K Number
K012724
Date Cleared
2001-11-08

(86 days)

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

The Smith & Nephew Vascular VideoEndoscope is indicated for use in subcutanous endoscopy, specifically for endocopically gaining access to, ligating and/or harvesting vessels within the subcutaneous and subfascial surgical planes in the lower extremities.

Device Description

The proposed Smith & Nephew Vascular VideoEndoscope is designed in an "L" shaped configuration as to have the horizontal optical train and working channel as the part that is introduced into the leg and the vertical shaft as a handle. The connecting cables and tubing are conveniently located far from the leg to minimize any interference with the surgeon's hand movements. The function of the Smith & Neohew Vascular VideoEndoscope is to create and maintain a subfascially working space, provide visualization of the working space, and provide access to hand instruments to the working space. The attachments utilize the same locking feature located on the endoscope which allows the Smith & Nephew Vascular VideoEndoscope to be used as a multi-purpose device.

AI/ML Overview

This document is a 510(k) summary for the Smith & Nephew Vascular VideoEndoscope. It focuses on demonstrating substantial equivalence to predicate devices, rather than performing a clinical study with detailed performance metrics and acceptance criteria for a new AI-powered diagnostic device. Therefore, the information requested in your prompt regarding acceptance criteria, study details, expert qualifications, and AI-related metrics is largely not available in this document.

However, I can extract the relevant information that is present and indicate where the requested information is absent based on the nature of this regulatory submission.


1. Table of Acceptance Criteria and Reported Device Performance

Acceptance CriteriaReported Device Performance
Not applicable. This document is a 510(k) summary demonstrating substantial equivalence to predicate devices, not a study reporting specific performance metrics against pre-defined acceptance criteria for a new device.The device is described as "substantially equivalent in design, materials of construction and function and intended use as to the Olympus Endoscopic System for Vessel Harvesting, Smith & Nephew's Images Endoscopes, and Ethicon's EndoPath Ultra Retractor and Vessel Dissector."

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

Not available. This document does not describe a test set or data provenance in the context of device performance evaluation. It is a regulatory submission comparing a new device to existing predicate devices.

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

Not available. This document does not mention experts establishing ground truth for a test set.

4. Adjudication method for the test set

Not available. No test set or adjudication method is described.

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. This document does not mention any MRMC study or AI assistance. The device described is a video endoscope, not an AI-powered diagnostic tool.

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

Not applicable. The device is an endoscope, not an algorithm.

7. The type of ground truth used

Not available. This document does not describe the establishment of a ground truth in the context of device performance.

8. The sample size for the training set

Not available. This document does not describe a training set.

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

Not available. This document does not describe a training set or its ground truth establishment.


Summary of available information from the document:

  • Device Name: Smith & Nephew Vascular VideoEndoscope
  • Intended Use: For use in subcutaneous endoscopy, specifically for endocopically gaining access to, ligating, and/or harvesting vessels within the subcutaneous and subfascial surgical planes in the lower extremities.
  • Predicate Devices:
    • Olympus Endoscopic System for Vessel Harvesting (K963184)
    • Ethicon's EndoPath Ultra Retractor and Vessel Dissector (K973139)
    • Smith & Nephew's Images Endoscopes (K971850)
  • Basis for Clearance: Substantial equivalence to predicate devices in "design, materials of construction and function and intended use."

The document is a 510(k) summary, which is a premarket notification to the FDA to demonstrate that a device is as safe and effective as a legally marketed predicate device. This process typically relies on comparing the new device's technical characteristics and intended use to predicate devices, rather than conducting new clinical performance studies with detailed statistical analyses as would be required for a novel AI/ML device.

§ 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.