K Number
K021854
Device Name
DFV CPG COLPOSCOPE
Date Cleared
2002-10-25

(141 days)

Product Code
Regulation Number
884.1630
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
A Colposcope is a device designed to permit viewing of the tissues of the vagina and cervix by a telescopic system located outside the vagina. A Colposcope is used to diagnose and examine abnormalities of the vagina and cervix. The patient's population for which the Colposcope is intended is any person of the feminine sex.
Device Description
A Colposcope is a device designed to permit viewing of the tissues of the vagina and cervix by a telescopic system located outside the vagina. The device consists of Stands, Power supply, and Microscope head.
More Information

Not Found

No
The summary describes a standard optical colposcope and does not mention any AI or ML capabilities, image processing, or performance studies related to algorithmic analysis.

No
The device is described as a diagnostic tool used for viewing and examining tissues for abnormalities, not for treating any condition.

Yes
The "Intended Use / Indications for Use" section explicitly states, "A Colposcope is used to diagnose and examine abnormalities of the vagina and cervix." This indicates its purpose is to aid in diagnosis.

No

The device description explicitly states that the device consists of "Stands, Power supply, and Microscope head," which are hardware components.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD devices are used to examine specimens derived from the human body. The intended use and device description clearly state that the Colposcope is used to view the tissues of the vagina and cervix directly on the patient's body using a telescopic system. It does not involve the analysis of samples like blood, urine, tissue biopsies, etc., which are typical for IVDs.
  • The device description focuses on optical viewing. The components listed (Stands, Power supply, Microscope head) are consistent with a device used for direct visual examination, not for performing laboratory tests on specimens.

Therefore, the Colposcope described is a medical device used for direct visualization and examination of anatomical structures, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

A Colposcope is a device designed to permit viewing of the tissues of the vagina and cervix by a telescopic system located outside the vagina. A Colposcope is used to diagnose and examine abnormalities of the vagina and cervix. The patient's population for which the Colposcope is intended is any person of the feminine sex.

Product codes

85 HEX

Device Description

The DFV CPG Colposcope consists of three main parts: Stands, Power supply, and Microscope head. The Stands support the microscope head and are made of brass, aluminum, plastic, and steel. The Power supply illuminates the microscope head and contains electronic components, lamps, and a fiber optic cable. The Microscope head amplifies and illuminates the human body region to be examined or observed by the physician and is made of brass, aluminum, steel, optical glass, and plastic.

Physical characteristics include a Galilean optical system, straight Porro type 160 mm binoculars, a 300 mm objective, and wide field type 12.5x adjustable eyepieces. It has an interpupillary distance of 55-75 mm and uses a 15V - 150W lamp for illumination. Macro focus is achieved with stand set movement, and micro focus is a gear rack and pinion manual. The head weight ranges from 3.8 kg to 6.0 kg, with a vertical stroke of 250 mm. The height between the floor and objective is 950 mm, and the stand set weight is 7 kg.

Resolution (reticule USAF 51) varies by selector position (A to E) with line-pairs/mm ranging from 20 to 72. Depth of field (reticule USAF 51 and comparator clock) also varies by selector position, ranging from approximately 1 mm to 15 mm.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vagina and cervix

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)

K000707, K981958, K963593, K955635, K940094, K932896, K884934, K871682, K853389, K852980, K770896, K770697, K761205, K760763

Reference Device(s)

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

§ 884.1630 Colposcope.

(a)
Identification. A colposcope is a device designed to permit direct viewing of the tissues of the vagina and cervix by a telescopic system located outside the vagina. It is used to diagnose abnormalities and select areas for biopsy. This generic type of device may include a light source, cables, and component parts.(b)
Classification. Class II (special controls). The device, when it is a standard colposcope (or colpomicroscope) that uses only a white light source, does not use filters other than a green filter, does not include image analysis software, and is not smartphone-based, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 884.9.

0

KD21854

OCT 2 5 2002

DFV-FDA CPG May 2002

2.h. 510(k) Summary

    1. Submitter's name: D.F.Vasconcellos S.A. Address: Avenida Indianópolis, 1706 - São Paulo - SP - Brasil Contact person: Gilberto Alves Barral Phone number: 11-55-11-5584 0411 E-mail: diretoria@dfv.com.br Date: 05/27/2002 2) Device's Name: DFV CPG Colposcope
    • Proprietary Name: D.F.Vasconcellos S.A. Usual Name: Colposcope Classification Name: Colposcope

3) Devices substantially equivalent

There are many others devices already registered on FDA, substantially equivalent to Colposcope DFV, with the same physical and technical characteristics. The structure and material of devices are the same too. See the table above:

| Device Name | Applicant Name | 510(k)
Number |
|----------------------------------|----------------------------------|------------------|
| Leica Colposcope | Leica Microscopy Systems | K000707 |
| Leisegang Video Colposcope | Netoptix Corp. | K981958 |
| IMT Loupe-Colposcope | Inventive Medical Technol | K963593 |
| Video Colposcope/vertical | Welch Allyn, Inc. | K955635 |
| Colposcopes and accessories | Leisegang Medical, Inc. | K940094 |
| HM-0690 Colposcope | Hill-Med, Inc. | K932896 |
| Jedmed KP6 Colposcope | Jedmed Instrument Co. | K884934 |
| Wallach Convertible Colposcope | Wallach Surgical Devices | K871682 |
| Wallach Zoom Colposcope | Wallach Surgical Devices | K853389 |
| OCS-2 Colposcope | Olympus Corp. | K852980 |
| Colposcope Model II | Dynatech Cryomedical Co. | K770896 |
| Colposcope System | Richard Wolf Medical Instruments | K770697 |
| Dynatech JD7/JD7P Colposcope | Dynatech Cryomedical Co. | K761205 |
| Colposcope (Dynatech Colposcope) | Dynatech Cryomedical Co. | K760763 |

1

4) Description of the Device

PartFunctionDesign
StandsServes to support the microscope headBrass, aluminum, plastic, steel
Power supplySupplies illumination to the microscope
headElectronic components, lamps, fiber optic cable
Microscope headAmplifies and illuminates the human body
region, which will be examined or
observed by the physicianBrass, aluminum, steel, optical glass, plastic

Physical characteristics:

ColposcopeGalilean system
BinocularsStraight Porro type 160 mm
Objective300 mm
EyepiecesWide field type 12.5x adjustable
MagnificationsSee table on page 9
Observation fieldSee table on page 9
Illuminated fieldSee table on page 9
Interpupillary distance55-75 mm
Illumination fieldLamp 15V - 150W
Macro focusWith stand set movement
Micro focusGear rack and pinion manual
Head weight3.8 kg to 6.0 kg
Vertical stroke250 mm
Height between floor and objective950 mm
Stand set weight7 kg

2

Resolution (reticule USAF 51):

Selector positionABCDE
Resolved block4-34-65-45-66-2
Line-pairs/mm2028455672

Depth of field (reticule USAF 51 and comparator clock):

Selector positionABCDE
Depth of field (mm)~15~9~3~2~1

Image /page/2/Figure/5 description: The image shows a graph titled "DISTORTION (%)". The y-axis ranges from -10 to 10, while the x-axis is not labeled. A curve starts near zero and gradually increases to a value near 10 as x increases.

5) Intended use of the device

A Colposcope is a device designed to permit viewing of the tissues of the vagina and cervix by a telescopic system located outside the vagina. A Colposcope is used to diagnose and examine abnormalities of the vagina and cervix. The patient's population for which the Colposcope is intended is any person of the feminine sex.

6) Not applicable

3

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POSITIONBUTTONക്ക് വിട്ടു ആവശ്യ വിവിച്ചു. വിവ്യക്ഷിക്കുന്നു. 1990 ലെ വിവ്യാവിയ 1990 ലെ വിള40 (2.5)6 (0.4)0 (0.6)16 (1.0)25 (1.6)40 (2.5)ופי ה) נפוצות המופים של מורים (היסטורים של משום של שנו של שנו של שנו של שנו של שלים (מילים של מיני (מיני מושים של שנו של שנו של שלים) מילים שלום ליני (מילים שלום שלום (מילים25 (1.6)
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4

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/4/Picture/1 description: The image contains the text 'Public Health Service'. The text is in a simple, sans-serif font. The words are arranged on a single line, with 'Public' and 'Health' being slightly larger than 'Service'. The text is dark and contrasts with the background.

Food and Drug Administration 200 Corporate Boulevard ockville MD 20850

D.F. Vasconcellos S/A % Mr. Jean M. Buchwald Albee Import & Export of California 1990 NE 163rd Street, Suite 107 NORTH MIAMI BEACH FL 33162

Re: K021854

Trade/Device Name: DFV Colposcopes Regulation Number: 21 CFR 884.1630 Regulation Name: Colposcope Regulatory Class: II Product Code: 85 HEX Dated: September 4, 2002 Received: September 11, 2002

Dear Mr. Buchwald:

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 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.

Image /page/4/Picture/11 description: The image shows a circular logo with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES" written around the top half of the circle. Inside the circle is a stylized image of an eagle's head with three curved lines extending from the back of the head. The logo is black and white.

5

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 contact the Office of Compliance 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 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,

Henry C. Snigdon

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

Enclosure

6

2.g. Indications for use

510 (k) Number:

02185if

Device Name:

Colposcope

Indications for use:

A Colposcope is a device designed to permit viewing of the tissues of the vagina and cervix by a telescopic system located outside the vagina. A Colposcope is used to diagnose and examine abnormalities of the vagina and cervix. The patient's population for which the Colposcope is intended is any person of the feminine sex.

Prescription Use

David A. Wegman

(Division Sign-Off) Division of Reproductive, Abdomi and Radiological Devices 510(k) Number _

Concurrence of CDRH, Office of Device Evaluation (ODE)