Varian Head Frame

K180586 · Varian Medical Systems, Inc. · IYE · Apr 2, 2018 · Radiology

Device Facts

• Record ID: K180586
• Device Name: Varian Head Frame
• Applicant: Varian Medical Systems, Inc.
• Product Code: IYE · Radiology
• Decision Date: Apr 2, 2018
• Decision: SESE
• Submission Type: Special
• Regulation: 21 CFR 892.5050
• Device Class: Class 2

Intended Use

The Varian Head Frame is for use with a charged particle accelerator to perform immobilization of the treatment target for stereotactic radiosurgery or radiotherapy treatments on cranial lesions, tumors and conditions where radiation treatment is indicated.

Device Story

Varian Head Frame provides rigid skull immobilization for stereotactic radiosurgery or radiotherapy. Device consists of a rigid halo (head frame) secured to the patient's skull via four invasive pins/screws. System includes brackets to secure the frame to CT or treatment tables. Used in clinical settings by medical professionals to prevent patient movement during imaging and radiation delivery. Immobilization ensures precise targeting of cranial lesions or tumors. Benefits include enhanced accuracy of radiation delivery to the treatment target.

Clinical Evidence

No clinical data. Evidence consists of non-clinical verification and validation testing, including cleaning and sterilization validation. Reprocessing testing demonstrated the head frame ring is valid for 60 cycles and posts for 286 cycles.

Technological Characteristics

Materials: Nickel-plated anodized aluminum (ring), PEEK (posts). CT compatible. Sterilization: Autoclave. Standards: IEC 62366, ISO 10993 series (1, 5, 10, 11), AAMI TIR12, AAMI TIR30, ANSI/AAMI ST81, ST79, ST35, AAMI TIR34, ASTM E2314-03, ISO 17664, ISO 17665-1.

Indications for Use

Indicated for patients requiring stereotactic radiosurgery or radiotherapy for cranial lesions, tumors, and conditions where radiation is indicated; used with CT scanners for treatment planning and charged particle accelerators for target immobilization.

Regulatory Classification

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.

Predicate Devices

• Varian Head Frame (K142560)

Submission Summary (Full Text)

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April 2, 2018

Image /page/0/Picture/1 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The FDA logo consists of two parts: the Department of Health and Human Services logo on the left and the FDA text logo on the right. The text logo features the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" and "ADMINISTRATION" in blue.

Varian Medical Systems, Inc. % Mr. Peter Coronado Director, Global Regulatory Affairs 3100 Hansen Way PALO ALTO CA 94304

Re: K180586

Trade/Device Name: Varian Head Frame Regulation Number: 21 CFR 892.5050 Regulation Name: Medical charged-particle radiation therapy system Regulatory Class: II Product Code: IYE Dated: March 2, 2018 Received: March 5, 2018

Dear Mr. Coronado:

We have reviewed vour 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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to 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); medical device reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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(1-800-638-2041 or 301-796-7100).

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.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email ([e-mail]) or phone

Sincerely,

Michael D. O'Hara
For

Robert Ochs, Ph.D Director Division of Radiological Health Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

Enclosure

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# Indications for Use

510(k) Number (if known)

K180586

Device Name Varian Head Frame

#### Indications for Use (Describe)

The Varian Head Frame System is for use with a computed tomography scanner to perform imaging for treatment planning and a charged particle accelerator to perform immobilization of the treatment target for stereotactic radiosurgery or radiotherapy treatments on cranial lesions, tumors and conditions where radiation treatment is indicated.

Type of Use (Select one or both, as applicable)

> Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

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Varian Medical Systems, Inc. 3100 Hansen Way Palo Alto, CA 94304-1038 USA Tel [phone] www.varian.com

# Premarket Notification [510(k)] Summary

varian

# Varian Head Frame

The following information is provided following the format of 21 CFR 807.92(c).

| Submitter's Name: | Varian Medical Systems, Inc.<br>3100 Hansen Way E-110<br>Palo Alto, CA 94304<br><br>Contact Name: Peter J. Coronado<br>Phone: [phone]<br>Fax: [phone]<br><br>Date: March 2, 2018 |
|-----------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Name of the Device:<br>Trade/ Proprietary<br>Names: | Varian Head Frame |
| Classification Name: | Medical charged-particle radiation therapy system<br>21 CFR 892.5050, Class II<br>Product Code: IYE |
| Common/Usual<br>Name: | Head Frame |
| Predicate Device: | Varian Head Frame K142560 |
| Device Description: | The Head Frame provides rigid immobilization of a patient's skull by attaching a rigid halo<br>(head frame) to the patient through four invasive contact points (called screws or pins)<br>which penetrate the patient's skin and contact the bone of the skull. The head frame is<br>secured to either the CT table or the treatment table via a bracket which is included in<br>the system. This ensures the patient cannot easily move during imaging or treatment.<br>This level of immobilization is generally used for stereotactic radiosurgery. |
| Intended Use<br>Statement | The Varian Head Frame is for use with a charged particle accelerator to perform<br>immobilization of the treatment target for stereotactic radiosurgery or radiotherapy<br>treatments on cranial lesions, tumors and conditions where radiation treatment is<br>indicated. |
| Indications for Use<br>Statement | The Varian Head Frame System is for use with a computed tomography scanner to<br>perform imaging for treatment planning and a charged particle accelerator to perform<br>immobilization of the treatment target for stereotactic radiosurgery or radiotherapy<br>treatments on cranial lesions, tumors and conditions where radiation treatment is<br>indicated |

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# Technological Characteristics:

| FEATURE AND/OR SPECIFICATION | VARIAN HEAD FRAME | VARIAN HEAD FRAME |
|------------------------------|------------------------------------------------------|-----------------------------------------|
| OF NEW/MODIFIED DEVICE | | |
| | (v1.0) K142560 | (v2.0) |
| Indications for use | The Varian Head Frame System is for | The Varian Head Frame System is for |
| | use with a computed tomography | use with a computed tomography |
| | scanner to perform imaging for | scanner to perform imaging for |
| | treatment planning and a charged | treatment planning and a charged |
| | particle accelerator to perform | particle accelerator to perform |
| | immobilization of the treatment | immobilization of the treatment |
| | target for stereotactic radiosurgery or | target for stereotactic radiosurgery or |
| | radiotherapy treatments on cranial | radiotherapy treatments on cranial |
| | lesions, tumors and conditions where | lesions, tumors and conditions where |
| | radiation treatment is indicated. | radiation treatment is indicated. |
| Intended Use | The Varian Head Frame is for use with | The Varian Head Frame is for use with |
| | a charged particle accelerator to | a charged particle accelerator to |
| | perform immobilization of the | perform immobilization of the |
| | treatment target for stereotactic | treatment target for stereotactic |
| | radiosurgery or radiotherapy | radiosurgery or radiotherapy |
| | treatments on cranial lesions, tumors | treatments on cranial lesions, tumors |
| | and conditions where radiation | and conditions where radiation |
| | treatment is indicated. | treatment is indicated. |
| Head Frame Ring | Nickel-plated anodized aluminum | Nickel-plated anodized aluminum |
| Posts | Material: Delrin | Material: PEEK |
| CT | CT compatible | CT compatible |
| Sterilization: | Cleaning for the Head Frame and | Cleaning and Autoclave Sterilization |
| | Posts | for the Cranial pins, Head Frame and |
| | Autoclave Sterilization for the Cranial<br>Pins only | Posts |

## Summary of Performance Testing

Results of verification and validation testing showed conformance to applicable requirements specifications and that the assured hazard safeguards functioned properly. Cleaning, sterilization and reprocessing testing validated the outlined procedures and demonstrated the Head Frame ring can be reprocessed up to 60 cycles and the posts can be reprocessed up to 286 cycles.

Clinical Tests No clinical tests have been included in this pre-market submission

## Standards conformance

The Varian Head Frame conforms with the following standards.

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IEC 62366:2007 ANSI/AAMI/ISO 10993-1:2009 ANSI/AAMI/ISO 10993-5:2009 AMSI/AAMI/ISO 10993-10:2010 AMSI/AAMI/ISO 10993-11:2010 AAMI TIR12 AAMI TIR30:2011

ANSI/AAMI ST81 ANSI/AAMI ST79 ANSI/AAMI ST35 AAMI TIR34 ASTM E2314-03 ISO 17664 ANSI/AAMI/ISO 17665-1

#### Conclusions

Based on the verification, validation and non-clinical cleaning and sterilization testing, the Varian Head Frame is as safe and effective and performs at least as well as the predicate device.