K Number
K213113
Manufacturer
Date Cleared
2021-10-21

(24 days)

Product Code
Regulation Number
892.1650
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Orthoscan TAU Mini C-arm is designed to provide physicians with general fluoroscopic visualization, using pulsed or continuous fluoroscopy, of a patient including but not limited to, diagnostic, surgical, and critical emergency care procedures for patients of all ages including when imaging limbs/extremities, shoulders; at locations including but not limited to, hospitals, ambulatory surgery, emergency, traumatology, orthopedic, critical care, or physician office environments.

Device Description

The proposed modifications to Orthoscan, Inc. TAU Mini C-Arm series (which we will refer to internally and in this submittal as Orthoscan TAU 2.0, for distinction from predicate Orthoscan TAU) retain identical function as the predicate TAU Mini C-arm (K183220) as a mobile fluoroscopic mini C-arm system that provides fluoroscopic images of patients of all ages during diagnostic, treatment and surgical procedures involving anatomical regions such as but not limited to that of extremities, limbs, shoulders, knees, and Hips. The system consists of C-arm support attached to the image workstation.

The changes to the Orthoscan TAU series of Mini C-arm X-ray systems represent a modification of our presently legally marketed device Orthoscan TAU mini C-Arm K183220. The proposed modifications to the predicate encompass the implementation of an optional IGZO 15 cm x 15 cm Flat Panel Detector (FPD) in the 15x12cm and 15x15cm device detector sizes, a new LINUX based operating system and related software, image processing board revisions and a revised Power Manager Board for AC to DC conversion that will distribute 24Vdc via a medical grade DC power supply. The proposed device incorporates software architecture and other improvements that replicate the features and functions of the predicate device and improve image clarity without increasing dose levels.

AI/ML Overview

This FDA 510(k) summary describes the modified Orthoscan TAU Mini C-arm (Orthoscan TAU 2.0) and its substantial equivalence to its predicate device (Orthoscan TAU Mini C-arm, K183220). The device is an image-intensified fluoroscopic x-ray system.

Here's an analysis of the provided information regarding acceptance criteria and the study:

1. Table of Acceptance Criteria and Reported Device Performance

The submission does not explicitly present a table of "acceptance criteria" against "reported device performance" in a quantitative manner for specific benchmarks. Instead, it focuses on demonstrating substantial equivalence to the predicate device by comparing technological characteristics and asserting overall safety and effectiveness.

The document highlights differences in the modified device (Orthoscan TAU 2.0) compared to the predicate (Orthoscan TAU):

  • Optional IGZO Flat Panel Detector (FPD): The predicate used CMOS detectors. The modified device offers CMOS or optional IGZO for 15x12cm and 15x15cm sizes.
    • Reported Performance: "Substantially Equivalent. The introduction of the optional IGZO technology was found to be equal in safety and effectiveness including image quality (Essential Performance). IGZO sensor technology demonstrates equal/better image quality to that of the predicate... and provides slightly improved image quality at equal dose values as the predicate."
  • Linux-based Operating System: The predicate used Windows 8.1 Embedded.
    • Reported Performance: "Substantially Equivalent operating system was shown to support nearly identical workflows to achieve the same basic functionality with new proposed device software application. During verification and validation activities this change did not raise any safety and/or effectiveness concerns. The difference does not affect the safety or efficacy of the device."
  • Revised Power Manager Board: For AC to DC conversion.
    • Reported Performance: "Substantially Equivalent. The AC to DC conversion will provide intrinsic value through risk reduction such as leakage, while standardizing distribution of 24Vdc."
  • Software Architecture (OrthoTouch Application vs. OrthoMini Application):
    • Reported Performance: "Software architecture design is Substantially Equivalent to that of the predicate device... The OrthoTouch Application provides the main user interface to Orthoscan fluoroscopic X-Ray products, identical to OrthoMini, application. OrthoTouch on LINUX operating system performs equal to OrthoMini."
  • Graphical User Interface (GUI):
    • Reported Performance: "Substantially Equivalent GUI application are nearly Identical in workflows to achieve the same basic functionality with new proposed device software application. During verification and validation activities this change did not raise any safety and/or effectiveness concerns. The difference does not affect the safety or efficacy of the device."
  • Minor Differences in Detector Specifications (Pixel Spacing, Dynamic Range, DQE) for IGZO:
    • Reported Performance: These differences "do not affect the safety or efficacy of the device."

The overall "acceptance criteria" seem to be the demonstration of substantial equivalence to the predicate device, ensuring at least the same level of safety and effectiveness, including image quality.

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

  • Test Set: The "test set" for the image quality comparison consisted of:
    • "Numerous Image comparison sets"
    • Images from "Anthropomorphic (PMMA material) phantoms"
    • Images from "anatomical simulation phantoms"
  • Sample Size: The exact number of images or phantoms in the "numerous image comparison sets" is not specified.
  • Data Provenance: The study was a retrospective lab test image comparison study conducted by Orthoscan, Inc. (the manufacturer). There is no mention of country of origin for the data; it was an internal company lab study.

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

  • Number of Experts: One expert.
  • Qualifications: A "board-certified Radiologist." No details on years of experience or specialization are provided beyond this.
  • Ground Truth Establishment: The radiologist performed an "assessment of individual images arranged in groups of image sets." Their conclusion served as the basis for the ground truth regarding image quality comparison between the modified and predicate devices.

4. Adjudication Method for the Test Set

  • Adjudication Method: None mentioned or implied. Only one radiologist was involved in the assessment, so there was no multi-reader consensus or adjudication process.

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

  • MRMC Study: No, an MRMC comparative effectiveness study was not done. The study involved a single radiologist's assessment of image sets from phantoms.
  • Effect Size: Not applicable, as no MRMC study was performed.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

  • Standalone Study: The device is a fluoroscopic X-ray system, not an AI algorithm in the context of standalone performance studies typically seen for AI/ML devices. The "algorithm" here refers to image processing within the device. The performance assessment was based on visual evaluation of the output images by a human expert. Therefore, a standalone algorithm-only performance study in the way it's usually defined for AI software was not conducted or described. The performance tested was for the integrated device.

7. The Type of Ground Truth Used

  • Type of Ground Truth: The ground truth for image quality was established by expert consensus (albeit by a single expert) and comparison of visual characteristics ("image quality") based on images of "anthropomorphic (PMMA material) phantoms and anatomical simulation phantoms." The expert's conclusion stated "the image quality at same or similar patient dose rates will result in a slight improvement in patient care (images) for the proposed modified TAU device over the Predicate device."

8. The Sample Size for the Training Set

  • Training Set Sample Size: This submission is for a medical device (Mini C-arm X-ray system), not an AI/ML software. It describes modifications to an existing device, including a new operating system and detector options. There is no mention of a training set in the context of machine learning. The device itself is not presented as an AI-powered diagnostic tool requiring a separate training process for its core functionality.

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

  • Ground Truth for Training Set: Not applicable, as there is no mention of a training set for machine learning.

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October 21, 2021

Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health and Human Services logo on the left and the FDA logo 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.

Orthoscan, Inc. % Mr. Kevin Bridgman Director of Regulatory Affairs and Quality Assurance 14555 N. 82nd Street SCOTTSDALE AZ 85260

Re: K213113

Trade/Device Name: Orthoscan Tau Mini C-Arm Regulation Number: 21 CFR 892.1650 Regulation Name: Image-intensified fluoroscopic x-ray system Regulatory Class: Class II Product Code: OXO, JAA, MQB Dated: September 21, 2021 Received: September 27, 2021

Dear Mr. Bridgman:

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

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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 medical devices and radiation-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) K213113

Device Name Orthoscan TAU Mini C-arm

Indications for Use (Describe)

The Orthoscan TAU Mini C-arm is designed to provide physicians with general fluoroscopic visualization, using pulsed or continuous fluoroscopy, of a patient including but not limited to, diagnostic, surgical, and critical emergency care procedures for patients of all ages including when imaging limbs/extremities, shoulders; at locations including but not limited to, hospitals, ambulatory surgery, emergency, traumatology, orthopedic, critical care, or physician office environments.

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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K213113

Image /page/3/Picture/1 description: The image shows the logo for Orthoscan. The logo consists of a stylized letter "C" in blue, followed by a vertical blue line. To the right of the line is the word "ORTHOSCAN" in black, with each letter evenly spaced.

U.S. Food and Drug Administration Center for Devices and Radiological Health Document Mail Center -W066-G609 10903 New Hampshire Avenue Silver Spring, MD 20993-0002

Volume 005 Special 510(k) Summary

Special 510 (k) Premarket Notification Submission- Orthoscan, Inc. TAU Mini C-Arm

Date: September 21, 2021

In accordance with the requirements of 21 CFR §807.92 the following Special 510(k) summary of information is provided:

Submitter Address:Orthoscan, Inc.14555 N 82nd St.Scottsdale, AZ 85260Phone: (480) 503-8010Fax: (480) 503-8011
Primary Contact Person:Kevin Bridgman14555 N 82nd St.Scottsdale, AZ 85260Cell: (909) 262-9930Phone: (480) 503-8010Fax: (480) 503-8011
Secondary ContactPerson:Brenda Sparks14555 N 82nd St.Scottsdale, AZ 85260Phone: (480) 503-8010Fax: (480) 503-8011

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ORTHOSCAN

Proposed Device:

Device Trade Name: 510(k) Number: Common /Usual Names:

Device Class: Classification(s): Classification Names: Device: Product Code:

21CFR 807.92(a)(2)

21 CFR 807.92(a)(3)

Orthoscan, Inc. TAU Mini C-Arm Unknown at this time Fluoroscopic X-Ray System, Mobile Mini Mobile C-arm, Mini C-arm Class II 21CFR 892.1650 image-intensified fluoroscopic x-ray system, mobile Image-intensified fluoroscopic x-ray system. OXO, JAA, MQB

Predicate Device:

Device Identification: Classification(s): Device Class: Classification Names: Regulation Description: Product Codes:

General Description:

Orthoscan, Inc. TAU Mini C-Arm (K183220) 21CFR 892.1650 Class II Image-intensified fluoroscopic x-ray system, mobile Image-intensified fluoroscopic x-ray system OXO, JAA, MQB

The proposed modifications to Orthoscan, Inc. TAU Mini C-Arm series (which we will refer to internally and in this submittal as Orthoscan TAU 2.0, for distinction from predicate Orthoscan TAU) retain identical function as the predicate TAU Mini C-arm (K183220) as a mobile fluoroscopic mini C-arm system that provides fluoroscopic images of patients of all ages during diagnostic, treatment and surgical procedures involving anatomical regions such as but not limited to that of extremities, limbs, shoulders, knees, and Hips. The system consists of C-arm support attached to the image workstation.

The changes to the Orthoscan TAU series of Mini C-arm X-ray systems represent a modification of our presently legally marketed device Orthoscan TAU mini C-Arm K183220. The proposed modifications to the predicate encompass the implementation of an optional IGZO 15 cm x 15 cm Flat Panel Detector (FPD) in the 15x12cm and 15x15cm device detector sizes, a new LINUX based operating system and related software, image processing board revisions and a revised Power Manager Board for AC to DC conversion that will distribute 24Vdc via a medical grade DC power supply. The proposed device incorporates software architecture and other improvements that

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Image /page/5/Picture/0 description: The image shows the logo for Orthoscan. The logo consists of a stylized letter "C" in blue, followed by a vertical blue line. To the right of the line is the word "ORTHOSCAN" in black sans-serif font.

replicate the features and functions of the predicate device and improve image clarity without increasing dose levels.

For both the predicate and proposed device, the following are unchanged; Identical C-arm support and mechanical connections, balancing, locking, rotations, work-station platform, monitor display and main user interface controls, touch screen interface, selectable imaging, X-ray technique control, entry of patient information, wired or wireless footswitch operation, interface connection panel and DICOM fixed wire and wireless network interfaces.

The proposed modifications to Orthoscan, Inc. TAU Mini C-Arm series do not change the identical intended use. Intended use is the same as the predicate device TAU (K183220) Mini C-Arm.

Indications for Use: The Orthoscan TAU Mini C-arm is designed to provide physicians with general fluoroscopic visualization, usinq pulsed or continuous fluoroscopy, of a patient including but not limited to, diagnostic, surgical, and critical emergency care procedures for patients of all ages including pediatric populations when imaging limbs/extremities, shoulders; at locations including but not limited to, hospitals, ambulatory surgery, emergency, traumatology, orthopedic, critical care, or physician office environments.

The proposed modifications to Orthoscan, Inc. TAU Mini C-Arm series do not change the indications for use. The indications for use are the same as the predicate device TAU (K183220) Mini C-Arm.

Technology: The changes to proposed device Orthoscan TAU 2.0 series of Mini C-arm X-ray systems represent a modification of our presently legally marketed device Orthoscan TAU Mini C-Arm K183220. The proposed device will provide an option in supplier of detectors. The optional IGZO Solid-State X-ray Imagers (SSXI) provide newer technology in the Flat Panel Detectors (FPD). The inclusion of IGZO detector size 15cmx15cm in the 15cmx15cm sized Orthoscan device will also be fitted into the smaller active field

Intended Use:

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model 15cmx12cm sized device with minor mechanical modifications.

The proposed modified TAU 2.0 will be equipped with a revised Power Manager Board for AC to DC conversion that will distribute 24vdc via a new medical grade DC power supply. This supply will power all electronic sub-assemblies. The AC to DC conversion will provide intrinsic value through risk reduction such as leakage, while standardizing distribution of 24Vdc.

With the introduction of a Linux based operating system (OS) an open source highly secure OS, and revisions to the image processing board, software architecture design has been improved and functions are identical to that of the predicate device Orthoscan, Inc. TAU Mini C-arm (K183220).

Summary of Technological Characteristics: The comparisons of the proposed modifications to Orthoscan, Inc. TAU Mini C-Arm demonstrate that the scientific and technology characteristics indicate substantial equivalence to the predicate device Orthoscan, Inc. TAU Mini C-Arm (K183220). The following table provides a comparison of the technology characteristics.

DifferencesFeatures/Technology:Modified Device Orthoscan,Inc. TAU 2.0 Mini C-Armsmodel#/sizes, serialnumber prefix:1000-0015, 15x12cm,Serial No. sequence5Txxx1000-0016, 15x15cm,Serial No. sequence5Uxxx1000-0017, 20x20cm,Serial No. sequence5VxxxPredicate Device Orthoscan,Inc. TAU Mini C-Armsmodel#/sizes, and serialnumber prefix;1000-0015, 15x12cm,Serial No. sequence5Nxxx1000-0016, 15x15cm,Serial No. sequence5Pxxx1000-0017, 20x20cm,Serial No. sequence5Rxxx(K183220)Comparison to Predicate,Comments to Differences
Product Codes
Device Classification Nameimage-intensifiedfluoroscopic x-ray system,mobileimage-intensifiedfluoroscopic x-ray system,mobileIdentical
Regulation DescriptionImage-intensifiedfluoroscopic x-ray system.Image-intensifiedfluoroscopic x-ray system.Identical
Classification Product CodeOXOOXOIdentical
Subsequent Product CodeJAAJAAIdentical
Regulation Number892.165892.165Identical
Device ClassIIIIIdentical
Non-Contact DeviceNon-ContactNon-ContactIdentical
510(k) Panel ReviewRadiologyRadiologyIdentical
510(K) NumberNew Proposed Device -unknown at this timeK183220New Proposed Device -unknown at this time
Detector Specifications
CMOS and IGZO Flat PanelDetector/Image ReceptorCsI(T1)/ solid state X-raydetector20x20cm remains CMOSsame as predicate.15x12cm and 15x15cmwill be CMOS or optionalIGZOCsI(T1)/ solid state X-raydetector20x20cm, 15x15cm and15x12cm are CMOSSubstantially Equivalent.The introduction of theoptional IGZO technologywas found to be equal insafety and effectivenessincluding image quality(Essential Performance).IGZO sensor technologydemonstrates equal/better image quality tothat of the predicate. TheIGZO detector featuresthe same scintillatortechnology and equal orimproved active area,pixel pitch, frame rate, X-Ray energy, powerspecifications andmechanical dimensions,and also has identicalimage processing featuresas the predicate.IGZO based detectors aremanufactured usingprocesses that are similarto CMOS detectors. Theslight differences in usedsensor glass technologydoes not have influenceon safety & effectivenessof the product andprovides slightly improvedimage quality at equaldose values as thepredicate.
Detector ResolutionTAU 2.0 2020 =2.0k x2.2kTAU 2.0 1515 =1.5 k x1.5kTAU 2.0 1512 =2.0 k x1.5kTAU 2020 =2.0k x 2.2 kTAU 1515 =1.5k x 1.5kTAU 1512 =2.0 x 1.5kIdentical
Field of View (Full)TAU 2.0 2020 = 8" x 8"TAU 2.0 1515 = 5.5" x5.5"TAU 2.0 1512 = 5.5" x4.3"TAU 2020 = 8" x 8"TAU 1515 = 5.5" x 5.5"TAU 1512 = 5.5" x 4.3"Substantially Equivalent.The 15x12cm model willbe mechanically modifiedto house the 15x15cmIGZO Flat Detector for auseful array area15x12cm. The differencedoes not affect the safetyor efficacy of the device
Field of View (Collimated MagMode)TAU 2.0 2020 = 4" x 4"TAU 2.0 1515 = 4.3" x4.3"TAU 2.0 1512 = 4.3" x3.3"TAU 2020 = 4" x 4"TAU 1515 = 4.3" x 4.3"TAU 1512 = 4.3" x 3.3"Identical to predicate
Detector SizeTAU 2.0 2020 = 20 x20cmTAU 2.0 1515 = 15 x15cmTAU 2.0 1512 = 15 x15cmTAU 2020 = 20 x 20 cmTAU 1515 = 15 x 15 cmTAU 1512 = 15 x 12 cmSubstantially Equivalent.The TAU 2.0 (15x12cm)model will bemechanically modified tohouse the 15x15cm IGZOFlat Detector for a usefularray area 15x12cm. Thedifference does not affectthe safety or efficacy ofthe device.
Useful ArrayTAU 2.0 2020 = 20 x20cmTAU 2.0 1515 = 15 x15cmTAU 2.0 1512 = 15 x15cmTAU 2020 = 20 x 20 cmTAU 1515 = 15 x 15 cmTAU 1512 = 15 x 12 cmSubstantially Equivalent.The TAU 2.0 (15x12cm)model will bemechanically modified tohouse the 15x15cm IGZOFlat Detector for a usefularray area 15x12cm. Thedifference does not affectthe safety or efficacy ofthe device.
Pixel SpacingTAU 2.0 2020 = 99micronsTAU 2.0 1515 = same forCMOS or 100microns forIGZO detectorTAU 2.0 1512 = same forCMOS or 100microns forIGZO detectorTAU 2020 = 99 micronsTAU 1515 = 100 micronsTAU 1512 = 75 micronsSubstantially Equivalent.The difference for theTAU 2.0 15x12 cm IGZOdetector pixel spacingdoes not affect thesafety or efficacy of thedevice.
Dynamic RangeTAU 2.0 same for CMOSor >69dB for IGZOTAU 2020 = 71 dBTAU 1515 = 71 dBTAU 1512 = 70 dBSubstantially EquivalentThe difference in dynamicrange for the IGZOdetector does not affectthe safety or efficacy ofthe device.
DQETAU 2.0 2020 = 70%TAU 2.0 1515 = same forCMOS or 65% for IGZOTAU 2.0 1512 = same forCMOS or 65% for IGZOTAU 2020 = 70%TAU 1515 = 70%TAU 1512 = 70%Substantially Equivalent.The difference in DQE forthe IGZO detector doesnot affect the safety orefficacy of the device.
A/D Conversion16 bit16 bitIdentical
Image Processing Features
Startup time30 sec30 secIdentical
Cine Loop ExportYesYesIdentical
Fluoroscopy Frame Rate30/15/7.5/2 fps30/15/7.5/2 fpsIdentical
Edge EnhancementYesYesIdentical
Post ProcessBrightness/ContrastYesYesIdentical
Adaptive Noise SuppressionAutomaticAutomaticIdentical
Manual Noise Suppression3 Modes3 ModesIdentical
AERC Automatic X-RayTechnique ControlYESYESIdentical
Adaptive Noise FilterNoise reductionNoise reductionIdentical
Save and Auto StoreYESYESIdentical
Last image holdYESYESIdentical
Edge EnhancementYESYESIdentical
Cine Loop Frame Rate30 fps30 fpsIdentical
Snapshot CapabilitiesYESYESIdentical
Post ProcessingBrightness/Contrast ControlYESYESIdentical
Image invertYESYESIdentical
Image ZoomYESYESIdentical
Manual Noise Suppression4 modes4 modesIdentical
Image Documentation:
Wireless Communication (Wi-Fi)/(WLAN)Capable IEEE 802.11Capable IEEE 802.11Identical
DICOM 3 CompliantYesYesIdentical
MPPSCapableCapableIdentical
RDSRYESYESIdentical
Image Capacity26, 00026, 000Identical
Video Capacity14.4 min14.4 minIdentical
Cine Loop ExportYesYesIdentical
TP Link High Gain WirelessUSBOptionOptionIdentical
USB Ports22Identical
Printer option22Identical
Dose Measurement
Air Kerma (US-Standard)YESYESIdentical
DAP (Optional in the US)OptionalOptionalIdentical
Pediatric Features
Pediatric Dose Reduction IDRYESYESIdentical
Adult Dose Reduction IDRYESYESIdentical
Software
Software ArchitectureOrthoTouch ApplicationOrthoMini ApplicationSoftware architecture design is Substantially Equivalent to that of the predicate device Orthoscan, Inc. TAU Mini C-arm (K183220). The OrthoTouch Application provides the main user interface to Orthoscan fluoroscopic X-Ray products, identical to OrthoMini, application. OrthoTouch on LINUX operating system performs equal to OrthoMini.
Graphical User Interface (GUI)OrthoTouch ApplicationOrthoMini ApplicationSubstantially Equivalent GUI application are nearly Identical in workflows to achieve the same basic functionality with new proposed device software application. During verification and validation activities this change did not raise any safety and/or effectiveness concerns. The difference does not affect the safety or efficacy of the device.
Operating systemLINUX Ubuntu 16.04, EmbeddedWindows 8.1 EmbeddedSubstantially Equivalent operating system was shown to support nearly identical workflows to achieve the same basic functionality with new proposed device software application. During verification and validation activities this change did not raise any safety and/or effectiveness concerns. The difference does not affect the safety or efficacy of the device.
Pediatric Workflow SupportYesYesIdentical
MeasurementYesYesIdentical
X-Ray Generator Specifications
Focal Spot42.5 microns42.5 micronsIdentical
kV Range40 - 78 kVp40 - 78 kVpIdentical
mA Range0.04 - 0.160 mA0.04 - 0.160 mAIdentical
Operating ModePulse/ ContinuousPulse/ ContinuousIdentical
Pulse Rate2 to 30 pps2 to 30 ppsIdentical
Beam Pre-filter 0.1mm CuYesYesIdentical
HVL Filter2.5mm(Al Equivalent)2.5mm(Al Equivalent)Identical
Magnification ModeYesYesIdentical
CollimatorTAU 1512 Fixed Aperture@ Fixed SID(Normal, Mag)TAU 1515 Fixed Aperture@ Fixed SID(Normal, Mag)TAU 2020Stepless Collimator withFixed SID(4 Leaf, 2 Axis)TAU 1512 Fixed Aperture @Fixed SID(Normal, Mag) TAU 1515Fixed Aperture @ Fixed SID(Normal, Mag)TAU 2020Stepless Collimator withFixed SID(4 Leaf, 2 Axis)Identical
Physical Dimensions:
Source to Image17.7" (45cm)17.7" (45cm)Identical
Free space13.8"13.8"Identical
Arc Depth20"20"Identical
Pivot430°430°Identical
Lateral RotationB + Y axis (Wig-Wag)320°320°Identical
Orbital Rotation160°160°Identical
Vertical Range26.5"26.5"Identical
Distance to Cabinetmax 68"max 68"Identical
Distance to Wheel basemax 45"max 45"Identical
Weight475lb475lbIdentical
Height49"49"Identical
Footprint28" x 33"28" x 33"Identical
Power System
Input Power250W AC to DC 24Vdc,90-264 VAC @ 50/60Hzpower supply medicalgrade.90-253 VAC @ 47-63 HzSubstantially equivalent.
EMI FilterYesFN2060B-6-06Substantially Equivalent.TAU 2.0 consist of an ACto DC 24vdc powersupply with in line filterand isolation.
AC Power CordRetractable (25ft)Retractable (25ft)Identical
Isolation TransformerYesYesSubstantially Equivalent.TAU 2.0 consist of an ACto DC 24vdc power supplywith in line filter andisolation.
UPS (Battery Backup)TAU 2020 OptionalTAU 1515 OptionalTAU 1512 OptionalTAU 2020 OptionalTAU 1515 OptionalTAU 1512 OptionalIdentical
Laser Alignment:
Laser position indicatorYesYesIdentical
Surgical Lights:
Light bar assembliesYesYesIdentical

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Image /page/7/Picture/0 description: The image shows the logo for Orthoscan. The logo consists of a stylized letter "C" in blue, followed by a vertical blue line. To the right of the line is the word "ORTHOSCAN" in black, with each letter evenly spaced.

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Image /page/8/Picture/0 description: The image shows the word "ORTHOSCAN" in a simple, sans-serif font. To the left of the word is a blue vertical line and a blue abstract symbol that resembles a stylized letter "C". The overall design is clean and modern, with a focus on simplicity and readability.

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Image /page/9/Picture/0 description: The image shows the logo for Orthoscan. The logo consists of a stylized letter "C" in blue, followed by a vertical blue line. To the right of the line is the word "ORTHOSCAN" in black sans-serif font.

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Image /page/10/Picture/0 description: The image shows the word "ORTHOSCAN" in a sans-serif font. The letters are spaced out evenly and are all uppercase. To the left of the word is a blue graphic that looks like a stylized letter "C" and a vertical line.

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O R T H O S C A N

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Image /page/12/Picture/0 description: The image shows the logo for Orthoscan. The logo consists of a stylized blue "C" shape on the left, followed by a vertical blue line. To the right of the line is the word "ORTHOSCAN" in a simple, sans-serif font.

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Image /page/13/Picture/0 description: The image shows the logo for Orthoscan. The logo consists of a stylized letter 'e' in blue, followed by a vertical blue line. To the right of the line is the word 'ORTHOSCAN' in all capital letters.

Conclusion of Table Information:

The changes and differences of the proposed Orthoscan, Inc. TAU Mini C-Arm described in the table do not change the control mechanism, operating principle, energy type, or intended use found on the predicate device Orthoscan, Inc. TAU Mini C-Arm (K183220).

Adverse Effects on Health:The proposed modified Orthoscan, Inc. TAU Mini C-arm's potential radiation, mechanical, and electrical hazards are identified and analyzed as part of risk management, and controlled by meeting the applicable CDRH 21CFR subchapter J performance requirements, Recognized Consensus Standards, designing and manufacturing under Orthoscan, Inc. Quality System, and system verification and validation testing ensure the device performs to the product specifications and its intended use. The adherence to these applicable regulations and certification to Recognized Consensus Standards that apply to this product provides the assurance of device safety and effectiveness.
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Applicable Standards: Annex II of the European Medical Devices Directive (MDD) 93/42/EEC.

Please see EC Certificate for predicate devices EC Declaration of Conformity in VOL 009 FILES 003 and FILE 009

EN ISO 13485 Medical devices - Quality management systems - Requirements for regulatory purposes. Date: 2016. Please see Certificate in Volume 009 File 013

IEC 60601-1 Medical Electrical Equipment, General Requirements for Safety IEC 60601-1:200 5 (Third Edition) + CORR. 1:2006 + CORR. 2:2007 + A1:2012 (or IEC 60601-1: 2012 reprint). No Recognized Conformance Standard but is general basis of AAMI/ANSI ES60601-1 conformance standard 19-4.

Please see CB test report in VOL_017_EMC-Eectrical Safety FILE007

IEC 60601-1-2 MEDICAL ELECTRICAL EQUIPMENT - Part 1-2: General requirements for basic safety and essential performance - Collateral Standard: Electromagnetic disturbances - Requirements and tests

IEC 60601-1-2:2014 Conformance Standard #19-8

Please see CB test report in VOL_017_FILE017 and FILE019

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ORTHOSCAN

IEC 60601-1-3

Medical Electrical Equipment, Radiation Protection in Diagnostic X-ray Equipment

Edition 2.1, Date: 2013 Conformance Standard #12-269 Please see CB test report in VOL017 EMC-Eectrical Safety_FILE009

60601-2-28 Edition 2 (2010/03/10) Particular requirements for the basic safety and essential performance of X-ray tube assemblies for medical diagnosis. Conformance Standard #12-309

Please see CB test report in VOL017 EMC-Electrical Safety FILE011

IEC 60601-2-54

Medical electrical equipment, Part 2-54: Particular requirements for the basic safety and essential performance of X-ray equipment for radiography and radioscopy

Edition 1.1, 2015 #12-296

Please see CB test report in VOL017_EMC-Electrical Safety FILE013

Orthoscan understands that the FDA will accept declarations of conformity, in support of premarket submissions, to [Rec # 12-296] until September 28, 2021. After this transition period, declarations of conformity to [Rec # 12-296] will not be accepted.

IEC 60825-1

Safety of laser products, Equipment Safety, requirements, and user guide

Edition 2.0, Date: 2007-03-30 Conformance Standard #12-273

See predicate (K183220) Test reports VOL 018 Performance testing

ISO 14971

Medical devices - Application of risk management to medical devices

Edition 2.0, Date: 2007-03-01 Conformance Standard #5-40

Compliance is shown by risk management and software Verification and Validation documentation see Volume 016_Software.

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Image /page/15/Picture/0 description: The image shows the logo for Orthoscan. The logo consists of a stylized letter "C" in blue, followed by a vertical blue line. To the right of the line is the word "ORTHOSCAN" in black, all caps.

Determination of Substantial Equivalence:

Summary Bench Testing

Verification and Validation including hazard mitigations executed resulted in demonstrated system that met Design Input and user needs.

The device was tested by notified test laboratory resulting in device being certified compliant with 60601-1 ED 3 series, including IEC 60601-2-54. Further, the device met all applicable sections of 21 CFR Subchapter J performance standards.

The proposed modified Orthoscan, Inc. TAU Mini C-Arm development occurred under our design control processes, software development processes, and overall quality management system. They included but are not limited to;

  • . Risk Analvsis
  • Required reviews ●
  • Design reviews ●
  • Component testing ●
  • Integration testing ●
  • . Performance testing
  • Safety testing ●
  • . Product use testing

Performance bench testing included:

Non-clinical testing methods specific to quidance for submission of 510(k)s for Solid State X-Ray Imaging Devices (SSXI); demonstrating system, and imaging performance. Non-clinical image and dose Lab testing, were employed. Anthropomorphic (PMMA material) phantoms and anatomical simulation phantoms were employed, images were taken by both the modified and the predicate device Orthoscan, Inc. TAU (K183220). Numerous Image comparison sets were taken and a Radiologist performed an assessment of individual images arranged in groups of image sets. His conclusion was the image quality at same or similar patient dose rates will result in a slight improvement in patient care (images) for the proposed modified TAU device over the Predicate device. Therefore, Orthoscan, Inc. believes the TAU Mini C-arm image quality, safety and effectiveness to be substantially equivalent to that of the predicate device Orthoscan, Inc. TAU (K183220).

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Image /page/16/Picture/0 description: The image shows the logo for Orthoscan. The logo consists of a stylized letter "C" in blue, followed by a vertical blue line. To the right of the line is the word "ORTHOSCAN" in black, with each letter evenly spaced.

Summary of Clinical Test Data:

Orthoscan, Inc. TAU mobile fluoroscopic Mini C-arm system did not require live human clinical studies to support substantial equivalence in accordance with the TAU quidance Documents, UCM089742- Premarket Assessment of Pediatric Medical Devices May 24, 2014 and UCM 302938- Pediatric Information for X-ray Imaging Device Premarket Notifications Nov 28, 2017.

Therefore, Orthoscan, Inc. conducted a lab test image comparison study employing the use of anthropomorphic phantoms in establishing substantial equivalence based on the modifications to the proposed device and the bench data taken with Orthoscan, Inc. TAU Mini C-Arm in comparison to the predicate Orthoscan, Inc. TAU Mini C-Arm (K183220). Evaluation of the images was conducted by a board-certified Radiologist. His conclusion was the image quality at the same or equivalent patient dosage will result in a slight improvement in patient care (images) for the proposed modified TAU device over the Predicate device. His comparison of the dose and images provided further evidence in addition to the laboratory performance data that the complete system works as intended and is substantially equivalent to the predicate device.

Conclusion:

Orthoscan, Inc. considers the proposed modified Orthoscan, Inc. TAU Mini C-arm to be as safe, as effective, and performs substantially equivalent to the predicate device Orthoscan, Inc. TAU Mini C-arm (K183220) in accordance with its labeling.

§ 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.