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510(k) Data Aggregation

    K Number
    K050888
    Manufacturer
    Date Cleared
    2005-05-23

    (46 days)

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

    To enable head and neck immobilization for patient placement during radiation therapy planning and treatment.

    Device Description

    The Integra Immobilization System consists of three device options which may be used as the patient simulation and treatment circumstances indicate. All three options of the System utilize the same thermoplastic, all three are designed with high strength carbon fiber, with foam core to provide a strong but light weight support base and all three provide head, neck and shoulder immobilization for patients undergoing simulation or radiation therapy using the exact same attachment of the thermoplastic to the carbon fiber board.

    The "Integra ce Extension" option to the Varian Exact Couch provides a means to attach the extension securely to the end of the Exact Couch utilizing Varian's end of table design. The board provides rigid support to the head and shoulders by means of its carbon fiber and foam core construction.

    The "Integra ci Insert" option to the Varian Exact Couch provides the means to provide head, neck and shoulder immobilization on a CT Scanner couch or a Varian Exact Treatment Table. This insert fits into a mating recess in the CT table overlay or a similar insert space in the Exact Treatment Table.

    The "Integra co Cantilever Board" option provides head, neck and shoulder immobilization as part of a stand alone carbon fiber and foam core board. The board is constructed utilizing carbon fiber surfaces with a foam interior. The result is an extremely stong but light weight board. The overall design of the board provides comfortable patient support and a means to index the board to the table or overlay that it rests upon.

    The Integra Immobilization System utilizes the method of head, neck and shoulder fixation that is also commonly found in radiation therapy departments and has been repeatedly shown to be safe and effective in immobilizing the head, neck and shoulders. The thermoplastic from Orfit is heated in a water bath to a temperature that makes the thermoplastic moldable. The material is removed from the bath, dried and placed over the patients head, neck and shoulders. It is stretched over the head, neck and shoulders, molded to conform to the patients head, neck and shoulder contour and attached to the support board in such a way that the patient is firmly held in place and yet can be released from the position very quickly if needed. As the thermoplastic cools, it hardens and thus permanently maintains the patient contour for repeated identical immobilizations required during a course of treatment.

    AI/ML Overview

    The provided text is a 510(k) Premarket Notification Summary for the Integra™ Immobilization System. This is a medical device submission, and as such, it focuses on demonstrating substantial equivalence to a predicate device rather than presenting a study with specific acceptance criteria and performance metrics typically seen for AI/ML-driven devices.

    Therefore, the requested information regarding acceptance criteria, device performance, sample sizes, expert involvement, adjudication methods, MRMC studies, standalone performance, and ground truth establishment is not available in the provided document. The document primarily details the device description, its intended use, and a comparison to a predicate device to establish substantial equivalence based on technological characteristics.

    Instead of providing the requested table for acceptance criteria and performance (which is not present), I will summarize the key information available in the document that aligns with an equivalence demonstration for a non-AI/ML device.

    Summary of Device Equivalence Information (as presented in the 510(k) Summary):

    1. Acceptance Criteria and Reported Device Performance:

      • Acceptance Criteria (Implicit): Substantial equivalence to the predicate device (Orfit Industries Raycast Immobilization Systems and Thermoplastics, K991319) in terms of construction, form, function, and safety and effectiveness.
      • Reported Device Performance: The document does not provide specific performance metrics in the way an AI/ML device would (e.g., sensitivity, specificity, AUC). Instead, it asserts that the Integra Immobilization System is "substantially equivalent to the Orfit boards in construction, form and function." This equivalence is based on the comparison of technological characteristics.
    2. Sample Size and Data Provenance:

      • Not Applicable. This type of device (physical immobilization system) does not involve data in the sense of a test set for algorithmic evaluation. Therefore, there are no sample sizes for test sets or data provenance cited.
    3. Number of Experts and Qualifications:

      • Not Applicable. The evaluation of this device is based on its physical design and materials, and comparison to an established predicate, rather than an expert review of algorithmic outputs or study data.
    4. Adjudication Method:

      • Not Applicable. There is no adjudication process described as there is no diagnostic or interpretive output requiring expert consensus.
    5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study:

      • No. This is not an AI-assisted diagnostic or interpretive device, so an MRMC study is irrelevant to its evaluation.
    6. Standalone Performance:

      • Not Applicable. "Standalone performance" in the context of AI refers to the algorithm's performance without human intervention. This device is a physical immobilization system and does not have an "algorithm."
    7. Type of Ground Truth Used:

      • Not Applicable. No ground truth data (e.g., pathology, outcomes data) is used because the device's function is mechanical immobilization, not diagnostic or predictive. The "truth" here is essentially that it effectively immobilizes the patient, which is established through its design and similarity to the predicate.
    8. Sample Size for the Training Set:

      • Not Applicable. There is no training set for this type of device.
    9. How Ground Truth for the Training Set Was Established:

      • Not Applicable. As there is no training set, there is no ground truth to establish for it.

    Key Information from the Document that demonstrates equivalence:

    The applicant established substantial equivalence by comparing the Integra Immobilization System to the predicate device, the Orfit Industries Raycast Immobilization Systems and Thermoplastics (K991319), across several technological characteristics:

    • Intended Use: Both devices are intended to retain/immobilize the head, neck, and shoulders of the patient during radiation therapy simulation or treatment.
    • Construction: Both utilize carbon fiber over foam core board construction (Orfit also uses HPL in some cases).
    • Thermoplastic Head Immobilization: Both use thermoplastic masks.
    • Head and Neck Restraint: Both use non-invasive thermoplastic masks.
    • Head Positioning: Both use head holders and foam wedges.
    • Thermoplastic Mask Release: Both use a foam insert to hold the mask in a slot for release.

    The document states, "The Diacor Integra Head and Neck Immobilization boards are substantially equivalent to the Orfit boards in construction, form and function." This statement, coupled with the detailed comparison table, forms the basis of their claim for meeting the FDA's regulatory requirements for this type of device via the 510(k) pathway.

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