(44 days)
The OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber is indicated for the incision, excision, ablation, vaporization and coagulation of body soft tissues including intraoral tissues, in the medical specialties of general and plastic surgery, oral / maxillofacial surgery, dentistry, dermatology, endoscopic and open surgical procedures related to gynecology, otorhinolaryngology, gastroenterology, neurosurgery, pulmonary surgery for surgical and aesthetic applications.
The indications for use for which the delivery system is used are dependent upon the cleared indications for use of the laser system and those laser system accessories to which it is attached.
The OmniGuide Zero Flow ZF-T 150 WaveGuide fiber is an accessory for CO2 laser systems. It consists of a fiber assembly that propagates CO2 laser beams and vents the cooling gases outside of the body. The OmniGuide ZF-T 150 wave guide fiber is supplied sterile and is intended for single procedure use.
The device consists of an optical fiber assembly. The main functional component of the fiber assembly is a photonic bandgap reflector lining its hollow core that reflects and thereby guides CO2 laser energy. The fiber incorporates a lens at the tip which is transparent to the laser beam. The fiber also incorporates a sensor on the fiber tip that allows physicians to determine when the lens becomes obstructed by debris. The fiber assembly is 1.5 m long and transmits at the CO2 laser emission wavelength of 10.6 gm.
This 510(k) summary describes a CO2 laser accessory, the OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber, and its substantial equivalence to predicate devices. It does not contain information about acceptance criteria or a study proving the device meets specific acceptance criteria in the way a clinical trial for diagnostic AI would.
Here's an analysis of the provided text in relation to your questions:
1. Table of Acceptance Criteria and Reported Device Performance
This document does not define specific quantitative "acceptance criteria" or present a table of device performance against such criteria. Instead, it relies on demonstrating equivalence to predicate devices based on "energy transmission levels and beam quality."
| Acceptance Criteria (Not explicitly stated as such) | Reported Device Performance (Summary) |
|---|---|
| Laser Power Output | Evaluated through testing and analysis. "Performance of OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber and related parameters of predicate devices are comparable." |
| Beam Quality | Evaluated through testing and analysis. "Performance of OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber and related parameters of predicate devices are comparable." |
| Similar to Predicate Devices | Concluded to be similar or equivalent in intended use and major performance parameters (energy transmission levels and beam quality). |
2. Sample Size Used for the Test Set and Data Provenance
This document does not describe a "test set" in the context of clinical or AI performance evaluation. The "testing and analysis" for laser power output and beam quality appear to be laboratory-based engineering tests. No information regarding sample size for these tests, or data provenance (country of origin, retrospective/prospective) is provided.
3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications
This information is not applicable. The document describes laboratory performance testing of a laser fiber, not a diagnostic device requiring expert-established ground truth.
4. Adjudication Method for the Test Set
This information is not applicable for the reasons stated in point 3.
5. If a Multi Reader Multi Case (MRMC) Comparative Effectiveness Study Was Done, and Effect Size
No MRMC study was performed or described. This is a laser fiber accessory, not an AI-based diagnostic tool that would typically undergo such a study.
6. If a Standalone (i.e. algorithm only without human-in-the-loop performance) Was Done
This information is not applicable as the device is a laser fiber, not an algorithm or AI system.
7. The Type of Ground Truth Used
The "ground truth" for this device's performance appears to be directly measured physical properties (laser power output, beam quality) via laboratory testing, compared against the characteristics of predicate devices. There is no mention of expert consensus, pathology, or outcomes data being used as ground truth for technical performance evaluation.
8. The Sample Size for the Training Set
This information is not applicable. There is no described "training set" as this is not an AI/machine learning device.
9. How the Ground Truth for the Training Set Was Established
This information is not applicable for the reasons stated in point 8.
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Image /page/0/Picture/1 description: The image shows the logo for OmniGuide. The logo consists of the word "OmniGuide" in a simple sans-serif font, positioned to the right of two concentric circles. The circles are not complete, with a break in the upper right and lower left quadrants, giving the impression of a stylized "O" shape.
NOV 2 9 2006
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510(k) Summary
| Submitter: | OmniGuide, Inc.One Kendall Square, Building 100 3rd FloorCambridge, MA 02139 |
|---|---|
| Contact Person:Telephone: | Douglas W. Woodruff617-551-8404 |
| Fax: | 617-551-8445 |
| Proprietary Name: | OmniGuide Zero Flow ZF-T 150 Waveguide Fiber |
| Common Name: | CO2 Laser Powered Surgical Instrument |
| Classification: | 878.4810 |
| Product Code: | GEX |
| Classification Name: | Laser surgical instrument for use in general and plasticsurgery and in dermatology. |
Substantial Equivalence Claimed To:
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:
:
K050541, OmniGuidc Beam Path CO2 Mark I Laser Beam Delivery System K061909, OmniGuide Highland Beam Delivery System
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Description:
The OmniGuide Zero Flow ZF-T 150 WaveGuide fiber is an accessory for CO2 laser systems. It consists of a fiber assembly that propagates CO2 laser beams and vents the cooling gases outside of the body. The OmniGuide ZF-T 150 wave guide fiber is supplied sterile and is intended for single procedure use.
Intended Use:
The OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber is indicated for the incision, excision, ablation, vaporization and coagulation of body soft tissues including intraoral tissues, in the medical specialties of general and plastic surgery, oral / maxillofacial surgery, dentistry, dermatology, endoscopic and open surgical procedures related to gynecology, otorhinolaryngology, gastroenterology, neurosurgery, pulmonary surgery for surgical and aesthetic applications.
The indications for use for which the delivery system is used are dependent upon the cleared indications for use of the laser system and those laser system accessories to which it is attached.
Summary of Technological Characteristics:
The device consists of an optical fiber assembly. The main functional component of the fiber assembly is a photonic bandgap reflector lining its hollow core that reflects and thereby guides CO2 laser energy. The fiber incorporates a lens at the tip which is transparent to the laser beam. The fiber also incorporates a sensor on the fiber tip that allows physicians to determine when the lens becomes obstructed by debris. The fiber assembly is 1.5 m long and transmits at the CO2 laser emission wavelength of 10.6 gm.
Performance Data:
Non-clinical Performance Data: The OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber performance characteristics have been evaluated through testing and analysis of laser power output and beam quality. This type of testing complies with the respective section of the FDA Guidance on the Content and Organization of a Premarket Notification for a Medical Laser (1995) and is similar to the predicate device tests. The performance of OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber and related parameters of predicate devices are comparable.
Clinical Performance Data: Formal clinical trials were not deemed necessary as the device is using the same technology and intended use as predicate devices.
Conclusions Drawn from Tests and Analysis:
The intended use and major performance parameters (energy transmission levels and beam quality) of the OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber are similar or equivalent to same characteristics of above mentioned legally marketed devices.
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Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with its wings spread, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged in a circle around the eagle. The eagle is black, and the text is also black. The logo is simple and recognizable.
Public Health Service
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
OmniGuide, Inc. % Regulatory Technology Services, LLC Mr. Mark Job 1394 25th Street, Northwest Buffalo, Minnesota 55313
NOV 2 9 2006
Re: K063141 Trade/Device Name: OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber Regulation Number: 21 CFR 878.4810 Regulation Name: Laser surgical instrument for use in general and plastic surgery
and in dermatology Regulatory Class: II Product Code: GEX Dated: November 10, 2006 Received: November 13, 2006
Dear Mr. Job :
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 gencral 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
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Page 2 -- Mr. Mark Job
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.
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 (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.
Sincerely yours.
for Pso
Mark N. Melkerson
Mark N. Melkerson 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
510(k) Number (if known): Not yet assigned Device Name: OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber
Indications for Use:
The OmniGuide Zero Flow ZF-T 150 WaveGuide Fiber is indicated for the incision, excision, ablation, vaporization and coagulation of body soft tissues including intraoral tissues, in the medical specialties of general and plastic surgery, oral / maxillofacial surgery, dentistry, dermatology, endoscopic and open surgical procedures related to gynecology, otorhinolaryngology, gastroenterology, neurosurgery, pulmonary surgery for surgical and aesthetic applications.
The indications for use for which the delivery system is used are dependent upon the cleared indications for use of the laser system and those laser system accessories to which it is attached.
Prescription Use × (Part 21 CFR 801 Subpart D) AND/OR
Over-The-Counter Use (21 CFR 801 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
Division of General, Restorative, - and Neurological Devices
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§ 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology.
(a)
Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.
(b)
Classification. (1) Class II.(2) Class I for special laser gas mixtures used as a lasing medium for this class of lasers. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 878.9.