K Number
K012613
Date Cleared
2001-11-07

(86 days)

Product Code
Regulation Number
888.1100
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Reprocessed Arthroscopic Shavers are indicated for use in orthopedic surgical procedures of the joints, jaw or sinuses where the cutting and removal of soft and hard tissue or bone is needed in patients requiring orthopedic surgery.

Device Description

Arthroscopic shavers can be used to abrade, cut and excise tissue and bone; remove loose fragments; and shave away debris in arthroscopic surgeries, as well as surgeries of the jaw and sinuses.

The arthroscopic shaver components reprocessed by Alliance Medical Corporation include a burr or blade at the end of a long rod that rotates within a long hollow stain- less steel housing. The housing has a window cut out on one side of the distal end, allowing the burr to cut one structure while the adjacent one is still protected by the housing on the opposite side of the burr or blade. This system attaches to a motorized handpiece that drives the internal burr or blade inside the outer housing and provides suction to pull the cut tissue away from the surgical site.

AI/ML Overview

The provided document is a 510(k) summary for the Alliance Medical Corporation's Reprocessed Arthroscopic Shavers. It doesn't describe the acceptance criteria and study for a software-as-a-medical-device (SaMD) or an AI/ML device. Instead, it focuses on the substantial equivalence of a reprocessed medical device (arthroscopic shavers) to predicate devices.

Therefore, the information requested in the prompt regarding acceptance criteria, device performance, sample sizes, data provenance, ground truth establishment, expert qualifications, adjudication methods, MRMC studies, and standalone performance for an AI/ML device is not available in the provided text.

The document discusses:

  • Device Description: Arthroscopic shavers used to abrade, cut, and excise tissue and bone, remove loose fragments, and shave debris in arthroscopic surgeries.
  • Intended Use: Resecting tissue and bone in articular body cavities during various surgeries (orthopedic, maxillofacial, hand, foot, plastic surgery).
  • Indications Statement: Cutting and removal of soft and hard tissue or bone in orthopedic surgical procedures of joints, jaw, or sinuses.
  • Technological Characteristics: States that the design, materials, and intended use of the reprocessed shavers are identical to predicate devices.
  • Performance Data: Mentions that "Bench and laboratory testing was conducted to demonstrate performance (safety and effectiveness) of the Reprocessed Arthroscopic Shavers." It also states "Biocompatibility Validation of reprocessing Functionality Test(s)" was done and "Performance testing demonstrates that Reprocessed Arthroscopic Shavers perform as originally intended."

However, it does not provide specific acceptance criteria or detailed results of these tests in a quantitative manner as requested for an AI/ML device. The focus is on demonstrating that the reprocessed device performs as originally intended by the predicate devices, not on proving a novel algorithm's performance.

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

Image /page/0/Picture/1 description: The image shows the logo for Alliance Medical Corporation. The logo consists of three curved lines above the company name. The lines are thick and black, and they are arranged in a semi-circular shape. The text "ALLIANCE MEDICAL CORPORATION" is written in a serif font.

Kola 613

PART B: 510(k) SUMMARY OF SAFETY AND EFFECTIVENESS

10232 South 51st Street Phoenix, Arizona 85044

TEL 480.763.5300
FAX 480.763.5310 Toll Free 888.888.3433 www.alliance-medical.com

Submitter:Alliance Medical Corporation10232 South 51st StreetPhoenix, Arizona 85044
Contact:Don SelveyVice President, Regulatory Affairs and Quality Assurance(480) 763-5300
Date of preparation:August 10, 2001
Name of device:Trade/Proprietary Name: Reprocessed Arthroscopic ShaversCommon or Usual Name: Arthroscopic ShaverClassification Name: Arthroscope

Reprocessed devices:

ManufacturerDescriptionModel
Linvatec CorporationFull-RadiusResector9246A
Linvatec CorporationFull-RadiusResector9247A
Linvatec CorporationGator®9260A
Linvatec CorporationGator®9263A
Linvatec CorporationFull-RadiusResectorC9241
Linvatec CorporationFull-RadiusResectorC9245
Linvatec CorporationFull-RadiusResectorC9248
Linvatec CorporationCuda®C9253
Linvatec CorporationCuda®C9254
Linvatec CorporationCuda®C9255
Linvatec CorporationCuda®C9256
Linvatec CorporationCuda®C9258
Linvatec CorporationGator®C9262
ManufacturerDescriptionModel
Linvatec CorporationGator®C9264
Linvatec CorporationGator®C9266
Linvatec CorporationSlotted WhiskerC9274
Linvatec CorporationSlotted WhiskerC9275
Linvatec CorporationEnd CutterC9283
Linvatec CorporationEnd CutterC9284
Linvatec CorporationDragon®C9291
Linvatec CorporationDragon®C9292
Linvatec CorporationMeniscus CutterC9760
Linvatec CorporationMerlin Cuda®P9356
Linvatec CorporationMerlin Gator®P9366
Linvatec CorporationMerlin Full-RadiusResectorP9376
Linvatec CorporationGreat White™9299A
Predicate device(s):
K940515Linvatec® Merlin Polyblade Shavers
K971059Linvatec® Universal Drive System
K981269Linvatec® Universal Drive System
K981636Linvatec® Integrated Drive/Pump System
K990524Linvatec® E9000 System

Antonio Station Market Particle Particle Property Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come Come

ﺍﻟﻤﺴﺘﻘﻠﺔ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘﺤﺪﺓ ﺍﻟﻤﺘ

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

Image /page/1/Picture/0 description: The image shows three curved black lines. The lines are parallel to each other and are arranged in a slightly arched formation. The lines appear to be thick and solid, with a smooth, uniform texture. The background is plain white, which contrasts with the black lines.

A L L I A N C E

MEDICAL CORPORATION

MEDICAL CORPORATION
Device description:Arthroscopic shavers can be used to abrade, cut and excise tissue and bone;remove loose fragments; and shave away debris in arthroscopic surgeries, as wellas surgeries of the jaw and sinuses.The arthroscopic shaver components reprocessed by Alliance MedicalCorporation include a burr or blade at the end of a long rod that rotates within along hollow stain- less steel housing. The housing has a window cut out on oneside of the distal end, allowing the burr to cut one structure while the adjacentone is still protected by the housing on the opposite side of the burr or blade. Thissystem attaches to a motorizedhandpiece that drives the internal burr or blade inside the outer housing andprovides suction to pull the cut tissue away from the surgical site.
Intended use:Reprocessed Arthroscopic Shavers are intended for resecting tissue and bonefound in articular body cavities during orthopedic, maxillofacial, hand, foot andplastic surgery in patients requiring arthroscopic or orthopedic surgery.
Indicationsstatement:Reprocessed arthroscopic shavers are indicated for use in orthopedic surgicalprocedures of the joints, jaw or sinuses where the cutting and removal of soft andhard tissue or bone is needed in patients requiring orthopedic surgery.
Technologicalcharacteristics:The design, materials, and intended use of the Reprocessed Arthroscopic Shaversare identical to the predicate devices. The mechanism of action of theReprocessed Arthroscopic Shaver is identical to the predicate devices in that thesame standard mechanical design, materials, shapes and sizes are utilized. Thereare no changes to the claims, intended use, clinical applications, patientpopulation, performance specifications, or method of operation.
Performance data:Bench and laboratory testing was conducted to demonstrate performance (safetyand effectiveness) of the Reprocessed Arthroscopic Shavers.Biocompatibility Validation of reprocessing Functionality Test(s)
Performance testing demonstrates that Reprocessed Arthroscopic Shaversperform as originally intended.
Conclusion:In accordance with the Federal Food, Drug and Cosmetic Act 21 CFR Part 807and based on the information provided in this premarket notification, AllianceMedical Corporation concludes that the modified device (the ReprocessedArthroscopic Shaver) is safe, effective and substantially equivalent to thepredicate devices as described herein.

.

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

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" arranged around the perimeter. Inside the circle is a stylized image of an eagle with three curved lines representing its wings or feathers.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

NOV 0 7 2001

Mr. Don Selvey Vice President, Regulatory Affairs and Quality Assurance Alliance Medical Corporation 10232 South 51st Street Phoenix, Arizona 85044

Re: K012613

Trade/Device Name: Alliance Medical Reprocessed Linvatec® Arthroscopic Shavers Regulation Number: 888.1100 Regulation Name: Arthroscope and accessories Regulatory Class: II Product Code: HRX Dated: August 10, 2001 Received: August 13, 2001

Dear Mr. Selvey:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is 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 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 (PMA), 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 898. In addition, FDA may publish further announcements concerning your device 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 device complies 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 requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements 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.

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

Page 2 - Mr. Don Selvey

This letter will allow you to begin marketing your device as described in your Section 510(k) I mis icter will and in you to ough finding of substantial equivalence of your device to a legally prematicated predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and If you desire specific ad 1.0 for in vitro diagnostic devices), please contact the Office of additionally 21 CFTC Far 8659. Additionally, for questions on the promotion and advertising of Compliance at (301) 597-1697 First of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Togulation childed, "Milordanaing of esponsibilities under the Act may be obtained from the Oiner general mistmation sturers, 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 yours,

Susan Walker, MP

Image /page/3/Picture/5 description: The image shows a handwritten symbol or character. It appears to be a stylized or cursive form, possibly resembling a letter or a unique mark. The symbol has a loop at the top and a line extending from the bottom left.

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

Enclosure

{4}------------------------------------------------

NOV 0 7 2001

II. Indications for Use Statement

KO12613 510(k) Number (if known):

Device Name: Alliance Medical Corporation Reprocessed Arthroscopic Shavers

Indications for Use: Reprocessed Arthroscopic Shavers are indicated for use in orthopedic surgical procedures of the joints, jaw or sinuses where the cutting and removal of soft and hard tissue or bone is needed in patients requiring orthopedic surgery.

ManufacturerDescriptionModelManufacturerDescriptionModel
Linvatec CorporationFull-RadiusResector9246ALinvatec CorporationGator®C9264
Linvatec CorporationFull-RadiusResector9247ALinvatec CorporationGator®C9266
Linvatec CorporationGator®9260ALinvatec CorporationSlotted WhiskerC9274
Linvatec CorporationGator®9263ALinvatec CorporationSlotted WhiskerC9275
Linvatec CorporationFull-RadiusResectorC9241Linvatec CorporationEnd CutterC9283
Linvatec CorporationFull-RadiusResectorC9245Linvatec CorporationEnd CutterC9284
Linvatec CorporationFull-RadiusResectorC9248Linvatec CorporationDragon®C9291
Linvatec CorporationCuda®C9253Linvatec CorporationDragon®C9292
Linvatec CorporationCuda®C9254Linvatec CorporationMeniscus CutterC9760
Linvatec CorporationCuda®C9255Linvatec CorporationMerlin Cuda®P9356
Linvatec CorporationCuda®C9256Linvatec CorporationMerlin Gator®P9366
Linvatec CorporationCuda®C9258Linvatec CorporationMerlin Full-RadiusResectorP9376
Linvatec CorporationGator®C9262Linvatec CorporationsGreat White™9299A

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use
(per 21 CFR 801.109)

(Division Sign-Off) Division of Gen-1. Restorative over-the-Counter Use __________________________________________________________________________________________________________________________ and Neurological evices

510(k) Number ________________________________________________________________________________________________________________________________________________________________

CONFIDENTIAL

Alliance Medical Corporation Reprocessed Arthroscopic Shavers Traditional 510(k)

12

§ 888.1100 Arthroscope.

(a)
Identification. An arthroscope is an electrically powered endoscope intended to make visible the interior of a joint. The arthroscope and accessories also is intended to perform surgery within a joint.(b)
Classification. (1) Class II (performance standards).(2) Class I for the following manual arthroscopic instruments: cannulas, currettes, drill guides, forceps, gouges, graspers, knives, obturators, osteotomes, probes, punches, rasps, retractors, rongeurs, suture passers, suture knotpushers, suture punches, switching rods, and trocars. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 888.9.