STarFix™Designer software is intended to be used by a neurosurgeon, neurologist or clinical neurophysiologist to plan and monitor positioning of microelectrodes, stimulating electrodes, or other instruments in specific anatomical structures in brain or nervous system.
Device Story
STarFix Designer is image-based neurosurgical planning software for generating patient-specific frames (FHC Platform) for DBS and SEEG procedures. Inputs: CT and MR images. Processing: rigid registration between CT/MR; manual/automatic localizer extraction; 2D/3D visualization of anatomical landmarks (AC, PC, MP); trajectory planning; platform frame modeling. Output: surgical plan data for frame construction. Used in clinical settings by neurosurgeons, neurologists, or neurophysiologists. Software guides user through numbered menus and toolbar-based operations to verify planning elements before platform model generation. Benefits: enables accurate, efficient planning for electrode implantation.
Clinical Evidence
Bench testing only. Software regression testing performed iteratively per IEC 62304. All major software functions verified against predicate device workflows. No clinical data presented.
Technological Characteristics
Image-based planning software; rigid intensity-based registration; 2D/3D volume reconstruction; thresholding; distance/angle measurement tools. Connectivity: data import/export for planning transfer. Software lifecycle management per IEC 62304.
Indications for Use
Indicated for use with commercially available stereotactic systems for neurosurgical procedures requiring accurate positioning of microelectrodes, stimulating electrodes, or other instruments in the brain or nervous system.
Regulatory Classification
Identification
A stereotaxic instrument is a device consisting of a rigid frame with a calibrated guide mechanism for precisely positioning probes or other devices within a patient's brain, spinal cord, or other part of the nervous system.
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September 8, 2023
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FHC, Inc. Kelly Moeykens QSO & Quality/Regulatory Manager 1201 Main Street Bowdoin, Maine 04287
Re: K231141
Trade/Device Name: STarFix Designer Software (C0265) Regulation Number: 21 CFR 882.4560 Regulation Name: Stereotaxic Instrument Regulatory Class: Class II Product Code: QRI, HAW Dated: August 9, 2023 Received: August 10, 2023
Dear Kelly Moeykens:
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/cfpmn/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
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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 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).
Sincerelv.
Image /page/1/Picture/5 description: The image shows a digital signature. The signature includes the name "Adam D. Pierce - S". The signature indicates that the document was digitally signed on September 8, 2023, at 11:37:42 -04'00'.
Adam D. Pierce, Ph.D. Assistant Director DHT5A: Division of Neurosurgical, Neurointerventional and Neurodiagnostic Devices OHT5: Office of Neurological and Physical Medicine Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known) K231141
Device Name STarFix Designer Software (C0265)
#### Indications for Use (Describe)
The STarFix Designer Software is part of the WayPoint Stereotactic System. The WayPoint Stereotactic System is intended to be used with commercially available stereotactic system for neurological procedures which require the accurate positioning of microelectrodes, stimulating electrodes, or other instruments in the brain or nervous system.
| Type of Use (Select one or both, as applicable) | |
|-----------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|
| <div> <span> <b> ☑ </b> Prescription Use (Part 21 CFR 801 Subpart D) </span> </div> | <div> <span> ☐ Over-The-Counter Use (21 CFR 801 Subpart C) </span> </div> |
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# K231141 Page 1 of 7
# 510(K) Summary
1. Submitter's name, address, telephone number, a contact person, and the date the summary was prepared:
FHC, Inc. 1201 Main Street Bowdoin, ME-04287 Tel: 207-666-5651 Fax: 207-666-8292
Contact: Kelly Moeykens Date: 04/20/2023
### 2. Name(s) of the Device:
| Proprietary/Trade Name: | STarFix™Designer |
|-------------------------|-----------------------------------------------|
| | STarFix™Designer, SFD or C0265 or Stereotaxis |
| Common Name: | Planning Software |
| Regulation Number | |
| Regulation Name: | Neurological Stereotaxic Instrument |
| Classification Panel | Neurology |
| Product Code: | QRI |
| Regulatory Class: | II |
### 3. Legally Marked Predicate Device to which the submitter claims substantial equivalence:
The STarFix™Designer is substantially equivalent to FHC, Inc.'s Voxim and WayPoint™ Planning Software, part of the WayPoint™ Stereotactic System (K092192); decision date: February 12™ 2010, product code: HAW
### 4. Description of device:
FHC, Inc. STarFix™ Designer software is an advanced image-based neurosurgical planning software application designed for generating patient specific frames (FHC, Platform) primarily for Deep Brain Stimulation (DBS) Proedures and stereo-electroencephalography (SEEG) by means of the WayPoint™ Stereotactic platforms.
The STarFix™ Designer offers the following core features:
- Image import and registration
- Open and manipulate CT and MR images for surgical planning
- . Rigid registration between CT and MR images, with user-selected reference scan of either modality.
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# K231141
## Page 2 of 7
- Automatic localizer extraction
- Extract localizers from preoperative CT manually or automatically
- I Manually place localizers on MR scans
- Manual refinement of localizer position
- Patient specific 2D and 3D visualization of anatomical landmarks: AC, PC, MP
- Trajectory planning ●
●
- DBS STarFix™ Platform frame modeling ●
- . Multi-Oblique STarFix™ Platform frame modeling
- . Export and import planning data, including images, for transfer on another computer or to be saved for easy reference during the surgery
- Save the plan any time during the planning session
The STarFix™ Designer provides a modern design, built to ease user interaction, and allow fast and efficient planning for the WayPoint™ Platforms and ultimately, the implantation of DBS electrodes. With safety as a primary concern, all planning elements need to be verified and marked explicitly before a platform model can be built. The user interface is guiding the necessary planning steps, by using numbered menus and intuitive labeling, along with a minimum of application settings and common actions arranged in the form of a toolbar dedicated to either 2D or 3D operations.
Image /page/4/Figure/13 description: The image shows a medical imaging interface with multiple views of a brain scan. The interface is divided into sections for imaging, fiducials, anatomy, trajectories, and platform. The brain scans are displayed in 2D and 3D views, with green lines indicating trajectories or points of interest. The display orientation is set to 'Original' with L: 2.75, P: 0.82, and S: -1.93.
Figure 1 : DBS planning session using the bilateral platform.
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#### 5. Statement of Intended Use:
STarFix™Designer software is intended to be used by a neurosurgeon, neurologist or clinical neurophysiologist to plan and monitor positioning of microelectrodes, stimulating electrodes, or other instruments in specific anatomical structures in brain or nervous system.
### Statement of Indications for Use:
The STarFix™Designer is part of the WayPoint™ Stereotactic System. The WayPoint™ Stereotactic System is intended to be used with commercially available stereotactic systems for neurosurgical procedures which require the accurate positioning of microelectrodes, stimulating electrodes, or other instruments in the brain or nervous system.
### 6. Comparison of Technological Characteristics to Predicate Device
The technological characteristics of the STarFix™ Designer are the same as those in the predicate device. There is no new technology, materials or method of manufacture introduced. A summary of similarities in the specifications between the STarFix™ Designer and its predecessor is provided below.
| Component<br>Section | Feature | Subject Device:<br>STarFix™ Designer | Predicate:<br>Waypoint™ Planner | Predicate:<br>Voxim | |
|------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------|----------------------------------------------------|------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------|------|
| Imaging<br>Load images, preview | CT loading | Yes | Yes | Yes, load<br>patient<br>datasets. | |
| | MRI loading | Yes | Yes | Yes, load<br>patient<br>datasets. | |
| Aligning images | Manual pre-align:<br>Align/Rotate | Yes | Yes | Yes | |
| | Automatic<br>Registration | Rigid<br>Registration by<br>Intensity | Rigid Registration<br>by Intensity,<br>Registration<br>by points,<br>Registration<br>by device | Yes,<br>automatic<br>matching,<br>imaging<br>device<br>referential, or<br>frame<br>registrations. | |
| | Incremental<br>registration – use<br>previous<br>registration step as<br>a base for a new<br>registration step | Yes | Yes | No | |
| Viewing Images -2D | Checkerboard, Lens<br>to check accurate<br>alignment | Yes | Same | Yes, shade<br>feature | |
| | Brightness/Contrast | Yes | Same | Yes, grayscale<br>tool. | |
| | Measurement | Yes, distance and<br>angles | Same | Yes, distance,<br>angles,<br>surface | |
| Viewing Images -3D | 3D volume<br>reconstruction | Yes | Yes | Yes | |
| | Thresholding | Yes, lower and<br>upper limit | Yes, lower<br>limit | Yes, lower<br>and upper<br>limit | |
| | Solid/ Slice views | Yes | Yes | Yes, solid and<br>surface cut | |
| | Distance<br>measurement | Yes | Same | Yes | |
| Fiducials<br>Anchor Detection | Automatic Anchor<br>detection | Yes | Same | Yes | |
| | Seed and search<br>(semi-automatic<br>search) | Yes | Same | No | |
| | Manual placement | Yes | Same | Yes | |
| Anatomy | AC, PC, MP manual<br>point placement | Yes | Same | Yes | |
| Point Selection | Display of AC-PC<br>Length | Yes | Yes | Yes | |
| Trajectories<br>Adding trajectories | Editing of trajectory<br>name, entry and<br>target coordinates | Yes | Yes | Yes,<br>trajectory<br>parameter<br>panel | |
| | Mirroring an<br>existing trajectory<br>with respect to the<br>mid-plane | Yes | Same | Yes | |
| | Using templates to<br>add trajectories | Yes | Same | No | |
| | Displaying distance<br>to target | Yes | No | Yes | |
| | Surgeon's eye view<br>(trajectory view) | Yes | Same | Yes | |
| Platform<br>STarFix™ Platform –<br>Unilateral or Bilateral | Select platform<br>model | Yes | Same | Yes | |
| | Automatically sort<br>anchors | Yes | Yes | Yes | |
| | Automatically sort<br>trajectories | Yes | Yes | Yes | |
| | Specifying Platform<br>height | Yes | Same | Yes | |
| | Building the<br>platform | Yes | Same | Yes | |
| Multi-Oblique Platform | Select platform<br>model | Yes | Same | No | |
| | Edit connections | Yes | Yes | No | |
| | | Specifying hub height | Yes | Yes | No |
| | | Building the platform | Yes | Same | No |
| Data Export | Exporting the production file | Edit the patient details and save the file to disk | Yes | Same | Yes |
| | Plan files | Save the current plan to disk | Yes | Yes. | Yes. |
Table 2: Similarities between STarFix™Designer, Waypoint Planner and Voxim microTargeting™
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## 8. Substantial Equivalence statement:
The STarFix™ Designer Software System is substantially equivalent in design, construction, materials, intended use and performance characteristics to its predicative devices, FHC, Inc.'s Voxim and WayPoint™ Planner Planning Software, part of the WayPoint™ Stereotactic System (K092192); decision date: February 12th 2010.
### 9. Performance Data:
Performance data of the STarFix™Designer Software System is documented in the verification and validation reports. Software regression test results show the system to be the equivalent to the predicate system.
| Test | Test Method Summary | Results |
|-----------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Software<br>regression<br>testing | The internally created<br>software regression test<br>protocol is based on the<br>workflow established in the<br>Usability specification of the<br>predicate device. It is<br>performed iteratively at each<br>software release per IEC<br>62304. | All major areas of software<br>functionality were confirmed for the<br>subject device. No remaining bugs<br>had a risk level of greater than<br>Acceptable as defined by risk<br>management plan. |
| | All major and minor software<br>functions were tested<br>iteratively prior to each | Over the course of its life-cycle, the<br>predicate device received similar<br>treatment with respect to bug fixes,<br>bug risk acceptance, software |
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K231141 Page 7 of 7
| release of a new software<br>revision. Additionally, bugs<br>fixed since the previous round<br>of regression testing were<br>assessed for effectiveness and<br>risk. | releases, and regression testing. As<br>such, substantive equivalence is<br>established. |
|----------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|
|----------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|
### 10. Conclusion
Based on the non-clinical performance data performed comparing the STarFix™ Designer software to the predicate device (Voxim and WayPoint Planning Software), it is concluded that the subject device is as safe and effective as the predicate device.
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.