K Number
K991922
Device Name
DIGITAL IMAGING SYSTEM (BSR)
Date Cleared
1999-09-01

(86 days)

Product Code
Regulation Number
892.1600
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Digital Imaging Systems (BSR), are intended for use in acquiring diagnosic quality images during cardiac, angiographic, vascular and neurovascular applications.
Device Description
Digital Imaging System (BSR)
More Information

Not Found

No
The summary does not mention AI, ML, or related terms, nor does it describe any characteristics typically associated with AI/ML devices like training/test sets or performance metrics like AUC.

No.
The device is described as a Digital Imaging System intended for acquiring diagnostic quality images, not for treating any condition.

Yes
Explanation: The "Intended Use / Indications for Use" section explicitly states that the device is "intended for use in acquiring diagnostic quality images."

No

The device description and intended use clearly indicate a "Digital Imaging System" used for acquiring diagnostic quality images during medical procedures, which inherently involves hardware components like an angiographic x-ray system. The summary does not mention the device being solely software.

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

Here's why:

  • Intended Use: The intended use clearly states the device is for "acquiring diagnostic quality images during cardiac, angiographic, vascular and neurovascular applications." This describes an imaging system used to visualize internal structures of the body, which is a function of medical imaging devices, not IVDs.
  • Device Description: The device is described as a "Digital Imaging System (BSR)." This further supports it being an imaging device.
  • Input Imaging Modality: The input modality is an "Angiographic x-ray system," which is a type of medical imaging equipment.
  • Anatomical Site: The anatomical sites listed (cardiac, angiographic, vascular, and neurovascular) are areas of the body that are imaged, not samples that would be tested in vitro.

IVD devices are used to examine specimens (like blood, urine, or tissue) taken from the human body to provide information for diagnosis, monitoring, or screening. This device does not appear to perform such testing on specimens.

N/A

Intended Use / Indications for Use

The Digital Imaging Systems (BSR), are intended for use in acquiring diagnosic quality images during cardiac, angiographic, vascular and neurovascular applications.

Product codes

90 IZI

Device Description

Digital Imaging System (BSR)

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

x-ray

Anatomical Site

cardiac, angiographic, vascular and neurovascular

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 Found

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

Not Found

Summary of Performance Studies

Not Found

Key Metrics

Not Found

Predicate Device(s)

K933664, K984545

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 892.1600 Angiographic x-ray system.

(a)
Identification. An angiographic x-ray system is a device intended for radiologic visualization of the heart, blood vessels, or lymphatic system during or after injection of a contrast medium. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II.

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Summary Of Safety and Effectiveness

K991922

I.General Information
Classification Name:Angiographic x-ray system
Common/Usual Name:digital imaging system
Device Trade Name:Digital Imaging System (BSR)
Classification:Class II Medical Device
Intended Use:Intended for use in acquiring diagnostic quality
images during cardiac, angiographic, vascular
and neurovascular applications.
Establishment Name
and Address:Siemens Medical Systems, Inc.
Nuclear Medicine Group
2501 North Barrington Road
Hoffman Estates, IL 60195-5203
Establishment Registration
Number:1423253 (Owner/Operator 9010023)
Performance Standard:None established under Section 514 of the Food
Drug and Cosmetic Act

II Safety and Effectiveness Information Supporting the Substantial Equivalence Determination

General Safety and Effectiveness Concerns:

The device labeling contains instructions for use. It includes indications for use and cautions. This information assures safe and effective use of the device.

Substantial Equivalence:

The Digital Imaging System (BSR), is substantially equivalent to currently marketed Siemens Medical Systems, Inc. Polytron TOP (K933664) and Phillips Integris Series (K984545).

Contact:

Robert W. Callahan Manager of Regulatory Affairs Siemens Medical Systems, Inc. Nuclear Medicine Group 2501 North Barrington Road Hoffman Estates, IL 60195-5203 Tel: (847) 304-7516 Fax: (847) 304-6023 E-Mail: robert.callahan@nmg.sms.siemens.com

1

Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is circular and contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES-USA" around the perimeter. In the center of the circle is an abstract symbol that resembles an eagle or bird in flight, composed of three curved lines.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

SEP 1 1999

Mr. Robert W. Callahan Manager of Regulatory Affairs Siemens Medical Systems, Inc. 2501 North Barrington Road Hoffman Estates, IL 60195-5203

Dear Mr. Callahan:

Re: K991922 Digital Imaging System (BSR) Dated: June 4, 1999 Received: June 7, 1999 Requlatory Class: Il (two) Product Code: 90 IZI 21 CFR 892.1600

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 redassified 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. Iisting of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either 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 regulatory 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,
Dan Petit

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

2

Indications for Use Form

510(k) Number (if known)_ k99 ) 922

Device Name: Digital Imaging System (BSR)

Indication for Use:

The Digital Imaging Systems (BSR), are intended for use in acquiring diagnosic quality images during cardiac, angiographic, vascular and neurovascular applications.

PLEASE DO NOT WRITE BELOW THIS LINE Concurrence of the CDRH, Office of Device Evaluation (ODE)

David A. Leipson

(Division Sign-Off) (Division Sign-Oil)
Division of Reproductive, Abdominal, EN and Radiological Devic 510(k) Number

Prescription Use (Per 21 CFR 801.109)

ﮯ۔

Or

Over-The-Counter Use_

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