SHIMADZU COLLIMATOR R-20J

K101036 · Shimadzu Corp. · IZX · Aug 26, 2010 · Radiology

Device Facts

• Record ID: K101036
• Device Name: SHIMADZU COLLIMATOR R-20J
• Applicant: Shimadzu Corp.
• Product Code: IZX · Radiology
• Decision Date: Aug 26, 2010
• Decision: SESE
• Submission Type: Abbreviated
• Regulation: 21 CFR 892.1610
• Device Class: Class 2

Intended Use

This device is intended to be used in radiology. This collimator is to be used in conjunction with an x-ray generator and x-ray tube to limit the area of radiation that is emitted to a confined field of view. This limits the potential for radiation to the general population in the exam area. This device is for diagnostic use. This device is operated and used by Physicians and X-Ray technologist. The object of this device is total patient populations.

Device Story

R-20I is a diagnostic x-ray beam-limiting device (collimator). It functions by mechanically restricting the x-ray beam emitted from an x-ray tube to a specific, confined field of view. Used in clinical radiology settings, it is operated by physicians and x-ray technologists. By limiting the radiation field, the device reduces unnecessary radiation exposure to the patient and the surrounding exam area. It serves as an accessory to x-ray generators and tubes to ensure precise diagnostic imaging.

Clinical Evidence

Bench testing only.

Technological Characteristics

Diagnostic x-ray beam-limiting device (collimator). Mechanical assembly designed to restrict x-ray beam geometry. Operates in conjunction with x-ray generators and tubes. Class II device (21 CFR 892.1610).

Indications for Use

Indicated for use in diagnostic radiology for all patient populations to limit the x-ray radiation field of view when used with an x-ray generator and tube.

Regulatory Classification

Identification

A diagnostic x-ray beam-limiting device is a device such as a collimator, a cone, or an aperture intended to restrict the dimensions of a diagnostic x-ray field by limiting the size of the primary x-ray beam.

Special Controls

*Classification.* Class II (special controls). The device 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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Image /page/0/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is a staff with two snakes entwined around it. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the caduceus symbol.

# DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -- WO66-G609 Silver Spring, MD 20993-0002

Shimadzu Corporation % Mr. Don Karle Director, National Service Shimadzu Medical Systems 20101 South Vermont Avenue TORRANCE CA 90502-1328

AUG 2 6 2010

Re: K101036

Trade/Device Name: R-201 Regulation Number: 21 CFR 892.1610 Regulation Name: Diagnostic x-ray beam-limiting device Regulatory Class: II Product Code: IZX Dated: April 13, 2010 Received: April 15, 2010

Dear Mr. Karle:

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, Or to 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 1 ... 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 class II (Special Controls), it may be subject to such additional controls. Existing major regulations affecting your device can be found in Title 21. Code of Federal Regulations (CFR), Parts 800 to 895. 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 Parts 801 and 809); medical device reporting (reporting of

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medical device-related adverse events) (21 CFR 803); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820). This letter will allow you to begin marketing your device as described in your Section 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 Parts 801 and 809), please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its tolli inte [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Donald J. Trump

Donald J. St.Pierre Acting Director Division of Radiological Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

### Enclosure

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510(K) Notification Submission, R-20J

## Section XI. INDICATION FOR USE

K101036

Page 1 of 1

| 510(K) number (if known): | Unknown K101036 |
|---------------------------|-----------------|
| Device Name: | R-20I |
| Indication for Use: | |

/ This device is intended to be used in radiology.

/ This collimator is to be used in conjunction with an x-ray generator and x-ray tube
to limit the area of radiation that is emitted to a confined field of view. This limits
the potential for radiation to the general population in the exam area.

/ This device is for diagnostic use.

/ This device is operated and used by Physicians and X-Ray technologist.

/ The object of this device is total patient populations.

| Prescription Use | X |
|------------------|----------------------|
| AND/OR | Over-The-Counter Use |

(Per 21CFR801 Subpart D)

,

(21 CFR 801 Subpart D)

(PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE) - O IV D

Division of Radiological Device ce Evaluation and Safety Office of in Vitro

ice Of In Vitro Diagnostic P
510K. K101036