K Number
K012821
Device Name
D.O.R.C. CRYOSTAR CRYOSURGICAL SYSTEM
Date Cleared
2001-10-22

(60 days)

Product Code
Regulation Number
886.4170
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The D.O.R.C. Harmony CryoStar Cryosurgical System is a surgical system for ophthalmic surgery intended for use in surgery of the posterior segment or anterior segment including cryopexy for retinal detachment, glaucoma, cataract extraction, trichiasis, and retinopathy of prematurity.
Device Description
The D.O.R.C. CryoStar Cryosurgical System consists of a cryogen gas bottle, a console, an ophthalmic probe, a footswitch and necessary interconnections. The console controls delivery of the gas to the probe. It also processes signals from the footswitch, enabling the probe to freeze and defrost.
More Information

Not Found

No
The description focuses on the mechanical and control aspects of a cryosurgical system, with no mention of AI, ML, image processing, or data-driven performance metrics.

No
The device is a surgical system for ophthalmic surgery, designed to freeze and defrost tissue during procedures, which is an interventional surgical function rather than a therapeutic one.

No
The device is described as a surgical system for ophthalmic surgery, specifically for procedures like cryopexy, glaucoma, and cataract extraction, which are therapeutic interventions rather than diagnostic processes.

No

The device description explicitly lists hardware components such as a cryogen gas bottle, console, ophthalmic probe, and footswitch.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to provide information for diagnosis, monitoring, or screening.
  • Device Function: The D.O.R.C. Harmony CryoStar Cryosurgical System is a surgical system that uses cryosurgery (freezing) to treat ophthalmic conditions. It directly interacts with the patient's tissue during a surgical procedure.
  • Intended Use: The intended use clearly states it is a "surgical system for ophthalmic surgery" and lists specific surgical procedures. It does not mention analyzing samples from the body.

Therefore, based on the provided information, the D.O.R.C. Harmony CryoStar Cryosurgical System is a surgical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

The D.O.R.C. Harmony CryoStar Cryosurgical System is a surgical system for ophthalmic surgery intended for use in surgery of the posterior segment or anterior segment including cryopexy for retinal detachment, glaucoma, cataract extraction, trichiasis, and retinopathy of prematurity.

Product codes (comma separated list FDA assigned to the subject device)

HRN

Device Description

The D.O.R.C. CryoStar Cryosurgical System consists of a cryogen gas bottle, a console, an ophthalmic probe, a footswitch and necessary interconnections. The console controls delivery of the gas to the probe. It also processes signals from the footswitch, enabling the probe to freeze and defrost.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

posterior segment or anterior segment (for ophthalmic surgery)

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K940373, K992954

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 886.4170 Cryophthalmic unit.

(a)
Identification. A cryophthalmic unit is a device that is a probe with a small tip that becomes extremely cold through the controlled use of a refrigerant or gas. The device may be AC-powered. The device is intended to remove cataracts by the formation of an adherent ice ball in the lens, to freeze the eye and adjunct parts for surgical removal of scars, and to freeze tumors.(b)
Classification. Class II.

0

OCT 22 2001

510(k) Summary Dutch Ophthalmic, USA D.O.R.C. CryoStar Cryosurgical System (per 21 CFR 807.92)

012821

1. SUBMITTER NAME AND ADDRESS

Dutch Ophthalmic, USA One Little River Road P.O. Box 968 Kingston, NH 03848

Contact Person:Mark W. Furlong, President
Telephone: 603-642-8468

Date Prepared: August 22, 2001

2. DEVICE NAME

Proprietary Name:D.O.R.C. CryoStar Cryosurgical System
Common/Usual Name:Cryosurgical System
Classification Name:Unit, Cryophthalmic, AC-Powered
(HRN & 21CFR 886.4170)

3. PREDICATE DEVICES

ManufacturerProduct Name510(k) Number
Spembly Medical LtdD.O.R.C. Cryo 1500K940373
Spembly Medical LtdKeeler Cryo MasterK992954

4. DEVICE DESCRIPTION

The D.O.R.C. CryoStar Cryosurgical System consists of a cryogen gas bottle, a console, an ophthalmic probe, a footswitch and necessary interconnections. The console controls delivery of the gas to the probe. It also processes signals from the footswitch, enabling the probe to freeze and defrost.

റ് INTENDED USE

The D.O.R.C. Harmony CryoStar Cryosurgical System is a surgical system for ophthalmic surgery intended for use in surgery of the posterior segment or anterior segment including cryopexy for retinal detachment, glaucoma, cataract extraction, trichiasis, and retinopathy of prematurity.

1

K 01282|

BASIS FOR SUBSTANTIAL EQUIVALENCE 6.

Operational and technological characteristics form the basis for the determination of substantial equivalence of the D.O.R.C. CryoStar Cryosurgical System with legally marketed predicate devices. Information supplied in this premarket notification includes descriptive information about the intended use, operation and technological characteristics. The following table summarizes the technological characteristics of the D.O.R.C. CryoStar Cryosurgical System in comparison to the predicate devices.

| Significant
Feature | DORC
CryoStar | DORC
Model 1500 | Keeler
Cryomaster |
|------------------------|-------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------|
| CONSOLE | | | |
| Basic technology | Electro-mechanical | Electro-mechanical | Electro-mechanical |
| Software content | Non-programmable
firmware | None | Non-programmable
firmware |
| Pressure control | Manual | Manual | Manual |
| Temperature | Thermocouple (for some | Thermocouple (for some | Thermocouple (for some |
| measurement | probes in range only) | probes in range only) | probes in range only) |
| Indicator panel: | | | |
| timer | Digital display | None | Digital display |
| pressure | LED array | Dial gauge | Digital display |
| temperature | LED array | LED array | Digital display |
| Power source | Mains | Battery | Mains |
| Gas inlet | Screw connection | Screw connection | Screw connection |
| Gas outlet | Barbed fitting | Barbed fitting | Barbed fitting |
| Probe connection | Screw fitting | Screw fitting | Bayonet fitting |
| PROBES | Ophthalmic standard
freeze and end-freeze,
some with thermocouples
Re-usable when sterilised
by autoclaving | Ophthalmic standard
freeze and end-freeze.
some with thermocouples.
Re-usable when sterilised
by autoclaving | Ophthalmic standard
freeze and end-freeze.
some with thermocouples.
Re-usable when sterilised
by autoclaving |
| ACCESSORIES | | | |

CRYOSTAR COMPARISON CHART

ACCESSORIES
Probe adaptorUniversal
(suits probes with or
without thermocouples)NoneOne adaptor for probes
with thermocouples and
one adaptor for those
without
CONSUMABLE CRYOGEN GASES
Nitrous oxideMedical grade, vapour
withdrawal gasMedical grade, vapour
withdrawal gasMedical grade, vapour
withdrawal gas
Carbon dioxideMedical grade, vapour
withdrawal gasMedical grade, vapour
withdrawal gasMedical grade, vapour
withdrawal gas

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" around the perimeter. Inside the circle is an abstract symbol that resembles a stylized human figure or a bird in flight, composed of three curved lines.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

OCT 22 2001

Mr. Mark Furlong President Dutch Ophthalmic USA, Inc. One Little River Rd. P.O. Box 968 Kingston, NH 03848

Re: K012821

Trade/Device Name: D.O.R.C. CryoStar Cryosurgical System Regulation Number: 21 CFR 886.4170 Regulation Name: Cryophthalmic Unit Regulatory Class: Class II Product Code: HRN Dated: August 22, 2001 Received: August 23, 2001

Dear Mr. Furlong:

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

This letter will allow you to begin marketing your device as described in your Section 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 your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4613. 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" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained 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 yours,

A. Ralph Rosenthal

A. Ralph Rosenthal, M.D. Director Division of Ophthalmic and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

4

KO1282

510(k) Number (if known):

Device Name: _ D.O.R.C. CryoStar Cryosurgical System

Indications For Use:

The D.O.R.C. CryoStar Cryosurgical System is a surgical system for ophthalmic surgery intended for use in surgery of the posterior segment or ophicilanine surger y mosing for retinal detachment, glaucoma, cataract extraction, trichiasis and retinopathy of prematurity.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Dexinder, 10-15-01

Division of Ophthalmic De 510(k) Number

Prescription Use (Per 21 CFR 801.109) OR

Over-The-Counter Use