← Product Code [KXK](/productcode/KXK) · K102811

# AOS ORION IR-192 SOURCE CABLE (K102811)

_Alpha-Omega Services, Inc. · KXK · Jun 2, 2011 · Radiology · SESE_

**Canonical URL:** https://fda-staging.innolitics.com/device/K102811

## Device Facts

- **Applicant:** Alpha-Omega Services, Inc.
- **Product Code:** [KXK](/productcode/KXK.md)
- **Decision Date:** Jun 2, 2011
- **Decision:** SESE
- **Submission Type:** Traditional
- **Regulation:** 21 CFR 892.5730
- **Device Class:** Class 2
- **Review Panel:** Radiology
- **Attributes:** Therapeutic

## Indications for Use

The AOS Orion Ir-192 Source Cable is a sealed radionuclide brachytherapy source to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy. This device is the replaceable Ir-192 source for the Nucletron Corp. MicroSelectron HDR V2 and V3 Afterloaders.

## Device Story

AOS Orion Ir-192 Source Cable is a replaceable sealed radionuclide brachytherapy source; designed for use with Nucletron microSelectron HDR Version 2 and V3 remote afterloaders. Device consists of 1x7 nitinol inner core with 6-wire crosslaid stainless steel outer wrap; provides radiation therapy by delivering Iridium-192 source to target tissue. Operated by clinical staff within radiation oncology settings; device is inserted into body cavities or placed on surfaces via afterloader system. Benefits include targeted radiation delivery for therapy; nitinol construction enhances flexibility compared to predicate designs. Performance verified through mechanical strength, weld integrity, and compatibility testing; meets ISO 2919 and ISO 9978 standards.

## Clinical Evidence

Bench testing only. No clinical data presented. Testing included mechanical strength, weld integrity, and compatibility with Nucletron afterloaders, confirming compliance with ISO 2919 and ISO 9978 standards.

## Technological Characteristics

Sealed radionuclide brachytherapy source; Iridium-192 isotope; 12 Curie nominal activity. Construction: 1x7 nitinol inner core with 6-wire crosslaid stainless steel outer wrap. Dimensions: 0.9mm diameter, 2022mm length. Laser-welded seals. Compatible with Nucletron microSelectron HDR V2/V3 afterloaders. Standards: ISO 2919, ISO 9978.

## Regulatory Identification

A radionuclide brachytherapy source is a device that consists of a radionuclide which may be enclosed in a sealed container made of gold, titanium, stainless steel, or platinum and intended for medical purposes to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy.

## Special Controls

*Classification.* Class II (special controls). A prostate seeding kit intended for use with a radionuclide brachytherapy source 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

- MicroSelectron HDR Version 2 ([K092804](/device/K092804.md))
- MicroSelectron V3 ([K061354](/device/K061354.md))

## Submission Summary (Full Text)

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# 510(k) Summary

### 1. General Information

| 510(k) Owner:                       | Alpha-Omega Services, Inc.<br>9156 Rose Street<br>Bellflower, California 90706<br>Tel: (562) 804-0604<br>Fax: (562) 804-0610 |
|-------------------------------------|------------------------------------------------------------------------------------------------------------------------------|
| Contact Person:                     | Bob A. Robnett<br>Director Regulatory Affairs & Quality                                                                      |
| Date:                               | September 20, 2010                                                                                                           |
| Trade Name:                         | AOS Orion Ir-192 Source Cable                                                                                                |
| Common/Usual Name:                  | Radionuclide Brachytherapy Source                                                                                            |
| Classification Name:                | Radionuclide Brachytherapy Source<br>21 CFR 892.5730, Class II, Product Code: KXK                                            |
| Establishment Registration Numbers: | 2022694, 3003660614                                                                                                          |
| Special Controls                    | None                                                                                                                         |
| Substantial Equivalence:            | K092804 MicroSelectron HDR Version 2<br>K061354 MicroSelectron V3                                                            |

#### 2. Device Description

The AOS Orion Ir-192 Source Cable (Model No. CSO0012-192) is a nominal 12 Curie Iridium-192 source cable for use in the Nucletron microSelectron HDR Version 2 (Model No. 105.99) and the Nucletron microSelectron V3 (Model No. 106.990) Remote Afterloaders.

#### 3. Intended Use

The AOS Orion Ir-192 Source Cable is a sealed radionuclide brachytherapy source to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy. This device is the replaceable Ir-192 source for the Nucletron Corp. MicroSelectron HDR V2 and V3 Afterloaders.

#### Performance Test বে

#### 4.1. Compatibility and Mechanical

The mechanical strength and compatibility of the AOS Orion ir-192 Source Cable has been verified through a series of tests demonstrating worst case scenarios. Testing was successfully completed as prescribed and all the acceptance criteria have been met. The Orion Cable has been demonstrated to be compatible for use with the Nucletron microSelectron V2 and Nucletron microSelectron V3 HDR Remote Afterloaders.

#### 4.2.ISO 2919 and Cable/Weld Strength Testing

The AOS Orion Ir-192 Source Cable has been tested and acceptance criteria outlined in the ISO 2919 and ISO 9978 standards. In addition, the Orion Cable's weld and cable strength have been 

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tested and are equivalent to the predicate's performance.

### 5. Substantial Equivalence

|                                       | Predicate Information | New Device                                                                      | Predicate 1                                               | Predicate 2                                               |
|---------------------------------------|-----------------------|---------------------------------------------------------------------------------|-----------------------------------------------------------|-----------------------------------------------------------|
| Device Name                           |                       | AOS Orion Ir-192 Source Cable<br>Patent Pending                                 | MicroSelectron HDR Version 2                              | MicroSelectron V3                                         |
| Model Number                          | 510(k)                | CSO0012-192                                                                     | 105.999                                                   | 106.990                                                   |
|                                       |                       |                                                                                 | K092804                                                   | K061354                                                   |
| Registry of Sealed Source<br>& Device |                       | Not yet submitted. Awaiting<br>510(k) approval.                                 | MD-0497-S-107-S                                           | MD-0497-S-107-S                                           |
| Diameter                              |                       | 0.9mm                                                                           | 0.9mm                                                     | 0.9mm                                                     |
| Length                                |                       | 2022mm                                                                          | 2022mm                                                    | 2022mm                                                    |
| Cable Type1                           |                       | 1x7 Nitinol Inner Core with a<br>6 Wire Crosslaid Stainless Steel<br>Outer Wrap | Section 1: 19 Stands Crosslaid<br>Section 2: 7x7 Stranded | Section 1: 19 Stands Crosslaid<br>Section 2: 7x7 Stranded |
| Materials2                            |                       | Stainless Steel/Nitinol                                                         | Stainless Steel                                           | Stainless Steel                                           |
| Seal Method                           |                       | Laser Weld                                                                      | Laser Weld                                                | Laser Weld                                                |
| Cable Strength                        |                       | ≥ 200 Newtons                                                                   | ≥ 200 Newtons                                             | ≥ 200 Newtons                                             |
| Welds Strength                        |                       | Able to withstand 15 Newtons<br>for 3 minutes                                   | Able to withstand 15 Newtons<br>for 3 minutes             | Able to withstand 15 Newtons for 3 minutes                |
| Range of Motion                       |                       | Radius of ≥ 12mm                                                                | Radius of ≥ 15mm                                          | Radius of ≥ 15mm                                          |
| Isotope                               |                       | Iridium-192                                                                     | Iridium-192                                               | Iridium-192                                               |
| Nominal Activity                      |                       | 12 Curies                                                                       | 12 Curies                                                 | 12 Curies                                                 |
| Tested Transfer Cycles                |                       | 100,000                                                                         | 100,000                                                   | 100,000                                                   |
| Certified Cycles                      |                       | 25,000                                                                          | 25,000                                                    | 25,000                                                    |
| Recommended Cycles                    |                       | 5000                                                                            | 5000                                                      | 5000                                                      |

1 The AOS Orion Ir-192 Source Cable is a one piece cable constructed of a 1x7 nitinol inner core with a 6 Wire Crosslaid Stainless Steel Outer Wrap. Performance testing has demonstrated that this design provides the same strength and flexibility as the 2 piece predicate cable.

² The addition of nitinol strands provides the required flexibility without the need for a smaller diameter cable attachment as found on the predicate cable.

#### 6. Conclusion

Based on the above information, the AOS Orion Ir-192 Source Cable has been demonstrated to be equivalent to the source cable used in both predicate devices.

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Image /page/2/Picture/0 description: The image is a seal for the Department of Health & Human Services (HHS) in the USA. The seal is circular, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. In the center of the seal is a stylized depiction of an eagle, with its wings spread. The eagle is facing to the right.

## DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

JUN - 2 2011

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room - WO66-G609 Silver Spring, MD 20993-0002

Mr. Bob A. Robnett Director Regulatory Affairs & Quality Alpha-Omega Services, Inc. 9156 Rose Street, P.O. Box 789 BELLFLOWER CA 90706

Re: K102811

Trade/Device Name: AOS Orion Ir-192 Source Cable Regulation Number: 21 CFR 892.5730 Regulation Name: Radionuclide brachytherapy source Regulatory Class: II Product Code: KXK Dated: May 2, 2011 Received: May 3, 2011

Dear Mr. Robnett:

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 (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 (301) 796-5450. 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 (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely Yours.

Mary S 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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510(k) Number (if known):

Device Name: AOS Orion Ir-192 Source Cable

Indications for Use: The AOS Orion Ir-192 Source Cable is a sealed radionuclide brachytherapy source to be placed onto a body surface or into a body cavity or tissue as a source of nuclear radiation for therapy. This device is the replaceable Ir-192 source for the Nucletron Corp. MicroSelectron HDR V2 and V3 Afterloaders.

Prescription Use _ Yes (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use _ No_ (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)

Mary S Pastle

Division Sign-Off Office of In Vitro Diagnostic Device Evaluation and Safety

K102811 510(k)_

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