K Number
K034012
Date Cleared
2004-03-16

(83 days)

Product Code
Regulation Number
882.4725
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Smith & Nephew RF Denervation Probes and Cannulae are indicated for use in RF heat lesion procedures for the relief of pain.

Device Description

The Smith & Nephew RF Denervation Probe is a temperature sensing electrode designed for use in radiofrequency lesion procedures. The RF Denervation Probe is used with a disposable Smith & Nephew RF Cannula. The Smith & Nephew RF Denervation Probe is packaged non-sterile for reuse. Smith & Nephew RF Cannulae are offered in a variety of sizes and tip configurations. The RF Cannulae are packaged sterile for single use.

AI/ML Overview

The provided text describes a 510(k) summary for the Smith & Nephew RF Denervation Probes & RF Cannulae. For devices cleared through the 510(k) process, the primary "study" that proves the device meets acceptance criteria is a demonstration of substantial equivalence to legally marketed predicate devices. This typically involves performance data showing the new device functions similarly and safely to the predicate, rather than an extensive clinical trial designed to prove clinical efficacy.

Therefore, the requested information focusing on AI-specific metrics (like MRMC studies, standalone algorithm performance, training/test set sizes, expert adjudication for ground truth) is not applicable to this type of device and submission. The document explicitly states: "The Smith & Nephew RF Denervation Probes & RF Cannulae are substantially equivalent in design, materials, function and intended use to the following devices cleared for commercial distribution: Radionics Racz-Finch Electrode K870028 and Radionics Disposable RF Cannulae K980430."

However, the document does contain information about performance data related to electrical safety standards.

Here's the breakdown based on the available information:


Acceptance Criteria and Device Performance

Acceptance CriteriaReported Device Performance
Electrical Safety Standards: Compliance with UL 60601-1 and IEC 60601-1The Smith & Nephew RF Denervation Probes & RF Cannulae meet the requirements of UL 60601-1 and IEC 60601-1 when used in combination with the Smith & Nephew Electrothermal® 20S Spine System Generator.
Substantial Equivalence to Predicate Devices (Radionics Racz-Finch Electrode K870028 and Radionics Disposable RF Cannulae K980430) in design, materials, function, and intended use.The device is deemed substantially equivalent to the predicate devices.

Study Details (Based on available 510(k) summary)

  1. Sample size used for the test set and the data provenance:

    • Sample Size: Not explicitly stated as a separate "test set" in the context of a clinical performance study. The 510(k) process relies on demonstrating equivalence through technical characteristics and a summary of performance data (like electrical safety testing).
    • Data Provenance: Not applicable in the context of a clinical trial for substantial equivalence based on technical standards and comparisons. The performance data relates to general electrical safety testing.
  2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. Ground truth as typically defined for algorithm performance (e.g., in AI/ML studies) is not part of this 510(k) submission. The "ground truth" for substantial equivalence is the established performance and safety of the predicate devices and compliance with recognized standards.

  3. Adjudication method (e.g., 2+1, 3+1, none) for the test set: Not applicable. There was no clinical study requiring adjudication of expert interpretations as described.

  4. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance: Not applicable. This device is not an AI-assisted diagnostic or imaging device.

  5. If a standalone (i.e. algorithm only without human-in-the loop performance) was done: Not applicable. This device is a medical instrument (probe and cannula), not a software algorithm.

  6. The type of ground truth used (expert consensus, pathology, outcomes data, etc): The "ground truth" for this submission are the established safety and performance requirements of electrical safety standards (UL 60601-1, IEC 60601-1) and the characteristics of the legally marketed predicate devices.

  7. The sample size for the training set: Not applicable. This device is not an AI-based system that requires a training set.

  8. How the ground truth for the training set was established: Not applicable.


Summary Rationale:

The provided document is a 510(k) summary for medical devices (RF Denervation Probes and Cannulae). The 510(k) pathway is for demonstrating substantial equivalence to a legally marketed predicate device, not for proving independent clinical effectiveness through extensive clinical trials as would be required for a novel device or an AI/ML product. The "study" here is primarily a technical comparison and confirmation of compliance with relevant industry standards (electrical safety), rather than a clinical trial with human subjects, ground truth panels, or AI performance metrics.

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MAR 1 6 2004

Endoscopy Smith & Nephew, Inc. 150 Minuteman Road Andover, MA 01810 USA

978 749 1000 978 749 1599 Fax www.smith-nephew.com We are smith&nephew

Page ① of 2

SECTION IN

K 034012

510{k} SUMMARY OF SAFETY AND EFFECTIVENESS INFORMATION

as required by the Safe Medical Devices Act of 1990 and codified in 21 CFR 807.92 upon which the substantial equivalence is based.

Date Prepared: December 23, 2003

A. Submitter's Name: Smith & Nephew, Inc., Endoscopy Division 150 Minuteman Road

Andover, MA 01810

B. Company Contact:
Karen Provencher
Regulatory Affairs Specialist
Phone:978-749-1365
Fax:978-749-1443
  • C. Device Name
Trade Name:Smith & Nephew RF Denervation ProbesSmith & Nephew RF Cannulae
Common Name:Probe, Radiofrequency Lesion
Classification Name:Radiofrequency Lesion Probe

D. Predicate Devices

The Smith & Nephew RF Denervation Probes & RF Cannulae are substantially equivalent in intended use and fundamental scientific technology to the following legally marketed devices in commercial distribution: Radionics Racz-Finch Electrode and RFK Needles (K870028 and K980430).

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Page ② of ②

  • Description of Device ப்
    The Smith & Nephew RF Denervation Probe is a temperature sensing electrode designed for use in radiofrequency lesion procedures. The RF Denervation Probe is used with a disposable Smith & Nephew RF Cannula. The Smith & Nephew RF Denervation Probe is packaged non-sterile for reuse. Smith & Nephew RF Cannulae are offered in a variety of sizes and tip configurations. The RF Cannulae are packaged sterile for single use.

  • Intended Use F.
    The Smith & Nephew RF Denervation Probes and Cannulae are indicated for use in RF heat lesion procedures for the relief of pain.

  • G. Comparison of Technological Characteristics
    The Smith & Nephew RF Denervation Probes & RF Cannulae are substantially equivalent in design, materials, function and intended use to the following devices cleared for commercial distribution:

  • Radionics Racz-Finch Electrode K870028 .

  • Radionics Disposable RF Cannulae K980430 .

  • H. Summary Performance Data

The Smith & Nephew RF Denervation Probes & RF Cannulae meet the requirements of electrical safety standards for UL 60601-1 and IEC 60601-1 when use in combination with the Smith & Nephew Electrothermal® 20S Spine System Generator.

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Image /page/2/Picture/1 description: The image is a black and white seal for the Department of Health & Human Services - USA. The seal is circular with text around the perimeter. Inside the circle is an abstract image of an eagle.

MAR 1 6 2004

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ms. Karen Provencher Regulatory Affairs Specialist Smith & Nephew, Inc. Endoscopy Division 150 Minuteman Road Andover, Massachusetts 01810

Re: K034012

Trade/Device Name: Smith & Nephew RF Denervation Probes & RF Cannulae Regulation Number: 21 CFR 882.4725; 21 CFR 882.4400 Regulation Name: Radicfrequency lesion probe, Radiofrequency lesion generator Regulatory Class: II Product Code: GXI, GXD Dated: December 23, 2003 Received: December 24, 2003

Dear Ms. Provencher:

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.

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Page 2 - Ms. Karen Provencher

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.

Miriam C. Provost

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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Indications for Use

K034012 510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________

Smith & Nephew RF Denervation Probes & RF Cannulae Device Name: _________________________________________________________________________________________________________________________________________________________________

Indications For Use:

The Smith & Nephew RF Denervation Probes and Cannulae are indicated for use in RF heat lesion procedures for the relief of pain.

Prescription Use __ X_ (Per 21 CFR 801 Subpar! D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart Cl

(Please do not WRITE BELOW THIS LINE – CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Miriam C. Provost

(Division Sign-Off) Division of General, Restorative. and Neurological Devices

510(k) Number_ /< 03 40 / 2

§ 882.4725 Radiofrequency lesion probe.

(a)
Identification. A radiofrequency lesion probe is a device connected to a radiofrequency (RF) lesion generator to deliver the RF energy to the site within the nervous system where a lesion is desired.(b)
Classification. Class II (performance standards).