K Number
K100019
Device Name
PASCAL STREAMLINE PHOTOCOAGULATOR
Date Cleared
2010-05-04

(119 days)

Product Code
Regulation Number
886.4390
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The PASCAL Streamline Photocoagulator indications for use are the following: Intended for use in the treatment of ocular pathology in the posterior segment. Retinal photocoagulation, panretinal photocoagulation, focal photocoagulation and grid photocoagulation for vascular and structural abnormalities of the retina and choroid including: - proliferative and nonproliferative diabetic retinopathy - macular edema - choroidal neovascularization - branch and central retinal vein occlusion - age-related macular degeneration - lattice degeneration - retinal tears and detachments Intended for use in the treatment of ocular pathology in the anterior segment including: - iridotomy - trabeculoplasty
Device Description
The PASCAL Streamline Photocoagulator is an integrated system comprising of solid state aiming and treatment lasers, control electronics, graphical user interface, slit lamp and table. It is intended for use in the treatment of ocular pathology in both the posterior and anterior segments.
More Information

No
The document does not mention AI, ML, or any related concepts like image processing, training sets, or performance metrics typically associated with AI/ML devices. The description focuses on the hardware components and intended uses of a laser photocoagulator.

Yes
The device is described as a "Photocoagulator" intended for "treatment of ocular pathology" such as diabetic retinopathy and macular edema. The term "treatment" directly implies a therapeutic use to address and manage medical conditions.

No
The device is described as a photocoagulator intended for the treatment of ocular pathology, not for diagnosis. Its functions involve treatment procedures like retinal and panretinal photocoagulation, iridotomy, and trabeculoplasty.

No

The device description explicitly states it is an "integrated system comprising of solid state aiming and treatment lasers, control electronics, graphical user interface, slit lamp and table," indicating it includes significant hardware components beyond just software.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices used to perform tests on samples taken from the human body (like blood, urine, tissue) to provide information about a person's health. They are used outside the body (in vitro).
  • PASCAL Streamline Photocoagulator Function: The description clearly states that this device is a photocoagulator used for treatment of ocular pathology. It uses lasers to treat conditions within the eye. This is a therapeutic device, not a diagnostic one.
  • Lack of Diagnostic Activity: The description does not mention any analysis of biological samples or providing diagnostic information based on such analysis.

Therefore, based on the provided information, the PASCAL Streamline Photocoagulator is a therapeutic medical device, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The PASCAL Streamline Photocoagulator indications for use are the following: Intended for use in the treatment of ocular pathology in the posterior segment. Retinal photocoagulation, panretinal photocoagulation, focal photocoagulation and grid photocoagulation for vascular and structural abnormalities of the retina and choroid including: - l proliferative and nonproliferative diabetic retinopathy - 트 macular edema - י choroidal neovascularization - 피 branch and central retinal vein occlusion - צ age-related macular degeneration - lattice degeneration - retinal tears and detachments Intended for use in the treatment of ocular pathology in the anterior segment including: - 트 iridotomy - M trabeculoplasty

Product codes

GEX, HQF

Device Description

The PASCAL Streamline Photocoagulator is an integrated system comprising of solid state aiming and treatment lasers, control electronics, graphical user interface, slit lamp and table. It is intended for use in the treatment of ocular pathology in both the posterior and anterior segments.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

posterior segment, anterior segment (ocular)

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

All necessary bench testing was conducted on the modified PASCAL Streamline Photocoagulator to support a determination of substantial equivalence to the predicate device.

Key Metrics

Not Found

Predicate Device(s)

PASCAL Streamline Photocoagulator (K092621)

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 886.4390 Ophthalmic laser.

(a)
Identification. An ophthalmic laser is an AC-powered device intended to coagulate or cut tissue of the eye, orbit, or surrounding skin by a laser beam.(b)
Classification. Class II.

0

PASCAL® STREAMLINE™ PHOTOCOAGULATOR

SECTION 6 510(k) SUMMARY

510(k) Notification K100019

GENERAL INFORMATION

Applicant:

.

. *.

OptiMedica Corporation 3130 Coronado Drive Santa Clara, CA 95054 U.S.A. Pone: 408-850-8600 FAX: 408-850-8595

MAY - 4 2010

Contact Person:

Darlene Crockett-Billig President Experien Group, LLC 155-A Moffett Park Drive, Suite 210 Sunnyvale, CA 94089-1330 U.S.A. Phone: 408-400-0856 ext. 105 FAX: 408-400-0865 Email: dcb(@experiengroup.com

Date Prepared:

April 12, 2010

Classification:

21 CFR§878.4810, Class II 21 CFR§886.4390, Class II

Product Code:

GEX, HQF

Trade Name:

PASCAL® Streamline™ Photocoagulator

Generic/Common Name:

Laser instrument, surgical, powered Laser, ophthalmic

Predicate Device:

PASCAL Streamline Photocoagulator (K092621)

1

SECTION 6 510(k) Summary

Intended Use

The PASCAL Streamline Photocoagulator indications for use are the following:

Intended for use in the treatment of ocular pathology in the posterior segment. Retinal photocoagulation, panretinal photocoagulation, focal photocoagulation and grid photocoagulation for vascular and structural abnormalities of the retina and choroid including:

  • proliferative and nonproliferative diabetic retinopathy 지
  • 트 macular edema
  • 포 choroidal neovascularization
  • branch and central retinal vein occlusion 트
  • age-related macular degeneration 트
  • 트 lattice degeneration
  • retinal tears and detachments 에

Intended for use in the treatment of ocular pathology in the anterior segment including:

  • iridotomy ■
  • ı trabeculoplasty

Product Description

The PASCAL Streamline Photocoagulator is an integrated system comprising of solid state aiming and treatment lasers, control electronics, graphical user interface, slit lamp and table. It is intended for use in the treatment of ocular pathology in both the posterior and anterior segments.

Substantial Equivalence

The modified PASCAL Streamline Photocoagulator is substantially equivalent to the predicate device with regard to function, intended use and performance. Any differences in the technological characteristics between the two devices do not raise any new issues of safety or efficacy. Thus, the modified PASCAL Streamline Photocoagulator is substantially equivalent to the predicate device.

Testing in Support of Substantial Equivalence Determination

All necessary bench testing was conducted on the modified PASCAL Streamline Photocoagulator to support a determination of substantial equivalence to the predicate device.

Summary

The PASCAL Streamline Photocoagulator is substantially equivalent to the predicate device.

2

Image /page/2/Picture/1 description: The image shows the seal of the Department of Health & Human Services USA. The seal features a stylized eagle with outstretched wings, symbolizing protection and service. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" are arranged in a circular pattern around the eagle.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

MAY ~ 4 2010

OptiMedica Corporation % Experien Group, LLC Ms. Darlene Crockett-Billig President 155-A Moffett Park Drive, Suite 210 Sunnyvale, California 94089-1330

Re: K100019

Trade/Device Name: PASCAL® Streamline™ Photocoagulator Regulation Number: 21 CFR 886.4390 Regulation Name: Opthalmic laser Regulatory Class: Class II Product Code: HQF Dated: April 12, 2010 Received: April 13, 2010

Dear Ms. Crockett-Billig:

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you; however, that device labeling must be truthful and not misleading.

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, 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

3

Page 2 - Ms. Darlene Crockett-Billig

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 of medical device-related adverse events) (21 CFR 803); 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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm 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/MedicalDevices/Safety/ReportaProblem/default.htm 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 (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Mark M. Millers

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

Enclosure

4

SECTION 5

INDICATIONS FOR USE STATEMENT

510(k) Number (if known): K100019

Device Name: PASCAL Streamline Photocoagulator

Indications for Use:

The PASCAL Streamline Photocoagulator indications for use are the following:

Intended for use in the treatment of ocular pathology in the posterior segment. Retinal photocoagulation, panretinal photocoagulation, focal photocoagulation and grid photocoagulation for vascular and structural abnormalities of the retina and choroid including:

  • l proliferative and nonproliferative diabetic retinopathy
  • 트 macular edema
  • י choroidal neovascularization
  • 피 branch and central retinal vein occlusion
  • צ age-related macular degeneration
  • lattice degeneration
  • retinal tears and detachments

Intended for use in the treatment of ocular pathology in the anterior segment including:

  • 트 iridotomy
  • M trabeculoplasty

Prescription Use X ___________________________________________________________________________________________________________________________________________________________ (21 CFR Part 801 Subpart D) and/Or

Over the Counter Use (21 CFR Part 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Neil RP Ohle for MXA
(Division Sign-Off)

Division of Surgical, Orthopedic, and Restorative Devices

510(k) Number K100019