K Number
K041285
Manufacturer
Date Cleared
2004-09-10

(120 days)

Product Code
Regulation Number
878.4400
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Gyrus G3 System is intended for use for ablation. resection and coagulation of soft tissue and hemostasis of blood vessels in otorhinolaryngology (Head and Neck) surgery coagulation of soft tissue.

This device is intended for use by qualified medical personnel trained in the use of electrosurgery.

The Bipolar Generator section of the G3 RF Workstation is indicated for ablation, resection and coagulation of soft tissue and hemostasis of blood vessels in otorhinolaryngology (Head and Neck) surgery including:

  • Adenoidectomy .
  • Cysts .
  • Head, Neck, Oral, and Sinus Surgery
  • Mastoidectomy
  • Myringotomy with effective Hemorrhage Control
  • Nasal Airway Obstruction by Reduction of Hypertrophic Nasal Turbinates
  • Nasopharyngeal / Laryngeal indications including Tracheal Procedures, Laryngeal
  • Polypectomy, and Laryngeal Lesion Debulking
  • Neck Mass
  • Papilloma Keloids
  • Submucosal Palatal Shrinkage
  • Tonsillectorny
  • Traditional Uvulopalatoplasty (RAUP)
  • Tumors
  • Tissue in the Uvula/Soft Palate for the Treatment of Snoring
  • Uvulopaiatopharyngoplasty (UPPP)
  • Parotidectomy
  • Radical Neck Disection

The Gyrus Somnoplasty TCRF Generator section of the G3 RF Workstation with the Temperature Controlled Radio-frequency (Somnoplasty®) Electrodes is indicated for coagulation of soft tissue including:

The coagulation of enlarged tonsils in patients 13 years of age and older; the reduction of the incidence of airway obstructions, e.g., base of tongue, soft palate, etc., in patients suffering from UARS or OSAS: tissue coagulation in the inferior turbinates; and tissue coagulation in the uvula/soft palate which may reduce the severity of snoring in some individuals.

The system is intended for use by qualified medical personnel trained in the use of electrosurgical equipment and familiar with potential complications that may arise during or following fead and Neck surgery.

Device Description

The Gyrus G3 System Generator has two principal modes of operation:

  • The monopolar mode has controls for maximum temperature and energy delivered. The unit has readouts for total energy delivered, impedance. temperature for two thermocouples and time of energy delivery.
  • -The bipolar mode has controls for output waveform type and power. The unit has readouts for set power and waveform.

Connectors on the front panel include the monopolar connector for active electrode and dispersive electrode and separate dual bipolar connectors for PlasmaCision electrodes and bipolar instruments. The foot pedal is connected on the back panel.

Accessories included with the generator are the electrodes, connector cable, footswitch and a power cable.

AI/ML Overview

The provided text is related to a 510(k) Premarket Notification for the Gyrus G3 Generator System & Accessories, an electrosurgical device. It outlines the device's description, intended use, and a comparison to predicate devices, but does not contain any information about acceptance criteria or a study proving the device meets acceptance criteria.

Therefore, I cannot fulfill your request for the following information based on the provided text:

  1. A table of acceptance criteria and the reported device performance
  2. Sample size used for the test set and the data provenance
  3. Number of experts used to establish the ground truth for the test set and their qualifications
  4. Adjudication method for the test set
  5. If a multi-reader multi-case (MRMC) comparative effectiveness study was done, and its effect size
  6. If a standalone performance (algorithm only) study was done
  7. The type of ground truth used
  8. The sample size for the training set
  9. How the ground truth for the training set was established

The document primarily focuses on regulatory approval (510(k)) based on substantial equivalence to predicate devices and states that "performance testing has been done to validate the performance of the device," but it does not detail the specifics of such testing, acceptance criteria, or study results.

{0}------------------------------------------------

Gyrus Medical, Cardiff, UK 11 May 2004

SEP 1 0 2004

510(k) Premarket Notification Gyrus G3 Generator System & Accessories

K041285

Page 1 of (2)

510(k) Summary of Safety and Effectiveness

Gyrus G3 System (Generator & Accessories)

Submitted by:Gyrus Medical LtdFortran RoadSt Mellons,Cardiff CF30LTUK
Contact Person:Andrew DzimitrowiczQuality Manager
Telephone:+44 29 20 776 349
Facsimile:+44 29 20 776 591
Date Summary Prepared:11 th May 2004
Name of the Device:
Proprietary Name:Gyrus G3 System (Generator & Accessories)
Project Name:G3
Common/Usual Name:Electrosurgical Generator and Accessories
Classification Name:Electrosurgical Cutting & Coagulation Device andAccessories (per 21 CFR 878.4400)
Brand Name:Not yet assigned
Predicate Devices:K021777 (G2 Radio-frequency Workstation &Accessories)

{1}------------------------------------------------

Page 2 of (2)

Gyrus Medical, Cardiff, UK 11 May 2004

510(k) Premarket Notification Gyrus G3 Generator System & Accessories

Description:

The Gyrus G3 System Generator has two principal modes of operation:

  • The monopolar mode has controls for maximum temperature and energy delivered. The unit has readouts for total energy delivered, impedance. temperature for two thermocouples and time of energy delivery.
  • -The bipolar mode has controls for output waveform type and power. The unit has readouts for set power and waveform.

Connectors on the front panel include the monopolar connector for active electrode and dispersive electrode and separate dual bipolar connectors for PlasmaCision electrodes and bipolar instruments. The foot pedal is connected on the back panel.

Accessories included with the generator are the electrodes, connector cable, footswitch and a power cable.

Statement of Intended Use:

The Gyrus G3 System is intended for use for ablation. resection and coagulation of soft tissue and hemostasis of blood vessels in otorhinolaryngology (Head and Neck) surgery coagulation of soft tissue.

This device is intended for use by qualified medical personnel trained in the use of electrosurgery.

The Gyrus G3 System has been carefully compared to Comparison to Predicate Devices: legally marketed devices with respect to intended use technological and characteristics. In addition. performance testing has been done to validate the performance of the device. The comparison and validation results presented in this 510(k) notification to the FDA show that the device is substantially equivalent to predicate devices and is safe and effective in its intended use.

{2}------------------------------------------------

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/Picture/1 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular, with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. In the center of the seal is an abstract image of an eagle.

Public Health Service

SEP 1 0 2004

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Andrew Dzimitrowicz Director of RA/QA Gyrus Medical Ltd. Fortran Road, St. Mellons Cardiff United Kingdom CF3 OLT

Re: K041285

Trade/Device Name: Gyrus G3 Radio-Frequency Workstation and Accessories Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: II Product Code: GEI Dated: July 13, 2004 Received: July 16, 2004

Dear Mr. Dzimitrowicz:

We have reviewed your Section 510(k) premarket notification of intent to market the device we nave reviewed your becament be device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate for use stated in the encreated of the enactment date of the Medical Device Amendments, or to commerce proc to ritly 20, 1978, as excerdance with the provisions of the Federal Food, Drug, devices that have been require approval of a premarket approval application (PMA). and Costherior (110) that as nevice, subject to the general controls provisions of the Act. The 1 ou may, mererore, mainer of the Act include requirements for annual registration, listing of general controls provision 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 If your device 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 r reaso be actived a determination that your device complies with other requirements of the Act that I Dr has Intacted and regulations administered by other Federal agencies. You must or unly 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 CI It Fat 80 77, accems (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.

{3}------------------------------------------------

Page 2 - Mr. Andrew Dzimitrowicz

This letter will allow you to begin marketing your device as described in your Section 510(k) This iciter will anow you've begin finding of substantial equivalence of your device to a legally premailed 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 If you desire spocents acrive ice 3 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 other general mionnal 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
for

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

{4}------------------------------------------------

Gyrus Medical, Cardiff, UK 11 May 2004

510(k) Premarket Notification Gyrus G3 Generator System & Accessories

Indications for Use

510(k) Number (if known):

Not Yet Assigned

K041285

Device Name:

Gyrus G3 Radio-frequency workstation & Accessories

Indications For Use:

y modulation @ 1.000000

The Bipolar Generator section of the G3 RF Workstation is indicated for ablation, resection and coagulation of soft tissue and hemostasis of blood vessels in otorhinolaryngology (Head and Neck) surgery including:

  • Adenoidectomy .
  • Cysts .
  • Head, Neck, Oral, and Sinus Surgery
  • Mastoidectomy
  • Myringotomy with effective Hemorrhage Control
  • Nasal Airway Obstruction by Reduction of Hypertrophic Nasal Turbinates
  • Nasopharyngeal / Laryngeal indications including Tracheal Procedures, Laryngeal
  • Polypectomy, and Laryngeal Lesion Debulking
  • Neck Mass
  • Papilloma Keloids
  • Submucosal Palatal Shrinkage
  • Tonsillectorny
  • Traditional Uvulopalatoplasty (RAUP)
  • Tumors
  • Tissue in the Uvula/Soft Palate for the Treatment of Snoring
  • Uvulopaiatopharyngoplasty (UPPP)
  • Parotidectomy
  • Radical Neck Disection

The Gyrus Somnoplasty TCRF Generator section of the G3 RF Workstation with the Temperature Controlled Radio-frequency (Somnoplasty®) Electrodes is indicated for coagulation of soft tissue including:

The coagulation of enlarged tonsils in patients 13 years of age and older; the reduction of the incidence of airway obstructions, e.g., base of tongue, soft palate, etc., in patients suffering from UARS or OSAS: tissue coagulation in the inferior turbinates; and tissue coagulation in the uvula/soft palate which may reduce the severity of snoring in some individuals.

The system is intended for use by qualified medical personnel trained in the use of electrosurgical equipment and familiar with potential complications that may arise during or following fead and Neck surgery.

Contraindications for Use:

There are no known absolute contraindications to the use of radio-frequency surgery. The use of the Gyrus G3 Radio-frequency Workstation is contraindicated when, in the judgement of the physician, electross urgal procedures would be contrary to the best interests of the patient. The use of the system is also contraindicated for patients with heart pacemakers or other active device implants.

Prescription Use X (Per 21 CFR 801.109) OH

Over-The-Counter Use (Optional Format 1-2-96)

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

Muriam C. Provost

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

510(k) Number K041285

§ 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.