K Number
K183212
Date Cleared
2018-12-07

(18 days)

Product Code
Regulation Number
892.1680
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Varex Nexus DR Digital X-ray Imaging System is a high resolution digital imaging system intended to replace conventional film techniques, or existing digital systems, in multipurpose or dedicated applications specified below. The Nexus DR Digital X-ray Imaging System enables an operator to acquire, display, process, export images to portable media, send images over a network for long term storage and distribute hardcopy images with a laser printer. Image processing algorithms enable the operator to bring out diagnostic details difficult to see using conventional imaging techniques. Images can be stored locally for temporary storage. The major system components include an image receptor, computer, monitor and imaging software.

The Varex Nexus DR Digital X-ray Imaging System is intended for use in general radiographic examinations and applications (excluding fluoroscopy, angiography, and mammography).

Device Description

The Varex DRTM Digital X-ray Imaging System is a high resolution digital imaging system designed for digital X-ray imaging through the use of an X-ray detector. The DR-m Digital X-ray Imaging System is designed to support general radiographic (excluding fluoroscopy, angiography, and mammography) procedures through a single common imaging platform.

The modified device consists of an X-ray imaging receptor, computer, monitor, and the digital imaging software and the optional Stitching software.

The Varex DR™ Digital X-ray Imaging System is a configurable product platform designed to allow Varex to leverage the common components of digital X-ray imaging systems from which the following medical modalities can be served: General Radiography (excluding fluoroscopy, angiography, and mammography). The DR™ Digital X-ray Imaging System is then configured to function on a computer with modality specific components, functionality and capabilities to complete the specific product package.

Like the predicate device, the modified DR™ Digital X-ray Imaging System is in a class of devices that all use similar technology to acquire digital radiographic images. These devices convert X-rays into visible light that shines onto a TFT array, which converts the visible light into a digital electronic signal. This process is ultimately used for the same purpose as Radiographic film, to create an X-ray image.

Identical to the predicate device, the modified device is capable of interfacing with flat panel detectors in vTrigger Mode or RAD Mode utilizing an external I/O box to interface with compatible X-ray generators, in non-integrated mode. The modified device also retains the ability to apply the grid suppression feature.

However, the modified device allows the operator to generate sequential radiographic images and electronically join them to create a single electronic image (a leg from hip to foot, for example). Stitching is a post-processing feature that allows the user to merge up to four (4) DICOM images and does not alter the original images. Using a digital flat panel detector, and a non-integrated generator, the Nexus DR Digital X-ray Imaging System (with Stitching) is capable of acquiring multiple digital radiographic images, processing and then displaying them in a high quality single image format to visualize long bones or other anatomical features such as the spine. The Nexus DR Digital X-ray Imaging System can then store the images on the local computer, archive them to CD/DVD media, transfer them to Hard Copy format via DICOM printers, or transfer them to PACS reviewing stations in DICOM format.

AI/ML Overview

Here's an analysis of the acceptance criteria and the study proving the device meets them, based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

The provided text does not explicitly list quantitative acceptance criteria in a dedicated table format with corresponding reported device performance for the stitching feature. Instead, the document focuses on demonstrating substantial equivalence through a comparison of technological characteristics and a subjective image comparison study.

However, based on the non-clinical and clinical test discussions, we can infer the acceptance criterion to be:

Acceptance Criteria (Implied)Reported Device Performance
Non-clinical: All release criteria met for validation protocols of the stitching feature. The device is as safe and effective as predicate devices and does not raise different questions of safety and effectiveness."Validation was completed in accordance with the Validation Protocols included with this submission. Protocols were designed, executed and documented according to the Design Validation process with predetermined test methods and corresponding acceptance criteria. In conclusion, all release criteria have been met..."
Clinical: Images produced with stitching feature are substantially equivalent to those from the reference predicate device."Based on the image comparison study performed; images provided by the Subject Device (DR™ Digital X-ray Imaging System (with Stitching)) along with bench testing results provide enough evidence to demonstrate that the Subject Device (DR™ Digital X-ray Imaging System (with Stitching)) is as safe and effective as the predicate devices and does not raise different questions of safety and effectiveness."

2. Sample Size Used for the Test Set and Data Provenance

  • Sample Size: The document states "Previously acquired sequential radiographic images." No specific number or range of images (sample size) is provided for the test set.
  • Data Provenance: The images were "Previously acquired sequential radiographic images from the Reference Predicate Device (InfiStitch for i5™ Digital X-Ray Imaging System)." This indicates the data is retrospective, as it was collected prior to the study for the subject device. The country of origin is not specified, but the predicate device's information (K101833) would likely originate from the US given the submission to the FDA.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

The document does not provide details on the number of experts or their qualifications used to establish ground truth for the test set. It only mentions an "image comparison study performed."

4. Adjudication Method for the Test Set

The adjudication method used is not specified. It only states an "image comparison study performed."

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

No, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not explicitly stated or implied. The study described is an "image comparison study" to demonstrate substantial equivalence to a reference predicate device, not a comparison of human readers with and without AI assistance.

6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) Was Done

Yes, the "image comparison study" and "bench testing results" described for the stitching feature appear to be a standalone performance evaluation of the algorithm's ability to stitch images, rather than involving human-in-the-loop performance measurement. The critical aspect is the quality and diagnostic utility of the stitched image itself, which is then compared (presumably by experts) to existing stitched images from a predicate device.

7. The Type of Ground Truth Used

The ground truth for the image comparison study was based on previously acquired sequential radiographic images from a legally marketed reference predicate device (InfiStitch for i5™ Digital X-Ray Imaging System). This implies that the accepted output of the predicate device serves as the "ground truth" or standard for comparison against the subject device's stitched images.

8. The Sample Size for the Training Set

The document does not provide any information regarding a training set or its sample size. This is a 510(k) submission for a device incorporating a known function (stitching) onto a new system, not a de novo submission for a novel AI algorithm requiring extensive training data. The stitching logic itself is likely rule-based or uses established image processing techniques rather than machine learning that necessitates a training set.

9. How the Ground Truth for the Training Set Was Established

As no training set is mentioned (see point 8), there is no information on how its ground truth was established.

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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.

December 7, 2018

Varex Imaging Corporation Michael Ryn Regulatory Affairs Analyst 121 Metropolitan Drive Liverpool, New York 13088

Re: K183212

Trade/Device Name: Nexus DR Digital X-ray Imaging System with stitching Regulation Number: 21 CFR 892.1680 Regulation Name: Stationary x-ray system Regulatory Class: Class II Product Code: MQB Dated: November 15, 2018 Received: November 19, 2018

Dear Michael Ryn:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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

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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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 medical devices and radiation-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 A. 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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DEPARTMENT OF HEALTH AND HUMAN SERVICESFood and Drug Administration
Indications for UseForm Approved: OMB No. 0910-0120Expiration Date: 06/30/2020See PRA Statement below.
510(k) Number (if known)K183212
Device NameNexus DR Digital X-ray Imaging System (with Stitching)
Indications for Use (Describe)The Varex Nexus DR Digital X-ray Imaging System is a high resolution digital imaging system intended to replace conventional film techniques, or existing digital systems, in multipurpose or dedicated applications specified below. The Nexus DR Digital X-ray Imaging System enables an operator to acquire, display, process, export images to portable media, send images over a network for long term storage and distribute hardcopy images with a laser printer. Image processing algorithms enable the operator to bring out diagnostic details difficult to see using conventional imaging techniques. Images can be stored locally for temporary storage. The major system components include an image receptor, computer, monitor and imaging software.The Varex Nexus DR Digital X-ray Imaging System is intended for use in general radiographic examinations and applications (excluding fluoroscopy, angiography, and mammography).
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 Varex Imaging. The logo consists of a stylized "V" made up of three vertical lines in different colors: blue, yellow, and green. To the right of the "V" is the word "VAREX" in blue, block letters. Below "VAREX" is the word "IMAGING" in smaller, gray letters.

Varex Imaging Corporation 121 Metropolitan Drive Liverpool, NY 13088- USA www.vareximaging.com

Section 3: 510(k) Summary

Date Prepared: November 13, 2018

Contact Person:Michael Van RynRegulatory Affairs Manager
Telephone:315-234-6853
Fax:315-234-6801
Submitter Name:Varex Imaging Corporation121 Metropolitan DriveLiverpool, NY 13088
Subject Device
Trade Name:DR TM Digital X-ray Imaging System (with Stitching)
Common Name:Digital Radiographic System
Regulation:21 CFR 892.1680
Classification Name:Stationary X-ray System
Class:II
Primary Product Code:MQB

Primary Predicate Device

Trade Name:DR TM Digital X-ray Imaging System(with PaxScan 4343RC and PaxScan 4343Rv3)
Common Name:Digital Radiographic System
Regulation:21 CFR 892.1680
Classification Name:Stationary X-ray System
Class:II
Primary Product Code:MQB
510(k) Number:K172951

Reference Predicate Device:

Trade Name:InfiStitch for i5 TM Digital X-Ray Imaging System
Common Name:Digital Radiographic System
Regulation:21 CFR 892.1680
Classification Name:Stationary X-ray System
Class:II
Primary Product Code:JAA, MQB
510(k) Number:K101833

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Image /page/4/Picture/0 description: The image shows the logo for Varex Imaging. The logo consists of a stylized "V" made up of three vertical lines in blue, yellow, and green, followed by the text "VAREX" in blue. Below "VAREX" is the word "IMAGING" in smaller, blue letters.

Device Description:

The Varex DRTM Digital X-ray Imaging System is a high resolution digital imaging system designed for digital X-ray imaging through the use of an X-ray detector. The DR-m Digital X-ray Imaging System is designed to support general radiographic (excluding fluoroscopy, angiography, and mammography) procedures through a single common imaging platform.

The modified device consists of an X-ray imaging receptor, computer, monitor, and the digital imaging software and the optional Stitching software.

The Varex DR™ Digital X-ray Imaging System is a configurable product platform designed to allow Varex to leverage the common components of digital X-ray imaging systems from which the following medical modalities can be served: General Radiography (excluding fluoroscopy, angiography, and mammography). The DR™ Digital X-ray Imaging System is then configured to function on a computer with modality specific components, functionality and capabilities to complete the specific product package.

Like the predicate device, the modified DR™ Digital X-ray Imaging System is in a class of devices that all use similar technology to acquire digital radiographic images. These devices convert X-rays into visible light that shines onto a TFT array, which converts the visible light into a digital electronic signal. This process is ultimately used for the same purpose as Radiographic film, to create an X-ray image.

Identical to the predicate device, the modified device is capable of interfacing with flat panel detectors in vTrigger Mode or RAD Mode utilizing an external I/O box to interface with compatible X-ray generators, in non-integrated mode. The modified device also retains the ability to apply the grid suppression feature.

However, the modified device allows the operator to generate sequential radiographic images and electronically join them to create a single electronic image (a leg from hip to foot, for example). Stitching is a post-processing feature that allows the user to merge up to four (4) DICOM images and does not alter the original images. Using a digital flat panel detector, and a non-integrated generator, the Nexus DR Digital X-ray Imaging System (with Stitching) is capable of acquiring multiple digital radiographic images, processing and then displaying them in a high quality single image format to visualize long bones or other anatomical features such as the spine. The Nexus DR Digital X-ray Imaging System can then store the images on the local computer, archive them to CD/DVD media, transfer them to Hard Copy format via DICOM printers, or transfer them to PACS reviewing stations in DICOM format.

Indications for Use:

The Varex DR™ Digital X-ray Imaging System is a high resolution digital imaging system intended to replace conventional film techniques, or existing digital systems, in multipurpose or dedicated applications specified below. The DR™ Digital X-ray Imaging System enables an operator to acquire, display, process, export images to portable media, send images over a network for long term storage and distribute hardcopy images with a laser printer. Image processing algorithms enable the operator to bring out diagnostic details difficult to see using conventional imaging techniques. Images can be stored locally for temporary storage. The major system components include an image receptor, computer, monitor and imaging software.

The Varex DR™ Digital X-ray Imaging System is intended for use in general radiographic examinations and applications (excluding fluoroscopy, angiography, and mammography).

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Image /page/5/Picture/0 description: The image shows the logo for Varex Imaging. The logo consists of a stylized "V" made up of four vertical lines in different colors: blue, blue, yellow, and green. To the right of the "V" is the text "VAREX" in blue. Below the word "VAREX" is the word "IMAGING" in a smaller font size and in black.

Technological Characteristics Comparison:

The DR™ Digital X-ray Imaging System (with Stitching) supports the same modality as the predicate device with similar components or imaging concepts, has the same Indications for Use as the predicate device, and delivers equivalent image quality as the predicate device. The comparison chart below reveals that functions performed by the predicate device are performed by the modified device for the DR application. Therefore, the modified device is substantially equivalent to the predicate device.

However, the modified device, DRTM Digital X-ray Imaging System, has the additional ability electronically join up to four (4) DICOM images into a single electronic image. All other features and functions remain unchanged.

The DR™ Digital X-ray Imaging System (with Stitching) operating in RAD Mode (Panel Acquisition Mode) is designed to communicate with X-ray generators that provide Select, Prep and Request signals. The DR™ Digital X-ray Imaging System (with Stitching) utilizes an external I/O box to interface with compatible X-ray generators; not integrated. If an X-ray generator does not provide Select, Prep and Request signals, vTrigger Mode (AED) is used; thus no connection to the generator is required.

Feature/ItemNexus DR™Digital X-ray ImagingSystem (PaxScan4343RC and4343Rv3)InfiStitch for i5™Digital X-RayImaging SystemNexus DR™Digital X-ray ImagingSystem (Stitching)
Device TypePrimary PredicateDeviceReference PredicateDeviceSubject Device
510 (k) NumberK161459K101833TBD
Flat PanelDetectorVarian PaxScan4343RC/4343Rv3SimilarSame
DetectorMateriala-Si sensor array withCsI or Gd2O2S:TBscintillatorSameSame
DetectorDimensions17" x 17"SameSame
PixelSize139 x 139 micronsSimilarSame
DetectorElement Matrix3072 x 3072SimilarSame
DynamicRange16 bitsSameSame
UniformDensity1.52SameSame
Feature/ItemNexus DR™ Digital X-ray Imaging System (PaxScan 4343RC and 4343Rv3)InfiStitch for i5™ Digital X-Ray Imaging SystemNexus DR™ Digital X-ray Imaging System (Stitching)
Device TypePrimary Predicate DeviceReference Predicate DeviceSubject Device
510 (k) NumberK161459K101833TBD
Spatial Resolution3.2 lp/mmSimilarSame
Sensitivity540 @ 1.1uGy/frame1206 @ 3.9uGy/frame4290 @ 10uGy/frame12804@ 30uGy/frame(16-bit subject panel)SimilarSame
Signal to Noise Ratio73 @ 2.8uGy/frame117 @ 7uGy/frame174 @ 17uGy/frame285 @ 50uGy/frameSimilarSame
Modulation Transfer Function0.551 @ 1cycle/mm0.234 @ 2cycles/mm0.099 @ 3cycles/mmSimilarSame
Detective Quantum Efficiency0.232 @ 1cycle/mm0.15 @ 2cycles/mm0.07 @ 3cycles/mmSimilarSame
External ConnectivityDICOM3.0 CompatibleSameSame
Operator ConsoleGraphical User InterfaceSameSame
Image ProcessorIntel CPU Based PCSameSame
Image StorageHard DriveSameSame
Operating SystemWindows 10SimilarSame
Total Image Processing Time10 seconds per imageSameSame
Power Requirements110/120V,230/240V,50/60 HzSameSame
StitchingNoYesYes

Comparison Chart:

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Image /page/6/Picture/0 description: The image shows the logo for Varex Imaging. The logo consists of a stylized "V" made up of three vertical lines in blue, yellow, and green. To the right of the "V" is the word "VAREX" in blue, with the word "IMAGING" in smaller, gray letters below it.

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Image /page/7/Picture/0 description: The image shows the logo for Varex Imaging. The logo consists of a stylized "V" made up of four vertical lines in different colors, followed by the text "VAREX" in a dark blue sans-serif font. Below the word "VAREX" is the word "IMAGING" in a smaller, lighter font.

Non-clinical Tests Discussion:

Non-clinical Data submitted is consistent with FDA guidance document "Guidance for Industry and/or for FDA Reviewers/Staff and/or Compliance: Guidance for the Submission of 510(k)'s for Solid State Xray Imaging Devices" available at the website

http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/uc m073781.pdf.

Validation was completed in accordance with the Validation Protocols included with this submission. Protocols were designed, executed and documented according to the Design Validation process with predetermined test methods and corresponding acceptance criteria. In conclusion, all release criteria have been met and the Nexus DR™ Digital X-ray Imaging System (with Stitching) is as safe and effective as the predicate devices and does not raise different questions of safety and effectiveness.

Clinical Tests Discussion:

Previously acquired sequential radiographic images from the Reference Predicate Device (InfiStitch for i5™ Digital X-Ray Imaging System) were used to establish, at a minimum, substantial equivalency for images processed by the Subject Device (Nexus DR™ Digital X-ray Imaging System (with Stitching)).

Based on the image comparison study performed; images provided by the Subject Device (DR™ Digital X-ray Imaging System (with Stitching)) along with bench testing results provide enough evidence to demonstrate that the Subject Device (DR™ Digital X-ray Imaging System (with Stitching)) is as safe and effective as the predicate devices and does not raise different questions of safety and effectiveness.

Standards and Guidance Documents:

Electrical Safety and EMC Standards The modified device conforms to these consensus standards and has passed all relevant required testing:

  • AAMI ANSI ES60601-1:2005/(R)2012 and A1:2012, C1:2009/(R)2012 and A2:2010/(R)2012; ● Medical electrical equipment - Part 1: General requirements for basic safety and essential performance
  • . IEC 60601-1-2 Edition 3: 2007-03: Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility -Requirements and tests (2007)

Data Storage and Exchange Standards

The DRTM Digital X-ray Imaging System is designed to meet American College of Radiology / American College of Cardiology / National Electrical Manufacturers Association DICOM. Version 3.0, Parts 1 through 8, Part 10 (Media Storage and File Formats), Part 11 (Media Storage Applications Profiles) and Part 12 (CD-R Annex):

  • . NEMA PS 3.1 - 3.20; Digital Imaging and Communications in Medicine (DICOM) Set (2011)

Radiation Control

The DRTM Digital X-ray Imaging System meets the requirements of the Radiation Performance Standards of 21 CFR Subchapter J. applicable Sections 21 CFR 1020.30. 1020.31 and 1020.32.

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Image /page/8/Picture/0 description: The image shows the logo for Varex Imaging. The logo consists of a stylized "V" made up of four vertical lines in different colors: blue, yellow, green, and blue. To the right of the "V" is the text "VAREX" in a dark blue sans-serif font. Below "VAREX" is the word "IMAGING" in a smaller, lighter blue sans-serif font.

aging Corporation

Any video monitors chosen for this application meet the requirements of the Radiation Performance Standards of 21 CFR Subchapter J, applicable Section 21 CFR 1020.10.

Optical disk storage devices (reader and writer) comply with Radiation Performance Standards of 21 CFR Subchapter J, applicable Section 21 CFR 1040.10.

Guidance

The following guidance documents were considered and utilized in the development of the modified device. Applicable identified requirements derived from these guidance documents have been met.

  • Guidance for the Submission of 510(k)'s for Solid State X-ray Imaging Devices ●
  • How to Prepare a Special 510(k)
  • Guidance for Content of Premarket Submissions for Software Contained in Medical Devices ●
  • Deciding When to Submit a 510(k) for a Change to and Existing Device
  • Pediatric Information for X-ray Imaging Device Premarket Notifications
  • Applying Human Factors and Usability Engineering to Medical Devices
  • Use of Symbols in Medical Device Labeling
  • Content of Premarket Submissions for Management of Cybersecurity in Medical Devices ●
  • Refuse to Accept Policy for 510(k)s
  • eCopy Program for Medical Device Submissions
  • Global Unique Device Identification Database (GUDID)

Conclusion:

Based upon the results of Verification and Validation testing, the DR™ Digital X-Ray Imaging System (Stitching) has no new indications for use, has no significant technological differences, and is as safe and effective as, does not raise different questions of safety and effectiveness and is therefore substantially equivalent to the above listed current legally marketed predicate device.

§ 892.1680 Stationary x-ray system.

(a)
Identification. A stationary x-ray system is a permanently installed diagnostic system intended to generate and control x-rays for examination of various anatomical regions. 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 radiographic contrast tray or radiology diagnostic kit intended for use with a stationary 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.