K Number
K052686
Manufacturer
Date Cleared
2005-10-05

(7 days)

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

The ArthroCare ArthroWands are indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures:

Arthroscopic and Orthopedic ProceduresJoint Specific or AllJoints (ankle, elbow,hip, knee, shoulder, andwrist)
Ablation and Debridement
• ACL/PCLKnee
• AcromioplastyShoulder
• Articular CartilageAll Joints
• BursectomyAll Joints
• ChondroplastyAll Joints
• FaciaAll Joints
• LigamentAll Joints
• NotchplastyKnee
• Scar TissueAll Joints
• Soft TissueAll Joints
• Subacromial DecompressionShoulder
• SynovectomyAll Joints
• TendonAll Joints
Excision and Resection
• Acetabular LabrumHip
• Articular LabrumAll Joints
• CapsuleAll Joints
• Capsular ReleaseKnee
• Cartilage FlapsKnee
• CystsAll Joints
• Discoid MeniscusKnee
• Frozen Shoulder ReleaseShoulder
• Glenoidale LabrumShoulder
• Lateral ReleaseKnee
• LigamentAll Joints
• Loose BodiesAll Joints
• Meniscal CystectomyKnee
• MeniscectomyKnee
Continued
Arthroscopic and Orthopedic ProceduresJoint Specific or All Joints (ankle, elbow, hip, knee, shoulder, and wrist)
• Plica RemovalAll Joints
• Scar TissueAll Joints
• Soft TissueAll Joints
• Synovial MembraneAll Joints
• TendonAll Joints
• Triangular Fibrocartilage (TFCC)Wrist
• VillusectomyKnee
Coagulation
• ACL/PCLKnee
• Articular CartilageAll Joints
• Carpal LigamentsWrist
• Glenohumeral CapsuleShoulder
• LigamentAll Joints
• Medial RetinaculumKnee
• Rotator CuffShoulder
• TendonAll Joints
• Wrist TendonsWrist
Device Description

The ArthroCare ArthroWands are bipolar, single use, high frequency electrosurgical devices designed for specific indications in arthroscopic and orthopedic procedures.

AI/ML Overview

This is a 510(k) premarket notification for electrosurgical devices (ArthroCare® ArthroWands®). The document states that the proposed modifications are not substantial changes or modifications, and do not significantly affect the safety or efficacy of the devices; therefore, no new studies were conducted. The device is found to be substantially equivalent to previously cleared predicate devices (K020557 and K033584).

Here's an analysis based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

No specific acceptance criteria or performance metrics derived from new testing are provided in this special 510(k). The basis for clearance is substantial equivalence to predicate devices. The document explicitly states: "The proposed modifications in the performance specifications, labeling, and packaging configuration are not substantial changes or modifications, and do not significantly affect the safety or efficacy of the devices."

Therefore, the "acceptance criteria" here is that the modified device's performance remains consistent with, and not significantly worse than, the predicate devices cleared under K020557 and K033584, for which presumably performance data would have been submitted at that time.

Acceptance Criteria (Implied)Reported Device Performance (Implied by Substantial Equivalence)
Performance specifications not significantly alteredPerformance is consistent with predicate devices
Safety not significantly affectedSafety profile is consistent with predicate devices
Efficacy not significantly affectedEfficacy is consistent with predicate devices
Indications for Use remain the sameIndications for Use are identical to predicate devices
Technology remains the sameTechnology is identical to predicate devices
Principle of operation remains the samePrinciple of operation is identical to predicate devices
Sterilization parameters remain the sameSterilization parameters are identical to predicate devices

2. Sample Size Used for the Test Set and Data Provenance

No new test set was used for a study comparing the modified device's performance directly. This submission relies on the established performance of its predicate devices.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

Not applicable, as no new clinical or performance test set was evaluated.

4. Adjudication Method for the Test Set

Not applicable, as no new test set was evaluated.

5. Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study

No. This document does not mention any MRMC study. The device is an electrosurgical tool, which typically undergoes performance testing (e.g., power output, tissue effects) rather than MRMC studies.

6. Standalone Performance Study (Algorithm Only)

No. This is a physical electrosurgical device, not an AI algorithm.

7. Type of Ground Truth Used

Not applicable, as no new performance claims, clinical data, or "ground truth" establishment are presented for the modified device beyond its substantial equivalence to predicates.

8. Sample Size for the Training Set

Not applicable, as this is not an AI/machine learning device.

9. How the Ground Truth for the Training Set Was Established

Not applicable, as this is not an AI/machine learning device.

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

OCT 5 - 2005

K052686

510(k) Summary

ArthroCare Corporation ArthroCare ArthroWands

Page 1 of Page (3)

General Information

Submitter Name/Address:

ArthroCare Corporation 680 Vaqueros Avenue Sunnyvale, CA 94085-3523

Establishment Registration Number:

Contact Person:

Director, Regulatory Affairs September 27, 2005

Valerie Defiesta-Ng

2951580

Date Prepared:

Device Description

Trade Name:

Generic/Common Name:

Classification Name:

Predicate Devices

ArthroCare® ArthroWands®

Electrosurgical Device and Accessories

Electrosurgical Cutting and Coagulation Device and Accessories (21 CFR 878.4400)

ArthroCare® ArthroWands®

K020557, K033584

Product Description

The ArthroCare ArthroWands are bipolar, single use, high frequency electrosurgical devices designed for specific indications in arthroscopic and orthopedic procedures.

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

K052686

( 3) 2 6

Intended Uses

The ArthroCare ArthroWands are indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures:

Arthroscopic and Orthopedic ProceduresJoint Specific or AllJoints (ankle, elbow,hip, knee, shoulder, andwrist)
Ablation and Debridement
• ACL/PCLKnee
• AcromioplastyShoulder
• Articular CartilageAll Joints
• BursectomyAll Joints
• ChondroplastyAll Joints
• FaciaAll Joints
• LigamentAll Joints
• NotchplastyKnee
• Scar TissueAll Joints
• Soft TissueAll Joints
• Subacromial DecompressionShoulder
• SynovectomyAll Joints
• TendonAll Joints
Excision and Resection
• Acetabular LabrumHip
• Articular LabrumAll Joints
• CapsuleAll Joints
• Capsular ReleaseKnee
• Cartilage FlapsKnee
• CystsAll Joints
• Discoid MeniscusKnee
• Frozen Shoulder ReleaseShoulder
• Glenoidale LabrumShoulder
• Lateral ReleaseKnee
• LigamentAll Joints
• Loose BodiesAll Joints
• Meniscal CystectomyKnee
• MeniscectomyKnee
Continued
Arthroscopic and Orthopedic ProceduresJoint Specific or All Joints (ankle, elbow, hip, knee, shoulder, and wrist)
• Plica RemovalAll Joints
• Scar TissueAll Joints
• Soft TissueAll Joints
• Synovial MembraneAll Joints
• TendonAll Joints
• Triangular Fibrocartilage (TFCC)Wrist
• VillusectomyKnee
Coagulation
• ACL/PCLKnee
• Articular CartilageAll Joints
• Carpal LigamentsWrist
• Glenohumeral CapsuleShoulder
• LigamentAll Joints
• Medial RetinaculumKnee
• Rotator CuffShoulder
• TendonAll Joints
• Wrist TendonsWrist

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

K052686

Page 3 of (3)

Substantial Equivalence

This Special 510(k) proposes modifications in performance specifications, labeling, and packaging configuration for the ArthroCare ArthroWands, which were previously cleared in K020557 (March 21, 2002) and K033584 (November 28, 2003). The indications for use, technology, principle of operation, and sterilization parameters of the ArthroCare ArthroWands remain the same as in the predicate cleared 510(k)s.

Summary of Safety and Effectiveness

The modified ArthroCare ArthroWands, as described in this Special 510(k), are substantially equivalent to the predicate device. The proposed modifications in the performance specifications, labeling, and packaging configuration are not substantial changes or modifications, and do not significantly affect the safety or efficacy of the devices.

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

Image /page/3/Picture/2 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized depiction of an eagle or bird-like figure with three curved lines representing its body and wings. The logo is encircled by the text "DEPARTMENT OF HEALTH AND HUMAN SERVICES, USA" in a circular arrangement.

OCT 5 - 2005

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Ms. Valerie DeFiesta-Ng Director, Regulatory Affairs ArthroCare Corporation 680 Vaqueros Avenue Sunnyvale, California 94085-3523

Re: K052686 Trade/Device Name: ArthroCare® Arthro Wands® Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: II Product Code: GEI Dated: September 27, 2005 Received: September 28, 2005

Dear Ms. DeFiesta-Ng:

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 complics 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.

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

Page 2- Ms. Valerie DeFiesta-Ng

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 (240) 276-0115. 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,

farbara Buchelt

Mark N. Melkerson Acting Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

{5}------------------------------------------------

Indications for Use Statement

KOS2686 510(k) Number:

Page 1 of 2

ArthroCarc® ArthroWands® Device Name

Indications for Use:

The ArthroCare ArthroWands are indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures:

Arthroscopic and Orthopedic ProceduresJoint Specific or AllJoints (ankle, elbow,hip, knee, shoulder, andwrist)
Ablation and Debridement
• ACL/PCLKnee
• AcromioplastyShoulder
• Articular CartilageAll Joints
• BursectomyAll Joints
• ChondroplastyAll Joints
• FaciaAll Joints
• LigamentAll Joints
• NotchplastyKnee
• Scar TissueAll Joints
• Soft TissueAll Joints
• Subacromial DecompressionShoulder
• SynovectomyAll Joints
• TendonAll Joints
Excision and Resection
• Acetabular LabrumHip
• Articular LabrumAll Joints
• CapsuleAll Joints
• Capsular ReleaseKnee
• Cartilage FlapsKnee
• CystsAll Joints
• Discoid MeniscusKnee
• Frozen Shoulder ReleaseShoulder
• Glenoidale LabrumShoulder
• Lateral ReleaseKnee
• LigamentAll Joints
• Loose BodiesAll Joints
• Meniscal CystectomyKnee
MeniscectomyKnee

(Division Sign-Off)

410/1) Numbe

Division of General, Restorative,

and Neurological Devices
Barbara Buchner

{6}------------------------------------------------

K052686

Page. 2 of (2)

Arthroscopic and Orthopedic ProceduresJoint Specific or All Joints (ankle, elbow, hip, knee, shoulder, and wrist)
Plica RemovalAll Joints
Scar TissueAll Joints
Soft TissueAll Joints
Synovial MembraneAll Joints
TendonAll Joints
Triangular Fibrocartilage (TFCC)Wrist
VillusectomyKnee
Coagulation
ACL/PCLKnee
Articular CartilageAll Joints
Carpal LigamentsWrist
Glenohumeral CapsuleShoulder
LigamentAll Joints
Medial RetinaculumKnee
Rotator CuffShoulder
TendonAll Joints
Wrist TendonsWrist

Prescription Use (Part 21 CFR 801 Subpart D) AND/OR

X

Over-The-Counter Use (21 CFR 801 Subpart C)

(PI.EASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of Device Evaluation (ODE)

Barbara Buchus for MXY
(Division Sign-Off)

Division of General, Restorative, and Neurological Devices

510(k) Number_KUS 2605 ﺻﺎﻛ

§ 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.