K Number
K223010
Device Name
Portable X-ray System
Date Cleared
2023-01-17

(110 days)

Product Code
Regulation Number
872.1800
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Portable X-ray System is used as a portable, extra oral x-ray source for producing diagnostic x-ray images using conventional film, PSP (phosphor plates) or digital sensors. It is intended for adult and pediatric patients. This equipment is available only to trained and qualified dentist or dental technician.
Device Description
The portable X-Ray system, Canis014D07, is intended to be used by trained dentists and dental technicians as an extra-oral x-ray source for producing diagnostic x-ray images using intraoral image receptors. The images presented in the product screen are for preview purposes only, not for imaging diagnosis. It also includes accessories, which are battery, recharging unit and hand switch.
More Information

No
The summary does not mention AI, ML, or any related concepts like deep learning, neural networks, or algorithms that would suggest the use of AI/ML for image analysis, processing, or other functions beyond basic preview. The focus is on the hardware and its function as an X-ray source.

No.
The device is described as an X-ray system used to produce diagnostic images, not to treat or alleviate a medical condition.

No

The device is an x-ray source used to produce diagnostic images, but it does not perform diagnosis itself. The description explicitly states that "The images presented in the product screen are for preview purposes only, not for imaging diagnosis."

No

The device description explicitly states it is a "Portable X-ray System" and includes hardware components like a battery, recharging unit, and hand switch. It is an extra-oral x-ray source, which is a physical device.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD devices are used to examine specimens derived from the human body. This device is an X-ray system that produces images of the inside of the body, not from analyzing samples like blood, urine, or tissue.
  • The intended use clearly states it's for producing diagnostic x-ray images. This is a form of medical imaging, not in vitro diagnostics.
  • The device description reinforces its use as an extra-oral x-ray source. This is consistent with imaging, not laboratory testing of specimens.

The information provided describes a medical imaging device used for diagnosis through visualization, not through the analysis of biological samples.

N/A

Intended Use / Indications for Use

The Portable X-ray System is used as a portable, extra oral x-ray source for producing diagnostic x-ray images using conventional film, PSP (phosphor plates) or digital sensors. It is intended for adult and pediatric patients. This equipment is available only to trained and qualified dentist or dental technician.

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

EHD

Device Description

The portable X-Ray system, Canis014D07, is intended to be used by trained dentists and dental technicians as an extra-oral x-ray source for producing diagnostic x-ray images using intraoral image receptors. The images presented in the product screen are for preview purposes only, not for imaging diagnosis. It also includes accessories, which are battery, recharging unit and hand switch.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray

Anatomical Site

Dental

Indicated Patient Age Range

adult and pediatric patients

Intended User / Care Setting

trained and qualified dentist or dental technician

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

Validation was performed for overall operation by taking and reviewing test images. The nonclinical tests demonstrate that the device is as safe, as effective, and performs as well as the primary predicate.
The subject of this premarket submission, the test images were reviewed by a professional with adequate qualifications, and that the images were of diagnostic quality did not require more clinical studies.

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

The performance test for the subject device (Canis014D07) and the predicate device (PORT-X IV, K172810) are identical in the indications for use, patient population, intended operation environment, and electrical safety. They are similar in technical specification. The differences between the proposed device and the predicate device will not raise any new risk to affect safety or effectiveness.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K172810

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

K081664

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 872.1800 Extraoral source x-ray system.

(a)
Identification. An extraoral source x-ray system is an AC-powered device that produces x-rays and is intended for dental radiographic examination and diagnosis of diseases of the teeth, jaw, and oral structures. The x-ray source (a tube) is located outside the mouth. This generic type of device may include patient and equipment supports and component parts.(b)
Classification. Class II.

0

January 17, 2023

Image /page/0/Picture/1 description: The image contains 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 a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

iRay Technology Taicang Ltd. % Wei Pan Registration and Regulatory Affairs Director No.33 Xinggang Rd. Taicang Port Economic & Technological Development Zone Taicang, Jiangsu 215434 CHINA

Re: K223010

Trade/Device Name: Portable X-ray System Regulation Number: 21 CFR 872.1800 Regulation Name: Extraoral source x-ray system Regulatory Class: Class II Product Code: EHD Dated: December 19, 2022 Received: December 19, 2022

Dear Wei Pan:

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 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,

2023.01.17
Lu Jiang 21:51:54
-05'00'

Lu Jiang, Ph.D. Assistant Director Diagnostic X-Ray Systems Team DHT8B: Division of Radiological Imaging Devices and Electronic Products OHT8: Office of Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known) K223010

Device Name Portable X-ray System

Indications for Use (Describe)

The Portable X-ray System is used as a portable, extra oral x-ray source for producing diagnostic x-ray images using conventional film, PSP (phosphor plates) or digital sensors. It is intended for adult and pediatric patients. This equipment is available only to trained and qualified dentist or dental technician.

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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iRay Imaging Technology (Haining) Limited

510 (k) SUMMARY OF SAFETY AND EFFECTIVENESS

4

510 (k) SUMMARY OF SAFETY AND EFFECTIVENESS

(As Required by 21 CFR 807.92)

1. Date Prepared [21 CFR 807.92(a)(1)]

Sep. 18, 2022

2. Submitter's Information [21 CFR 807.92(a)(1)]

Company Name:iRay Technology Taicang Ltd.
Company Address:No.33 Xinggang Rd., Taicang Port Economic &
Technological Development Zone
Contact Person:Wei Pan
Phone:+86 21 50720560
Fax:+86 21 50720561
Email:wei.pan@iraygroup.com

3. Trade Name, Common Name, Classification [21 CFR 807.92(a)(2)]

Trade Name:Portable X-ray System
Common Name:Extraoral Source X-ray System
Model Name:Canis014D07
Classification Name:Extraoral Source X-ray System
Product Code:EHD
Regulation Number:21 CFR 872.1800
Device Class:Class II

4. Identification of Predicate Devices(s) [21 CFR 807.92(a)(3)[

The identification predicates within this submission are as follows:

Manufacturer:GENORAY Co., Ltd.
Trade Name:PORT-X IV
Model Name:PORT-X IV
Product Code:EHD
Classification Name:Extraoral Source X-ray System
Regulation Number:21 CFR 872.1800
Device Class:Class II
FDA 510 (k) #:K172810

5

The identification of reference device within this submission are as follows:

Manufacturer:Aribex, Inc.
Trade Name:NOMAD Pro X-ray system
Model Name:NOMAD Pro
Product Code:EHD
Classification Name:Extraoral Source X-ray System
Regulation Number:21 CFR 872.1800
Device Class:Class II
FDA 510 (k) #:K081664

5. Description of the Device [21 CFR 807.92(a)(4)]

The portable X-Ray system, Canis014D07, is intended to be used by trained dentists and dental technicians as an extra-oral x-ray source for producing diagnostic x-ray images using intraoral image receptors. The images presented in the product screen are for preview purposes only, not for imaging diagnosis. It also includes accessories, which are battery, recharging unit and hand switch.

6. Intended Use [21 CFR 807.92(a)(5)]

6.1. Indications for use

The portable X-Ray system is used as a portable, extra oral x-ray source for

producing diagnostic x-ray images using conventional film, PSP

(phosphor plates) or digital sensors. It is intended for adult and pediatric patients.

This equipment is available only to trained and qualified dentist or dental technician.

6.2. Suitable patient

The Canis014D07 is intended for adult and pediatric patients.

7. Technological Characteristic [21 CFR 807.92(a)(6)]

ItemPredicate Device:Reference Device:Proposed Device:
PORT-X IVNOMAD ProCanis014D07
Model namePORT-X IVNOMAD ProCanis014D07
510(K) NumberK172810K081664K223010
Classification
NameExtraoral Source X-ray
SystemSameSame
Product CodeEHDSameSame
ItemPredicate Device:Reference Device:Proposed Device:
PORT-X IVNOMAD ProCanis014D07
Regulation Number21 CFR 872.1800SameSame
PanelDentalSameSame
Classification:IISameSame
Installation Type:PortablehandheldPortable
Indications for usePORT-X IV is a
portable X-ray system
to be used by trained
dentists and dental
technicians as a mobile,
extraoral x-ray source
for producing
diagnostic x-ray images
using intraoral image
receptors. It is intended
for both adult and
pediatric subjects.The NOMAD Pro X-
ray System is intended
to be used by trained
dentists and dental
technicians as an
extraoral X-ray source
for producing
diagnostic X-ray
images using intraoral
image receptors. Its use
is intended for both
adult and pediatric
subjectsThe Portable X-ray
System is used as a
portable, extra oral x-
ray source for
producing diagnostic x-
ray images using
conventional film, PSP
(phosphor plates) or
digital sensors. It is
intended for adult and
pediatric patients.
This equipment is
available only to
trained and qualified
dentist or dental
technician.
X-ray MonoblockTube Voltage : 70 kVTube Voltage : 60 kV
fixedTube Voltage : 70 kV
Tube Current : 2 mATube Current : 2.5 mATube Current : 2 mA
Stationary AnodeStationary AnodeStationary Anode
Focus : 0.4 mmFocus : 0.4 mmFocus : 0.4 mm
Target Angle : 12.5°
Total Filtration : 2.2Target Angle : 12.5°
Total Filtration :
1.5mmAlTarget Angle : 12.5°
Total Filtration : 3.1
mmAlmmAl
(Inherent Filtration : 1.0
mmAl;(Inherent Filtration : 1.0
mmAl;
Additional Filtration :
1.2 mmAl)Additional Filtration :
2.1 mmAl)
Exposure controllerExposure Time :
0.05~1.6 sec.Exposure Time : 0.02~1
sec.Exposure Time : 0.04~2
sec.
BatteryRechargeable lithium
batterySameSame
DisplayLCD panel DispalySameSame
Dimensions(140 × 173 × 254)mm(280×165×296)mm(197×139×240) mm
Weight1.6 kg2.5kg2.2kg
ItemPredicate Device:
PORT-X IVReference Device:
NOMAD ProProposed Device:
Canis014D07
Cooling:Air coolingSameSame
Protection against
matter/WaterIPX0SameSame
Operation:Temperature: 10 to 35°CTemperature: -5 to 40°CTemperature: 10 to 40°C
Humidity: 30 to 85%
(Non-Condensing)Humidity: 10 to 80%
(Non-Condensing)Humidity: 10 to 90%
(Non-Condensing)
Atmospheric pressure:
70 to 106 kPaAtmospheric pressure:
70 to 106 kPaAtmospheric pressure:
70 to 106 kPa
Altitude: Max. 3000
metersAltitude: Max. 3000
metersAltitude: Max. 3000
meters
Humidity: 10 to 90%
(Non-Condensing)Humidity: 95% (Non-
Condensing)Humidity: 5% ~ 95%
(Non-Condensing)
Atmospheric pressure:
50 ~ 106 kPaAtmospheric pressure:Atmospheric pressure:
70kPa~106kPa
Altitude: Max. 3000
metersAltitude: Max. 3000
metersAltitude: Max. 3000
meters
Software

6

[510(k)] Application

7

[510(k)] Application

8. Safety, EMC and Performance data comparison to Predicate device

  • 8.1 Safety, EMC and Performance data
    Canis014D07 complies with industry standards such as IEC 60601-1 Series and 21 CFR 1020.30 and 21CFR 1020.31 to minimize electrical, mechanical and radiation hazards.

  • Electrical, mechanical, environmental safety and performance testing which are a) mentioned in the standard ANSI ES:60601-1, IEC 60601-1-3 and IEC 60601-2-65 were performed.

  • EMC testing was conducted in accordance with standard IEC 60601-1-2. b)

  • Performance testing performed according to FDA 21 CFR 1020.30, 21 CFR c) 1020.31 standards, Software Validation, nonclinical Evaluation. All test

5 of 7

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results were fulfill the requirements.

  • 8.2 Summary of Performance Testing
    The performance test for the subject device (Canis014D07) and the predicate device (PORT-X IV, K172810) are identical in the indications for use, patient population, intended operation environment, and electrical safety. They are similar in technical specification. The differences between the proposed device and the predicate device will not raise any new risk to affect safety or effectiveness.

9. Nonclinical study

  • 9.1 Electrical Safety and EMC Summary
    The electrical safety and EMC data included in the submission is in compliance with the following FDA recognized standards:

  • ANSI AAMI ES60601-1:2005 + A1:2012 + A2:2021 a)

  • b) IEC 60601-1-3:2008 + A1:2013 + A2:2021

  • IEC 60601-2-65:2012 + A1:2017 C)

  • d) IEC 60601-1-2:2014

9.2 Bench Testing Summary

The verification test results showed compliance with the above standards. Validation was performed for overall operation by taking and reviewing test images. The nonclinical tests demonstrate that the device is as safe, as effective, and performs as well as the primary predicate.

  • 9.3 Summary of Clinical Tests:
    The subject of this premarket submission, the test images were reviewed by a professional with adequate qualifications, and that the images were of diagnostic quality did not require more clinical studies.

10. FDA Guidance Documents Utilized

  • Format for Traditional and Abbreviated 510(k)s Guidance issued on September 13, a) 2019.
  • Radio Frequency Wireless Technology in Medical Devices b)
  • Guidance for Medical X-ray Imaging Devices Conformance with IEC Standards c)

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  • Guidance for the Content of Premakret Submissions for Software Contained d) in Medical Devices, issued Nov 28, 2017
  • e) Pediatric Information for X-ray Imaging Device Premarket Notifications, issued November 28, 2017
  • a) Content of Premarket Submissions for Management of Cybersecurity in Medical Devices, issued October 2, 2014

11. Conclusion [21 CFR 807.92(b)(3)]

In accordance with the Federal Food, Drug and Cosmetic Act, 21 CFR Part 807 and based on the information provided in this premarket notification, the manufacturer, iRay Imaging Technology (Haining) Limited concludes that Canis014D07 is substantially equivalent to predicate device with regards to safety and effectiveness.