PORTABLE X-RAY SYSTEM, MODEL POWERMAX 1260

K090655 · Source-Ray, Inc. · IZL · Jul 14, 2009 · Radiology

Device Facts

• Record ID: K090655
• Device Name: PORTABLE X-RAY SYSTEM, MODEL POWERMAX 1260
• Applicant: Source-Ray, Inc.
• Product Code: IZL · Radiology
• Decision Date: Jul 14, 2009
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 892.1720
• Device Class: Class 2

Intended Use

The Model PowerMax 1260 Portable X-Ray System is intended for General Purpose Portable Radiographic Applications

Device Story

PowerMax 1260 is a mobile X-ray system designed for general purpose radiographic imaging. Device operates as a portable unit, allowing clinicians to perform X-ray examinations at point-of-care settings. System generates X-ray radiation to capture diagnostic images of patients. Operated by trained healthcare professionals (radiologic technologists or physicians). Output consists of radiographic images used by clinicians to diagnose patient conditions. Benefits include increased accessibility to diagnostic imaging for non-ambulatory or critically ill patients.

Clinical Evidence

Bench testing only.

Technological Characteristics

Mobile X-ray system; 21 CFR 892.1720; portable form factor; utilizes X-ray radiation for diagnostic imaging.

Indications for Use

Indicated for general purpose portable radiographic applications in patients requiring diagnostic X-ray imaging.

Regulatory Classification

Identification

A mobile x-ray system is a transportable device system intended to be used to generate and control x-ray for diagnostic procedures. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.

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 consists of a circular seal on the left and a stylized symbol on the right. The seal contains the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter of the circle.

## DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Ray Manez Director. Operations Source-Ray, Inc. 167 Keyland Court BOHEMIA NY 11716

Re: K090655

Trade/Device Name: PowerMax 1260 Portable X-Ray System Regulation Number: 21CFR §892.1720 Regulation Name: Mobile x-ray system Regulatory Class: II Product Code: IZL Dated: May 29, 2009 Received: June 2, 2009

Dear Mr. Manez:

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 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 (reporting of medical

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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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR 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/cdrh/mdr/ 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,

Jadine M. Morris

Janine M. Morris Acting Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use Form (Text Version)

## Medical Devices

## Indications for Use

510(k) Number (if known): K090655

Device Name: _PowerMax 1260 Portable X-Ray System

Indications for Use:

The Model PowerMax 1260 Portable X-Ray System is intended for General Purpose Portable Radiographic Applications

| Prescription Use | X |
|----------------------|--------------|
| | AND/OR |
| Over-The-Counter Use | |
| | (Part 21 CFR |

801 Subpart D) (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)
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(Division Sign-Off)
Division of Reproductive, Abdominal and
Radiological Devices

510(k) Number