K Number
K024015

Validate with FDA (Live)

Date Cleared
2003-03-04

(90 days)

Product Code
Regulation Number
876.1500
Reference & Predicate Devices
N/A
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Reprocessed Endoscopic Trocars and Cannulas are indicated for use to establish a port of entry for endoscopic instruments in patients requiring minimally invasive surgical procedures.

Device Description

Reprocessed Endoscopic Trocars and Cannulas. The submission includes a list of specific Endoscopic Trocars and Cannulas from manufacturers US Surgical, Auto Suture, and Ethicon that will be reprocessed.

AI/ML Overview

The provided document is a 510(k) clearance letter for reprocessed endoscopic trocars and cannulas. It does not contain information about acceptance criteria for an AI/device performance study, nor does it describe a study that proves a device meets such criteria.

The letter from the FDA (dated March 3, 2006) refers to a "supplemental validation data as required for reprocessed single-use devices by the Medical Device User Fee and Modernization Act of 2002." This "validation data" would relate to the reprocessing of medical devices to ensure they are safe and effective for reuse, not to the performance of an AI or diagnostic device.

Therefore, I cannot provide the requested information as it is not present in the given text.

To be clear:

  • 1. A table of acceptance criteria and the reported device performance: Not available. The document is about reprocessing medical devices, not an AI device or a performance study.
  • 2. Sample sized used for the test set and the data provenance: Not available.
  • 3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not available.
  • 4. Adjudication method: Not available.
  • 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 available.
  • 6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done: Not available.
  • 7. The type of ground truth used: Not available.
  • 8. The sample size for the training set: Not available.
  • 9. How the ground truth for the training set was established: Not available.

{0}------------------------------------------------

Image /page/0/Picture/2 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three lines representing its body and wings. The eagle is facing right. The text "DEPARTMENT OF HEALTH AND HUMAN SERVICES, USA" is arranged in a circular pattern around the eagle.

MAR - 3 2006

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Eric Varty Research and Development Manager Alliance Medical Corporation 10232 South 51st Street Phoenix, Arizona 85044

Re: K024015 -- Supplemental Validation Submission Trade/Device Name: See Enclosed List Regulation Number: 21 CFR 876.1500 Regulation Name: Endoscope and accessories Regulatory Class: II Product Code: NLM Dated: December 3, 2002 Received: December 4, 2002

Dear Mr. Varty:

The above-referenced premarket notification (510(k)) was cleared by the Office of Device Evaluation (ODE) on March 4, 2003. We have received your supplemental validation data as required for reprocessed single-use devices by the Medical Device User Fee and Modernization Act of 2002. After reviewing your supplemental validation data. we have determined the devices listed in the enclosure accompanying this letter as 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 these devices, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration. Ilsting of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your devices are classified (see above) into either class II (Special Controls) or class III (PMA) they may be subject to such additional controls. Existing major regulations affecting vour 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 devices 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 devices comply 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 applicable requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements

{1}------------------------------------------------

Page 2 - Mr. Varty

as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

The FDA finding of substantial equivalence of your devices to legally marketed predicate devices results in classification for your devices and thus, permits you to legally market the devices. This letter will allow you to continue marketing the devices listed in the enclosure accompanying this letter.

If you desire specific advice for your devices on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at (301) 594-4659. Also, please note the regulation entitled. "Misbranding by reference to premarket notification" (21CFR Part 807.97). 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) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely yo

Mark N. Me

Mark N. Melkerson Acting Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{2}------------------------------------------------

Indications for Use

510(k) Number (if known): K024015

Device Name: Alliance Medical Corporation Reprocessed Endoscopic Trocars and Cannulas

Indications For Use: Reprocessed Endoscopic Trocars and Cannulas are indicated for use to establish a port of entry for endoscopic instruments in patients requiring minimally invasive surgical procedures.

Prescription Use × (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

2gN2l

(Division Sign-Off) Division of General, Restorative, and Neurological Devices

Page 1 of _

KC240i5 510(k) Number_

{3}------------------------------------------------

The following list represents the specific Endoscopic Trocars and Cannulas to be
reprocessed by Alliance Medical Corporation under this submission.

ManufacturerDescriptionModel
US Surgical, Auto SutureSurgiport Trocar w/ radiolucent (bladed)171040
US Surgical, Auto SutureSpring Grip Non-Conductive Spring Grip Non-Conductive174102
US Surgical, Auto SutureConductive174103
US Surgical, Auto SutureSpring Grip Non-Conductive174104
US Surgical, Auto SutureSpring Grip Non-Conductive174110
US Surgical, Auto SutureThoracoport Trocar179301
US Surgical, Auto SutureThoracoport Trocar179303
US Surgical. Auto SutureThoracoport Trocar179305 179307
US Surgical, Auto SutureThoracoport Trocar179315
EthiconENDOPATH adjustable cannulaT355
EthiconENDOPATH adjustable cannulaT511
EthiconENDOPATH adjustable cannulaT512
EthiconBladeless Trocar with Stability Sleeve, Non-handled35NST
EthiconBladeless Trocar with Smooth Sleeve, non-handled35OS
EthiconBladeless Trocar with Smooth Sleeve, handled35HL
EthiconBladeless Trocar with Smooth Sleeve, Non-handled35OL
EthiconBladeless Trocar with Stability Sleeve, Non-handled35NLT
EthiconBladeless Trocar with Smooth Sleeve, Handled511H
EthiconBladeless Trocar with Smooth Sleeve, Non-handled511O
EthiconBladeless Trocar with Stability Sleeve, Handled511 HT
EthiconBladeless Trocar with Stability Sleeve, Non-handled511NT
EthiconBladeless Trocar with Smooth Sleeve, Handled512HN
EthiconBladeless Trocar with Smooth Sleeve, Non-512ON
EthiconBladeless Trocar with Stability Sleeve, Handled512HT
EthiconBladeless Trocar with Stability Sleeve, Non-handled512NT
EthiconBladeless Trocar with Smooth Sleeve5128
EthiconENDOPATH Dilating Tip Trocar with Stability Sleeve355SD
EthiconENDOPATH Dilating Tip Trocar with Smooth Sleeve355SM
EthiconENDOPATH Dilating lip Trocar with Stability Sleeve578SD
EthiconENDOPATH Dilating Tip Trocar with Smooth Sleeve511SM
EthiconENDOPATH Dilating Tip Trocar with Stability Sleeve511SD
EthiconENDOPATH Dilating Tip Trocar with Stability Sleeve512SD
EthiconENDOPATH Dilating Tip Trocar with Smooth Sleeve512SM
EthiconENDOPATH Dilating Tip Trocar with Smooth Sleeve512XD
EthiconENDOPATH TRISTAR Trocar with Smooth Sleeve355S
EthiconENDOPATH TRISTAR Trocar with Integrated Stability Threads355T
EthiconENDOPATH TRISTAR Trocar with Smooth Sleeve355L
EthiconENDOPATH TRISTAR Trocar with Smooth Sleeve511S

........

§ 876.1500 Endoscope and accessories.

(a)
Identification. An endoscope and accessories is a device used to provide access, illumination, and allow observation or manipulation of body cavities, hollow organs, and canals. The device consists of various rigid or flexible instruments that are inserted into body spaces and may include an optical system for conveying an image to the user's eye and their accessories may assist in gaining access or increase the versatility and augment the capabilities of the devices. Examples of devices that are within this generic type of device include cleaning accessories for endoscopes, photographic accessories for endoscopes, nonpowered anoscopes, binolcular attachments for endoscopes, pocket battery boxes, flexible or rigid choledochoscopes, colonoscopes, diagnostic cystoscopes, cystourethroscopes, enteroscopes, esophagogastroduodenoscopes, rigid esophagoscopes, fiberoptic illuminators for endoscopes, incandescent endoscope lamps, biliary pancreatoscopes, proctoscopes, resectoscopes, nephroscopes, sigmoidoscopes, ureteroscopes, urethroscopes, endomagnetic retrievers, cytology brushes for endoscopes, and lubricating jelly for transurethral surgical instruments. This section does not apply to endoscopes that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.(b)
Classification —(1)Class II (special controls). The device, when it is an endoscope disinfectant basin, which consists solely of a container that holds disinfectant and endoscopes and accessories; an endoscopic magnetic retriever intended for single use; sterile scissors for cystoscope intended for single use; a disposable, non-powered endoscopic grasping/cutting instrument intended for single use; a diagnostic incandescent light source; a fiberoptic photographic light source; a routine fiberoptic light source; an endoscopic sponge carrier; a xenon arc endoscope light source; an endoscope transformer; an LED light source; or a gastroenterology-urology endoscopic guidewire, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I for the photographic accessories for endoscope, miscellaneous bulb adapter for endoscope, binocular attachment for endoscope, eyepiece attachment for prescription lens, teaching attachment, inflation bulb, measuring device for panendoscope, photographic equipment for physiologic function monitor, special lens instrument for endoscope, smoke removal tube, rechargeable battery box, pocket battery box, bite block for endoscope, and cleaning brush for endoscope. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807of this chapter, subject to the limitations in § 876.9.