K Number
K972709
Device Name
TBI STAND
Date Cleared
1997-10-16

(87 days)

Product Code
Regulation Number
892.5050
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The TBI Stand is used to safely support and reposition a patient for radiation therapy treatment in the vertical (standing) position when a physician desires to treat the patient with whole body irradiation by high energy photons or electrons, usually from a medical electron accelerator. At times, the physician utilizes the optional Scatter Screen to increase the surface dose to the patient during photon treatment.

Device Description

The TBI Stand is used to safely support and reposition a patient for radiation therapy treatment in the vertical (standing) position when physician desires to treat the patient with whole body irradiation by high energy photons or electrons, usually from a medical electron accelerator. At times, the physicians utilizes the optional Scatter Screen to increase the surface dose to the patient during photon treatment.

AI/ML Overview

The provided document describes a 510(k) premarket notification for a medical device called the "TBI Stand." This type of submission is for demonstrating substantial equivalence to a predicate device, not for establishing novel clinical performance through acceptance criteria and a detailed study.

Therefore, the requested information regarding acceptance criteria, device performance, study details (sample size, data provenance, expert involvement, adjudication, MRMC study, standalone performance, ground truth, training set), and effect size cannot be extracted from this document, as these concepts are not applicable to a 510(k) substantial equivalence submission for the TBI Stand.

The document focuses on comparing the TBI Stand's technological characteristics to a legally marketed predicate device (MED-TEC Radio Therapy Treatment Chair K951947) to demonstrate that it is substantially equivalent and thus safe and effective for its intended use.

Here's a breakdown of what can be extracted related to the device and its comparison:

1. A table of acceptance criteria and the reported device performance:

Instead of "acceptance criteria," the document provides a "Predicate Comparison Table" which lists technological characteristics of both the predicate device and the TBI Stand. The "reported device performance" in this context is how the TBI Stand meets or exceeds these characteristics compared to the predicate.

SpecificationsMED-TEC Treatment Chair K951947 (Predicate)Mick Radio-Nuclear Total Body Irradiation Stand (TBI) (Reported Device Performance)
Vertical Patient PositioningYes, upper torsoYes, whole body
Head PositioningYesYes
Shoulder PositioningNoYes
Arm SupportYesYes
Hand GripsYesYes
Seat-PaddedYesYes
AP/PA Treatment PositionsYesYes
Transparent Back SupportYesYes
Film Cassette HolderNoYes
Reproducible SettingsYesYes
Lung Shield SupportsNoYes
Radiation Spoiler (Scatter Screen)NoYes
Construction:Wood, Plastic and Carbon FiberStainless Steel, Delrin, Acrylic, Wood, Formica
Weight:22 lbs100 lbs
Use LocationOn treatment tableRolls on floor

Summary of why the other points cannot be answered:

  • 2. Sample size used for the test set and the data provenance: Not applicable. This is a comparison of design and features, not a performance study involving a test set of data.
  • 3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. No ground truth was established by experts for a test set in this context.
  • 4. Adjudication method (e.g. 2+1, 3+1, none) for the test set: Not applicable. No test set adjudication occurred.
  • 5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance: Not applicable. This device is a physical stand, not an AI or imaging diagnostic device that would involve human readers or AI assistance.
  • 6. If a standalone (i.e. algorithm only without human-in-the loop performance) was done: Not applicable. This is a physical device, not an algorithm.
  • 7. The type of ground truth used (expert concensus, pathology, outcomes data, etc): Not applicable. The "ground truth" for a 510(k) of this nature is the established performance and safety of the predicate device, against which the new device's characteristics are compared.
  • 8. The sample size for the training set: Not applicable. No training set is involved for this type of device submission.
  • 9. How the ground truth for the training set was established: Not applicable, as there is no training set.

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Image /page/0/Picture/0 description: The image shows a close-up of a logo or design, primarily in black and white. The upper portion features bold, block-style lettering, with the letters appearing to be 'MRI'. Below the letters, there's a graphic representation of a sine wave, followed by a floral or star-like design on the right side.

MICK RADIO-NUCLEAR INSTRUMENTS, INC.

Tab 10

73

1972709

OCT 16 1997

Premarket Notification [510(k)] Summary

July 12, 1997

Trade Name:TBI Stand
Common Name:Total Body Irradiation Stand
Classification Name:Medical charged partical radiation therapy system,90 IYE (per 21 CFR section 892.5050)
Manufacturer's Name:Mick Radio-Nuclear Instruments, Inc.
Address:1470 OutlookmAvenueP.O. Box 99Bronx, New York 10465
Corresponding Official:Mr. Felix W. Mick
Title:President
Telephone:718-597-3999
Fax:718-824-8834
Predicate:MED-TEC Radio Therpay Treatment Chair,Number: K951947

The TBI Stand is used to safely support and reposi-Device Description: tion a patient for radiation therapy treatment in the vertical (standing) position when physician desires to treat the patient with whole body irradiation by high energy photons or electrons, usually from a medical electron accelerator. At times, the physicians utilizes the optional Scatter Screen to increase the surface dose to the patient during photon treatment.

Support and permit repositioning of a vertical (standing) Intended Use: patient for total body radiation therapy.

See the attached "Predicate Comparison Technology Characteristics: Table" of the Mick TBI Stand and the MED-TEC Radio Therapy Treatment Chair.

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Tab 10

Predicate Comparison Table

SpecificationsMED-TEC TreatmentChairK951947Mick Radio-NuclearTotal BodyIrradiation Stand (TBI)
Vertical Patient PositioningYes, upper torsoYes, whole body
Head PositioningYesYes
Shoulder PositioningNoYes
Arm SupportYesYes
Hand GripsYesYes
Seat-PaddedYesYes
AP/PA Treatment PositionsYesYes
Transparent Back SupportYesYes
Film Cassette HolderNoYes
Reproducible SettingsYesYes
Lung Shiedl SupportsNoYes
Radiation Spoiler(Scatter Screen)NoYes
Construction:Wood, Plastic andCarbon FiberStainless Steel, Delrin,Acrylic, Wood, Formica
Weight:22 lbs100 lbs
Use LocationOn treatment tableRolls on floor

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Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES (USA)" around the perimeter. Inside the circle is an abstract image of an eagle with its wings spread.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

16 1997

Felix W. Mick President Mick Radio-Nuclear Instruments, Inc. 1470 Outlook Avenue P.O. Box 99 Bronx, New York 10465

Re:

K972709

Total Body Irradiation Stand Dated: July 13, 1997 Received: July 21, 1997 Regulatory class: II 21 CFR 892.5050/Procode: 90 IYE

Dear Mr. Mick:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the device, subject to the general controls provisions of the Act. 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.

If your device is classified (see above) into either class II (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirement, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic OS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Fedgral Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4613. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

h) Kiau Yu

Lillian Yin, Ph.D. Director, Division of Reproductive, Abdominal, Ear, Nose and Throat, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Tab 11

510(k) Number (if known):_____________________________________________________________________________________________________________________________________________________

Device Name: TBI Stand

Indications for Use:

The TBI Stand is used to safely support and reposition a patient for radiation therapy treatment in the vertical (standing) position when a physician desires to treat the patient with whole body irradiation by high energy photons or electrons, usually from a medical electron accelerator. At times, the physician utilizes the optional Scatter Screen to increase the surface dose to the patient during photon treatment.

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Gerrit A. Sygmon

(Division Sign-Off)
Division of Reproductive, Abdominal, ENT,
and Radiological Devices
510(k) Number 1972709

OR

Prescription Use
(per 21 CFR 801.109)

Over-The-Counter Use

75

§ 892.5050 Medical charged-particle radiation therapy system.

(a)
Identification. A medical charged-particle radiation therapy system is a device that produces by acceleration high energy charged particles (e.g., electrons and protons) intended for use in radiation therapy. This generic type of device may include signal analysis and display equipment, patient and equipment supports, treatment planning computer programs, component parts, and accessories.(b)
Classification. Class II. When intended for use as a quality control system, the film dosimetry system (film scanning system) included as an accessory to the device described in paragraph (a) of this section, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.