K Number
K242847
Device Name
EXSYS DEXi (EXSYS DEXi-D401S-FRM); EXSYS DEXi (EXSYS DEXi-A401S-FRM); EXSYS DEXi (EXSYS DEXi-D402S-FRM); EXSYS DEXi (EXSYS DEXi-A402S-FRM); EXSYS DEXi (EXSYS DEXi-D401P-FRM); EXSYS DEXi (EXSYS DEXi-A401P-FRM); EXSYS DEXi (EXSYS DEXi-D402P-FRM); EXSYS DEXi (EXSYS DEXi-A402P-FRM); EXSYS DEXi (EXSYS DEXi-D503T-FRM); EXSYS DEXi (EXSYS DEXi-A503T-FRM); EXSYS DEXi (EXSYS DEXi-D401S-FRA); EXSYS DEXi (EXSYS DEXi-D402S-FRA); EXSYS DEXi (EXSYS DEXi-D401P-FRA); EXSYS DEXi (EXSYS DEXi-D402P-FRA);
Manufacturer
Date Cleared
2024-10-23

(33 days)

Product Code
Regulation Number
892.1680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The EXSYS DEXi is a diagnostic X-ray system intended for use in generating radiographic images of human anatomy for general purpose. The system obtains necessary information of patient's anatomical structure by an image processing (workstation) after process of examination using radiation exposure with DR. This system is not intended for mammography applications.
Device Description
The EXSYS DEXi is a diagnostic X-ray system intended for use in generating radiographic images of human anatomy for general purpose. The system obtains necessary information of patient's anatomical structure by an image processing (workstation) after process of examination using radiation exposure with DR. This system is not intended for mammography applications. The EXSYS DEXi composed of a x-ray generator, tube, collimator, tube stand, bucky stand, patient table, flat panel detector and console.
More Information

No
The summary mentions "image processing" but does not include any terms like AI, ML, DNN, or provide details about training or test sets, which are typical indicators of AI/ML use in medical devices.

No
The device is described as a "diagnostic X-ray system," indicating its purpose is to image and assist in identifying conditions, not to treat them.

Yes
The "Intended Use / Indications for Use" and "Device Description" sections explicitly state: "The EXSYS DEXi is a diagnostic X-ray system intended for use in generating radiographic images of human anatomy for general purpose."

No

The device description explicitly lists multiple hardware components including an x-ray generator, tube, collimator, tube stand, bucky stand, patient table, and flat panel detector, in addition to the console and image processing workstation.

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

Here's why:

  • Intended Use: The intended use clearly states it's a "diagnostic X-ray system intended for use in generating radiographic images of human anatomy for general purpose." This describes an imaging device that visualizes internal structures, not a device that analyzes samples (like blood, urine, or tissue) outside the body.
  • Device Description: The components listed (x-ray generator, tube, collimator, etc.) are typical of an X-ray imaging system. There are no components mentioned that would be used for analyzing biological samples.
  • Input Imaging Modality: The input is X-ray, which is an imaging modality, not a method for analyzing biological samples.
  • Clinical Data: The summary of clinical data states "Not Applicable. Clinical studies are unnecessary to validate the safety and effectiveness." This is consistent with a device that is primarily focused on image acquisition and processing for visualization, rather than a device that provides a diagnostic result based on sample analysis, which often requires clinical validation.

IVD devices are specifically designed to examine specimens derived from the human body (like blood, urine, tissue, etc.) to provide information for diagnostic purposes. The EXSYS DEXi operates by generating images of the body itself using radiation.

N/A

Intended Use / Indications for Use

The EXSYS DEXi is a diagnostic X-ray system intended for use in generating radiographic images of human anatomy for general purpose. The system obtains necessary information of patient's anatomical structure by an image processing (workstation) after process of examination using radiation exposure with DR. This system is not intended for mammography applications.

Product codes

KPR

Device Description

The EXSYS DEXi is a diagnostic X-ray system intended for use in generating radiographic images of human anatomy for general purpose. The system obtains necessary information of patient's anatomical structure by an image processing (workstation) after process of examination using radiation exposure with DR. This system is not intended for mammography applications.

The EXSYS DEXi composed of a x-ray generator, tube, collimator, tube stand, bucky stand, patient table, flat panel detector and console.

Mentions image processing

Yes

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

X-ray

Anatomical Site

human anatomy

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Applicable

Description of the test set, sample size, data source, and annotation protocol

Not Applicable

Summary of Performance Studies

Non-clinical performance studies were conducted. The device complies with the following international and FDA-recognized consensus standards: ISO 14971: Third Edition 2019-12, IEC 60601-1 Edition 3.2 2020-08 CONSOLIDATED VERSION, IEC 60601-1-2 Edition 4.1 2020-09 CONSOLIDATED VERSION, IEC 60601-1-6 Edition 3.2 2020-07 CONSOLIDATED VERSION, IEC 62366-1 Edition 1.1 2020-06 CONSOLIDATED VERSION, IEC 60601-1-3 Edition 2.2 2021-01 CONSOLIDATED VERSION, IEC 60601-2-28 Edition 3.0 2017-06, IEC 60601-2-54 Edition 1.2 2018-06 CONSOLIDATED VERSION, IEC 62304 Edition 1.1 2015-06 CONSOLIDATED VERSION, UL ANSI 2900-1 First Edition 2017, IEC 81001-5-1 Edition 1.0 2021-12. The risk analysis was completed and risk controls were implemented to mitigate identified hazards. The test results support that all the specifications have met the acceptance criteria. Verification and validation testing were found acceptable to support the claim of substantial equivalence.

Key Metrics

Not Found

Predicate Device(s)

K233530

Reference Device(s)

K193017, K192400, K193031, K223124, K231959, K232082, K232753, K231225, K240243

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.

0

Image /page/0/Picture/0 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 the FDA logo, which 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.

October 23, 2024

DRTECH Corporation % Hanbyul Kim Assistant Manager Suite No.1, 2 Floor /Suite No. 2, 3 Floor, 29, Dunchon-Daero 541 Beon-Gil, Jungwon-Gu Seongnam-si. Gyeonggi-do 13216 SOUTH KOREA

Re: K242847

Trade/Device Name: EXSYS DEXi (EXSYS DEXi-D401S-FRM); EXSYS DEXi (EXSYS DEXi-A401S-FRM); EXSYS DEXi (EXSYS DEXi-D402S-FRM); EXSYS DEXi (EXSYS DEXi-A402S-FRM); EXSYS DEXi (EXSYS DEXi-D401P-FRM); EXSYS DEXi (EXSYS DEXi-A401P-FRM); EXSYS DEXi (EXSYS DEXi-D402P-FRM); EXSYS DEXi (EXSYS DEXi-A402P-FRM); EXSYS DEXi (EXSYS DEXi-D503T-FRM); EXSYS DEXi (EXSYS DEXi-A503T-FRM); EXSYS DEXi (EXSYS DEXi-D401S-FRA); EXSYS DEXi (EXSYS DEXi-D402S-FRA); EXSYS DEXi (EXSYS DEXi-D401P-FRA); EXSYS DEXi (EXSYS DEXi-D402P-FRA); EXSYS DEXi (EXSYS DEXi-D503T-FRA) Regulation Number: 21 CFR 892.1680 Regulation Name: Stationary X-Ray System Regulatory Class: Class II Product Code: KPR Dated: September 20, 2024 Received: September 20, 2024

Dear Hanbyul 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 (the 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 available 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

1

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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device" (https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 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 Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rule"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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.

2

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,

Lu Jiang

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

Enclosure

3

Indications for Use

Submission Number (if known)

K242847

Device Name

EXSYS DEXi (EXSYS DEXi-D401S-FRM); EXSYS DEXi (EXSYS DEXi-A401S-FRM): EXSYS DEXi (EXSYS DEXi-D402S-FRM); EXSYS DEXi (EXSYS DEXi-A402S-FRM): EXSYS DEXi (EXSYS DEXi-D401P-FRM): EXSYS DEXi (EXSYS DEXi-A401P-FRM); EXSYS DEXi (EXSYS DEXi-D402P-FRM); EXSYS DEXi (EXSYS DEXi-A402P-FRM); EXSYS DEXi (EXSYS DEXi-D503T-FRM); EXSYS DEXi (EXSYS DEXi-A503T-FRM): EXSYS DEXi (EXSYS DEXi-D401S-FRA); EXSYS DEXI (EXSYS DEXi-D402S-FRA); EXSYS DEXi (EXSYS DEXi-D401P-FRA); EXSYS DEXi (EXSYS DEXi-D402P-FRA); EXSYS DEXi (EXSYS DEXi-D503T-FRA)

Indications for Use (Describe)

The EXSYS DEXi is a diagnostic X-ray system intended for use in generating radiographic images of human anatomy for general purpose. The system obtains necessary information of patient's anatomical structure by an image processing (workstation) after process of examination using radiation exposure with DR. This system is not intended for mammography applications.

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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4

510(k) Summary

[As required by 21 CFR 807.92]

510(k) Number: K242847

This 510(k) summary of safety and effectiveness information is prepared in accordance with 21 CFR 807.92

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

09/20/2024

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

  • Name of Sponsor: DRTECH Corporation ●
    • Address: Suite No.1, 2 Floor / Suite No. 2, 3 Floor, 29, Dunchon-daero541 beon-gil, Jungwon-gu, Seongnam-si, Gyeonggi-do, 13216, Republic of Korea
  • Contact Name: Hanbyul Kim
  • Telephone No.: + 82-31-779-7720 ●
  • Fax No.: + 82-31-779-7790
  • Email Address : ● drtechra@drtech.com
  • Registration Number: 3005172103 ●
  • Name of Manufacturer: Same as Sponsor .

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

  • Trade(Brand) Name: ● EXSYS DEXi Device(Model) Name : ● EXSYS DEXi (EXSYS DEXi-D401S-FRM); EXSYS DEXi (EXSYS DEXi-A401S-FRM); EXSYS DEXi (EXSYS DEXi-D402S-FRM); EXSYS DEXi (EXSYS DEXi-A402S-FRM); EXSYS DEXi (EXSYS DEXi-D401P-FRM); EXSYS DEXi (EXSYS DEXi-A401P-FRM); EXSYS DEXi (EXSYS DEXi-D402P-FRM); EXSYS DEXi (EXSYS DEXi-A402P-FRM); EXSYS DEXi (EXSYS DEXi-D503T-FRM); EXSYS DEXi (EXSYS DEXi-A503T-FRM); EXSYS DEXi (EXSYS DEXi-D401S-FRA); EXSYS DEXi (EXSYS DEXi-D402S-FRA); EXSYS DEXi (EXSYS DEXi-D401P-FRA); EXSYS DEXi (EXSYS DEXi-D402P-FRA); EXSYS DEXi (EXSYS DEXi-D503T-FRA);
  • Common Name: Diagnosis X-Ray System ●
  • . Classification Name: Stationary x-ray system
  • Classification Panel: ● Radiology
  • Classification Regulation: 21 CFR 892.1680 ●
  • . Product Code: KPR
  • Device Class: II ●

5

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

  • 510(k) Number: ● K233530
  • Applicant: DRTECH Corporation
  • Trade(Brand) Name: EXSYS DEXi
  • Device(Model) Name : EXSYS DEXi (EXSYS DEXi-D401S-FRM); ● EXSYS DEXi (EXSYS DEXi-A401S-FRM); EXSYS DEXi (EXSYS DEXi-D402S-FRM); EXSYS DEXi (EXSYS DEXi-A402S-FRM); EXSYS DEXi (EXSYS DEXi-D401P-FRM); EXSYS DEXi (EXSYS DEXi-A401P-FRM); EXSYS DEXi (EXSYS DEXi-D402P-FRM); EXSYS DEXi (EXSYS DEXi-A402P-FRM); EXSYS DEXi (EXSYS DEXi-D503T-FRM); EXSYS DEXi (EXSYS DEXi-A503T-FRM);
  • Classification Name: Stationary x-ray system .
  • Classification Panel: Radiology
  • Classification Regulation: 21 CFR 892.1680 ●
  • Product Code: KPR
  • Device Class: . II

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

The EXSYS DEXi is a diagnostic X-ray system intended for use in generating radiographic images of human anatomy for general purpose. The system obtains necessary information of patient's anatomical structure by an image processing (workstation) after process of examination using radiation exposure with DR. This system is not intended for mammography applications.

The EXSYS DEXi composed of a x-ray generator, tube, collimator, tube stand, bucky stand, patient table, flat panel detector and console.

Although it shares the same brand name as the predicate device EXSYS DEXi (K233530), a model name has been added with the following modifications:

    1. Addition of collimator
    1. Addition of mechanical parts (tube stand, bucky stand, patient table)
    1. Addition of a detector
    1. Addition of software
    1. Update of software

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

The EXSYS DEXi is a diagnostic X-ray system intended for use in generating radiographic images of human anatomy for general purpose. The system obtains necessary information of patient's anatomical structure by an image processing (workstation) after process of examination using radiation exposure with DR. This system is not intended for mammography applications.

6

7. Summary of Technological Characteristics of the Subject Device as Compared with the Predicate Device [21 CFR 807.92(a)(6), 21 CFR 807.92(b)]

The EXSYS DEXi composed of a x-ray generator, tube stand, bucky stand, bucky stand, patient table, flat panel detector and console.

It is a diagnostic X-ray system intended for use in generating radiographic images of human anatomy for general purpose. The system obtains necessary information of patient's anatomical structure by an image processing (workstation) after process of examination using radiation exposure with DR. This system is not intended for mammography applications.

The subject device has the same fundamental scientific technologies as the predicate devices. The technological comparison table below demonstrates the comparability of the technological characteristics of the new device and the currently cleared predicate devices. The Technological differences do not affect the intended use of the device.

The table 1 below compares the main performance data of the subject device with the predicate devices to substantiate equivalence of the subject device and predicates.

ParameterSubject DevicePredicate DeviceDiscussion
510(K) NumberUnknownK233530N/A
ManufacturerDRTECH CorporationDRTECH CorporationN/A
Device/
Brand NameEXSYS DEXiEXSYS DEXiN/A
Model NameEXSYS DEXi-A401S-FRM
EXSYS DEXi-A402S-FRM
EXSYS DEXi-A401P-FRM
EXSYS DEXi-A402P-FRM
EXSYS DEXi-A503T-FRM
EXSYS DEXi-D401S-FRM
EXSYS DEXi-D402S-FRM
EXSYS DEXi-D401P-FRM
EXSYS DEXi-D402P-FRM
EXSYS DEXi-D503T-FRM
EXSYS DEXi-D401S-FRA
EXSYS DEXi-D402S-FRA
EXSYS DEXi-D401P-FRA
EXSYS DEXi-D402P-FRA
EXSYS DEXi-D503T-FRAEXSYS DEXi-A401S-FRM
EXSYS DEXi-A402S-FRM
EXSYS DEXi-A401P-FRM
EXSYS DEXi-A402P-FRM
EXSYS DEXi-A503T-FRM
EXSYS DEXi-D401S-FRM
EXSYS DEXi-D402S-FRM
EXSYS DEXi-D401P-FRM
EXSYS DEXi-D402P-FRM
EXSYS DEXi-D503T-FRMModel names have
been added due to the
addition of product
configurations.
The system has been
tested and there is "No
negative impact on
safety or efficacy" and
there are no new
potential or increased
safety risks concerning
this difference.
Classification
NameStationary x-ray systemStationary x-ray systemIdentical
Classification
Regulation21 CFR 892.168021 CFR 892.1680Identical
Product CodeKPRKPRIdentical
Device ClassClass IIClass IIIdentical
Intended UseThe EXSYS DEXi is a
diagnostic X-ray system
intended for use in generating
radiographic images of
human anatomy for general
purpose. The system obtains
necessary information of
patient's anatomical structure
by an image processingThe EXSYS DEXi is a
diagnostic X-ray system
intended for use in generating
radiographic images of
human anatomy for general
purpose. The system obtains
necessary information of
patient's anatomical structure
by an image processingIdentical
(workstation) after process of
examination using radiation
exposure with DR. This
system is not intended for
mammography applications.(workstation) after process of
examination using radiation
exposure with DR. This
system is not intended for
mammography applications.
High Frequency X-ray Generator
Output Power40kW, 50kW40kW, 50kWIdentical
Generator
modelsDXG-40S
DXG-40P
DXG-50TDXG-40S
DXG-40P
DXG-50TIdentical
Line voltageDXG-40S, DXG-40P :
220~230VAC
DXG-50T :
230/380/400/480VACDXG-40S, DXG-40P :
220~230VAC
DXG-50T :
230/380/400/480VACIdentical
kV RangeDXG-40S, DXG-40P :
40~125kV, 1kV step
DXG-50T :
40~150kV, 1kV stepDXG-40S, DXG-40P :
40~125kV, 1kV step
DXG-50T :
40~150kV, 1kV stepIdentical
mA RangeDXG-40S, DXG-40P :
10 to 500mA
DXG-50T :
10 to 630mADXG-40S, DXG-40P :
10 to 500mA
DXG-50T :
10 to 630mAIdentical
Image Acquisition
DetectorUsed with DRTECH
Detector

K193017 :
EVS 4343W, EVS 4343WP,
EVS 3643W, EVS 3643WP
K192400 :
EVS 4343A, EVS 3643A
K193031 :
EXPD 4343P, EXPD 3643P
K223124 :
EXPD 86P, EXPD 86PG,
EXPD 129P, EXPD 129PG
K231959 :
EXPD 4357, EXPD 4357P
K232082 :
EXPD 4343S
K232753 :
EXPD 3643D, EXPD 4343D | Used with DRTECH
Detector

K193017 :
EVS 4343W, EVS 4343WP,
EVS 3643W, EVS 3643WP
K192400 :
EVS 4343A, EVS 3643A
K193031 :
EX PD 4343P, EXPD 3643P
K223124 :
EXPD 86P, EXPD 86PG,
EXPD 129P, EXPD 129PG | 510(k) cleared
detectors have been
added.

The system has been
tested and there is “No
negative impact on
safety or efficacy” and
there are no new
potential or increased
safety risks concerning
this difference.

All the flat panel
detectors have been
previously cleared by
510(k). |
| Image Management Software | | | |
| Software | EConsole1 (K231225)
EConsole2 (K240243) | EConsole1 (K231225) | Added our software,
EConsole2 (K240243),
which was previously
cleared with 510(k).

The system has been
tested and there is “No
negative impact on
safety or efficacy” and
there are no new
potential or increased |
| | | | safety risks concerning |
| | | | this difference. |
| Image viewing | Available | Available | Identical |
| Image search | Available | Available | Identical |
| Image storage | Available | Available | Identical |
| Image
annotation | Available | Available | Identical |
| Image
measurement | Available | Available | Identical |
| Image
processing | Available | Available | Identical |
| Image stitch | Available | Available | Identical |
| Generator
Control | Available | Available | Identical |
| X-ray Tube | | | |
| Tube models | E7239X, E7242X, E7884X | E7239X, E7242X, E7884X | Identical |
| Max. Tube
Voltage | E7239X : 125 kV
E7242X : 125 kV
E7884X : 150 kV | E7239X : 125 kV
E7242X : 125 kV
E7884X : 150 kV | Identical |
| Anode Heat
Capacity | E7239X : 140 kHU
E7242X : 200 kHU
E7884X : 300 kHU | E7239X : 140 kHU
E7242X : 200 kHU
E7884X : 300 kHU | Identical |
| Collimator | | | |
| Collimator
Models | M-38
R 221/A DHHS
R 225 ACS DHHS | M-38 | A new collimator that
operates manually and
another type that
operates automatically
have been added.
We have conducted
tests regarding the |
| Adjustment
method | Manual, Auto | Manual | addition of these
collimators, and there
is "no negative impact
on safety or efficacy."
Furthermore, there are
no new potential risks
or increased safety
hazards related to these
differences. |
| Tube Stand | | | |
| Models | DTS-M
DTS-A | DTS-M | Motorized tube stand
has been added.
We have conducted
tests regarding this
addition, and there is |
| Operation
Method | Manual, Auto | Manual | "no negative impact on
safety or efficacy."
Furthermore, there are
no new potential risks
or increased safety
hazards related to these
differences. |
| | | | |
| Type | Floor-supported type | Floor-supported type | Identical |
| Tube Head
Console | Membrane OP
LCD Console | Membrane OP
LCD Console | Identical |
| Bucky Stand | | | |
| Models | DBS-43M
LLD 129 With Rotation
LLD 129 Compact
DBS-57M
DBS-43A
DBS-57A | DBS-43M
LLD 129 With Rotation
LLD 129 Compact | Three Types of bucky
stands have been
added.
We have conducted
tests regarding this
addition, and there is |
| Operation
Method | Manual, Auto | Manual | "no negative impact on
safety or efficacy."
Furthermore, there are
no new potential risks
or increased safety
hazards related to these
differences. |
| Type | Floor-supported type | Floor-supported type | Identical |
| Patient Table | | | |
| Models | DPT-4A
DPT-6A
DPT-4B
DPT-6B
DPT-6AT
DPT-6BT | DPT-4A
DPT-6A | Four Types of patient
tables have been added.
We have conducted
tests regarding this
addition, and there is |
| Type | 4 way : DPT-4A, DPT-4B
6 way : DPT-6A, DPT-6B,
DPT-6AT, DPT-6BT | 4 way : DPT-4A
6 way : DPT-6A | "no negative impact on
safety or efficacy."
Furthermore, there are
no new potential risks
or increased safety
hazards related to these
differences. |
| Fixed method | Electromagnet | Electromagnet | Identical |

Table 1. Comparison of the Subject Device to the Predicate Device Substantial Equivalence

7

8

9

There are no significant differences between the subject Device and the predicate device that would have a negative impact on the product's use. Therefore, the subject device substantially equivalent to the predicate device.

10

9. Summary of Non-Clinical Data [21 CFR 807.92(b)(1)]

The EXSYS DEXi comply with the following international and FDA-recognized consensus standards list in Table 2.

| Standards development
organization, reference

number, and dateStandard name
ISO 14971: Third Edition
2019-12Medical devices - Application of risk management to medical devices
IEC 60601-1 Edition 3.2
2020-08
CONSOLIDATED
VERSIONMedical electrical equipment - Part 1: General requirements for basic
safety and essential performance
IEC 60601-1-2 Edition 4.1
2020-09
CONSOLIDATED
VERSIONMedical electrical equipment - Part 1-2: General requirements for basic
safety and essential performance - Collateral Standard: Electromagnetic
disturbances - Requirements and tests
IEC 60601-1-6 Edition 3.2
2020-07
CONSOLIDATED
VERSIONMedical electrical equipment - Part 1-6: General requirements for basic
safety and essential performance - Collateral standard: Usability
IEC 62366-1 Edition 1.1
2020-06
CONSOLIDATED
VERSIONMedical devices - Part 1: Application of usability engineering to
medical devices
IEC 60601-1-3 Edition 2.2
2021-01
CONSOLIDATED
VERSIONMedical electrical equipment - Part 1-3: General requirements for basic
safety and essential performance - Collateral Standard: Radiation
protection in diagnostic X-ray equipment
IEC 60601-2-28 Edition
3.0 2017-06Medical electrical equipment - Part 2-28: Particular requirements for the
basic safety and essential performance of X-ray tube assemblies for
medical diagnosis
IEC 60601-2-54 Edition
1.2 2018-06
CONSOLIDATED
VERSIONMedical electrical equipment - Part 2-54: Particular requirements for the
basic safety and essential performance of X-ray equipment for
radiography and radioscopy
IEC 62304 Edition 1.1
2015-06
CONSOLIDATED
VERSIONMedical device software - Software life cycle processes
UL ANSI 2900-1 First
Edition 2017Standard for Safety, Standard for Software Cybersecurity Network-
Connectable Products, Part 1: General Requirements
IEC 81001-5-1 Edition
1.0 2021-12Health software and health IT systems safety, effectiveness and security
Part 5.1: Security - Activities in the product life cycle

Table 2. International and FDA-recognized consensus standards

11

And EXSYS DEXi comply with the FDA guidance documents listed in Table 3.

Table 3. FDA Guidance Documents

Title of Guidance DocumentIssue Date
Guidance for Industry and Food and Drug Administration Staff: The 510(k)
Program: Evaluating Substantial Equivalence in Premarket Notifications [510(k)]July 28, 2014
Pediatric Information for X-ray Imaging Device Premarket Notifications,
Guidance for Industry and Food and Drug Administration StaffNov 28, 2017
Guidance for Industry and Food and Drug Administration Staff: Medical X-Ray
Imaging Devices Conformance with IEC StandardsMay 8, 2019
Content of Premarket Submissions for Device Software Functions, Guidance for
Industry and Food and Drug Administration StaffJune 14, 2023
Cybersecurity in Medical Devices Quality System Considerations and Content of
Premarket SubmissionsSep 27, 2023

The risk analysis was completed and risk controls were implemented to mitigate identified hazards. The test results support that all the specifications have met the acceptance criteria. Verification and validation testing were found acceptable to support the claim of substantial equivalence.

10. Summary of Clinical Data [21 CFR 807.92(b)(2)]

Not Applicable

Clinical studies are unnecessary to validate the safety and effectiveness of the Stationary x-ray system, EXSYS DEXi, the subject of this 510(k) notification.

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

The EXSYS DEXi is substantially equivalent to the currently marketed predicate device (K233530) in terms of technical characteristics, general function, applications for use, safety, and effectiveness.

Substantial equivalence for Stationary X-ray System(EXSYS DEXi) was demonstrated through the non-clinical performance in compliance with the requirements specified in the international and FDA recognized consensus standards, IEC 60601-1, IEC 60601-1-6, IEC 60601-1-6, IEC 62366-1, IEC 60601-1-3, IEC 60601-2-28, IEC 60601-2-54, IEC 62304, IEC 81001-5-1 and ANSI UL 2900-1.

The comparison of technological characteristics, non-clinical performance data and safety testing demonstrate that the EXSYS DEXi is substantially equivalent to the predicate devices.