K Number
K090393
Device Name
ARTHROCARE SYSTEM 15000 CONTOLLER, MODEL 72202149, ARTHROCARE ARTHROWANDS, MODEL 72202139,72202141, 72202143, 72202144
Manufacturer
Date Cleared
2009-06-23

(126 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The ArthroCare System 15000 is indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures: Arthroscopic and Orthopedic Procedures | Joint Specific or All Joints (ankle, elbow, hip, knee, shoulder, and wrist) ----------------------------------------|----------------------------------------------------------------------------- Ablation and Debridement | • ACL/PCL | Knee • Acromioplasty | Shoulder • Articular Cartilage | All Joints • Bursectomy | All Joints • Chondroplasty | All Joints • Fascia | All Joints • Ligament | All Joints • Notchplasty | Knee • Scar Tissue | All Joints • Soft Tissue | All Joints • Subacromial Decompression | Shoulder • Synovectomy | All Joints • Tendon | All Joints Excision and Resection | • Acetabular Labrum | Hip • Articular Labrum | All Joints • Capsule | All Joints • Capsular Release | Knee • Cartilage Flaps | Knee • Cysts | All Joints • Discoid Meniscus | Knee • Frozen Shoulder Release | Shoulder • Glenoidale Labrum | Shoulder • Lateral Release | Knee • Ligament | All Joints • Loose Bodies | All Joints • Meniscal Cystectomy | Knee • Meniscectomy | Knee Continued | Arthroscopic and Orthopedic Procedures | Joint Specific or All Joints (ankle, elbow, hip, knee, shoulder, and wrist) • Plica Removal | All Joints • Scar Tissue | All Joints • Soft Tissue | All Joints • Synovial Membrane | All Joints • Tendon | All Joints • Triangular Fibrocartilage (TFCC) | Wrist • Villusectomy | Knee Coagulation | • ACL/PCL | Knee • Articular Cartilage | All Joints • Carpal Ligaments | Wrist • Glenohumeral Capsule | Shoulder • Ligament | All Joints • Medial Retinaculum | Knee • Rotator Cuff | Shoulder • Tendon | All Joints
Device Description
The ArthroCare System 15000 consists of a bipolar, high frequency, electrosurgical generator called the Controller, a family of disposable, bipolar, single use Wands and Foot Control.
More Information

Not Found

No
The summary describes a standard electrosurgical system for arthroscopic procedures and does not mention any AI or ML components or capabilities.

Yes
The device is used for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures, which are therapeutic interventions.

No

Explanation: The "Intended Use / Indications for Use" section states that the device is "indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures." These are therapeutic, not diagnostic, actions.

No

The device description explicitly states that the ArthroCare System 15000 consists of a bipolar, high frequency, electrosurgical generator (Controller), disposable Wands, and a Foot Control, all of which are hardware components.

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

Here's why:

  • Intended Use: The intended use clearly states that the device is for "resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures." This describes a surgical intervention performed directly on the patient's body.
  • Device Description: The device is described as a "bipolar, high frequency, electrosurgical generator called the Controller, a family of disposable, bipolar, single use Wands and Foot Control." This is consistent with surgical equipment used for tissue manipulation and hemostasis during surgery.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue samples) to provide information for diagnosis, monitoring, or treatment.

IVD devices are used in vitro (outside the body) to analyze samples for diagnostic purposes. This device is used in vivo (inside the body) for surgical procedures.

N/A

Intended Use / Indications for Use

The ArthroCare System 15000 is 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 All Joints (ankle, elbow, hip, knee, shoulder, and wrist)
Ablation and Debridement
• ACL/PCLKnee
• AcromioplastyShoulder
• Articular CartilageAll Joints
• BursectomyAll Joints
• ChondroplastyAll Joints
• FasciaAll 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
• 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

Product codes

GEI

Device Description

The ArthroCare System 15000 consists of a bipolar, high frequency, electrosurgical generator called the Controller, a family of disposable, bipolar, single use Wands and Foot Control.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

ankle, elbow, hip, knee, shoulder, and wrist

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)

Performance testing has been completed to demonstrate the substantial equivalence of the ArthroCare System 15000 to the predicate device. The performance testing and device comparison demonstrated that the subject devices are substantially equivalent to the predicate devices, and is safe and effective for its intended use.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K071709, K082666, K070958, K082980

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 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.

0

K090393

JUN 23 2009

510(k) Summary

ArthroCare Corporation ArthroCare® System 15000

General Information

Submitter Name/Address:

Establishment Registration Number:

Contact Person:

Date Prepared:

Device Description

Trade Name:

Generic/Common Name:

Classification Name:

ArthroCare Corporation 680 Vaqueros Avenue Sunnyvale, CA 94085-3523

2951580

Valerie Defiesta-Ng Director, Regulatory Affairs

February 13, 2009

ArthroCare® System 15000

Electrosurgical Device and Accessories

Electrosurgical Cutting and Coagulation Device and Accessories (Class II, 21 CFR 878.4400, Product Code GEI)

Predicate Devices

ArthroCare System 12000 ArthroCare ArthroWands

K071709 and K082666 K070958 and K082980

Product Description

The ArthroCare System 15000 consists of a bipolar, high frequency, electrosurgical generator called the Controller, a family of disposable, bipolar, single use Wands and Foot Control.

1

Intended Uses

.

The ArthroCare System 15000 is 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 All Joints (ankle, elbow, hip, knee, shoulder, and wrist)
Ablation and Debridement
• ACL/PCLKnee
• AcromioplastyShoulder
• Articular CartilageAll Joints
• BursectomyAll Joints
• ChondroplastyAll Joints
• FasciaAll 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

.

·

·

.

:

:

.

2

| Arthroscopic and Orthopedic Procedures | Joint Specific or All
Joints (ankle, elbow,
hip, knee, shoulder, and
wrist) |
|----------------------------------------|--------------------------------------------------------------------------------------|
| • Plica Removal | All Joints |
| • Scar Tissue | All Joints |
| • Soft Tissue | All Joints |
| • Synovial Membrane | All Joints |
| • Tendon | All Joints |
| • Triangular Fibrocartilage (TFCC) | Wrist |
| • Villusectomy | Knee |
| Coagulation | |
| • ACL/PCL | Knee |
| • Articular Cartilage | All Joints |
| • Carpal Ligaments | Wrist |
| • Glenohumeral Capsule | Shoulder |
| • Ligament | All Joints |
| • Medial Retinaculum | Knee |
| • Rotator Cuff | Shoulder |
| • Tendon | All Joints |
| • Wrist Tendons | Wrist |

Substantial Equivalence

In establishing substantial equivalence to the predicate devices, ArthroCare compared the indications for use, dimensional specifications, and performance specifications of the subject device and the predicate device. Additionally, performance testing has been completed to demonstrate the substantial equivalence of the ArthroCare System 15000 to the predicate device. The performance testing and device comparison demonstrated that the subject devices are substantially equivalent to the predicate devices, and is safe and effective for its intended use.

Summary of Safety and Effectiveness

The ArthroCare System 15000, as described in this premarket notification 510(k), is substantially equivalent to the predicate devices. The differences in performance specifications, and labeling are not substantial changes or modifications, and do not significantly affect the safety or efficacy of the System.

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle or bird-like symbol with flowing lines, positioned to the right of the department's name. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular fashion around the left side of the emblem.

JUN 23 2005

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

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

Re: K090393

Trade/Device Name: ArthroCare® System15000 Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical Cutting and Coagulation Device and Accessories Regulatory Class: II Product Code: GEI Dated: May 19, 2009 Received: May 20, 2009

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 111 (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, 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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing

4

Page 2-Ms. Valerie Defiesta-Ng

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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801). please go to http://www.fda.gov/cdrh/comp/ for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803). please go to http://www.fda.gov/cdrh/mdr/ for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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,

Mark H. Milliken

Mark N. Melkerson Division of Surgical, Orthopedic and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

Indications for Use Statement ·

Device Name

ArthroCare® System 15000

510(k) Number: K

Indications for Use:

The ArthroCare System 15000 is indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures:

| Arthroscopic and Orthopedic Procedures | Joint Specific or All
Joints (ankle, elbow,
hip, knee, shoulder, and
wrist) |
|----------------------------------------|--------------------------------------------------------------------------------------|
| Ablation and Debridement | |
| • ACL/PCL | Knee |
| • Acromioplasty | Shoulder |
| • Articular Cartilage | All Joints |
| • Bursectomy | All Joints |
| • Chondroplasty | All Joints |
| • Fascia | All Joints |
| • Ligament | All Joints |
| • Notchplasty | Knee |
| • Scar Tissue | All Joints |
| • Soft Tissue | All Joints |
| • Subacromial Decompression | Shoulder |
| • Synovectomy | All Joints |
| • Tendon | All Joints |
| Excision and Resection | |
| • Acetabular Labrum | Hip |
| • Articular Labrum | All Joints |
| • Capsule | All Joints |
| • Capsular Release | Knee |
| • Cartilage Flaps | Knee |
| • Cysts | All Joints |
| • Discoid Meniscus | Knee |
| • Frozen Shoulder Release | Shoulder |
| • Glenoidale Labrum | Shoulder |
| • Lateral Release | Knee |
| • Ligament | All Joints |
| • Loose Bodies | All Joints |
| • Meniscal Cystectomy | Knee |
| • Meniscectomy | Knee |

(Division Sign-Off)

Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number_

6

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

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

Prescription Use (Per 21 CFR 801.109) OR

X

Over-the-Counter Use

Division Sign Off

(Division Sign-Off) Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K090393

. .