(293 days)
A high specific activity radionuclide brachytherapy source to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy. Device is the active source for a Nucletron Microselection Device.
The source is made of a stainless steel capsule with an outer diameter of approximately 1.1mm. A hole is drilled through the center of the capsule to a depth of the ir 192 seed. The closed end of the capsule is welded to a 1.1 mm diameter 7 X 7 stranded stainless steel cable. On the opposite end, a solid connector is welded in the same manner to the free end of the cable A Ir 192 seed is inserted into the open end of the capsule. The Ir 192 seed is secured by welding the open end of the capsule. The post-weld length of capsule is approximately 4.5 mm in length and overall length of the finished source cable assembly is approximately 2000 mm. These physical specifications are the source for the Nucletron Microselection HDR device.
The provided text is a 510(k) summary for the "Alpha-Omega Services, Inc., 10 Curie Iridium 192 Source, Model CSN0010-192". This document does not describe a study that proves the device meets acceptance criteria. Instead, it focuses on demonstrating substantial equivalence to a predicate device (Nucletron Microselection Source, K864210) based on comparisons of:
- Indications for Use: Both devices are high specific activity radionuclide brachytherapy sources for placement onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy, and are active sources for a Nucletron Microselection Device.
- Physical Size and Materials: The subject device has identical dimensions (1.1 mm diameter, 2000 mm ± 5% length) and uses the same materials (Stainless steel 316LVM, 7X7 Stranded cable type, IR-192 Seed 3.5 mm) as the predicate device. The only difference noted is the "Seal Method" (Laser/Tig Welding for the subject device vs. Laser Welding for the predicate device).
- Radioisotope and Activity: Both use IR-192 with a radioactive half-life of 75 days and apparent activity levels of 9-13 Ci at the time of shipping.
- Tested Transfer Cycles: The subject device was tested for 50,000 transfer cycles, exceeding the predicate device's 20,000 tested cycles and both devices' recommended 5,000 cycles.
Given that this is a 510(k) submission based on substantial equivalence to a predicate device, and not a de novo clearance or PMA submission, a standalone clinical study with detailed acceptance criteria and performance metrics for the new device (as would be typical for an AI/software device) is not presented or required in this document. The "acceptance criteria" here are essentially the demonstration of equivalence to the predicate.
Therefore, many of the requested categories (e.g., sample size for test set, number of experts, adjudication method, MRMC study, standalone study, ground truth types for test/training sets, training set size) are not applicable or cannot be extracted from this specific document, as they pertain to clinical or performance studies of a different nature than what is presented.
Here's the information that can be extracted, adhering to the spirit of the request where possible:
1. Table of Acceptance Criteria and Reported Device Performance
| Acceptance Criteria (based on Predicate Equivalence) | Reported Device Performance (Subject Device) |
|---|---|
| Indications for Use: A high specific activity radionuclide brachytherapy source to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy, and acting as the active source for a Nucletron Microselection Device. (Identical to predicate) | Indications for Use: A high specific activity radionuclide brachytherapy source to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy. Device is the active source for a Nucletron Microselection Device. (Substantially equivalent) |
| Physical Dimensions: Diameter 1.1 mm, Length 2000 mm ± 5% (Identical to predicate) | Physical Dimensions: Diameter 1.1 mm, Length 2000 mm ± 5% (Identical) |
| Cable Type: 7X7 Stranded (Identical to predicate) | Cable Type: 7X7 Stranded (Identical) |
| Material: Stainless steel 316LVM (Identical to predicate) | Material: Stainless steel 316LVM (Identical) |
| Radioisotope: IR-192 Seed 3.5 mm (Identical to predicate) | Radioisotope: IR-192 Seed 3.5 mm (Identical) |
| Radioactive Half-life: 75 days (Identical to predicate) | Radioactive Half-life: 75 days (Identical) |
| Apparent Activity Levels: 9-13 Ci at time of shipping (Identical to predicate) | Apparent Activity Levels: 9-13 Ci at time of shipping (Identical) |
| Transfer Cycles (Tested): At least 20,000 (Based on predicate's tested cycles) | Transfer Cycles (Tested): 50,000 (Exceeds predicate) |
| Recommended Cycles: 5,000 (Identical to predicate) | Recommended Cycles: 5,000 (Identical) |
| Seal Method: Laser Welding (Based on predicate) | Seal Method: Laser/Tig Welding (Slight difference, but deemed equivalent as part of the overall substantial equivalence determination. The document implies this difference does not impact safety or effectiveness.) |
| External Radiation Levels: Dose rates for a 10 curie source at specified distances (e.g., 48,000,000 mr/hr at 1 cm, 76,800 mr/hr at 25 cm, 19,200 mr/hr at 50 cm, 4,800 mr/hr at 100 cm). (Implicitly, the subject device is expected to produce these same levels given identical radioisotope and activity). | External Radiation Levels: The document states "The following are radiation dose rates for a 10 curie source" and lists the same values as implicitly expected from an equivalent device. It explicitly states, "These values are for health physics ONLY and not for clinical use," indicating their role in safety and handling, not clinical performance. This implies the subject device exhibits these characteristics. |
2. Sample size used for the test set and the data provenance
Not applicable. This document describes a medical device (a brachytherapy source) and a 510(k) submission based on substantial equivalence, not a performance study of an AI/software device with test sets and data provenance in the typical sense. Equivalence is primarily based on design specifications and performance characteristics derived from physical testing (like transfer cycles) and material properties.
3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts
Not applicable. See point 2. Ground truth establishment by experts for a test set is not part of this type of submission.
4. Adjudication method (e.g. 2+1, 3+1, none) for the test set
Not applicable. See point 2.
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. See point 2. This is not an AI-assisted diagnostic device.
6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done
Not applicable. See point 2. This device is a physical brachytherapy source, not an algorithm.
7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)
Not applicable. For this type of physical medical device, "ground truth" (in the context of clinical or diagnostic performance) is not applicable. The equivalence is established against the known and accepted characteristics and performance of the predicate device. For "tested transfer cycles," the ground truth is the physical measurement of cycles completed before failure or degradation.
8. The sample size for the training set
Not applicable. See point 2. No training set is involved.
9. How the ground truth for the training set was established
Not applicable. See point 2. No training set is involved.
{0}------------------------------------------------
Section 2 Summary 510(k)
The following is a Summary of the Alpha-Omega Services, Inc., 10 Curie IR-92 Brachytherapy Source for Nucletron Microselection device.
| Applicant | Alpha-Omega Services, Inc.9156 Rose StreetBellflower, California 90706(800) 346-7894(562) 804-0610 Fax |
|---|---|
| Manufacturing Facility | Alpha-Omega Services, Inc.1282 Big Woods and Starks Rd.Edgerly, LA 70668(318) 589-5720 |
| Contact Person | Bruce Hedger, President and RSO |
| Classification Name | Radionuclide Brachytherapy Source. |
| Common/Usual Name | 10 Curie IR-92 Brachytherapy Source for NucletronAfterloader device. |
| Proprietary Name | 10 Curie Iridium 192 Source, Model CSN0010-192. |
| Establishment Registration Number | 2022694 California, Louisiana registration has been sent in. |
| Classification | 21 CFR 892.5730, Class II, Product Code: JAQ |
| Special Controls | Product will comply with the nuclear regulatory requirementsfor the State of Louisiana NRC and US NRC. |
| Substantial Equivalence | K864210 Nucletron Microselection Source. |
General Information
The contents of this premarket notification summary will demonstrate the substantial equivalence of the subject device, 10 Curie IR-92 Brachytherapy Source for Nucletron Afterloader device. The substantial equivalence will be based on the following features of the device:
- . Indications
- Physical Size .
- Radioisotope .
- . Radiation activity
The Alpha-Omega Services, Inc., 10 Curie Iridium 192 Source, Model CSN0010-192 device is a hermetically sealed radionuclide brachytherapy source indicated for, to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy.
The source is made of a stainless steel capsule with an outer diameter of approximately 1.1mm. A hole is drilled through the center of the capsule to a depth of the ir 192 seed. The closed end of the capsule is welded to a 1.1 mm diameter 7 X 7 stranded stainless steel cable. On the opposite end, a solid connector is welded in the same manner to the free end of the cable A Ir 192 seed is inserted into the open end of the capsule. The Ir 192 seed is secured by welding the open end of the capsule. The post-weld length of capsule is approximately 4.5 mm in length
{1}------------------------------------------------
and overall length of the finished source cable assembly is approximately 2000 mm. These physical specifications are the source for the Nucletron Microselection HDR device.
The following table compares indications statement for Alpha-Omega Services, Inc., 10 Curie IR-92 Brachytherapy Source for Nucletron Microselection HDR device and the predicate device.
| 10 Curie IR-92 Brachytherapy Source for | IR-192 (K864210), Nucletron Microselection |
|---|---|
| Nucletron Afterloader device | Predicate Device |
| A high specific activity radionuclidebrachytherapy source to be placed onto a bodysurface or into a body cavity or tissue as asource of nuclear radiation for therapy. Deviceis the active source for a NucletronMicroselection Device. | A high specific activity radionuclidebrachytherapy source to be placed onto a bodysurface or into a body cavity or tissue as asource of nuclear radiation for therapy. Deviceis the active source for an NucletronMicroselection |
Based on the intent of the indications statement for the subject device, the Alpha-Omega Services, Inc., 10 Curie IR-92 Brachytherapy Source for Nucletron Afterloader device, is substantially equivalent to the predicate device with respect to its indications.
The following table compares the physical size. materials of construction, and the radioisotope for the subject device and predicate device.
| Feature Description | 10 Curie Iridium 192 Source, ModelCSN0010-192 for NucletronMicroselection device | IIR-192 (K864210), NucletronMicroselectionPredicate Device |
|---|---|---|
| Diameter | 1.1 mm | 1.1 mm |
| Length | 2000 mm ± 5% | 2000 mm ± 5% |
| Cable Type | 7X7 Stranded | 7X7 Stranded |
| Material | Stainless steel 316LVM | Stainless steel 316LVM |
| Seal Method | Laser / Tig Welding | Laser Welding |
| Radioisotope | IR - 192 Seed 3.5 mm | IR - 192 Seed 3.5 mm |
| Tested transfers cycles | 50,000 | 20,000 |
| Recommended cycles | 5,000 | 5,000 |
| Radioactive half life | 75 days | 75 days |
| Apparent ActivityLevels | 9 - 13 Ci at time of shipping | 9 - 13 Ci at time of shipping |
LIMITATIONS AND/ OR OTHER CONSIDERATIONS OF USE
- The source cable shall be distributed in the United States to persons specifically 1. licensed by the United States NRC or an agreement state.
-
- The source cable shall be distributed internationally to users with approval from local competent authorities.
-
- The source cable shall be leak tested at six (6) month intervals using techniques capable of detecting 0.005 microcuries of removable contamination.
- Handling, storage, use, transfer and disposal will be determined by the licensing 4. authority. The sealed source must be installed and transferred by experienced, trained and licensed personnel only using adequate handling procedures.
- ક. The licensee shall not cut, splice or altar the source cable in any way.
- To be used as an active source cable for the Nucletron Oldelft Microselectron HDR 6.
{2}------------------------------------------------
Afterloader at existing irradiation equipment installations. The licensee shall strictly abide by all requirements of the customer's license and applicable requirements of the U.S.N.R.C., agreement state or international competent authorities in which the authorized work is performed
External Radiation Levels
The following are radiation dose rates for a 10 curie source
| Distance (in cm) | Dose Rate (mr/hr) |
|---|---|
| 1 | 48,000,000 |
| 25 | 76,800 |
| 50 | 19,200 |
| 100 | 4,800 |
These values are for health physics ONLY and not for clinical use.
Based on the dimensions of the subject device being the same as the predicate device, the body tissue contacting materials being made of a known biocompatible material, stainless steel, and both devices using IR-192 as the radionuclide, the subject device, Alpha-Omega Services, Inc., 10 Curie Indium 192 Source, Model CSN0010-192 for use with Nucletron Microselection HDR device is substantially equivalent to the predicate device with respect to features and indications.
{3}------------------------------------------------
Image /page/3/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo features a stylized image of an eagle with its wings spread, facing to the right. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular fashion around the eagle.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
FEB 2 2 2000
Alpha-Omega Services, Inc. C/O J. Harvey Knauss Delphi Consulting Group 11874 South Evelyn Circle Houston, TX 77071
Re:
K991571 10 Curie Iridium 192 Source, Model CSN0010-192 Dated: January 18, 2000 Received: January 19, 2000 Regulatory class: II 21 CFR 892.5730/Procode: 90 KXK
Dear Mr. Knauss:
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 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). 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 (Special Controls) or class III (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 requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic QS inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in requlatory action. In addition. FDA may publish further announcements concerning your device in the Federal 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 the Electronic Product 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/dsma/dsmamain.html".
Sincerely yours,
CAPT Daniel G. Schultz, M.D. Acting Director, Division of Reproductive. Abdominal, Ear, Nose and Throat, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
{4}------------------------------------------------
510(k) Number K 991571
10 Curie Iridium 192 Source, Model CSN0010-192 Device Name:
- Indications for use: A high specific activity radionuclide brachytherapy source to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy. Device is the active source for a Nucletron Microselection Device.
Prescription Device. Federal Law (US) restricts this device to dale by or on the order of a physician.
(PLEASE DO NOT WRITE BELOW THIS LINE- CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
(Division Sign-Off)
Division of Reproductive, Abdominal, ENT,
and Radiological Devices
510(k) Number K991571
Prescription Use
(Per 21 CFR 801.109)
OR
Over-The-Counter Use
(Optional Format 1-2-96)
ર્વ
§ 892.5730 Radionuclide brachytherapy source.
(a)
Identification. A radionuclide brachytherapy source is a device that consists of a radionuclide which may be enclosed in a sealed container made of gold, titanium, stainless steel, or platinum and intended for medical purposes to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy.(b)
Classification. Class II (special controls). A prostate seeding kit intended for use with a radionuclide brachytherapy source only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.