K Number
K013471
Device Name
DELTA 2000 SERIES EXTRACORPOREAL LITHOTRIPTER
Date Cleared
2002-04-29

(193 days)

Product Code
Regulation Number
876.5990
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Delta™ 2000 Series Lithotripter is intended to fragment urinary stones in the kidney (renal pelvis and renal calyces) and ureter (upper, middle, and lower ureter).
Device Description
The DELTA lithotripter utilizes well known spark gap technology. To generate a shock wave utilizing this method, an electrical discharge is created between two electrodes submerged in water. This sudden discharge of the enormous amount of energy lasts less than 1 microsecond. During this time an evaporation of water surrounding the gap between the electrodes occurs. The evaporation causes an instant expansion of vapor which produces a shock wave. In an extracorporeal lithotripter, the two wire electrodes are embedded in a plastic tube filled with insulating material. On one end of the tube the tips of the wire are bent towards each other with a small gap between them. A source of electrical energy is connected to each wire on the other end of this tubular structure. This electrode assembly is placed inside an ellipsoidal reflector in such a way that the gap between the two conductors coincides with the first focal point of the reflector. The reflector is filled with water and covered with a thin elastic membrane. After discharging the energy, reflected shock waves are transmitted to the second focal point through noncompressible medium, such as water in the reflector and in human tissue. The energy generated at the first focal point is recaptured at the second focal point of the ellipsoidal reflector with only minimal losses. When the second focal point is positioned on the treatment area such as the kidney stone inside the body, the repeated impact of the shock waves on the stone, at various energy levels, causes its disintegration.
More Information

No
The device description focuses on spark gap technology and shock wave generation, with no mention of AI or ML. The "Mentions AI, DNN, or ML" field is explicitly marked as "Not Found".

Yes
The device is intended to fragment urinary stones, which is a therapeutic action aimed at treating a medical condition.

No.
The device's intended use is to fragment urinary stones, which is a therapeutic treatment and not a diagnostic function.

No

The device description clearly details hardware components like electrodes, a reflector, and a membrane, which are essential for generating and transmitting shock waves. This is not a software-only device.

Based on the provided information, the Delta™ 2000 Series Lithotripter is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use is to fragment urinary stones within the body (in the kidney and ureter). IVD devices are used to examine specimens outside the body to provide information about a patient's health.
  • Device Description: The description details a system that generates and focuses shock waves to break up stones in vivo. This is a therapeutic device, not a diagnostic one.
  • Lack of IVD Characteristics: There is no mention of analyzing biological samples, using reagents, or providing diagnostic information based on laboratory tests.

Therefore, the Delta™ 2000 Series Lithotripter is a therapeutic medical device, specifically a lithotripter, used for treating kidney and ureter stones.

N/A

Intended Use / Indications for Use

The Delta™ 2000 Series Lithotripter is intended to fragment urinary stones in the kidney (renal pelvis and renal calyces) and ureter (upper, middle, and lower ureter).

The Delta™ 2000 Series of Extracorporeal Lithotripter is intended to fragment urinary stones in the kidney (renal pelvis and renal calyces) and ureter (upper, middle, and lower ureter).

Product codes

78 LNS

Device Description

The DELTA lithotripter utilizes well known spark gap technology. To generate a shock wave utilizing this method, an electrical discharge is created between two electrodes submerged in water. This sudden discharge of the enormous amount of energy lasts less than 1 microsecond. During this time an evaporation of water surrounding the gap between the electrodes occurs. The evaporation causes an instant expansion of vapor which produces a shock wave. In an extracorporeal lithotripter, the two wire electrodes are embedded in a plastic tube filled with insulating material. On one end of the tube the tips of the wire are bent towards each other with a small gap between them. A source of electrical energy is connected to each wire on the other end of this tubular structure. This electrode assembly is placed inside an ellipsoidal reflector in such a way that the gap between the two conductors coincides with the first focal point of the reflector. The reflector is filled with water and covered with a thin elastic membrane. After discharging the energy, reflected shock waves are transmitted to the second focal point through noncompressible medium, such as water in the reflector and in human tissue. The energy generated at the first focal point is recaptured at the second focal point of the ellipsoidal reflector with only minimal losses. When the second focal point is positioned on the treatment area such as the kidney stone inside the body, the repeated impact of the shock waves on the stone, at various energy levels, causes its disintegration.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

kidney (renal pelvis and renal calyces) and ureter (upper, middle, and lower ureter)

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Hospitals

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)

K003529

Reference Device(s)

K002929, K010340

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.5990 Extracorporeal shock wave lithotripter.

(a)
Identification. An extracorporeal shock wave lithotripter is a device that focuses ultrasonic shock waves into the body to noninvasively fragment urinary calculi within the kidney or ureter. The primary components of the device are a shock wave generator, high voltage generator, control console, imaging/localization system, and patient table. Prior to treatment, the urinary stone is targeted using either an integral or stand-alone localization/imaging system. Shock waves are typically generated using electrostatic spark discharge (spark gap), electromagnetically repelled membranes, or piezoelectric crystal arrays, and focused onto the stone with either a specially designed reflector, dish, or acoustic lens. The shock waves are created under water within the shock wave generator, and are transferred to the patient's body using an appropriate acoustic interface. After the stone has been fragmented by the focused shock waves, the fragments pass out of the body with the patient's urine.(b)
Classification. Class II (special controls) (FDA guidance document: “Guidance for the Content of Premarket Notifications (510(k)'s) for Extracorporeal Shock Wave Lithotripters Indicated for the Fragmentation of Kidney and Ureteral Calculi.”)

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APR 2 9 2002

K013471

PAGE / UF 2

EXHIBIT 2 510(k) Summary of Safety and Effectiveness E.S.W.L. Products, Inc. 1542 Barclay Blvd. Buffalo Grove, IL 60089 USA Tel 1+847-419-6844 Fax 1+847-419-6881 Contact: Christopher Nowacki, President

October 17, 2001

    1. Identification of the Device: Proprietary-Trade Name: "Delta™ 2000" Series Lithotripter. Classification Name/Product Code: 78 LNS Common/Usual Name: Extracorporeal Shock Wave Lithotripter
    1. Equivalent legally marketed devices: Dornier Compact Alpha Lithotripter, K002929; EDAP Technomed Sonolith Praktis, K003529; Storz Modulith Lithotripter Model SLK, K010340.
  • Indications for Use (intended use) The Delta™ 2000 Series Lithotripter is intended 3. to fragment urinary stones in the kidney (renal pelvis and renal calyces) and ureter (upper, middle, and lower ureter).
    1. Description of the Device: The DELTA lithotripter utilizes well known spark gap technology. To generate a shock wave utilizing this method, an electrical discharge is created between two electrodes submerged in water. This sudden discharge of the enormous amount of energy lasts less than 1 microsecond. During this time an evaporation of water surrounding the gap between the electrodes occurs. The evaporation causes an instant expansion of vapor which produces a shock wave. In an extracorporeal lithotripter, the two wire electrodes are embedded in a plastic tube filled with insulating material. On one end of the tube the tips of the wire are bent towards each other with a small gap between them. A source of electrical energy is connected to each wire on the other end of this tubular structure. This electrode assembly is placed inside an ellipsoidal reflector in such a way that the gap between the two conductors coincides with the first focal point of the reflector. The reflector is filled with water and covered with a thin elastic membrane. After discharging the energy, reflected shock waves are transmitted to the second focal point through noncompressible medium, such as water in the reflector and in human tissue. The energy generated at the first focal point is recaptured at the second focal point of the ellipsoidal reflector with only minimal losses. When the second focal point is positioned on the treatment area such as the kidney stone inside the body, the repeated impact of the shock waves on the stone, at various energy levels, causes its disintegration.

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K013471

PAGE 2 OF 2

Comparison AreasEDAP Technomed Sonolith"Delta™ 2000" Series
Praktis, K003529Lithotripter
Indications for useIntended to fragment urinary
stones in the kidney (renal
pelvis and renal calyces) and
ureter (upper, middle, and
lower ureter).SAME
Where usedHospitalsSAME
Standards compliancea. UL-2601 and IEC 60601
b. IEC 60601-2-36, "Medical
electrical equipment - Part 2:
Particular requirements for the
safety of equipment for
extracorporeally induced
lithotripsy" (1997).
c. IEC 61846, "Ultrasonics -
Pressure pulse lithotripters -
Characteristics of fields" (1998).
d. EMC: Compliance with IEC
60601-1-2 will be maintained,
except during the triggering and
generation cycle of the
PRESSURE PULSE releaseSAME
TechnologyExtracorporeal shock wave,
spark.SAME.
Power Source120 VAC 50-60~ 15 amp
outletSAME
    1. Safety and Effectiveness, comparison to predicate device:
  • Conclusion: In all material respects, the "Delta™ 2000" Series Lithotripter is 6. substantially equivalent to one or more products of similar description. Testing, certifications, and clinical experience demonstrates that the device is equivalent to the EDAP Technomed Sonolith Praktis, K003529, currently on the market. The "Delta™ 2000" Series Lithotripter meets the requirements of Guidance for the Content of Premarket Notifications (510(k)s) for Extracorporeal Shock Wave Lithotripters Indicated for the Fragmentation of Kidney and Ureteral Calculi, Document issued on August 9, 2000

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Rockville MD 20850

E.S.W.L. Products, Inc. c/o Daniel Kamm, P.E. Regulatory Engineer Kamm & Associates, Inc. P.O. Box 7007 DEERFIELD IL 60015

Re: K013471

Trade/Device Name: Delta™ 2000 Series Extracorporeal Lithotripter Regulation Number: 21 CFR 876.5990 Regulation Name: Extracorporeal shock wave lithotripter Regulatory Class: II Product Code: 78 LNS Dated: February 20, 2002 Received: February 21, 2002

Dear Mr. Kamm:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your becaon 3 re(x) presidentially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the encrosure) to regars actment date of the Medical Device Amendments, or to conniter co pror to may 20, 1978, the ecordance with the provisions of the Federal Food, Drug, devices that have been receasined in assee approval of a premarket approval application (PMA). and Cosmetic (110-) that to novice, subject to the general controls provisions of the Act. The r ou may, aference, manner of the Act include requirements for annual registration, listing of general controls provisions of tactice, 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 additional controls. Existing major regulations affecting your device can be It may be subject to additional come of the 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 I loase of advised that I Dris issum that your device complies with other requirements of the Act that I DA has made a dolorimiations administered by other Federal agencies. You must of any I ederal statures than ogenements, including, but not limited to: registration and listing comply with an the Hel Frequirement Bart 801); good manufacturing practice requirements as set (21 CFR Part 007), advening (21 CFR Part 820); and if applicable, the electronic forth in the quant) by events (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 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), please If you desire specific ac at one of the following numbers, based on the regulation number at the top of this letter:

8xx.1xxx(301) 594-4591
876.2xxx, 3xxx, 4xxx, 5xxx(301) 594-4616
884.2xxx, 3xxx, 4xxx, 5xxx, 6xxx(301) 594-4616
892.2xxx, 3xxx, 4xxx, 5xxx(301) 594-4654
Other(301) 594-4692

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 Part 807.97). Other general information on by rolerence to premiumed 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,

Nancy Brogdon

Nancy C. Brogdon Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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10. Indications for Use

K013471 510((k) Number________________________________________________________________________________________________________________________________________________________________

The Delta™ 2000 Series of Extracorporeal Lithotripter is intended to fragment urinary stones in the kidney (renal pelvis and renal calyces) and ureter (upper, middle, and lower ureter).

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Concurrence of CDRH, Office of Device Evaluation (ODE)
----------------------------------------------------------
Prescription Use
--------------------

OR

Over the Counter Use
(Per 21 CFR 801.109)

Nancy Brogdon

(Division Sign-Off)
Division of Reproductive, Abdominal,
and Radiological Devices

510(k) NumberK013471
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