K Number
K031023
Date Cleared
2003-06-27

(88 days)

Product Code
Regulation Number
886.4390
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

For photocoagulation and illumination during ophthalmic surgery. This device delivers illumination as well as laser energy to target tissue, causing coagulation. Spot size can be varied by altering the distance between the tissue and the probe tip

Device Description

The Peregrine Illuminated Laser Probe is an ophthalmic laser delivery device. By its design, it does not generate, intensify or significantly reduce energy. It consists of a connector that is plugged into an existing laser source, a glass fiber for laser delivery and acrylic fiber for illumination with PVC jacket, a Delrin handpiece and 304 stainless needle. The specific laser source to which the probe is connected will be specified in the "Indications for Use."

AI/ML Overview

The provided text describes a 510(k) premarket notification for a medical device (Peregrine Illuminated Laser Probe). However, it does not contain any information about acceptance criteria, device performance studies, sample sizes, ground truth establishment, expert qualifications, or comparative effectiveness studies (MRMC or standalone).

The document details:

  • Device Description: What the device is composed of and its function.
  • Intended Use: For photocoagulation and illumination during ophthalmic surgery.
  • Substantial Equivalence Comparison: A comparison of the Peregrine Illuminated Laser Probe to two predicate devices, highlighting similarities and differences in components and specifications. This is a regulatory comparison to justify substantial equivalence, not a performance study.
  • Sterility Information: States the device will be ETO sterilized and the validation method (AAMI Overkill Method).
  • FDA Clearance Letter: Confirms substantial equivalence to predicate devices and allows marketing.

Therefore, I cannot fulfill your request to describe the acceptance criteria and the study that proves the device meets them, as this information is not present in the provided text.

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Aviation

Peregrine Surgical Ltd. 51 Britain Drive ew Britain, PA 18901

K031023

10FJ

JUN 2 7 2003

March 17, 2003

Premarket Notification [510(k)] Summary

Submitter: Peregrine Surgical Ltd. 51 Britain Drive New Britain, PA 18901 Phone: (215) 348-0456 (215) 348-5526 Fax:

Official Correspondent: Jayne Guthrie

Trade Name: Peregrine Illuminated Laser Probe

Common Name: Ophthalmic Laser Probe

Registration Number: 2529392

Classification: Class II

Class Name: We were unable to find the device listed in the Disposable classification regulations, 21 CFR Parts 862-892 [807.87 (c)]

Panel: Ophthalmic

Product Code: HQF

Device Description: The Peregrine Illuminated Laser Probe is an ophthalmic laser delivery device. By its design, it does not generate, intensify or significantly reduce energy. It consists of a connector that is plugged into an existing laser source, a glass fiber for laser delivery and acrylic fiber for illumination with PVC jacket, a Delrin handpiece and 304 stainless needle. The specific laser source to which the probe is connected will be specified in the "Indications for Use."

Statement of indications for use. - For photocoagulation and illumination during ophthalmic surgery. This device delivers illumination as well as laser energy to target tissue, causing coagulation. Spot size can be varied by altering the distance between the tissue and the probe tip

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K031023
20F2

Substantial Equivalence Comparison

Substantial Equivalence to:Product PD600.00K024061Peregrine Straight Laser ProbeSubstantial Equivalence to:HGM Illuminating Laser Probe510K K931784Manufactured by Gamp & Assoc.Application for 510KPeregrine IlluminatedLaser ProbeManufactured by Peregrine
Light transmission forphotocoagulationIllumination and Lighttransmission forphotocoagulationIllumination and Lighttransmission forphotocoagulation
Aluminum connectorAluminum connectorDelrin connector
Delrin HandpieceDelrin HandpieceDelrin Handpiece
Optical FiberOptical FiberOptical Fiber
Glass - Silica CoreGlass - Silica CoreGlass - Silica Core
.008" (200 microns).008" (200 microns)400 micron
PVC JacketTeflon JacketTeflon Jacket
Length 101 inchesLength 96 inchesLength 81 inches
304 Stainless Needle304 Stainless Needle304 Stainless Needle
20 Gauge20 Gauge25 Gauge
Max power outputMax power output
1 watt1 watt
No illuminationIlluminationIllumination
Acrylic Optical fiberAcrylic Optical fiber
Aluminum illumination fiberconnectorAluminum illumination fiberconnector

Sterility

The Device will be ETO Sterilized.

The method used to validate the sterilization cycle is AAMI Overkill Method.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

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 border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the circumference. Inside the circle is a stylized symbol that resembles a bird in flight, composed of three curved lines.

Public Health Service

JUN 2 7 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Todd Richmond Director of Product Development Peregrine Surgical Ltd. 51 Britain Drive New Britain, Pennsylvania 18901

Re: K031023

Trade/Device Name: Peregrine Illuminated Laser Probe Regulation Number: 21 CFR 886.4390 Regulation Name: Ophthalmic laser Regulatory Class: II Product Code: HQF Dated: Received:

Dear Mr. Richmond:

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 (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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Page 2 - Mr. Todd Richmond

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), please contact the Office of Compliance at (301) 594-4659. 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) you may obtain. 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.

Sincerely, yours,

Mark N. Millburn

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

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STATEMENT OF INDICATIONS FOR USE

510K Number (if known):

Device Name: Peregrine Illuminated Laser Probe

Indications for Use:

For photocoagulation and illumination during ophthalmic surgery. This device delivers illumination as well as laser energy to target tissue, causing coagulation. Spot size can be varied by altering the distance between the tissue and the probe tip

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

Concurrence of CDRH, Office of Device Evaluation (ODE) OR Over-The-Counter Use Prescription Use _____________________________________________________________________________________________________________________________________________________________ XX Restorative and IN 510(k) Num

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§ 886.4390 Ophthalmic laser.

(a)
Identification. An ophthalmic laser is an AC-powered device intended to coagulate or cut tissue of the eye, orbit, or surrounding skin by a laser beam.(b)
Classification. Class II.