K Number
K970162
Date Cleared
1997-10-29

(286 days)

Product Code
Regulation Number
882.1480
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The device is intended for use for direct visualization, diagnosis and therapeutic application during intracranial procedures, such as

  • cyst fenestration
  • shunt placement
  • intraventricular coagulation
  • ventriculostomy of the 3rd ventricle when the aqueduct is obstructed
  • coagulation of small intraventricular lesions
  • biopsy of lesions which lead to the stricture of a ventricle

The instrument simultaneously permits visual control and utilization of a working, an irrigation, and an aspiration channel.

The Neuro-Endoscope can be used with or without a stereotactic frame. A special adapter is available to affix the endoscope.

Device Description

The set consists of a sheath, obturators, telescope, forceps, scissors, electrodes, suction needle, and adapters.

AI/ML Overview

Here is a summary of the acceptance criteria and study information for the Neurological Endoscope, based on the provided document:

1. Table of Acceptance Criteria and Reported Device Performance

The provided document (K970162) is a 510(k) summary, which focuses on demonstrating substantial equivalence to predicate devices rather than establishing novel performance criteria for a new device type. Therefore, explicit, quantifiable acceptance criteria in the typical sense (e.g., minimum sensitivity/specificity thresholds, precision limits) are not stated for clinical performance. Instead, the "acceptance criteria" are implied to be that the device performs safely and effectively for its intended use, comparable to its predicate devices.

The reported device performance is described through various safety and functional tests:

Acceptance Criteria (Implied)Reported Device Performance
Electrical Safety: Electrical isolation of user from device.Instruments and connection cables are designed with overlapping connections to ensure user is electrically isolated.
Material Integrity: Integrity and bonding of insulation material.Abrasion/Flaking testing was performed to assure the integrity and bonding of the insulation material to the instruments. (No quantitative results provided, but the statement implies successful testing).
Thermal Safety: Minimizing thermal damage risks.Testing was performed to verify thermal safety. "Thermal damage is unlikely to occur using the Richard Wolf Neuroendoscopy Set." (No quantitative results provided, but the statement implies successful testing).
Clinical Safety and Effectiveness: Operation for intended uses.Clinical tests were performed by Eric Weber, MD, PhD, at the University of South Alabama under protocol # 92-105. The conclusion states: "These devices are designed and tested to guarantee the safety and effectiveness, when used according to the instruction manual." (Specific clinical performance metrics like success rates, complication rates, or direct comparisons to predicate devices are not provided in this summary document.)

2. Sample Size Used for the Test Set and Data Provenance

  • Sample Size: This information is not provided in the 510(k) summary. The document mentions "Clinical tests were performed," but does not explicitly state the number of patients, endoscopic procedures, or specific data points included in these clinical tests.
  • Data Provenance: The clinical tests were performed in the USA at the University of South Alabama. The document does not explicitly state whether the study was retrospective or prospective, but clinical trials typically imply a prospective approach.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Their Qualifications

  • Number of Experts: The document states that clinical tests were performed by "Eric Weber, MD, PhD." This identifies a single individual as the primary investigator. It does not mention a panel of experts or a specific number of individuals involved in establishing ground truth for the test set.
  • Qualifications of Experts: Eric Weber, MD, PhD. His specific specialization (e.g., neurosurgeon, neurologist) is not explicitly stated, but his role in performing "clinical tests" for a neurological endoscope strongly implies relevant medical expertise in neurosurgery or a related field.

4. Adjudication Method for the Test Set

The document does not describe any specific adjudication method (e.g., 2+1, 3+1, none) for the clinical tests or for establishing ground truth. With only one named clinical investigator, it's unlikely a formal multi-reader adjudication process was employed as part of this submission.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and Effect Size of AI vs. Without AI Assistance

  • MRMC Study: No, an MRMC comparative effectiveness study was not performed. The device is a medical instrument (endoscope), not an AI-powered diagnostic or assistive tool.
  • Effect Size of AI: This question is not applicable as the device is not an Artificial Intelligence product.

6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) Was Done

  • No, a standalone (algorithm only) performance study was not done. The device is a physical medical instrument, not an algorithm.

7. The Type of Ground Truth Used

The type of ground truth used for the clinical tests is not explicitly detailed. However, for a surgical instrument like an endoscope, ground truth would likely be based on clinical observation, surgical findings, and potentially pathology of biopsied lesions, as assessed by the operating physician(s).

8. The Sample Size for the Training Set

This information is not applicable. The device is a physical medical instrument and does not employ a "training set" in the context of machine learning or AI.

9. How the Ground Truth for the Training Set Was Established

This information is not applicable, as there is no "training set" for this type of device.

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353 Corporate Woods Parkway Vernon Hills, Illinois 60064 Phone: 847.913.1143 Fax: 847.943.1488

K970162

OCT 2 9 1997

RICHARD W MEDICAL INSTRUMENTS CORPOR

510(k) Summary of Safety and Effectiveness

Submitter:Date of Preparation:October 8, 1997
Company / Institution name:FDA establishment registration number:
RICHARD WOLF MEDICAL INSTRUMENTS CORP.14 184 79
Division name (if applicable):Phone number (include area code):
N.A.(847) 913-1113
Street address:FAX number (include area code):
353 Corporate Woods Parkway(847) 913-0924
City:Vernon HillsState/Province:IllinoisCountry:USAZIP / Postal Code:60061
Contact name:
Mr. Robert L. Casarsa
Contact title:
Quality Assurance Manager
Product Information:
Trade name: Neurological EndoscopeModel number: 8765.001, 15016.299, 15016.300,
15016.301, 8989.401/.431, 8765.611, 8765.701
Common name:Classification name:
Neuro Endoscope SetNeurological Endoscope
Information on devices to which substantial equivalence is claimed:
510(k) NumberTrade or proprietary or model nameManufacturer
11Gaab Neuroendoscope system Sheath, 83-15211 Codman
22Auero Neuroendoscope system Sheath 28160D2 Storz
33Sheath Insert W/ Inflow Stopcock Connection 28160 J3 Storz
44Bougie Guide Obturator4 Storz
55Telescope Gaab 83-15235 Codman
66Auero system Telescope 27020 A6 Storz
77Auero Monoplar coagulating Electrode 27160B7 Storz
88Injection Needle 83-15348 Codman
99Suction Catheter 10468 A9 Storz
1010Neuroendoscope (Ventriculoscope) K94123910 Asculap

1.0 Description

.

The set consists of a sheath, obturators, telescope, forceps, scissors, electrodes, suction needle, and adapters.

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2.0 Intended Use

The device is intended for use for direct visualization, diagnosis and therapeutic application during intracranial procedures, such as

  • cyst fenestration �
  • shunt placement �
  • � intraventricular coagulation
  • � ventriculostomy of the 3rd ventricle when the aqueduct is obstructed
  • � coagulation of small intraventricular lesions
  • ◆ biopsy of lesions which lead to the stricture of a ventricle

The instrument simultaneously permits visual control and utilization of a working, an irrigation, and an aspiration channel.

The Neuro-Endoscope can be used with or without a stereotactic frame. A special adapter is available to affix the endoscope.

/3.0 Technological Characteristics

  • · Procedure can be performed through one single burr hole.
  • · Uses a small flexible endoscope able to pass through the working channel and the possibility of using different rigid telescopes with various viewing angles.
  • · Rigid telescopes can be advanced in a second stage beyond the tip of the sheath to penetrate small openings or channels and to "look around the corner".

Substantial Equivalence 4.0

The Richard Wolf Neuroendoscopy Set is substantially equivalent to the following devices:

  • Codman and Shurtleff, Inc.'s Gaab Neuroendoscope System .
  • · Karl Storz Auero Neuro-Endoscope System
  • · Aesculap. Inc. Neuroendoscope

All devices have the same intended use.

5.0 Performance Data

  • To ensure that the user is electrically isolated from the device, the instruments and connection cables . are designed so that the connection instrument/cable overlaps.
  • · Abrasion/Flaking testing was performed to assure the integrity and bonding of the insulation material to the instruments.
  • · Testing was performed to verify thermal safety. Thermal damage is unlikely to occur using the Richard Wolf Neuroendoscopy Set.

6.0 Clinical Tests

Clinical tests were performed by Eric Weber, MD, PhD, at the University of South Alabama under protocol # 92-105.

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7.0 Conclusions Drawn

These devices are designed and tested to guarantee the safety and effectiveness, when used according to the instruction manual.

By: Robert J. Casares

Robert L. Casarsa Quality Assurance Manager

Date: Oct 97

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Robert L. Casarsa Quality Assurance Manager Richard Wolf Medical Instruments Corporation 353 Corporate Woods Parkway Vernon Hills, Illinois 60061

OCT 2 9 1997

Re: K970162 Trade Name: Neurological Endoscope Regulatory Class: II. achines : Common an Product Code: GWG Dated: October 8, 1997

Received: October 9, 1997

Dear Mr. Casarsa:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). You may, therefore, market the device, subject to the general controls provisions of the Act. 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.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirements , as set forth in the Quality System Regulation (OS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

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Page 2 - Mr. Robert L. Casarsa

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits vour device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4595. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled. "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

t. Oellefa

Celia M. Witten, Ph.D., M.D. Director Division of General and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Pageof
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510(k) Number (if known):K970162
Device Name:Neurological Endoscope

Indications For Use:

The device is intended for use for direct visualization, diagnosis and therapeutic application during intracranial procedures, such as

  • cyst fenestration �
  • ్లా shunt placement
  • � intraventricular coagulation
  • � ventriculostomy of the 3th ventricle when the aqueduct is obstructed and more a
  • � coagulation of small intraventricular lesions
  • � biopsy of lesions which lead to the stricture of a ventricle

The instrument simultaneously permits visual control and utilization of a working, an irrigation, and an aspiration channel.

The Neuro-Endoscope can be used with or without a stereotactic frame. A special adapter is available to affix the endoscope.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off)
Division of General Restorative Devices
510(k) NumberK970162
Prescription Use(Per 21 CFR 801.109)OROver-The-Counter Use
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(Optional Formal 1-2-96)

§ 882.1480 Neurological endoscope.

(a)
Identification. A neurological endoscope is an instrument with a light source used to view the inside of the ventricles of the brain.(b)
Classification. Class II (performance standards).