K Number
K031869
Device Name
SISS INC. (D.B.A. MEDISISS) REPROCESSED ELECTROSURGICAL INSTRUMENTS AND ACCESSORIES
Date Cleared
2003-12-24

(190 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The SISS Inc. (d.b.a. MediSISS) Reprocessed electrosurgical instruments have applications in a variety of minimally invasive surgical procedures to manipulate and manage internal soft tissue by grasping, cutting, and/or to facilitate coagulation. transection, resection, mobilization, and dissections of tissue.
Device Description
Reprocessed Electrosurgical Instruments mav consist of hand-manipulated devices with electrocautery capability and with or without rotation capability. The distal end of the Ethicon device consists of a scissor distal end configuration. The U.S Surgical device consists of a dissector distal end configuration. The devices are designed to be inserted through an appropriately sized trocar sleeve or cannula. The end effectors are operated by the handpiece handles may be designed to be suppressed and released to activate the instruments end-effector. The device's insulated shaft may be designed to (depending on the device model and type) be rotated (up to 360") either direction (using a knob on the handle.)
More Information

No
The document describes reprocessed electrosurgical instruments and their functional testing, with no mention of AI or ML capabilities.

No.
Therapeutic devices are generally considered to treat or cure a disease or medical condition. These electrosurgical instruments are used to perform surgical procedures (cutting, coagulating, etc.) which are actions taken during surgery rather than a therapy in themselves, and they do not inherently treat, cure, or prevent a disease or condition post-procedure.

No

The device description indicates that it is used for surgical procedures like grasping, cutting, and coagulation, not for diagnosing conditions.

No

The device description clearly details physical, hand-manipulated instruments with electrocautery capability, including components like handpieces, shafts, and end effectors. This indicates a hardware-based medical device, not a software-only one.

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

Here's why:

  • Intended Use: The intended use describes the device as being used in surgical procedures to manipulate and manage internal soft tissue by grasping, cutting, and/or facilitating coagulation, transection, resection, mobilization, and dissections of tissue. This is a description of a surgical instrument used directly on the patient's body.
  • Device Description: The device description details a hand-manipulated surgical instrument with electrocautery capability, designed for insertion through a trocar sleeve or cannula and operation of end effectors. This aligns with the description of a surgical tool.
  • Lack of IVD Characteristics: An IVD is a medical device used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. The provided information does not mention any testing of samples or analysis of biological materials.

The device described is a reprocessed surgical instrument used for direct intervention on a patient during surgery, not for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

The SISS Inc. (d.b.a. MediSISS) Reprocessed electrosurgical instruments have applications in a variety of minimally invasive surgical procedures to manipulate and manage internal soft tissue by grasping, cutting, and/or to facilitate coagulation. transection, resection, mobilization, and dissections of tissue.

Product codes

GEI

Device Description

Reprocessed Electrosurgical Instruments mav consist of hand-manipulated devices with electrocautery capability and with or without rotation capability.

The distal end of the Ethicon device consists of a scissor distal end configuration. The U.S Surgical device consists of a dissector distal end configuration. The devices are designed to be inserted through an appropriately sized trocar sleeve or cannula. The end effectors are operated by the handpiece handles may be designed to be suppressed and released to activate the instruments end-effector.

The device's insulated shaft may be designed to (depending on the device model and type) be rotated (up to 360") either direction (using a knob on the handle.)

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

internal soft tissue

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

Reprocessed Instrument samples underwent bench testing to demonstrate appropriate functional characteristics. Process validation testing was done to validate the cleaning and packaging and sterilization procedures. In addition, the manufacturing process includes visual and functional testing of all products produced.

Performance data demonstrates that the Reprocessed Instruments perform as originally intended.

MediSISS™ Reprocessed Electrosurgical Instruments undergo mechanical testing to demonstrate that the parts do not change in function. Process validation testing was done to validate the cleaning and sterilization procedures as well as the device's packaging.

Cleaning, sterilization, and packaging validations, functional/performance testing, (product certification.) and (biocompatibility) testing demonstrate that the devices are equivalent and continue to be safe and effective for their intended use.

Representative samples of reprocessed electrosurgical instruments underwent bench testing to demonstrate appropriate functional characteristics. Process validation testing was done to validate the cleaning and sterilization procedures as well as the device's packaging. In addition, the manufacturing process includes visual and functional testing of all products produced.

Key Metrics

Not Found

Predicate Device(s)

K984240, K951589, K934784

Reference Device(s)

K012625, K012598, K012700

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.

0

Page 39 of 41

submitted by

SISS Inc. (d.b.a. MediSISS) P.O. 2060 723 Curtis Court Sisters. OR 97759 Phone: (800)-860-9482 Fax: (541) 549-4527 Email: mabarker(a MediSISS.com

Contact Person:Mary Ann Barker
Device Trade Names:Reprocessed Electrosurgical Instruments and Accessories
Common Names:Reprocessed Electrosurgical Instruments and Accessories
Classification Names:Electrosurgical, Cutting and Coagulation and Accessories
Classification and Code:CFR §878.4400, GEI

Identification of a Legally Marketed Predicate Device

The SISS Inc. (d.b.a. MediSISS) Reprocessed Electrosurgical Instruments are substantially equivalent to the electrosurgical instruments manufactured by:

Ethicon U.S.Surgical

These devices are legally marketed and distributed pursuant to 510(k)'s K984240, K951589, and K934784 and the counterpart devices from the original manufacturers.

They are also similar to the reprocessed electrosurgical instruments and accessories reprocessed by Alliance Corporation and legally marketed and distributed pursuant to, K012625. Likewise, SterilMed, Inc. Reprocessed Laparascopic Electric Instruments: -510(k) K012598; and Vanguard Medical Concepts, Inc Vanguard Reprocessed Endoscopic Instruments, 510(k) K012700.

Device Description

Reprocessed Electrosurgical Instruments mav consist of hand-manipulated devices with electrocautery capability and with or without rotation capability.

The distal end of the Ethicon device consists of a scissor distal end configuration. The U.S Surgical device consists of a dissector distal end configuration. The devices are designed to be inserted through an appropriately sized trocar sleeve or cannula. The end

1

effectors are operated by the handpiece handles may be designed to be suppressed and released to activate the instruments end-effector.

The device's insulated shaft may be designed to (depending on the device model and type) be rotated (up to 360") either direction (using a knob on the handle.)

Intended Use

The SISS Inc. (d.b.a. MediSIS) Reprocessed electrosurgical instruments have applications in a variety of minimally invasive surgical procedures to manipulate and manage internal soft tissue by grasping, cutting, and/or to facilitate coagulation, transection, resection, mobilization, and dissections of tissue.

Functional and Safety Testing

Reprocessed Instrument samples underwent bench testing to demonstrate appropriate functional characteristics. Process validation testing was done to validate the cleaning and packaging and sterilization procedures. In addition, the manufacturing process includes visual and functional testing of all products produced.

Summary of Technological Characteristics

The intended use and technological features of the reprocessed devices do not differ from the legally marketed predicate device(s). Both the reprocessed devices(s) and the predicate device(s) have the same materials and product design. There are no changes to the claims, intended use, clinical applications, patient populations, performance specifications, or methods of operation. The technological characteristics of the reprocessed clectrosurgical devices are the same as those of the legally marketed predicate devices. The technological characteristics of the reprocessed electrosurgical device(s) are the same as those of the legally marketed predicate devices. In addition the MediSISS™ manufacturing process includes 100 % visual and mechanical testing of all products prior to packaging, labeling, and sterilization.

Summary of Performance Data

Performance data demonstrates that the Reprocessed Instruments perform as originally intended.

The SISS Inc. (d.b.a. MediSISS) Reprocessed Electrosurgical Instruments comply with the following standards, practices, and guidance's:

  • ANSI/AAMI/ISO 11135-1994. Medical Devices-Validation and Routine . Control of Ethelene Oxide Sterilization
  • ANSI/AAMI/ISO 10993-7:1995, Biological Evaluation of Medical De-. vices Part 7: Ethylene oxide steritization residuals
  • ANSEAAMI/ISO 10993-1: 1997 (1999 Edition). Biological Evaluation of . Medical Devices Part 1 : Evaluation and Testing.

2

MediSISS™ Reprocessed Electrosurgical Instruments undergo mechanical testing to demonstrate that the parts do not change in function. Process validation testing was done to validate the cleaning and sterilization procedures as well as the device's packaging.

Cleaning, sterilization, and packaging validations, functional/performance testing, (product certification.) and (biocompatibility) testing demonstrate that the devices are equivalent and continue to be safe and effective for their intended use.

Representative samples of reprocessed electrosurgical instruments underwent bench testing to demonstrate appropriate functional characteristics. Process validation testing was done to validate the cleaning and sterilization procedures as well as the device's packaging. In addition, the manufacturing process includes visual and functional testing of all products produced.

Substantial equivalence has been established with respect to intended use, design, energy used or delivered, materials, performance, safety, effectiveness, labeling, biocompatibility, standards, and other applicable characteristics. The SISS Inc. (d.b.a. MediSISS) Reprocessed Electrosurgical Instruments are therefore substantially equivalent to the identified predicate devices.

3

Conclusion

Since the Reprocessed Electrosurgical Instruments meet the requirements of the stated standards and embody technological characteristics substantially equivalent to the predicate device, we believe the device is safe and effective and performs as well as or better than the predicate device. The Reprocessed Electrosurgical Instruments will be reprocessed per specifications and QSR good manufacturing practices that ensure the device is safe and effective for its intended use.

The reprocessed device have the:

  • same intended use as the predicate; and .
  • has the same technological characteristics as the predicate device .
  • and can meet the same performance standards as the predicates �

In accordance with the Federal Food, Drug, and Cosmetic Act, 21 CFR Part 807 and based on the information provided in this Premarket notification, SISS Inc. (d.b.a. MediSISS) concludes that the modified devices (Reprocessed Electrosurgical Instruments) are safe, effective and substantially equivalent to the predicate devices described herein.

Based on the information provided herein, the 510(k) "Substantial Equivalence" Decision Making Process Chart, and the FDA - *510(k) Guidance Document for General Surgical Fridant Process" 5/10/95, we conclude that the SISS Inc. (d.b.a. MediSISS) reprocessed clectrosurgical instruments are substantially equivalent to the predicate devices under the Federal Food and Drug, and Cosmetic Act.

This conclusion is based upon the devices' similarities in functional design, materials. indications for use, and methods of construction.

4

Image /page/4/Picture/1 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular and contains the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. In the center of the seal is an image of an eagle with its wings spread.

Public Health Service

DEC 2 4 2003

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Surgical Instruments Service and Savings, Inc. c/o Mr. Marc M. Mouser Project Engineer, Medical Devices Underwriters Laboratories, Inc. 2600 N.W. Lake Road Camas, Washington 98607-8542

Re: K031869

Trade/Device Name: SISS Inc. Reprocessed Electrosurgical Instruments and Accessories Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: II Product Code: GEI Dated: December 10, 2003 Received: December 12, 2003

Dear Mr. Mouser:

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 prodicate 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 classificd (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 clectronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

5

Page 2 - Mr. Marc M. Mouser

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. 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 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,

Celia M. Witten, Ph.D., M.D.

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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Page 1 of 1

510(k) Number (if known): K031869

SISS Inc. (d.b.a. MediSISS) Reprocessed Electrosurgical Instruments and Device Name: Accessories

Indications for Use:

The SISS Inc. (d.b.a. MediSISS) Reprocessed electrosurgical instruments have applications in a variety of minimally invasive surgical procedures to manipulate and manage internal soft tissue by grasping, cutting, and/or to facilitate coagulation. transection, resection, mobilization, and dissections of tissue.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Preseription Use (Per 21 CFR 801.109)

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Over-The-Counter Use__________________________________________________________________________________________________________________________________________________________

(Optional Format 1-2-96)

(Division Sign-Off)

al. Restorative

K031869