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510(k) Data Aggregation

    K Number
    K170815

    Validate with FDA (Live)

    Device Name
    PSA Cable
    Date Cleared
    2017-07-06

    (111 days)

    Product Code
    Regulation Number
    870.3630
    Reference & Predicate Devices
    Predicate For
    N/A
    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The PSA cable is an accessory indicated for use with external PSA equipment distributed by Boston Scientific and is used for the transmission of sensing signals and pacing pulses for evaluation of lead placement characteristics during implant of pacemakers and defibrillators and for the support of other pacemaker functionality.

    Device Description

    The Pacing System Analyzer (PSA) cable, Model 6763, is an external cable used to transmit signals to and from a connected PSA device. The connected PSA equipment is used during the implantation of pacemakers and defibrillators to evaluate the placement and integrity of leads and to determine the appropriate pacing parameters for the implanted device. The PSA cable leadwires are affixed to the implanted lead while the other end of the cable, the trunk cable, is plugged into the external PSA device. The PSA cable is used with the BSC distributed PSA devices.

    AI/ML Overview

    This document is a 510(k) summary for the Boston Scientific PSA Cable, Model 6763. It primarily focuses on demonstrating substantial equivalence to a predicate device rather than detailing specific clinical study results or acceptance criteria with numerical performance targets for an AI device.

    Therefore, many of the requested sections about acceptance criteria, performance metrics, sample sizes, and expert adjudication are not applicable or cannot be extracted from this document, as it pertains to a physical cable intended for signal transmission, not an AI-powered diagnostic device.

    Here's a breakdown based on the provided text, indicating where information is present and where it is not:

    1. Table of Acceptance Criteria and Reported Device Performance

    Not applicable in the context of an AI device's performance metrics (e.g., sensitivity, specificity). The "Performance Data" section describes categories of testing for a physical cable.

    Acceptance Criteria CategoryReported Device Performance (as far as applicable for a cable)
    SterilizationVerification and Validation (V&V) testing performed. Implied successful.
    BiocompatibilityV&V testing performed. Implied successful.
    Electromagnetic CompatibilityV&V testing performed. Implied successful.
    Electrical SafetyV&V testing performed. Implied successful.
    Performance/Bench testingV&V testing performed. Implied successful.

    2. Sample size used for the test set and the data provenance

    Not applicable. This document describes testing for a physical cable, not a software device that uses a test set of data. The performance section mentions "Design verification and validation (V&V) testing" which refers to laboratory and bench tests for electrical, mechanical, and safety aspects, not a dataset from patients.

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

    Not applicable. This is not a study requiring expert readers to establish ground truth for a diagnostic AI.

    4. Adjudication method for the test set

    Not applicable.

    5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

    Not applicable. This is not an AI device for diagnostic assistance.

    6. If a standalone (i.e. algorithm only, without human-in-the-loop performance) was done

    Not applicable. This is not an AI algorithm.

    7. The type of ground truth used

    Not applicable. The "ground truth" for a cable's performance would be engineering specifications and standards, verified through bench testing, not clinical outcomes or expert consensus on medical images/data.

    8. The sample size for the training set

    Not applicable. This is not an AI device that requires a training set.

    9. How the ground truth for the training set was established

    Not applicable.

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