K Number
K202722
Device Name
1212FCA
Manufacturer
Date Cleared
2020-10-26

(39 days)

Product Code
Regulation Number
892.1680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
1212FCA is indicated for digital imaging solution designed for human anatomy including head, neck, cervical spine, arm, leg and peripheral (foot, hand, wrist, fingers, etc.). It is intended to replace film based radiographic diagnostic systems and provide a case diagnosis and treatment planning for physicians and other health care professionals. Not to be used for mammography.
Device Description
1212FCA is a digital solid state X-ray detector that is based on flat-panel technology. This radiographic image detector and processing unit consists of a scintillator coupled to an IGZO TFT sensor. This device needs to be integrated with a radiographic imaging system. It can be utilized to capture and digitalize Xray images for radiographic diagnosis. The RAW files can be further processed as DICOM compatible image files by separate console SW for a radiographic diagnosis and analysis. The subject detectors are not wireless, but they are connected to a viewing station by ethernet connection.
More Information

Not Found

No
The document describes a digital X-ray detector and processing unit that captures and processes images. While it mentions image processing, there is no mention of AI, ML, or any related concepts like deep learning, neural networks, or algorithms that learn from data. The performance studies focus on standard imaging metrics (MTF, DQE, NPS) and comparison to a predicate device, not on the performance of any AI/ML-driven analysis or interpretation.

No
The device is an X-ray detector used for diagnostic imaging, not for treating conditions.

Yes

Explanation: The device is described as being for "case diagnosis and treatment planning for physicians and other health care professionals" and for "radiographic diagnosis and analysis." This clearly indicates its use in diagnosing medical conditions based on the images it produces.

No

The device description explicitly states it is a "digital solid state X-ray detector that is based on flat-panel technology" and includes hardware components like a scintillator and IGZO TFT sensor. While it mentions separate console software for processing, the core device is a hardware component.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to examine specimens taken from the human body, such as blood, urine, or tissue, to provide information about a person's health.
  • Device Function: The 1212FCA is a digital X-ray detector. It captures images of the inside of the human body using X-rays. It does not analyze biological specimens taken from the body.
  • Intended Use: The intended use is for digital imaging of human anatomy for case diagnosis and treatment planning. This is a function of medical imaging, not in vitro diagnostics.

The device is clearly a medical imaging device used for diagnostic purposes, but it falls under the category of radiological imaging devices, not in vitro diagnostics.

N/A

Intended Use / Indications for Use

1212FCA is indicated for digital imaging solution designed for human anatomy including head, neck, cervical spine, arm, leg and peripheral (foot, hand, wrist, fingers, etc.). It is intended to replace film based radiographic diagnostic systems and provide a case diagnosis and treatment planning for physicians and other health care professionals. Not to be used for mammography.

Product codes

MQB

Device Description

1212FCA is a digital solid state X-ray detector that is based on flat-panel technology. This radiographic image detector and processing unit consists of a scintillator coupled to an IGZO TFT sensor. This device needs to be integrated with a radiographic imaging system. It can be utilized to capture and digitalize Xray images for radiographic diagnosis.

The RAW files can be further processed as DICOM compatible image files by separate console SW for a radiographic diagnosis and analysis.

The subject detectors are not wireless, but they are connected to a viewing station by ethernet connection.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray

Anatomical Site

human anatomy including head, neck, cervical spine, arm, leg and peripheral (foot, hand, wrist, fingers, etc.).

Indicated Patient Age Range

Not Found

Intended User / Care Setting

physicians and other health care 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)

The non-clinical test report for the subject device was prepared and submitted to FDA to demonstrate the substantial equivalency of the subject device performance compared to the predicate device. The nonclinical test report contains the MTF, DQE and NPS performance test comparison between the subject device (1212FCA), and the predicate device (1012WCC), by using the identical test equipment and same analysis method described by IEC 62220-1.

The MTF and DQE testing represent the ability to visualize object details of a certain size and contrast. 1212FCA demonstrated equivalent or better performance in terms of MTF and DQE as well as NPS compared to 1012WCC, the predicate device, at all spatial frequencies.

Based on the non-clinical consideration evaluation, the sponsor can claim the substantial equivalency between the subject device and the predicate device in terms of diagnostic image quality.

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

Not Found

Predicate Device(s)

K162518

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

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October 26, 2020

Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which consists of the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" in blue, with the word "ADMINISTRATION" underneath.

Rayence Co., Ltd. % Mr. Dave Kim President Mtech Group 7707 Fannin St., Ste. 200 HOUSTON TX 77054

Re: K202722

Trade/Device Name: 1212FCA Regulation Number: 21 CFR 892.1680 Regulation Name: Stationary x-ray system Regulatory Class: Class II Product Code: MQB Dated: September 15, 2020 Received: September 17, 2020

Dear Mr. Kim:

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 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

1

devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

For

Thalia T. Mills, Ph.D. Director Division of Radiological Health OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K202722

Device Name

1212FCA

Indications for Use (Describe)

1212FCA is indicated for digital imaging solution designed for human anatomy including head, neck, cervical spine, arm, leg and peripheral (foot, hand, wrist, fingers, etc.). It is intended to replace film based radiographic diagnostic systems and provide a case diagnosis and treatment planning for physicians and other health care professionals. Not to be used for 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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510(k) Summary K202722

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

Date 510k summary prepared: October 15, 2020

Submitter's Name, address, telephone number, a contact person:
Submitter's Name :Rayence Co., Ltd.
Submitter's Address:14, Samsung 1-ro 1-gil, Hwaseong-si, Gyeonggi-do, Korea
Submitter's Telephone:+82-31-8015-6459
Contact person:Mr. Kee Dock Kim / RA Team Manager / +82-31-8015-6459
Official Correspondent:Dave Kim (davekim@mtech-inc.net)
Address:7707 Fannin St. Ste 200-V111, Houston, TX 77054
Telephone:+713-467-2607

Name of the device, including the trade or proprietary name if applicable, the common or usual name and the classification name, if known:

Trade/proprietary name: 1212FCA
Common Name: Digital Flat Panel X-ray Detector
Regulation Number: 21 CFR 892.1680
Regulation Name: Stationary X-ray System
Regulatory Class: Class II
Product Code: MQB
Predicate Device :
Trade/Device Name:1012WCC
Common Name: Digital Flat Panel X-ray Detector
510(k) Number: K162518
Regulation Number: 21 CFR 892.1680
Regulation Name: Stationary X-ray System
Regulatory Class: Class II
Product Code: MQB

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2. Device Description

1212FCA is a digital solid state X-ray detector that is based on flat-panel technology. This radiographic image detector and processing unit consists of a scintillator coupled to an IGZO TFT sensor. This device needs to be integrated with a radiographic imaging system. It can be utilized to capture and digitalize Xray images for radiographic diagnosis.

The RAW files can be further processed as DICOM compatible image files by separate console SW for a radiographic diagnosis and analysis.

The subject detectors are not wireless, but they are connected to a viewing station by ethernet connection.

3. Indication for use

1212FCA is indicated for digital imaging solution designed for human anatomy including head, neck, cervical spine, arm, leg and peripheral (foot, hand, wrist, fingers, etc.).It is intended to replace film or screen based radiographic systems in all general purpose diagnostic procedures. Not to be used for mammography.

4. Summary of Design Control Risk management

1212FCA digital X-ray detector is a modification of 1012WCC (K162518). 1212FCA was developed for the purpose of retrofitting the stationary X-ray system with a film detector. 1212FCA is slightly larger than 1012WCC (K162518).

The risks and the hazardous impact of the device modification were analyzed with FMEA method. The specific risk control and protective measures to mitigate the risks from the modification were reviewed and implemented in the new product design phase. The overall assessment concluded that all risks and hazardous conditions identified arising from the design change were successfully mitigated and accepted.

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5. Summary of the technological characteristics of the device compared to the predicate device:

1212FCA detector described in this 510(k) have the same indications for use and similar technical characteristics as its predicate devices, 1012WCC (K162518).

CharacteristicProposed DevicePredicate Device
ManufacturerRayence Co.,Ltd.Rayence Co.,Ltd.
Product Name1212FCA1012WCC
FeatureImage: 1212FCAImage: 1012WCC
510(k) numberK202722K162518
Intended Use1212FCA is indicated for digital
imaging solution designed for
human anatomy including head,
neck, cervical spine, arm, leg and
peripheral (foot, hand, wrist,
fingers, etc.). It is intended to
replace film based radiographic
diagnostic systems and provide a
case diagnosis and treatment
planning for physicians and other
health care professionals. Not to
be used for mammography.1012WCC and 1012 WGC Digital
Flat Panel X-Ray Detector is
indicated for digital imaging
solution designed for human
anatomy including head, neck,
cervical spine, arm, leg and
peripheral (foot, hand, wrist,
fingers, etc.). It is intended to
replace film based radiographic
diagnostic systems and provide a
case diagnosis and treatment
planning for physicians and other
health care professionals. Not to
be used for mammography.Similar
Detector TypeIGZO TFT + PIN type photodiodeAmorphous Silicon, TFTSimilar
ScintillatorCsI:TlCsI:TlSame
Imaging Area12 x 12 inches10 x 12 inchesSimilar
Pixel matrix1536 X 1536 (Full resolution)
768 X 768 (2x2 binning)2304 X 1792Similar
Pixel pitch194 µm (Full resolution) / 388 µm
(2x2 binning)127 μmSimilar
A/D conversion14 / 16 bit14 / 16bitSame
Frame rate18 (Full resolution) / 36 (2x2 binning)-Not
known
MTF0.1 lp/mm0.5270.488
1 lp/mm0.3270.283
2 lp/mm0.2100.181
2.5 lp/mm0.1360.117
DQE (0)0.7780.756
Preview time