1.5T 16ch Shoulder Coil, 3.0T 16ch Shoulder Coil

K201101 · Neocoil, LLC · MOS · Jun 2, 2020 · Radiology

Device Facts

Record IDK201101
Device Name1.5T 16ch Shoulder Coil, 3.0T 16ch Shoulder Coil
ApplicantNeocoil, LLC
Product CodeMOS · Radiology
Decision DateJun 2, 2020
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 892.1000
Device ClassClass 2

Intended Use

To be used in conjunction with GEHC 1.5T Magnetic Resonance Scanners to produce diagnostic images of the shoulder that can be interpreted by a trained physician. To be used in conjunction with GEHC 3.0T Magnetic Resonance Scanners to produce diagnostic images of the shoulder that can be interpreted by a trained physician.

Device Story

Receive-only phased array RF coils; designed for 1.5T or 3.0T GE Healthcare MRI scanners. Inputs: magnetic resonance signals from hydrogen nuclei in shoulder anatomy. Operation: coils receive RF signals while blocking high-frequency magnetic fields from scanner; tuned to proton precession frequency per Larmor equation. Output: diagnostic images (axial, sagittal, coronal oblique slices). Used in clinical MRI settings by trained physicians/technicians. Output enables visualization of shoulder structures (humerus, rotator cuff, etc.) to assist clinical diagnosis of shoulder pathology. Benefits: improved signal-to-noise ratio (SNR) and uniform coverage compared to previous 8-channel designs.

Clinical Evidence

Clinical performance data provided via sample shoulder MRI images (Oblique Axial PD, Oblique Coronal T1/T2, Oblique Sagittal T2). No adverse events reported. Bench testing included biocompatibility, electrical safety (IEC 60601-1, 60601-2-33, 60601-1-2), usability, surface temperature, and NEMA MS 6-2008 SNR/uniformity testing. Results confirm performance consistent with indications.

Technological Characteristics

Receive-only phased array RF coils; 16-channel configuration. Materials: biocompatible components. Energy source: passive (powered by MRI scanner). Form factor: rigid posterior array with flexible anterior array. Connectivity: proprietary system cable connectors for GEHC MRI scanners. Standards: IEC 60601-1, 60601-2-33, 60601-1-2, NEMA MS 6-2008.

Indications for Use

Indicated for patients requiring diagnostic MRI imaging of the shoulder anatomy, including humerus, humeral head, labrum, glenoid, scapula, clavicle, and rotator cuff regions, for interpretation by a trained physician.

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.

Predicate Devices

Related Devices

Submission Summary (Full Text)

{0}------------------------------------------------ June 2, 2020 Image /page/0/Picture/1 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue. NeoCoil, LLC % Ms. Katie Gonzalez Regulatory & Quality Engineering Manager N27 W23910A Paul Road PEWAUKEE WI 53072 Re: K201101 Trade/Device Name: 1.5T 16ch Shoulder Coil. 3.0T 16ch Shoulder Coil Regulation Number: 21 CFR 892.1000 Regulation Name: Magnetic resonance diagnostic device Regulatory Class: Class II Product Code: MOS Dated: April 22, 2020 Received: April 24, 2020 Dear Ms. Gonzalez: 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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmp/pmn.cfm identifies combination product submissions. 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) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see {1}------------------------------------------------ https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050. 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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems. For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100). Sincerely, For Thalia T. Mills, Ph.D. Director Division of Radiological Health OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health Enclosure {2}------------------------------------------------ # Indications for Use 510(k) Number (if known) ## K201101 Device Name 1.5T 16ch Shoulder Coil ### Indications for Use (Describe) To be used in conjunction with GEHC 1.5T Magnetic Resonance Scanners to produce diagnostic images of the shoulder that can be interpreted by a trained physician. Type of Use (Select one or both, as applicable) | <span style="font-family: DejaVu Sans, sans-serif">✘</span> Prescription Use (Part 21 CFR 801 Subpart D) | <span style="font-family: DejaVu Sans, sans-serif">❍</span> Over-The-Counter Use (21 CFR 801 Subpart C) | |----------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------| |----------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------| ## CONTINUE ON A SEPARATE PAGE IF NEEDED. This section applies only to requirements of the Paperwork Reduction Act of 1995. ## *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.* The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to: > Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov "An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number." {3}------------------------------------------------ ## Indications for Use 510(k) Number (if known) Device Name 3.0T 16ch Shoulder Coil Indications for Use (Describe) To be used in conjunction with GEHC 3.0T Magnetic Resonance Scanners to produce diagnostic images of the shoulder that can be interpreted by a trained physician. Type of Use (Select one or both, as applicable) | <div> <div> <svg fill="none" height="16" viewbox="0 0 16 16" width="16" xmlns="http://www.w3.org/2000/svg"> <path d="M13.25 4.75L6.75 11.25L2.75 7.25" stroke="#000000" stroke-linecap="round" stroke-linejoin="round" stroke-width="1.5"></path> </svg> Prescription Use (Part 21 CFR 801 Subpart D) </div> </div> | |---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| | <div> <div> <svg fill="none" height="16" viewbox="0 0 16 16" width="16" xmlns="http://www.w3.org/2000/svg"> </svg> Over-The-Counter Use (21 CFR 801 Subpart C) </div> </div> | ## CONTINUE ON A SEPARATE PAGE IF NEEDED. This section applies only to requirements of the Paperwork Reduction Act of 1995. ## *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.* The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to: > Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov "An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number." {4}------------------------------------------------ Image /page/4/Picture/1 description: The image contains the logo for NeoCoil. The logo consists of a black circular shape with a white crescent moon shape inside, and a black arrow pointing to the right. To the right of the logo is the word "NeoCoil" in blue and black lettering. # K201101 ## 5. Traditional 510(k) Summary - 5.1. Applicant NeoCoil, LLC N27 W23910A Paul Rd Pewaukee, WI 53072 USA - 5.2. Contact Katie Gonzalez Regulatory & Quality Engineering Manager 262-522-6124 (office) 262-347-1251 (fax) Katie.Gonzalez@neocoil.com - 5.3. Preparation Date April 22, 2020 - 5.4. Name of Device - Trade/Proprietary name(s): 1.5T 16ch Shoulder Coil . 3.0T 16ch Shoulder Coil . Common name: Magnetic Resonance Specialty Coil . Classification name: 21 CFR 892.1000, Magnetic resonance diagnostic device, Product Code MOS ## 5.5. Predicate Device NeoCoil 3.0T 8-Channel Shoulder Array Coil, K071611 cleared on 06/28/2007. ## 5.6. Device Description The 1.5T 16ch Shoulder Coil and 3.0T 16ch Shoulder Coil are receive-only phased array RF coils designed for optimum signal-to-noise ratio (SNR) and uniform coverage of the shoulder anatomy for use with GE Healthcare Maqnetic Resonance Imaging (MRI) scanners. The coils receive magnetic resonance signals generated in hydrogen nuclei (protons) in the shoulder while blocking the high-frequency magnetic field applied by the MRI scanner at specified timings. Images are typically generated as axial, sagittal, coronal oblique slices and include coverage of the Humerus, Humeral Head, Labrum, Labral Tear, Glenoid, Scapula, Clavicle, and Rotator Cuff regions of the shoulder anatomy. The 1.5T 16ch Shoulder Coil and 3.0T 16ch Shoulder Coil are tuned to receive RF frequency corresponding to the proton precession in a 1.5 tesla and 3.0 tesla magnetic field (respectively), which is governed by the Larmor equation. The 1.5T 16ch Shoulder Coil and 3.0T 16ch Shoulder Coil are intended for use in a manner that is identical to the predicate device described in this submission. {5}------------------------------------------------ Image /page/5/Picture/1 description: The image shows the logo for NeoCoil. The logo consists of a black coil-like symbol with an arrow on the left side, followed by the word "NeoCoil" in blue and black. The "Neo" part of the word is in blue, while the "Coil" part is in black. Proposed labeling is documented in the Instructions for Use manuals for the 1.5T 16ch Shoulder Coil (NC143IFUF-EN) and 3.0T 16ch Shoulder Coil (NC143IFU-EN). - 5.7. Intended Use The intended use for the 1.5T 16ch Shoulder Coil and the 3.0T 16ch Shoulder Coil are identical to that of the predicate device, the 3.0T 8-Channel Shoulder Array Coil, K071611 cleared on 06/28/2007. The intended use is: ldentical to that of routine imaging; specifically to produce diagnostic images of the shoulder. Use of the device in conjunction with an MRI scanner is unchanged. - 5.8. Indications for Use ### 1.5T 16ch Shoulder Coil: To be used in coniunction with GEHC 1.5T Magnetic Resonance Scanners to produce diagnostic images of the shoulder that can be interpreted by a trained physician. ### 3.0T 16ch Shoulder Coil: To be used in conjunction with GEHC 3.0T Magnetic Resonance Scanners to produce diagnostic images of the shoulder that can be interpreted by a trained physician. ### 5.9. Technological Characteristics Both the 1.5T 16ch Shoulder Coil and the 3.0T 16ch Shoulder Coil are similar in design, material, chemical composition and energy source to the legally marketed device, the 3.0T 8-Channel Shoulder Array Coil, K071611 cleared on 06/28/2007. At a high level, the 1.5T 16ch Shoulder Coil and the 3.0T 16ch Shoulder Coil included as part of this submission and the predicate device are based on the following same technological elements: - Prescription use; - Coil designs are receive-only phased array coils; ● - Decoupling methodology; ● - Patient contacting materials and chemical composition are known materials that . have been assessed for compliance with recognized biocompatibility standards; - . Energy source for the coils is the MRI scanner; - . No energy is supplied by the coils; - Coils designs are targeted for imaging the shoulder anatomy; . - Mechanical designs are contoured for the shoulder anatomy: ● - Manufactured for use with the same MRI scanner manufacturer. The following technological differences exist between the subject and predicate devices: - The exterior of the predicate device is a flexible foam whereas the 1.5T 16ch ● Shoulder Coil and 3.0T 16ch Shoulder Coil exterior is comprised of a rigid posterior array and a flexible anterior array; - Predicate device incorporates 8 channels whereas the1.5T 16ch Shoulder Coil and . the 3.0T 16ch Shoulder Coil incorporate 16 channels; {6}------------------------------------------------ Image /page/6/Picture/1 description: The image shows the logo for NeoCoil. The logo consists of a black circular shape with a white crescent shape inside, and a black arrow pointing to the right. To the right of the circular shape is the word "NeoCoil" in blue and black letters. The "Neo" part of the word is in blue, and the "Coil" part is in black. - . Different system cable connectors for the 1.5T 16ch Shoulder Coil and the 3.0T 16ch Shoulder Coil compared to the predicate to interface with the newer MRI scanners. - . Field strength for the 1.5T 16ch Shoulder Coil The Indications for Use for the 1.5T 16ch Shoulder Coil is similar to the predicate device, the 3.0T 8-Channel Shoulder Array Coil, K071611 cleared on 06/28/2007 differing in compatible scanner(s) and field strength. With the exception of compatible scanner(s), the Indications for Use for the 3.0T 16ch Shoulder Coil are identical to the 3.0T 8-Channel Shoulder Array Coil, K071611 cleared on 06/28/2007. Clinical testing demonstrates that the differences in the compatible scanners of the devices do not affect the safety and/or the effectiveness of the device when used as labeled. Clinical and non-clinical testing demonstrates that the safety and effectiveness of the 1.5T 16ch Shoulder Coil compared to the predicate device is not adversely affected as a result of the differences. - 5.10. Testing A combination of clinical and non-clinical performance data is included, referenced or relied on to demonstrate that the 1.5T 16ch Shoulder Coil and 3.0T 16ch Shoulder Coil are safe and effective and perform in a manner that demonstrates substantial equivalence to the predicate device, the 3.0T 8-Channel Shoulder Array Coil, K071611 cleared on 06/28/207. ## Performance testing - Bench: A Test Report Summary for non-clinical Bench Testing performed, including testing to FDArecognized consensus standards identified as relevant in FDA guidance document Submission of Premarket Notifications for Magnetic Resonance Diagnostic Devices, issued November 18, 2016 is outlined below: | Test<br>Performed | Objective(s) of the<br>Test | Test Method<br>Description | Pre-defined<br>pass/fail<br>criteria | Results<br>Summary | Discussions /<br>Conclusions | |------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------|--------------------|----------------------------------------------------------------------------------------------------------------------------------------| | Biocompatibility<br>Assessment | Assess potential<br>biological risks | Evaluation of<br>data; historical<br>use, biologic<br>testing where<br>warranted | Acceptable<br>level of risk | Pass | No identified significant<br>risks. | | Electrical<br>Safety | Basic electrical<br>safety/essential<br>performance, 60601-1 | Test Lab | Pre-defined<br>performance<br>standards | Pass | Applicable<br>requirements for basic<br>electrical safety and<br>essential performance<br>met. | | Electrical<br>Safety | Particular electrical<br>requirements; MR<br>equipment, 60601-2-<br>33 | Test Lab | Pre-defined<br>performance<br>standards | Pass | Applicable<br>requirements of the<br>particular standard<br>were met. | | Test<br>Performed | Objective(s) of the<br>Test | Test Method<br>Description | Pre-defined<br>pass/fail<br>criteria | Results<br>Summary | Discussions /<br>Conclusions | | Electrical<br>Safety | Collateral electrical<br>safety/essential<br>performance, 60601-<br>1-2 | Test Lab /<br>Bench Testing | Pre-defined<br>performance<br>standards | Pass | Applicable<br>requirements of the<br>collateral standard were<br>met. | | Usability<br>Assessment | Devices meet<br>customer, end user<br>and patient needs | Actual,<br>simulated or<br>retrospective<br>evaluation of<br>the device<br>and/or data | Pre-defined<br>requirements | Pass | The devices met the<br>needs of the customer,<br>end user and patient. | | Entrapment,<br>Trapping Zone<br>and Cable<br>Looping<br>(assessment w/<br>scanner) | Assess the device for<br>pinch points,<br>entrapment, cable<br>looping - interfacing<br>with MRI scanner | Evaluation of<br>coil-to-scanner<br>entrapment,<br>trapping and<br>cable looping<br>not covered by<br>test lab<br>assessments. | Requirements<br>based on pre-<br>defined<br>requirements<br>in 60601-1<br>and customer<br>requirements | Pass | Requirements were<br>met. | | Surface<br>Temperature | Surface temperatures<br>do not exceed limits | MRI scanner<br>test | Pre-defined<br>performance<br>standards | Pass | Surface temperatures<br>were within IEC limits. | | Unplugged<br>Surface<br>Temperature | Devices remain safe in<br>first fault condition | MRI scanner<br>test | Acceptable<br>level of risk | Pass | Surface temperatures<br>were within IEC limits<br>when the coil is left<br>unplugged in the MRI<br>scanner. | | Blocking<br>Network<br>Analysis | Ensures devices are<br>designed with<br>adequate active and<br>passive transmit<br>decoupling | Theoretical<br>calculations | Adequate<br>transmit<br>decoupling | Pass | Blocking network<br>demonstrates adequate<br>active and passive<br>transmit decoupling. | | Maximum B1<br>Peak | Demonstrate the<br>devices can withstand<br>the maximum B1 peak<br>without obvious signs<br>of arcing, burning,<br>voltage breakdown | MRI scanner<br>test and visual<br>inspection | Pre-defined<br>performance<br>standards | Pass | Coils were able to<br>withstand maximum B1<br>peak without obvious<br>signs of arcing, burning<br>or voltage breakdown. | | B1 Field<br>Distortion | Measure amount of<br>distortion produced<br>due to presence of an<br>RF coil in the scanner | MRI scanner<br>test | Pre-defined<br>performance<br>standards | Pass | B1 field inhomogeneity<br>meets performance<br>requirements and<br>demonstrates adequate<br>active and passive<br>transmit decoupling. | | B0 Filed<br>Distortion | Measure amount of<br>distortion produced<br>due to presence of an<br>RF coil in the scanner | MRI scanner<br>test | Pre-defined<br>performance<br>standards | Pass | B0 field inhomogeneity<br>meets performance<br>requirements and<br>demonstrates adequate<br>active and passive<br>transmit decoupling. | | Test<br>Performed | Objective(s) of the<br>Test | Test Method<br>Description | Pre-defined<br>pass/fail<br>criteria | Results<br>Summary | Discussions /<br>Conclusions | | NEMA MS 6-<br>2008 | Evaluate single-<br>channel non-volume<br>special purpose radio-<br>frequency (RF) coils<br>for use with magnetic<br>resonance (MR)<br>imaging (MRI)<br>systems | MRI scanner<br>test | Pre-defined<br>performance<br>standards | Pass | SNR and Image<br>Uniformity are<br>consistent with the<br>requirements for<br>indications for use. | {7}------------------------------------------------ Image /page/7/Picture/1 description: The image shows the logo for NeoCoil. The logo consists of a black circular shape with an arrow pointing to the right, followed by the word "NeoCoil" in blue. The word "Neo" is in a lighter shade of blue than the word "Coil". T {8}------------------------------------------------ Image /page/8/Picture/1 description: The image contains the logo for NeoCoil. The logo consists of a black circular design with an arrow pointing to the right, followed by the word "NeoCoil" in blue and black. The word "Neo" is in blue, while the word "Coil" is in black. ## Performance testing - Clinical: Clinical data exhibits a mix of technical factors and anatomy as recommended in the FDA guidance, Submission of Premarket Notifications for Magnetic Resonance Diagnostic Devices issued November 18, 2016. No adverse events were reported during clinical performance testing. | 1.5T 16ch Shoulder Coil | 3.0T 16ch Shoulder Coil | |----------------------------------|---------------------------------| | Oblique Axial PD | Oblique Axial PD | | Oblique Coronal T1 (no fat sat) | Oblique Coronal T1 (no fat sat) | | Oblique Sagittal T2 (no fat sat) | Oblique Coronal T2 (fat sat) | {9}------------------------------------------------ Image /page/9/Picture/1 description: The image shows the logo for NeoCoil. The logo consists of a black coil-like shape with an arrow at the end, followed by the word "NeoCoil" in blue. The coil shape is on the left side of the logo, and the word "NeoCoil" is on the right side. Image /page/9/Picture/2 description: This image shows two MRI scans of a shoulder, comparing the results from a 1.5T 16ch Shoulder Coil and a 3.0T 16ch Shoulder Coil. The scan on the left, labeled "Oblique Sagittal T2 (fat sat)," was taken using the 1.5T coil, while the scan on the right, labeled "Oblique Sagittal T2 (no fat sat)," was taken using the 3.0T coil. The image shows the difference in image quality and fat saturation between the two coils. ## 5.11. Conclusion This submission demonstrates by means of nonclinical and clinical testing that the 1.5T 16ch Shoulder Coil and 3.0T 16ch Shoulder Coil are safe and effective and perform as well as or better than the predicate device, the 3.0T 8-Channel Shoulder Array Coil, K071611 cleared on 06/28/2007 for the indications claimed.
Innolitics
510(k) Summary
Decision Summary
Classification Order
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