K Number
K040324
Device Name
WILSON-COOK DOUBLE LUMEN BILIARY CYTOLOGY BRUSH
Date Cleared
2004-05-20

(100 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Wilson-Cook Double Lumen Biliary Cytology Brush is intended to collect cells in the biliary system.
Device Description
The proposed Cytology Brush is a modification to existing cytology brushes currently marketed by Wilson-Cook. The Double Lumen Cytology Brush is supplied sterile and intended for single use only.
More Information

Not Found

No
The summary describes a physical cytology brush and does not mention any software, algorithms, or data processing that would indicate the use of AI/ML.

No.
The device is intended to collect cells for diagnostic purposes (cytology), not to treat a disease or condition.

No
The device is intended to collect cells, which is a step in diagnosis, but the device itself does not perform the diagnostic analysis or interpretation.

No

The device description explicitly states it is a "Cytology Brush," which is a physical medical device used to collect cells. There is no mention of software as the primary or sole component.

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

Here's why:

  • Intended Use: The intended use is to "collect cells in the biliary system." This describes a device used within the body to obtain a sample.
  • Device Description: The description confirms it's a physical brush used for collection.
  • Lack of IVD Characteristics: An IVD device is typically used outside the body (in vitro) to examine samples (like blood, urine, tissue) for diagnostic purposes. The information provided does not mention any analysis or diagnostic function performed by the device itself. It's a tool for sample collection.

Therefore, the Wilson-Cook Double Lumen Biliary Cytology Brush is a device used for sample collection from the biliary system, not an IVD. The collected cells would then likely be sent to a laboratory for in vitro analysis, which would be performed using IVD methods and devices.

N/A

Intended Use / Indications for Use

Wilson-Cook's Double Lumen Biliary Cytology Brush is intended to collect cells in the biliary system.
The Wilson-Cook Double Lumen Biliary Cytology Brush is intended for the collection of cells in the biliary system. The Wilson Cook Double is supplied sterile and intended for single use only.

Product codes (comma separated list FDA assigned to the subject device)

78 FDX

Device Description

The proposed Cytology Brush is a modification to existing cytology brushes currently marketed by Wilson-Cook. The Double Lumen Cytology Brush is supplied sterile and intended for single use only.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

biliary system

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): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K896318

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

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

§ 876.1500 Endoscope and accessories.

(a)
Identification. An endoscope and accessories is a device used to provide access, illumination, and allow observation or manipulation of body cavities, hollow organs, and canals. The device consists of various rigid or flexible instruments that are inserted into body spaces and may include an optical system for conveying an image to the user's eye and their accessories may assist in gaining access or increase the versatility and augment the capabilities of the devices. Examples of devices that are within this generic type of device include cleaning accessories for endoscopes, photographic accessories for endoscopes, nonpowered anoscopes, binolcular attachments for endoscopes, pocket battery boxes, flexible or rigid choledochoscopes, colonoscopes, diagnostic cystoscopes, cystourethroscopes, enteroscopes, esophagogastroduodenoscopes, rigid esophagoscopes, fiberoptic illuminators for endoscopes, incandescent endoscope lamps, biliary pancreatoscopes, proctoscopes, resectoscopes, nephroscopes, sigmoidoscopes, ureteroscopes, urethroscopes, endomagnetic retrievers, cytology brushes for endoscopes, and lubricating jelly for transurethral surgical instruments. This section does not apply to endoscopes that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.(b)
Classification —(1)Class II (special controls). The device, when it is an endoscope disinfectant basin, which consists solely of a container that holds disinfectant and endoscopes and accessories; an endoscopic magnetic retriever intended for single use; sterile scissors for cystoscope intended for single use; a disposable, non-powered endoscopic grasping/cutting instrument intended for single use; a diagnostic incandescent light source; a fiberoptic photographic light source; a routine fiberoptic light source; an endoscopic sponge carrier; a xenon arc endoscope light source; an endoscope transformer; an LED light source; or a gastroenterology-urology endoscopic guidewire, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I for the photographic accessories for endoscope, miscellaneous bulb adapter for endoscope, binocular attachment for endoscope, eyepiece attachment for prescription lens, teaching attachment, inflation bulb, measuring device for panendoscope, photographic equipment for physiologic function monitor, special lens instrument for endoscope, smoke removal tube, rechargeable battery box, pocket battery box, bite block for endoscope, and cleaning brush for endoscope. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807of this chapter, subject to the limitations in § 876.9.

0

MAY 2 0 2004

:

ATTACHMENT B-1: 510(k) Summary

KO40324
PAGE 1 OF 1

| SPONSOR: | Wilson-Cook Medical
4900 Bethania Station Road
Winston-Salem, NC 27105 |
|------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| CONTACT/SUBMITTER: | Marge Walls-Walker
Requlatory Affairs Specialist
[336] 744-0157 Ex.290 |
| DATE OF SUBMISSION: | February 6, 2004 |
| DEVICE: | Double Lumen Biliary Cytology Brush |
| Trade Name:
Common Name:
Classification: | Double Lumen Biliary Cytology Brush
Cytology Brush
Brush, Cytology for Endoscope, Class II
21 CFR § 876.1500 78 FDX |
| PREDICATE DEVICES: | Wilson-Cook Cytology Brushes (K896318) |
| INTENDED USE: | Wilson-Cook's Double Lumen Biliary Cytology
Brush is intended to collect cells in the biliary
system. |
| DEVICE DESCRIPTION: | The proposed Cytology Brush is a modification
to existing cytology brushes currently marketed
by Wilson-Cook. The Double Lumen Cytology
Brush is supplied sterile and intended for single
use only. |
| COMPARISON OF CHARACTERISITICS: | We believe the proposed device to be
substantially equivalent to currently marketed
Wilson-Cook cytology brushes as cleared by
K896318. Both devices share identical materials
of basic composition, the same operating
principal and the same technological
characteristics. |
| PERFORMANCE DATA: | We believe the proposed device to be
substantially equivalent to the named predicate
in terms of Intended Use, performance
characteristics tested and biocompatibility. |

1

Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three lines representing its wings, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the eagle. The logo is black and white.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAY 2 0 2004

Ms. Marge Walls-Walker Regulatory Affairs Specialist Wilson-Cook Medical GI Endoscopy 4900 Bethania Station Road WINSTON-SALEM NC 27105

Re: K040324

Trade/Device Name: Wilson-Cook Double Lumen Biliary Cytology Brush Regulation Number: 21 CFR §876.1500 Regulation Name: Endoscope and accessories Regulatory Class: II Product Code: 78 FDX Dated: April 2, 2004 Received: April 5, 2004

Dear Ms. Walls-Walker:

We have reviewed your Scction 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 for assumerous 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, I'DA 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 r 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 l'ederal 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.

2

This letter will allow you to begin marketing your device as described in your Section 510(k) This letter will allow you to begin marketing your antial equivalence of your device to a legally premarket notification. The PDA intuitig of basification 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 advice for your device on our last to good on the regulation number at the top of the 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 Additionally, for questions on the promotion the regulation entitled, "Misbranding Othce of Compliance at (501) 554-4057. Taxa, produkt (1) you may obtain. Other general by reference to premarked notification (21 cm ray be obtained from the Division of Small
information on your responsibilities under the Act may be of the surpher (800) 633, 2 information on your responsionalities und reserved its toll-free number (800) 638-2041 or
Manufacturers, International and Consumer Assistance at its toll-fremospain bron Manufacturers, International and Collidation - Letters http://www.fda.gov/cdch/dsmall.html.
(301) 443-6597 or at its Internet address http://www.fda.gov/cdch/dsmamain.html.

Sincerely yours,

Nancy C. Brogdon.

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

Enclosure

3

510(k) Number (if known): _K

Device Name: Wilson-Cook Double Lumen Biliary Cytology Brush

Indications for Use:

The Wilson-Cook Double Lumen Biliary Cytology Brush is intended for the collection of cells in The Wilson Oook Double is supplied sterile and intended for single use only

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use Only
(Per 21 CFR § 801.109

OR
David R. Lymm

Over-the-Counter______________________________________________________________________________________________________________________________________________________________

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