FDA-cleared profile

EFAI Chestsuite XR Malpositioned ETT Assessment System (ETT-XR-100)

Ever Fortune.AI, Co., Ltd.

EFAI CHESTSUITE XR MALPOSITIONED ETT ASSESSMENT SYSTEM (EFAI ETTXR) is a radiological computeraided triage and notification software indicated for use in the analysis of chest X-ray (CXR) images in adults. The device is intended to assist hospital networks and appropriately trained medical specialists in workflow triage by flagging and communicating suspected positive cases of vertically malpositioned endotracheal tube (ETT) in relation to the carina. Findings are flagged when the ETT distal tip is assessed as being more than 7 cm above the carina, less than 3 cm above the carina, or when it is below the carina (i.e in the right or left mainstem bronchus). The device assesses solely the vertical position of the ETT distal tip relative to the carina, does not factor patient positioning, and cannot detect esophageal intubation. The device is tested in the single lumen endotracheal tube, while it may trigger a false prioritization alert in the case of properly positioned double lumen ETT. EFAI ETTXR analyzes cases using deep learning algorithms to identify suspected malpositioned ETT findings. It makes case-level output available to a PACS/workstation for worklist prioritization or triage. EFAI ETTXR is not intended to direct attention to specific portions of an image or to anomalies of an image. Its results are not intended to be used on a stand-alone basis for clinical decision-making nor is it intended to rule out malpositioned ETT or otherwise preclude clinical assessment of chest radiographs.

Evidence status: each field shows source quality, applicability, and review date. Research pending, information not established in reviewed sources, and vendor documentation pending are distinct outcomes.

Clinical fit

What this tool is for

Start with the authorized purpose, then verify how it fits your service line and reading workflow.

Exact purpose
EFAI CHESTSUITE XR MALPOSITIONED ETT ASSESSMENT SYSTEM (EFAI ETTXR) is a radiological computeraided triage and notification software indicated for use in the analysis of chest X-ray (CXR) images in adults. The device is intended to assist hospital networks and appropriately trained medical specialists in workflow triage by flagging and communicating suspected positive cases of vertically malpositioned endotracheal tube (ETT) in relation to the carina. Findings are flagged when the ETT distal tip is assessed as being more than 7 cm above the carina, less than 3 cm above the carina, or when it is below the carina (i.e in the right or left mainstem bronchus). The device assesses solely the vertical position of the ETT distal tip relative to the carina, does not factor patient positioning, and cannot detect esophageal intubation. The device is tested in the single lumen endotracheal tube, while it may trigger a false prioritization alert in the case of properly positioned double lumen ETT. EFAI ETTXR analyzes cases using deep learning algorithms to identify suspected malpositioned ETT findings. It makes case-level output available to a PACS/workstation for worklist prioritization or triage. EFAI ETTXR is not intended to direct attention to specific portions of an image or to anomalies of an image. Its results are not intended to be used on a stand-alone basis for clinical decision-making nor is it intended to rule out malpositioned ETT or otherwise preclude clinical assessment of chest radiographs.
Public source Exact FDA submission Checked 2026-09-01

Exact-submission indication text from the ACR AI Central model card. FDA labeling remains controlling.

Intended users
Hospital networks and appropriately trained medical specialists
Public source Exact FDA submission Checked 2026-09-01

Intended-user text reported in the exact-submission ACR model card.

Care setting and population
Adult
Public source Exact FDA submission Checked 2026-09-01

Patient-population text reported in the exact-submission ACR model card; institutional setting may still require vendor confirmation.

Workflow role
Triage or notification support
Public source Exact FDA submission Checked 2026-09-01

Conservative normalization of explicit wording in an exact-submission source.

Required input
XRAY images or data. Inclusion criteria: Chest X-ray (CXR) images in adults (AP view), DICOM format, single lumen endotracheal tube cases
Public source Exact FDA submission Checked 2026-09-01

Conservative normalization of explicit wording in an exact-submission source.

Output and human action
Case-level output (text-based JSON file) available to a PACS/workstation for worklist prioritization or triage. The device flags suspected positive cases of vertically malpositioned ETT when the ETT distal tip is more than 7 cm above the carina, less than 3 cm above the carina, or below the carina (in the right or left mainstem bronchus). It provides passive notification to radiologists without marking or highlighting specific image locations.
Public source Exact FDA submission Checked 2026-09-01

Clinical output reported in the exact-submission ACR model card.

Limitations
Research pending
Needs research Exact FDA submission Checked 2026-08-31

Confirm contraindications, unsupported populations, scanners, protocols, and known failure modes.

Regulatory identity

FDA record and catalog context

The FDA listing establishes the regulatory identity. It does not by itself establish local workflow fit, pricing, security, or performance in your environment.

FDA submission
K242821
FDA source Exact FDA submission Checked 2026-08-31
Modality
X-ray/Radiography
Public source Exact FDA submission Checked 2026-09-01

Imaging modality reported in the exact-submission ACR AI Central model card.

Anatomy
Chest/Lung
Public source Exact FDA submission Checked 2026-09-01

Anatomy normalized from explicit exact-submission ACR model-card wording.

Clearance type
510(k)
FDA source Exact FDA submission Checked 2026-08-31
Decision date
2025-02-20
FDA source Exact FDA submission Checked 2026-08-31
FDA status
FDA-cleared
FDA source Exact FDA submission Checked 2026-08-31

Implementation

Questions for IT, informatics, and operations

Use these fields to structure a vendor demo, security review, and implementation estimate.

Integration
The exact-submission ACR model card explicitly references DICOM, PACS, and JSON in the described input, output, or workflow; exact interfaces, versions, and local compatibility require confirmation.
Public source Exact FDA submission Checked 2026-09-01

Interoperability terms explicitly reported in the exact-submission ACR model card; interface versions and local compatibility still require confirmation.

Deployment and data flow
On-premise
Public source Exact FDA submission Checked 2026-08-13

Deployment category preserved from the prior exact-submission review; hosting region, data flow, and current commercial configuration still require vendor confirmation.

Security and privacy
Vendor documentation pending
Vendor confirmation Exact FDA submission Checked 2026-08-13

FDA authorization does not establish the current commercial security posture. Request data-flow diagrams, hosting and retention details, access controls, audit logging, attestations, and incident-response documentation.

Training and support
Vendor documentation pending
Vendor confirmation Exact FDA submission Checked 2026-08-13

Training, onboarding, competency, and support commitments are commercial implementation details that require current vendor documentation.

Monitoring and change control
Vendor documentation pending
Vendor confirmation Exact FDA submission Checked 2026-08-13

Local acceptance testing, production monitoring, drift review, update control, and incident escalation require a current vendor and site-specific governance plan.

Input or output interoperability

DICOM is explicitly referenced in the described input, output, or workflow.

exact submission · checked 2026-09-01

The model card does not establish every supported DICOM object, transfer method, or local interface.

Result destination

PACS and workstation are explicitly referenced as a result destination.

exact submission · checked 2026-09-01

Confirm supported products, versions, routing behavior, and display requirements during local evaluation.

Evidence

Performance evidence

Metrics are shown only when they are tied to a source, endpoint, population, and tested product version.

Evidence summary
Study type: Stand-Alone Performance. Cases: 940. Reference standard: Interpretation by Reviewing Clinician. Reported sensitivity: 89% (95% CI: 84.6%, 92.3%). Reported specificity: 93.5% (95% CI: 90.9%, 95.4%)
Public source Exact FDA submission Checked 2026-09-01

Structured study metadata from the exact-submission ACR model card; this is not an independent evidence synthesis.

Reported sensitivity
89% (95% CI: 84.6%, 92.3%)
Public source Exact FDA submission Checked 2026-09-01

Model sensitivity reported by ACR AI Central. Review endpoint, threshold, study population, and tested version before comparison.

Reported specificity
93.5% (95% CI: 90.9%, 95.4%)
Public source Exact FDA submission Checked 2026-09-01

Model specificity reported by ACR AI Central. Review endpoint, threshold, study population, and tested version before comparison.

No contextualized exact-version metric has completed evidence review. Regulatory-document values, when available, are shown above with their limitations.

EFAI Chestsuite XR Malpositioned ETT Assessment System (ETT-XR-100) regulatory performance study summary

Stand-Alone Performance · Adult

exact submission · Tested version: Exact product version not reported; regulatory study summarized for FDA submission K242821 · n=940 · Independence not established

K242821

ACR AI Central summarizes the regulatory study; consult the exact FDA materials before comparative use.

Economics and lifecycle

Budget and ongoing governance

These are common procurement questions; unknown values remain visible until a source supports them.

Pricing and total cost
Vendor documentation pending
Vendor confirmation Exact FDA submission Checked 2026-08-13

FDA submission materials do not establish current commercial pricing. Request the pricing unit, term, minimum commitment, implementation fees, and included support from the vendor.

Reimbursement and coding
Research pending
Needs research Exact FDA submission Checked 2026-08-31

Determine whether any product-specific CPT/HCPCS pathway exists and separate it from billing for the underlying imaging service.

Safety and lifecycle

Postmarket record

Recall and adverse-event records are shown only after product matching. Adverse-event reports do not establish incidence or causality.

Postmarket safety review
Not established in reviewed sources
Reviewed sources checked Exact FDA submission Checked 2026-09-04

No native submission-identifier match was found in the checked openFDA radiology recall snapshot. Product-name, manufacturer, and adverse-event searches remain necessary; this does not establish that no recall or safety report exists.

Buyer worksheet

Open questions to take to the vendor

Open evaluation checklist

Research record

What has been checked

This audit distinguishes completed source review from fields that have not yet been researched.

Exact FDA record reviewedStatus
2026-09-04Last searched
19Fields reviewed
6Source classes checked
0Unreviewed PubMed leads
0Unreviewed trial leads
0Unreviewed FDA recall leads

Exact-submission ACR model-card fields were normalized under the current provenance rules; vendor and independent-study confirmation remain distinct. Automated exact-name discovery found 0 PubMed and 0 ClinicalTrials.gov candidate records. Candidates require human product and version matching; zero candidates is not evidence that no studies exist. Native FDA recall identifiers produced 0 postmarket candidate records; 0 have been reviewed (0 published, 0 rejected) and 0 remain unreviewed.

Candidate leads remain unpublished until a human confirms the exact product and tested version.

Source classes: fda ai list, fda decision summary, acr ai central product, pubmed, clinical trials, openfda device recall

Sources

Source ledger

Sources accessed through 2026-09-02.

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Modality
X-ray/Radiography
Anatomy
Chest/Lung
Decision
2024-05-10