MEVION S250i

Basic Information

• Brand Name: MEVION S250i
• Primary DI: 00864366000124
• Version / Model: S250i
• Catalog Number: MEVION S250i
• Company Name: MEVION MEDICAL SYSTEMS, INC.
• Labeler DUNS: 199652145
• Distribution Status: In Commercial Distribution
• Device Count in Pkg: 1
• Record Status: Published
• Publish Date: 2018-02-05
• Public Version: 3
• Public Version Date: 2018-07-06
• Public Version Status: Update
• Public Device Record Key: f5ca1d4e-e4ec-462c-bfeb-172b0bd47675

Device Characteristics

• Single Use: No
• Prescription Use (Rx): Yes
• Over the Counter (OTC): No
• Kit: No
• Combination Product: No
• HCT/P: No
• Contains NRL: No
• Not Made with NRL: No
• MRI Safety: Labeling does not contain MRI Safety Information
• Direct Marking Exempt: No
• PM Exempt: No
• Has Serial Number: Yes
• Has Lot/Batch Number: No
• Has Manufacturing Date: Yes
• Has Expiration Date: No
• Has Donation ID: No

Sterilization

• Is Sterile: No
• Sterilization Prior Use: No

Product Codes

Code	Name	Medical Specialty	Regulation #	Device Class
LHN	System, Radiation Therapy, Charged-Particle, Medical	Radiology	892.5050	2

GMDN Terms

Code	Name	Definition	Implantable	Status
47069	Proton therapy system	An assembly of devices/sub-systems designed to produce and deliver a transverse- and longitudinal-dose proton beam to treat localized tumours and other conditions susceptible to treatment by radiation. It typically consists of components for beam production, transport and delivery; patient positioning; system and component control; and software. It will typically be configured to a particular site’s requirements.	No	Active

Identifiers

Type	ID	Issuing Agency	Package Type	Qty per Pkg	Pkg Status	Pkg Discontinue Date
Primary	00864366000124	GS1

Premarket Submissions

Submission Number	Supplement Number
K172848	000

Storage Conditions

• Type: Storage Environment Temperature
• Temperature Range: 66 – 74 Degrees Fahrenheit
• Type: Storage Environment Humidity
• Temperature Range: 30 – 70 Percent (%) Relative Humidity