K Number
K992414
Device Name
PROTON BEAM THERAPY SYSTEM (PBTS)
Date Cleared
2000-07-21

(367 days)

Product Code
Regulation Number
892.5050
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Optivus Technology, Inc.'s Proton Beam Therapy System (PBTS) is an integrated facility designed to administer proton radiation treatments to patients through delivery of a predetermined radiation dose to a predetermined treatment target volume in a manner that protects people from unnecessary exposure to radiation and other hazards.
Device Description
The Optivus Proton Beam Therapy System (PBTS) is an integrated facility designed to deliver radiation treatment. Optivus' proposed facility is essentially the same as the facility that is currently operating at LLUMC. Both facilities consists of three major functional blocks; the accelerator, the beam transport system, and the treatment rooms. This complete, turnkey system consists of seven major subsystems: - 70 - 250 MeV proton synchrotron; - beam transport system; - . one or more fixed beam delivery systems; - . one or more isocentric gantries; - patient positioning system; - integrated facility control system; and . - integrated facility safety system.
More Information

No
The summary describes a traditional proton beam therapy system with standard components and control systems. There is no mention of AI, ML, or related concepts in the intended use, device description, or other sections.

Yes
The device is designed to administer proton radiation treatments to patients, indicating its role in providing therapy.

No
The device is described as a "Proton Beam Therapy System" designed to "administer proton radiation treatments," indicating its function is therapeutic, not diagnostic.

No

The device description clearly outlines multiple hardware components including a synchrotron, beam transport system, gantries, and patient positioning system, indicating it is a complex hardware system with integrated software, not a software-only device.

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

Here's why:

  • Intended Use: The intended use clearly states that the device is designed to "administer proton radiation treatments to patients". This is a therapeutic application, not a diagnostic one.
  • Device Description: The description details a system for delivering radiation, including an accelerator, beam transport, and treatment rooms. This aligns with a therapeutic device.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples (blood, tissue, etc.) or providing diagnostic information about a patient's condition.

IVD devices are used to examine specimens derived from the human body to provide information for diagnostic, monitoring, or compatibility purposes. This device's function is to treat a condition, not diagnose it.

N/A

Intended Use / Indications for Use

The Optivus Proton Beam Therapy System (PBTS) is an integrated facility designed to administer proton radiation treatments to patients through delivery of a predetermined radiation dose to a predetermined treatment target volume in a manner that protects people from unnecessary exposure to radiation and other hazards. This is the same intended use as the LLUMC PBTS.

The Optivus Technology, Inc.'s Proton Beam Therapy System (PBTS) is an integrated facility designed to administer proton radiation treatments to patients through delivery of a predetermined radiation dose to a predetermined treatment target volume in a manner that protects people from unnecessary exposure to radiation and other hazards.

Product codes

90 LHN

Device Description

The Optivus Proton Beam Therapy System (PBTS) is an integrated facility designed to deliver radiation treatment. Optivus' proposed facility is essentially the same as the facility that is currently operating at LLUMC. Both facilities consists of three major functional blocks; the accelerator, the beam transport system, and the This complete, turnkey system consists of seven major subsystems:
-70 - 250 MeV proton synchrotron;
-beam transport system;
-. one or more fixed beam delivery systems;
-. one or more isocentric gantries;
-patient positioning system;
-integrated facility control system; and .
-integrated facility safety system.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

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 (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

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

Not Found

Predicate Device(s)

K872369

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

0

JUL 2 1 2000

510(k) SUMMARY

For

OPTIVUS PROTON BEAM THERAPY SYSTEM

K992414
Page 1 of 3

COMPANY NAME/ADDRESS 1.

1.1 Sponsor Contact

Optivus Technology, Inc. P.O. Box 608 Loma Linda, CA 92354 Contact Person: Clark Taylor Telephone: (909) 799-8300

1.2 Sponsor Manufacturing Address

Optivus Technology, Inc. 1475 South Victoria Court San Bernardino, CA 92408

Date Prepared: July 19, 1999

2. DEVICE NAME

Proprietary Name: Common/Usual Name: Classification Name:

Proton Beam Therapy System (PBTS) Proton Beam Therapy System Medical Charged-Particle Radiation Therapy System

3. PREDICATE DEVICES

The Optivus Proton Beam Therapy System (PBTS) is substantially equivalent to the Loma Linda University Medical Center (LLUMC) PBTS. The LLUMC PBTS was cleared for marketing in the United States in the premarket notification, K872369.

1

4. DEVICE DESCRIPTION

K992414
Page 2 of 3

The Optivus Proton Beam Therapy System (PBTS) is an integrated facility designed to deliver radiation treatment. Optivus' proposed facility is essentially the same as the facility that is currently operating at LLUMC. Both facilities consists of three major functional blocks; the accelerator, the beam transport system, and the This complete, turnkey system consists of seven major treatment rooms. subsystems:

  • 70 - 250 MeV proton synchrotron;
  • beam transport system;
  • . one or more fixed beam delivery systems;
  • . one or more isocentric gantries;
  • patient positioning system;
  • integrated facility control system; and .
  • integrated facility safety system.

INTENDED USE ട.

The Optivus Proton Beam Therapy System (PBTS) is an integrated facility designed to administer proton radiation treatments to patients through delivery of a predetermined radiation dose to a predetermined treatment target volume in a manner that protects people from unnecessary exposure to radiation and other hazards. This is the same intended use as the LLUMC PBTS.

6. TECHNOLOGICAL CHARACTERISTICS AND SUBSTANTIAL EQUIVALENCE

The Optivus PBTS has the same technological characteristics as the LLUMC PBTS. The comparison matrix for the LLUMC PBTS and the Optivus PBTS is summarized below.

2

K992414
Page 3 of 3

Table 1: Comparison matrix between the Optivus PBTS and the Loma Linda University Medical Center PBTS

CharacteristicLLUMC PBTSOptivus PBTS
AcceleratorSynchrotron, approx. 20 ft.
diameterSame as LLUMC PBTS
ParticleProtonsSame as LLUMC PBTS
EnergyContinuously variable from 70-
250 MeV, corresponding to a
water depth of 3 cm to 38 cm.Same as LLUMC PBTS
Total Cycle Time2 seconds nominal1.5-10.0 seconds (2.2 sec
nominal)
Spill Time1 second0.1-9.0 seconds (0.5 sec nominal)
Cycle Completion Time0.5 seconds0.1-9.0 second (1 sec nominal)
Beam Intensity> 1.5x1011 protons per pulseA variable beam intensity in ten
steps over range ( $1x1019$ to
3x1010 protons per pulse).
Proton Source40 keV duoplasmatron40 keV duoplasmatron
(nominal)
Injector TypeRadio Frequency QuadrupoleSame as LLUMC PBTS
Injection Energy1.7 MeV2 MeV (nominal)
Treatment Facilities3 treatment rooms with
isocentric gantries, one
treatment room with fixed
horizontal beam, and a fixed-
beam dedicated to calibration
and non-patient use.At least one isocentric gantry
treatment room and one fixed-
beam treatment room.

3

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JUL 21 2000

Optivus, Inc. c/o James R. Veale Vice President, Regulatory Services Medical Device Consultants, Inc. 49 Plain Street North Attleboro, MA 02760

Re:

K992414 Optivus Proton Beam Therapy System (PBTS) Dated: April 28, 2000 Received: May 1, 2000 Regulatory class: II 21 CFR 892.5050/Procode: 90 LHN

Dear Mr. Veale:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have deemined the We have reviewed your Section 5 fincile in the enclosure) to legally in the enclosure) to legally marketed predicate devices and device is substantialy equivalent (for the novel on the states in the encline of the American of to devices that maketed in interstate commerce proct to way 20, 1910, the that have and Cosmetic Act (Act). You may, therefore,
have been reclassified in accordance with the provisions of t nave been recalssited in accordance will the provisions of the Act. The general controls provisions of the Activate market the device, subject to the gelleral control provisions of the golling and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) in the Corporal). it nay be subject (o If your device is classified (see above) into eller Class in (the Code of Frederal Regulations) Title 21,
such additional controls. Existing major regulations affecting your ട്രിറ്റ് ഓസ്റ്റ് - Extonig high legolations and only in the Current Cool Mandfacturing Practice Parts 800 to 895. A substantally equivalen described incr. Co enclares (o ocenter couldion (21 CFR Pat 820) and requirements, as set form in the Quality System regulation (FDA) will verify such assumptions. Faire to ormply with that, through periodic US inspections, the Food and Drug Forming announcements concerning your device in the GMP regulation may result in regulation. In addition of the mission does not affect any oligation you might the Federal Register. Please for the Response to your premainst nations of any of the Clecific on tother Federal laws or regulations.

This letter will allow you to begin marketing your 510(k) pemarket notification. The FDA finding of i his letter will allow you to begilly marketing your device in your virus promotive 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 80010 for in vitro If you desie spealic abite for your device of Canading of (301) 594-4591. Additionally, for questions on the promotion and diagnosite devices, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation under advertising of your device, please collice of Complanes of (or ) or rest information on your resorgeibilities under the ender he "Misolanding by release to peniance noticles from the reserved in the former (800) 638-2041 or (301) 443-5597 r or at its internet address "http://www.fda.gov/odch/dsmamain.html".

Sincerely yours,

Daniel G. Schultz, M.D.

Captain, USPHS Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure(s)

4

992414 510(k) Number (if known):

Device Name: Proton Beam Therapy System

Indications for Use:

The Optivus Technology, Inc.'s Proton Beam Therapy System (PBTS) is an integrated The Optivas Technology, the. 5 Procession treatments to patients through delivery of a predetermined radiation dose to a predetermined treatment target volume in a manner that a protection from unnecessary exposure to radiation and other hazards.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)
(Division Sign-Off)
Division of Reproductive, Abdominal, ENT, and Radiological Devices
510(k) NumberK992414
Prescription UseOROver-The-Counter Use
(Per 21 CFR 801.109)
Optivus Technology, Inc. 510(k)7/19/99CONFIDENTIAL
Proton Beam Therapy SystemPage vii