NEUROVASCULAR ARRAY COIL, MODEL NVA-127-16-A

K052497 · Invivo Corp. · MOS · Oct 12, 2005 · Radiology

Device Facts

• Record ID: K052497
• Device Name: NEUROVASCULAR ARRAY COIL, MODEL NVA-127-16-A
• Applicant: Invivo Corp.
• Product Code: MOS · Radiology
• Decision Date: Oct 12, 2005
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 892.1000
• Device Class: Class 2

Intended Use

To be used in conjunction with a Magnetic Resonance Scanner to produce diagnostic images of the head and neck that can be interpreted by a trained physician.

Device Story

Model NVA-127-16-A Neurovascular Array Coil is a radiofrequency (RF) coil accessory for Magnetic Resonance (MR) scanners. Device functions as signal receiver for MR imaging of head and neck anatomy. Operated by trained medical personnel in clinical radiology settings. Coil captures RF signals emitted by patient tissue during MR scan; signals transmitted to scanner console for image reconstruction. Output is diagnostic-quality MR images used by physicians to assess head and neck pathology. Device facilitates non-invasive visualization of internal structures, aiding clinical diagnosis and treatment planning.

Clinical Evidence

No clinical data provided; bench testing only.

Technological Characteristics

Passive radiofrequency (RF) receiver coil array. Designed for head and neck MR imaging. Compatible with standard MR scanner interfaces. Non-invasive, non-powered (passive) component. Materials and construction consistent with standard MR coil design requirements for signal reception and patient safety.

Indications for Use

Indicated for patients requiring diagnostic imaging of the head and neck via Magnetic Resonance Scanner. For use by trained physicians.

Regulatory Classification

Identification

A magnetic resonance diagnostic device is intended for general diagnostic use to present images which reflect the spatial distribution and/or magnetic resonance spectra which reflect frequency and distribution of nuclei exhibiting nuclear magnetic resonance. Other physical parameters derived from the images and/or spectra may also be produced. The device includes hydrogen-1 (proton) imaging, sodium-23 imaging, hydrogen-1 spectroscopy, phosphorus-31 spectroscopy, and chemical shift imaging (preserving simultaneous frequency and spatial information).

Special Controls

*Classification.* Class II (special controls). A magnetic resonance imaging disposable kit intended for use with a magnetic resonance diagnostic device only is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 892.9.

Submission Summary (Full Text)

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Thomas Schubert Chief Technology Officer Invivo Corporation N27W23676 Paul Rd. PEWAUKEE WI 53072

OCT 1 2 2005

Re: K052497 Trade/Device Name: Model NVA-127-16-A Neurovasculer Array Coil Regulation Number: 21 CFR 892.1000 Regulation Name: Magnetic resonance diagnostic device Regulatory Class: II Product Code: MOS Dated: August 29, 2005 Received: September 12, 2005

Dear Mr. Schubert:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and 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) that do not require approval of a premarket approval application (PMA). 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 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act s requirements. including, but not limited to registration and listing (21 CFR Part 807): labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the clectronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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This letter will allow you to begin marketing your device as described in your Section 510(k) I this ichel will anow you to ogh manieming of substantial equivalence of your device to a legally premarket nothleation: "The PDF maing of Sation 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), please If you desire specific advice for your corres on the following numbers, based on the regulation number at the top of this letter:

| 21 CFR 876.xxxx | (Gastroenterology/Renal/Urology) | 240-276-0115 |
|-----------------|----------------------------------|--------------|
| 21 CFR 884.xxxx | (Obstetrics/Gynecology) | 240-276-0115 |
| 21 CFR 892.xxxx | (Radiology) | 240-276-0120 |
| Other | | 240-276-0100 |

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Also, please note the regulation entires, formation on your responsibilities under the Act from the 807.97). Tou may obtain only golleral mironal and Consumer Assistance at its toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Nancy C. Hogdon

Nancy C. Brogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Special 510(K) Application, Device Modification Special > Pro(It) Fippineareurovascular Array Coil, August 29, 2005

## Section C – Statement of Indications for Use

Applicant: Invivo Corporation 510(k) number (if known): Device Name: Model NVA-127-16-A Neurovascular Array Coil

Indications for use:

To be used in conjunction with a Magnetic Resonance Scanner to produce diagnostic images of the head and neck that can be interpreted by a trained physician.

Concurrence of CDRH, Office of Device Evaluation (ODE)

| Prescription Use | ✓ | or | Over-The-Counter Use |
|------------------|---|----|----------------------|
|------------------|---|----|----------------------|

(Per 21 CFR 801.109)

(Optional Format 1-2-96)

(Division Sign-Off)

Division of Reproductive, Abdominal,

and Radiological Devices

| 510(k) Number | K052497 |
|---------------|---------|
|---------------|---------|

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