Application specific
organ programs | Same
processing
made user
friendly |
| MS Operating
system | Windows 10 | Windows 7 | New
Operating
system |
| Cybersecurity | Security package
based on MS Win 10 | Security package
based on MS Win 7 | Improved |
| Integration of
hospital IT | Hospital/Radiology
Information System | Hospital/Radiology
Information System | Improved |
| Maximum Frame
rate (acquisition) | 16 Frames/second* | 8 Frames/second | Improved
dynamic
resolution |
| *For Multitom Rax only | | | |
| Pediatric package | Increased number of
organ programs | Organ programs | Increased
number and
variability |

Table 6: Technical Comparison with the Predicates

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9. Summary of Non-Clinical Test Data:

The devices operating with software VF10 comply with the voluntary standards as listed in the following table:

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Table 7: Compliance with Standards

| Development
Organization and

Reference NumberStandard Title
IEC 60601-1:2012,
Edition 3.1Medical Electrical Equipment - Part 1: General
Requirements for Safety
IEC 60601-1-2:2007
Edition 4.0Medical Electrical Equipment - Part 1-2: General
requirements for basic safety and essential performance -
Collateral Standard: Electromagnetic Compatibility --
Requirements and Tests
IEC 60601-1-3: 2012,
Edition 2.1Medical electrical equipment - Part 1-3: General
requirements for basic safety and essential performance -
Collateral Standard: Radiation protection in diagnostic X-
ray equipment
IEC 62366:2014
Edition 1.1Medical devices – Application of usability engineering to
medical devices
ISO 14971, 2007medical devices – application of risk management to
medical devices
IEC 62304 Ed. 1.0, 2006Medical device software - Software life cycle processes
IEC 60601-2-28:2010
Edition 2.0Medical electrical equipment - Part 2-28: Particular
requirements for the basic safety and essential performance
of X-ray tube assemblies for medical diagnosis
IEC 60601-2-54, 2009
Edition 1.0Medical electrical equipment - Part 2-54: Particular
requirements for the basic
safety and essential performance of X-ray equipment for
radiography and
radioscopy
IEC 61910-1, 2014Medical electrical equipment - Radiation dose
documentation - Part 1: Radiation dose structured reports
for radiography and radioscopy (IEC 61910-1:2014)
NEMA PS 3.1 - 3.20,
2011Digital Imaging and Communications in Medicine
(DICOM) Set
ISO 10993-1, 2009Biological evaluation of medical devices -- Part 1:
Evaluation and testing within a risk management process
IEC 60601-2-43:2010
Edition 2.0Medical electrical equipment - Part 2-43: Particular
requirements for the safety of X-ray equipment for
interventional procedures

The following international standards were used in the development of the VF10:

The Software VF10 design was completed in accordance with Siemens Quality Management System Design Controls and verification and validation testing were successfully conducted. Non-clinical performance data are provided for the updated detectors. All radiology and fluoroscopy systems use the same software. Certain

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features of the software are enabled or disabled depending on the system and its indications for use (i.e. 16 frames per second for Multitom Rax versus 8 frames per second for all other systems. The new IEC 4th edition has been applied for the compliance to the IEC 60601-1-2 electromagnetic compatibility standard.

The tests were performed on the new software VF10 demonstrating that the devices are safe and effective, perform comparably to the predicate devices, and are substantially equivalent to the predicate devices.

Documentation provided demonstrates compliance of the subject devices to all FDA requirements stated in the Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices, including results of verification/validation tests of software requirements and software risk hazards.

Performance testing confirmed that the five devices comply with 21 CFR 1020.30-32 Federal Performance Standards for X-Ray Fluoroscopic equipment. The applicable sections include:

1020.30(c)Manufacturer's Responsibility (Certification)
1020.30(e)Identification of X-ray components
1020.30(g)Information to be provided to assemblers
1020.30(h)Information to be provided to users
1020.31(k)Leakage Radiation
1020.30(m)Beam Quality
1020.32(d)Fluoroscopic Entrance exposure rate
1020.32 (a)Primary Protective Barrier Transmission
1020.31(a)Peak Tube Potential
1020.32(b)Alignment of edges of the X-ray field with the edges
of the fluoroscopic image receptor
1020.32(k)Display of values of AKR and cumulative air kerma
1040.10Laser products

The software VF10 controls solid state X-ray imagers (SSXI) that are similar in performance to the predicates. Performance data are provided according to the "Guidance for the Submission of 510(k)'s for Solid State X-ray Imaging Devices, issued on: September 1, 2016".

Together, the verification/validation activities successfully confirmed that the software requirements have been fulfilled and that system functionality is consistent with the user needs and intended uses. The VF10 software correctly performs as designed and raises no new questions regarding safety or effectiveness. Therefore, when compared to the predicate devices the devices with the new software VF10 support a determination of substantial equivalence.

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10. Summary of Clinical Tests:

For the subject of this premarket submission, Siemens did not do an evaluation of the clinical image quality as x-ray technology; geometry and SSXI changes are minor.

General Safety and Effectiveness Concerns: 11.

Instructions for use are included within the device labeling, and the information provided will enable the user to operate the device in a safe and effective manner. Several safety features including visual and audible warnings are incorporated into the system design. In addition the devices are continually monitored, and if an error occurs, the system functions will be blocked and an error message will be displayed.

Furthermore the operators are health care professionals familiar with and responsible for the x-ray examinations to be performed. To minimize electrical, mechanical and radiation hazards, Siemens adheres to recognized and established industry practice, and all equipment is subject to final performance testing.

12. Conclusion as to Substantial Equivalence:

The radiology and fluoroscopy devices with VF10 software are intended for the same indications for use as the predicate devices. The operating environment is the same and the technology is effectively unchanged. Siemens concludes via the documentation provided in this 510(k) submission that the radiology and fluoroscopy devices Luminos Agile Max, Luminos dRF Max, Uroskop Omnia Max and Multitom Rax with VF10 software are substantially equivalent to the predicate devices Luminos Agile, AXIOM Luminos dRF, Uroskop Omnia, Multitom Rax.

13. Guidance documents

The following FDA guidance documents were utilized in the documentation of this Premarket Notification:

  • Guidance for Industry and FDA Staff . Bundling Multiple Devices or Multiple Indications in a Single Submission Document issued on: June 22, 2007
  • . Content of Premarket Submissions for Management of Cybersecurity in Medical Devices Guidance for Industry and Food and Drug Administration Staff Document Issued on: October 2, 2014
  • Information to Support a Claim of Electromagnetic Compatibility (EMC) of Electrically-Powered Medical Devices Guidance for Industry and Food and Drug Administration Staff Document issued on July 11, 2016. The draft of this document was issued on November 2, 2015.
  • Pediatric Information for X-ray . Imaging Device Premarket Notifications Guidance for Industry and Food and Drug Administration Staff

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Document issued on November 28, 2017.

  • . Guidance for the Submission of 510(k)s for Solid State X-ray Imaging Devices 1 Guidance for Industry and Food and Drug Administration Staff Document issued on: September 1, 2016
  • Guidance for Industry and FDA Staff ● Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices Document issued on: May 11, 2005
  • Guidance for Industry and FDA Staff Recognition and Use of Consensus Standards Document issued on: September 17, 2007
  • . The 510(k) Program: Evaluating Substantial Equivalence in Premarket Notifications [510(k)] Guidance for Industry and Food and Drug Administration Staff Document issued on: July 28, 2014
  • Radio Frequency Wireless Technology in Medical Devices ● Guidance for Industry and Food and Drug Administration Staff Document issued on: August 14, 2013