The Butterfly iQ Ultrasound System is indicated for use by trained healthcare professionals in environments where healthcare is provided to enable diagnostic ultrasound imaging and measurement of anatomical structures and fluids of adult and pediatric patients for the following clinical applications: Peripheral Vessel (including carotid, deep vein thrombosis and arterial studies), Procedural Guidance, Small Organs (including thyroid, scrotum and breast), Cardiac, Abdominal, Urology, Fetal/Obstetric, Gynecological, Musculoskeletal (conventional), Musculoskeletal (superficial) and Ophthalmic. Modes of operation include B-mode + M-mode, B-mode + Color Doppler, B-mode + Power Doppler.
Device Story
Butterfly iQ is a handheld diagnostic ultrasound system; consists of a single transducer probe connected to a commercial off-the-shelf (COTS) mobile device. Operates by capturing ultrasound signals; transforms inputs into B-mode, M-mode, Color Doppler, and Power Doppler images. Used by trained healthcare professionals in clinical environments. Operator controls system via touchscreen interface on the mobile device to view and measure imagery. Output assists clinicians in diagnostic assessment of anatomical structures and fluids; facilitates procedural guidance. Benefits include portable, point-of-care diagnostic imaging capability.
Clinical Evidence
Bench testing only. Performance verified against IEC 60601-1 (safety), IEC 60601-1-2 (EMC), IEC 60601-2-37 (ultrasound safety), ISO 10993 (biocompatibility), and NEMA UD-2 (acoustic output). No clinical data presented.
Technological Characteristics
Handheld diagnostic ultrasound system; single 2D phased array transducer probe. Connectivity via COTS mobile device. Energy source: battery-powered (120-minute scan time). Software-based image processing. Complies with IEC 60601-1, IEC 60601-1-2, IEC 60601-2-37, ISO 10993, and NEMA UD-2 standards.
Indications for Use
Indicated for trained healthcare professionals to perform diagnostic ultrasound imaging and measurement of anatomical structures and fluids in adult and pediatric patients (including fetal). Applications: peripheral vessel, procedural guidance, small organs, cardiac, abdominal, urology, fetal/obstetric, gynecological, musculoskeletal, and ophthalmic.
Regulatory Classification
Identification
An ultrasonic pulsed doppler imaging system is a device that combines the features of continuous wave doppler-effect technology with pulsed-echo effect technology and is intended to determine stationary body tissue characteristics, such as depth or location of tissue interfaces or dynamic tissue characteristics such as velocity of blood or tissue motion. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.
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September 16, 2020
Image /page/0/Picture/1 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). The logo consists of two parts: the Department of Health & Human Services logo on the left and the FDA logo on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG" and "ADMINISTRATION" in blue text.
Butterfly Network, Inc. % Prithul Bom Official Correspondent Regulatory Technology Services, LLC 1000 Westgate Drive, Suite 510k SAINT PAUL MN 55114
Re: K202406
Trade/Device Name: Butterfly iQ Ultrasound System Regulation Number: 21 CFR 892.1550 Regulation Name: Ultrasonic pulsed doppler imaging system Regulatory Class: Class II Product Code: IYN, IYO, ITX Dated: August 18, 2020 Received: August 21, 2020
Dear Prithul Bom:
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 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for
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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 mediation-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
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# Indications for Use
510(k) Number (if known) K202406
Device Name Butterfly iQ Ultrasound System
#### Indications for Use (Describe)
The Butterfly iQ Ultrasound System is indicated for use by trained healthcare professionals in environments where healthcare is provided to enable diagnostic ultrasound imaging and measurement of anatomical structures and fluids of adult and pediatric patients for the following clinical applications: Peripheral Vessel (including carotid, deep vein thrombosis and arterial studies), Procedural Guidance, Small Organs (including thyroid, scrotum and breast), Cardiac, Abdominal, Urology, Fetal/Obstetric, Gynecological, Musculoskeletal (conventional), Musculoskeletal (superficial) and Ophthalmic. Modes of operation include B- mode + M-mode, B-mode + Color Doppler, B-mode + Power Doppler.
Type of Use (Select one or both, as applicable)
| <span></span> | <label><input checked="true" type="checkbox"/> Prescription Use (Part 21 CFR 801 Subpart D)</label> |
|---------------|-----------------------------------------------------------------------------------------------------|
| <span></span> | <label><input type="checkbox"/> Over-The-Counter Use (21 CFR 801 Subpart C)</label> |
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# 510(k) Summary or Statement
Image /page/3/Picture/2 description: The image shows the logo for Butterfly Network. The logo consists of a blue butterfly icon on the left and the words "Butterfly Network" in black on the right. The word "Butterfly" is in a larger font than the word "Network", and there is a trademark symbol next to the word "Butterfly".
530 Old Whitfield Street Guilford, CT 06437
(203) 458-7100
## 510(k) Summary of Safety and Effectiveness
#### Submitter Information
#### Submitter Name and Address
Butterfly Network, Inc. 530 Old Whitfield St. Guilford, CT 06437 USA (tel.) 855-296-6188 (fax) 203-458-2514 www.butterflynetwork.com
### Contact Person
Brian Sawin Sr. Regulatory Affairs Manager 855-296-6188 bsawin@butterflynetwork.com
#### Date Prepared
July 20, 2020
# Subject Device - Proprietary/Trade Name
Butterfly iQ Ultrasound System
### Subject Device - Common Name
Ultrasound Imaging System
#### Classification Name
| | Regulation Number | Product Code |
|------------------------------------------|-------------------|--------------|
| Ultrasonic Pulsed Doppler Imaging System | 892.1550 | 90-IYN |
| Ultrasonic Pulsed Echo Imaging System | 892.1560 | 90-IYO |
| Diagnostic Ultrasound Transducer | 892.1570 | 90-ITX |
### Classification
Class II
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# Predicate Device:
K163510 - Poseidon Ultrasound System, Butterfly Network, Inc. (Clearance Date: 09/06/2017)
K170714 - Venue, GE Medical Systems Ultrasound & Primary Care Diagnostics, LLC (Clearance Date: 06/22/2017)
# Device Summary:
The Butterfly iQ Ultrasound System is a general-purpose diagnostic imaging system for use by qualified and trained healthcare professionals in environments where healthcare is provided to enable visualization and measurement of anatomical structures and fluid of adult and pediatric patients. The system consists of a single transducer with broad imaging capabilities connected to a standard handheld commercial off the shelf (COTS) mobile device. In addition to M-mode imaging the instrument also supports Color Doppler and Power Doppler imaging.
The user interface includes touchscreen menus, buttons, controls, indicators and navigation icons that allow the operator to control the system and to view and measure ultrasound imagery.
## Indications for Use:
The Butterfly iQ Ultrasound System is indicated for use by trained healthcare professionals in environments where healthcare is provided to enable diagnostic ultrasound imaging and measurement of anatomical structures and fluids of adult and pediatric patients for the following clinical applications: Peripheral Vessel (including carotid, deep vein thrombosis and arterial studies), Procedural Guidance, Small Organs (including thyroid, scrotum and breast). Cardiac, Abdominal, Uroloqy, Fetal/Obstetric, Gynecological, Musculoskeletal (conventional), Musculoskeletal (superficial) and Ophthalmic. Modes of operation include Bmode, B-mode + M-mode, B-mode + Color Doppler, B-mode + Power Doppler.
### Summary of Technological Characteristics
The Butterfly iQ Ultrasound System has a substantially equivalent intended use, imaging capability, technological characteristics and safety and effectiveness as the legally marketed predicate device and is used to aid in diagnosis. The subject and predicate devices are based on the following substantially equivalent clinical and technological elements:
- . Diaqnostic ultrasound system
- Ophthalmic clinical application
The following clinical and technological differences exist between the subject and predicate:
- Transrectal, Transvaginal, Neonatal and adult cephalic, Thoracic/pleural and . Cardiac Fetal Echo clinical applications
- . Handheld vs. mobile
- Single probe vs. multiple .
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- Commercial off the shelf display vs. LCD display •
# Device Comparison Table:
| Butterfly iQ<br>Ultrasound System<br>(This submission) | Butterfly Poseidon<br>Ultrasound System<br>510(k): K163510 | Venue<br>510(k): K170714 | |
|--------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| FDA Clearance | No - original submission | Yes (September 6, 2017) | Yes (June 22, 2017) |
| Intended Use | Intended for use by trained<br>healthcare professionals in<br>environments where<br>healthcare is provided to<br>enable diagnostic ultrasound<br>imaging and measurement<br>of anatomical structures and<br>fluids of adult and pediatric<br>patients for the following<br>clinical applications:<br>Peripheral Vessel (including<br>carotid, deep vein<br>thrombosis and arterial<br>studies), Procedural<br>Guidance, Small Organs<br>(including thyroid, scrotum<br>and breast), Cardiac,<br>Abdominal, Urology,<br>Fetal/Obstetric,<br>Gynecological,<br>Musculoskeletal<br>(conventional),<br>Musculoskeletal (superficial)<br>and Ophthalmic. Modes of<br>operation include B-mode,<br>B-mode + M-mode, B-mode<br>+ Color Doppler, B-mode +<br>Power Doppler. | Intended for use by qualified<br>and trained healthcare<br>professionals to enable<br>diagnostic ultrasound imaging<br>and measurement of<br>anatomical structures and<br>fluids of adult and pediatric<br>patients for the following clinical<br>applications: Peripheral Vessel<br>(including carotid, deep vein<br>thrombosis and arterial studies),<br>Procedural Guidance, Small<br>Organs (including thyroid,<br>scrotum and breast), Cardiac,<br>Abdominal, Urology,<br>Fetal/Obstetric, Gynecological,<br>Musculoskeletal (conventional)<br>and Musculoskeletal<br>(superficial). | Intended for ultrasound<br>imaging, measurement and<br>analysis of the human body<br>and fluid for multiple clinical<br>applications including:<br>abdominal (GYN and<br>Urology), thoracic/pleural,<br>ophthalmic, Fetal/OB, Small<br>Organ (including breast,<br>testes, thyroid), Peripheral<br>vascular, neonatal and adult<br>cephalic, pediatric,<br>musculoskeletal (conventional<br>and superficial), cardiac<br>(adults and pediatric),<br>Transrectal, Transvaginal,<br>and imaging guidance of<br>interventional procedures<br>(e.g. Nerve block, vascular<br>access). |
| General Device Description | Hand held portable diagnostic<br>ultrasound system. | Hand held portable diagnostic<br>ultrasound system. | Mobile diagnostic ultrasound<br>system. |
| Clinical Applications | | | |
| | | | |
| | Ophthalmic | Not Applicable | Ophthalmic |
| | Abdominal | Abdominal | Abdominal |
| | Cardiac | Cardiac | Cardiac |
| | Carotid | Carotid | Carotid |
| | Musculo-skeletal<br>(conventional and<br>superficial) | Musculo-skeletal<br>(conventional and superficial) | Musculo-skeletal<br>(conventional and superficial) |
| | Fetal/Obstetric,<br>Gynecological | Fetal/Obstetric, Gynecological | Fetal/Gynecological |
| | Peripheral Vessel<br>(including carotid, deep<br>vein thrombosis, arterial<br>studies) | Peripheral Vessel (including<br>carotid, deep vein thrombosis,<br>arterial studies) | Peripheral Vessel |
| | Procedural Guidance | Procedural Guidance | Imaging guidance of<br>interventional procedures |
| | Small Organs including<br>thyroid, scrotum, and<br>breast | Small Organs including<br>thyroid, scrotum, and breast | Small Organs including<br>thyroid, scrotum, and breast |
| | Urology | Urology | Urology |
| | Not Applicable | Not Applicable | Transrectal |
| | Not Applicable | Not Applicable | Transvaginal |
| | Not Applicable | Not Applicable | Neonatal and adult cephalic |
| | Not Applicable | Not Applicable | Thoracic/pleural |
| | Not Applicable | Not Applicable | Cardiac Fetal Echo |
| | Relevant Similarities | | |
| Target<br>Population | Fetal, Pediatric, Adult,<br>Male, Female | Fetal, Pediatric, Adult, Male,<br>Female | Fetal, Pediatric, Adult, Male,<br>Female |
| Where used | Professional healthcare<br>settings | Professional healthcare<br>settings | Environments where<br>healthcare is provided by<br>healthcare professionals |
| Energy<br>used/delivered<br>(MI/TI) | Meets FDA/AIUM<br>guidelines | Meets FDA/AIUM guidelines | Meets FDA/AIUM guidelines |
| FDA Regulatory<br>Classification | Class II | Class II | Class II |
| 510(k) Track | Track 3 | Track 3 | Track 3 |
| Portable/hand-<br>held | Yes | Yes | Yes |
| Biocompatibility | Yes | Yes | Yes |
| Sterility | Products not classified as<br>sterile | Products not classified as<br>sterile | Products not classified as<br>sterile |
| Electrical safety | Meets electrical safety<br>standards for a class II<br>medical device. | Meets electrical safety<br>standards for a class II<br>medical device. | Meets electrical safety<br>standards for a class II medical<br>device. |
| Mechanical<br>safety | Meets mechanical safety<br>standards for a class II<br>medical device | Meets mechanical safety<br>standards for a class II<br>medical device | Meets mechanical safety<br>standards for a class II<br>medical device |
| FDA Product<br>Codes | IYN, IYO, ITX | IYN, IYO, ITX | IYN, IYO, ITX |
| Transducer | | | |
| Type | Single probe 2D Phased<br>Array | Single probe 2D Phased Array…
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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.
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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).
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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.
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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.
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Reading rule for every project: how many summaries do you read in full?
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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.
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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.
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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.
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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.