K Number
K213351
Device Name
ds Head 32ch 3.0T
Date Cleared
2021-10-29

(21 days)

Product Code
Regulation Number
892.1000
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The dS Head 32ch 3.0T MR Coil is intended to be used in conjunction with a Philips 3.0T Magnetic Resonance Scanner to produce diagnostic images of the head on adult and pediatric patients that can be interpreted by a trained physician.
Device Description
The subject dS Head 32ch 3.0T Coil is a receive-only, phased-array radiofrequency (RF) coil designed for high-resolution head examinations on adult and pediatric patients. The coil is intended for use with Philips magnetic resonance (MR) scanners with a 3.0 tesla magnetic field strength.
More Information

No
The summary describes a receive-only MR coil and its performance characteristics, with no mention of AI or ML in the device description, intended use, or performance studies.

No
The device is used to produce diagnostic images, not to treat a condition or disease.

Yes
The device is described as producing "diagnostic images of the head" that "can be interpreted by a trained physician," explicitly stating its role in diagnosis.

No

The device description explicitly states it is a "receive-only, phased-array radiofrequency (RF) coil," which is a hardware component used in Magnetic Resonance imaging. The performance studies also focus on hardware-related criteria like surface heating, electrical/mechanical safety, and biocompatibility.

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

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections.
  • Device Function: The dS Head 32ch 3.0T MR Coil is a component of a Magnetic Resonance (MR) imaging system. It is used to produce images of the head within the body, not to analyze samples taken from the body.
  • Intended Use: The intended use is to produce diagnostic images of the head, which are then interpreted by a physician. This is a form of in vivo (within the living body) diagnostic imaging.

Therefore, the device falls under the category of a medical imaging device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The dS Head 32ch 3.0T MR Coil is intended to be used in conjunction with a Philips 3.0T Magnetic Resonance Scanner to produce diagnostic images of the head on adult and pediatric patients that can be interpreted by a trained physician.

Product codes

MOS

Device Description

The subject dS Head 32ch 3.0T Coil is a receive-only, phased-array radiofrequency (RF) coil designed for high-resolution head examinations on adult and pediatric patients. The coil is intended for use with Philips magnetic resonance (MR) scanners with a 3.0 tesla magnetic field strength.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Magnetic Resonance (MR)

Anatomical Site

head

Indicated Patient Age Range

adult and pediatric patients

Intended User / Care Setting

trained physician

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 subject dS Head 32ch 3.0T Coil met all safety and performance criteria outlined in the FDA guidance "Magnetic Resonance (MR) Receive-only Coil – Performance Criteria for Safety and Performance Based Pathway" issued December 11, 2020:

  • Image Signal to Noise and Image Uniformity characterization (NEMA MS 1, 3, 9 and IEC 62464-1)
  • Surface heating (ANSI/AAMI ES 60601-1 and NEMA MS 14)
  • Acquired Image quality was assessed by a U.S. Board Certified radiologist to confirm images produced on the subject coil are sufficient quality for diagnostic use on both adult and pediatric patient populations
  • Presence of decoupling mechanisms
  • EMC – Immunity, electrostatic discharge (IEC 60601-1-2)
  • General electrical/mechanical safety (IEC 60601-2-33 and AAMI/ANSI ES 60601-1)
  • Biocompatibility evaluation (ISO 10993 series)

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

Not Found

Predicate Device(s)

K082916

Reference Device(s)

K110151/K193215

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 892.1000 Magnetic resonance diagnostic device.

(a)
Identification. A magnetic resonance diagnostic device is intended for general diagnostic use to present images which reflect the spatial distribution and/or magnetic resonance spectra which reflect frequency and distribution of nuclei exhibiting nuclear magnetic resonance. Other physical parameters derived from the images and/or spectra may also be produced. The device includes hydrogen-1 (proton) imaging, sodium-23 imaging, hydrogen-1 spectroscopy, phosphorus-31 spectroscopy, and chemical shift imaging (preserving simultaneous frequency and spatial information).(b)
Classification. Class II (special controls). A magnetic resonance imaging disposable kit intended for use with a magnetic resonance diagnostic device 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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Invivo Corporation (Business Trade Name: Philips) % Prithul Bom Most Responsible Person Regulatory Technology Services, LLC 1000 Westgate Drive, Suite 510k SAINT PAUL, Minnesota 55114

Re: K213351

Trade/Device Name: ds Head 32ch 3.0T Regulation Number: 21 CFR 892.1000 Regulation Name: Magnetic resonance diagnostic device Regulatory Class: Class II Product Code: MOS Dated: October 7, 2021 Received: October 8, 2021

Dear Prithul Bom:

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

1

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/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,

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) K213351

Device Name dS Head 32ch 3.0T

Indications for Use (Describe)

The dS Head 32ch 3.0T MR Coil is intended to be used in conjunction with a Philips 3.0T Magnetic Resonance Scanner to produce diagnostic images of the head on adult and pediatric patients that can be interpreted by a trained physician.

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 K213351

prepared in accordance with 21 CFR §807.92

Date Prepared:October 26, 2021
Manufacturer:Invivo Corporation
(Business Trade Name: Philips)
3545 SW 47th Ave
Gainesville, FL 32608
Establishment Registration #1056069
Primary Contact
Person:Sarah Pleaugh
Regulatory Affairs Specialist
sarah.pleaugh@philips.com
Secondary Contact
Person:Ann Lebar
Head of Regulatory Affairs
ann.lebar@philips.com
Device Name:dS Head 32ch 3.0T
Classification:Classification Name:Coil, Magnetic Resonance, Specialty
Classification Regulation:21 CFR 892.1000
Classification Panel:Radiology
Device Class:Class II
Primary Product Code:MOS
Primary Predicate
Device:Trade name:Models HRB-127-32 High Resolution
Brain Coil
Manufacturer:Invivo Corporation
510(k) Clearance:K082916
Classification Name:Coil, Magnetic Resonance, Specialty
Classification Regulation:21 CFR 892.1000
Classification Panel:Radiology
Device Class:Class II
Primary Product Code:MOS
Reference Device:Trade name:Achieva, Intera, Ingenia, Ingenia CX,
Ingenia Elition, and Ingenia Ambition MR
Systems
Manufacturer:Philips Medical Systems Nederland B.V.
510(k) Clearance:K110151/K193215
Classification Name:Magnetic Resonance Diagnostic Device
Classification Regulation:21CFR 892.1000
Classification Panel:Radiology
Device Class:Class II
Product Codes:LNH, LNI, MOS
Device
Description:The subject dS Head 32ch 3.0T Coil is a receive-only, phased-array
radiofrequency (RF) coil designed for high-resolution head examinations
on adult and pediatric patients. The coil is intended for use with Philips
magnetic resonance (MR) scanners with a 3.0 tesla magnetic field
strength.
Indications for
Use:The dS Head 32ch 3.0T MR Coil is intended to be used in conjunction
with a Philips 3.0T Magnetic Resonance Scanner to produce diagnostic
images of the head on adult and pediatric patients that can be
interpreted by a trained physician.
Fundamental
Scientific
Technology:The subject dS Head 32ch 3.0T MR Coil is similar in design, material, and
energy source to the legally marketed predicate device, Models HRB-
127-32 High Resolution Brain Coil (K082916). The subject and predicate
devices are based on the following same technological elements:
· Prescription use
· Coil designs are 32-channel, receive-only, phased array RF coils
· Compatible field strength (3.0T)
· Decoupling methodology
· Patient contacting materials are known materials that have been
assessed for compliance with recognized biocompatibility standards
· Energy source for the coils is the MRI scanner
· Coils designed for imaging the head anatomy
· Coil mechanical design is a split housing to facilitate patient
positioning
· Manufactured for use with Philips MRI scanners
The following technological differences exist between the subject and
predicate devices:
· Predicate device is an analog coil whereas the subject dS Head 32ch
3.0T MR coil is a digital coil.
· Different system cable connectors to interface with the digital MRI
scanners.
These differences in technology are supported by the MR system and
digital coil designs cleared in the reference device Philips Ingenia MR
Systems (K110151/K193215), as well as the safety and performance
testing provided in this submission. The subject coil performs as
intended and does not raise new issues of safety or effectiveness.
Summary of Non-
Clinical and Clinical
Performance Data:The subject dS Head 32ch 3.0T Coil met all safety and performance
criteria outlined in the FDA guidance "Magnetic Resonance (MR) Receive-
only Coil – Performance Criteria for Safety and Performance Based
Pathway" issued December 11, 2020:
- Image Signal to Noise and Image Uniformity characterization
(NEMA MS 1, 3, 9 and IEC 62464-1)
- Surface heating (ANSI/AAMI ES 60601-1 and NEMA MS 14)
- Acquired Image quality was assessed by a U.S. Board Certified
radiologist to confirm images produced on the subject coil are
sufficient quality for diagnostic use on both adult and pediatric
patient populations
- Presence of decoupling mechanisms
- EMC – Immunity, electrostatic discharge (IEC 60601-1-2)
- General electrical/mechanical safety (IEC 60601-2-33 and
AAMI/ANSI ES 60601-1)
- Biocompatibility evaluation (ISO 10993 series)
Substantial
Equivalence
Conclusion:Substantial equivalence of the dS Head 32ch 3.0T MR Coil is
demonstrated through the Safety and Performance Based Pathway for
magnetic resonance (MR) receive-only coils. The subject device has the
same indications for use and technological characteristics as the
predicate and reference devices. Substantially equivalent performance is
demonstrated by meeting all criterion in the guidance "Magnetic
Resonance (MR) Receive-only Coil – Performance Criteria for Safety and
Performance Based Pathway" issued on December 11, 2020.

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PHILIPS

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PHILIPS