JETPACK 2.0

K111024 · Philips Medical Systems (Cleveland), Inc. · LLZ · Apr 21, 2011 · Radiology

Device Facts

• Record ID: K111024
• Device Name: JETPACK 2.0
• Applicant: Philips Medical Systems (Cleveland), Inc.
• Product Code: LLZ · Radiology
• Decision Date: Apr 21, 2011
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 892.2050
• Device Class: Class 2
• Attributes: Software as a Medical Device, 3rd-Party Reviewed

Intended Use

A nuclear medicine image display and processing application suite that provides software applications used to process, analyze, and display medical images/data. The results obtained may be used as a tool, by a nuclear physician, in determining the diagnosis of patient disease conditions in various organs, tissues, and other anatomical structure. The data processed may be derived from any nuclear medicine gamma camera. JETPack 2.0 should only be operated by qualified healthcare professionals trained in the use of nuclear medicine equipment.

Device Story

JETPack 2.0 is a Windows-based software suite for nuclear medicine image display and processing. It accepts raw image data from nuclear medicine gamma cameras. The software provides tools for image review, post-processing, interpretation, report generation, and workflow/data management. It is intended for use by nuclear physicians and technologists in clinical settings. The output consists of processed medical images and reports, which clinicians use as a diagnostic tool to evaluate patient disease conditions in organs and tissues. The device facilitates clinical decision-making by providing standardized visualization and analysis of nuclear medicine data.

Clinical Evidence

No clinical data provided; substantial equivalence is based on technological comparison and system performance characteristics.

Technological Characteristics

Windows-based software suite for nuclear medicine image processing. Functions as a PACS-related application (Product Code LLZ). Operates on standard hardware platforms meeting minimum system requirements. Provides tools for image display, analysis, and report generation. Connectivity supports data management and workflow integration.

Indications for Use

Indicated for use by qualified nuclear medicine professionals to process, analyze, and display medical images/data derived from nuclear medicine gamma cameras to assist in the diagnosis of disease conditions in various organs, tissues, and anatomical structures.

Regulatory Classification

Identification

A medical image management and processing system is a device that provides one or more capabilities relating to the review and digital processing of medical images for the purposes of interpretation by a trained practitioner of disease detection, diagnosis, or patient management. The software components may provide advanced or complex image processing functions for image manipulation, enhancement, or quantification that are intended for use in the interpretation and analysis of medical images. Advanced image manipulation functions may include image segmentation, multimodality image registration, or 3D visualization. Complex quantitative functions may include semi-automated measurements or time-series measurements.

Special Controls

*Classification.* Class II (special controls; voluntary standards—Digital Imaging and Communications in Medicine (DICOM) Std., Joint Photographic Experts Group (JPEG) Std., Society of Motion Picture and Television Engineers (SMPTE) Test Pattern).

Predicate Devices

• NM Application Suite (K080961)

Submission Summary (Full Text)

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# ADMINISTRATIVE INFORMATION

APR 2 1 2011

### 510(k) SUMMARY OF SAFETY AND EFFECTIVENESS I.

A. Submitted By: Philips Medical Systems (Cleveland), Inc. 3860 N. First Street, San Jose California 95134

[phone] Tel: Fax: [phone]

Contact Person:

Lori R. Peterson At address above

3/1/2011

Date Prepared:

- B. Device Trade Name: Common Name: Classification Name:
JETPack 2.0 Image Processing System Picture Archive and Communication Systems (PACS)

C. Predicate Device(s):

| Manufacturer | Product Name | 510(k)<br>No. |
|----------------------------------------------|----------------------|---------------|
| Philips Medical Systems<br>(Cleveland), Inc. | NM Application Suite | K080961 |

Device Description: D.

JETPack 2.0 is a Windows®-based Nuclear Medicine suite of image display and processing applications for the Nuclear Medicine market segment. The software package is deployable on hardware platforms, which meet the minimum requirements needed to run the software. The comprehensive tools and features provided with this product, will allow the technologist and/or physician to perform image review, processing of source data, post processing, hardcopy production, interpretation, report . generation and contains the utilities necessary to support the workflow and data management between those activities.

- E. Intended Use:

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A nuclear medicine image display and processing application suite that provides software applications used to process, analyze, and display medical images/data. The results obtained may be used as a tool, by a nuclear physician, in determining the diagnosis of patient disease conditions in various organs, tissues, and other anatomical structure. The data processed may be derived from any nuclear medicine gamma camera. JETPack 2.0 should only be operated by qualified healthcare professionals trained in the use of nuclear medicine equipment.

- F. Technological Comparison:
NM Application Suite (K080961) and JETPack 2.0 have similar indications for use and overall function and perform in a similar manner with respect to, display, review and processing applications.

#### II. CONCLUSION

The JETPack 2.0 is substantially equivalent to the NM Application Suite (K080961) a predicate device based on similar intended use, technological comparison, and system performance.

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Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized eagle with three stripes forming its body and wings. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" are arranged in a circular pattern around the eagle.

### 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

Philips Medical Systems (Cleveland), Inc. % Mr. Ned Devine Senior Staff Engineer Underwriters Laboratories, Inc. 333 Pfingsten Road NORTHBROOK IL 60062

APR 2 1 201

Re: K111024

Trade/Device Name: JETPack 2.0 Regulation Number: 21 CFR 892.2050 Regulation Name: Picture archiving and communications system Regulatory Class: II Product Code: LLZ Dated: April 11, 2011 Received: April 12, 2011

Dear Mr. Devine:

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 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 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 toll-free number [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely Yours.

Mary Patel

Mary S. Pastel, Sc.D. 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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# Indications for Use Form

510(k) Number (if known): _ K /// D24

JETPack 2.0 Device Name:

Indications for Use:

A nuclear medicine image display and processing application suite that provides software applications used to process, analyze and display medical images/data. The results obtained may be used as a tool, by a nuclear physician, in determining the diagnosis of patient disease conditions in various organs, tissues, and other anatomical structure. The data processed may be derived from any nuclear medicine gamma JETPack 2.0 should only be operated by qualified healthcare camera. professionals trained in the use of nuclear medicine equipment.

Prescription Use _____________________________________________________________________________________________________________________________________________________________ (21 CFR 801 Subpart C)

# (PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of In Vitro Diagnostic Devices (OIVD)

Mumy Slatel

Division Sian-Of Office of In Vitro Diagnostic Device Evaluation and Safe

510(k) K111024

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