(13 days)
The Carl Zeiss Surgical INFRARED 800 with the FLOW 800 option is a surgical microscope accessory used in viewing and visual assessment of intra-operative blood flow in the cerebral vascular area including, but not limited to, assessing cerebral aneurysm and vessel branch occlusion, as well as patency of very small perforating vessels. It also aids in the real-time visualization of blood flow and visual assessment of vessel types before and after Arteriovenous Malformation (AVM) surgery. Likewise, INFRARED 800 with the FLOW 800 option used during fluorescence guided surgery aids in the visual assessment of intra-operative blood flow as well as vessel patency in bypass surgical procedures in neurosurgery, plastic and reconstructive procedures and coronary artery bypass graft surgery.
INFRARED 800 with the FLOW 800 option is an accessory to the OPMI Pentero surgical microscope for visualizing blood flow intraoperatively. INFRARED 800 allows the surgical microscope to produce light to illuminate the fluorescence properties of the Indocyanine Green (ICG) dye and to detect the emitted fluorescent signal to examine the human vascular system during surgery. FLOW 800 provides the surgeon with a processing mode that allows convenient handling and visualization of the INFRARED 800 video data.
The provided 510(k) summary for the INFRARED 800 with FLOW 800 option does not contain explicit acceptance criteria or a dedicated study section detailing the device's performance against such criteria.
Instead, it relies on a "Substantial Equivalence" claim based on comparison to predicate devices and a review of existing clinical literature. This type of submission generally does not include a specific "acceptance criteria" table or a detailed "device performance" study as you might find for novel devices or those with specific quantitative performance claims.
However, I can extract information related to the device's clinical evaluation and training data based on the provided text.
Here's an analysis of the available information:
1. Table of Acceptance Criteria and Reported Device Performance
As mentioned, the document does not present a table of explicit acceptance criteria or a dedicated study with quantified device performance metrics against those criteria. The submission is a substantial equivalence claim, meaning the device is considered safe and effective because it is similar to already legally marketed devices.
The "performance" is implicitly demonstrated through:
- Technological Comparison: The device utilizes similar technology (surgical microscope, ICG dye, CCD cameras, real-time visualization of images) to the predicate devices (Leica FL800, Novadaq SPY Intra Operative Imaging System).
- Clinical Literature Review: The submission points to peer-reviewed medical literature demonstrating the use and effectiveness of the INFRARED 800 accessory with Indocyanine Green (ICG) angiography in hundreds of patients for various surgeries.
2. Sample Size Used for the Test Set and Data Provenance
- Sample Size: The document states that the INFRARED 800 accessory with ICG angiography "has been used in hundreds of patients." This suggests the "test set" for the clinical literature review encompasses a large, but unspecified, number of patients.
- Data Provenance: The data comes from "clinical literature that discusses the relevant studies," which are described as "peer-reviewed medical literature." This indicates the data is retrospective, collected from previously published studies. The countries of origin are not specified, but peer-reviewed medical literature generally implies multinational sources.
3. Number of Experts Used to Establish the Ground Truth for the Test Set and Their Qualifications
The document does not specify a number of experts or their qualifications for establishing ground truth within the context of a dedicated "test set" for this submission. The "ground truth" implicitly comes from the diagnostic and surgical outcomes reported in the peer-reviewed clinical literature that informed the substantial equivalence claim. These outcomes would have been determined by the operating surgeons and medical professionals involved in those published studies (e.g., neurosurgeons, plastic surgeons, cardiac surgeons).
4. Adjudication Method for the Test Set
No explicit adjudication method is described, as there wasn't a specific, controlled "test set" created for this 510(k) submission. The clinical evidence is derived from existing published studies, where the outcomes and diagnoses within those studies would have been adjudicated according to the standard practices of the respective clinical research teams.
5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done
No MRMC comparative effectiveness study is mentioned in the provided text. The submission focuses on the device's equivalence to existing technology and its utility as demonstrated in clinical literature, not on assessing the improvement of human readers with AI assistance (which is not relevant for this type of imaging device).
6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) was done
This device is not an algorithm, but rather a surgical microscope accessory that aids in viewing and visual assessment by a human surgeon. Therefore, a "standalone algorithm-only" performance study is not applicable and was not conducted. The "performance" is inherently human-in-the-loop.
7. The Type of Ground Truth Used
The ground truth is based on expert clinical observation and surgical outcomes reported in peer-reviewed medical literature. This includes:
- Assessment of closure/remnants of cerebral aneurysms
- Patency of vessels (including small perforating vessels)
- Real-time visualization of blood flow and vessel types in AVMs
- Assessment of patency in anastomosed vessels during bypass or free flap surgery
This is essentially "outcomes data" and "expert clinical consensus/observation" derived from actual surgical procedures.
8. The Sample Size for the Training Set
The document does not explicitly mention a "training set" in the context of device development or algorithm training. Since this is a hardware accessory for visualization, and not an AI/ML algorithm that requires training, the concept of a "training set" as typically understood in AI is not applicable. The device's design and functionality would be based on general engineering principles and medical knowledge related to fluorescence imaging.
9. How the Ground Truth for the Training Set was Established
As there is no mention of a "training set" in the context of algorithm development, there is no description of how ground truth for such a set was established.
In summary: The 510(k) submission for the INFRARED 800 with FLOW 800 option relies on a substantial equivalence pathway. It demonstrates this by comparing its technological features to legally marketed predicate devices and by referencing a body of existing clinical literature that documents the use and effectiveness of the INFRARED 800 accessory in "hundreds of patients." It does not present novel performance data against specific acceptance criteria, nor does it involve AI algorithms with distinct training and test sets in the modern sense.
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510(k) Premarket Notification INFRARED 800 with FLOW 800 option
510(K) SUMMARY
SECTION 5.
5. 510(K) SUMMARY
510(k) SUMMARY (per 21 CFR §807.92)
MAR - 3 2010
11
INFRARED 800 with FLOW 800 Option
GENERAL INFORMATION
Manufacturer:
Carl Zeiss Surgical GmbH Carl Zeiss Strasse 22 73447 Oberkochen, Germany 49 7364-20-2555 (phone) 49 7364-20-2035 (fax) Est. Reg. No. 2431026
Contact Person:
Judith A. Brimacombe, MA Director, Regulatory/Clinical Affairs Carl Zeiss Meditec Inc. 5160 Hacienda Drive Dublin, California 94568 (925) 557-4616 (phone) (925) 557-4259 (fax)
| Date Summary Prepared: | December 22, 2009 |
|---|---|
| Classification name: | System, X-Ray, Angiographic |
| Classification: | 21 CFR 892.1600 |
| Regulatory Class: | II |
| Product Code: | IZI |
| Trade/Proprietary name: | INFRARED 800TM with FLOW® 800 option |
PREDICATE DEVICES
Company: Device:
Leica Microsystems Leica FL800 (K061871, K080612)
Company: Device:
Novadaq Technologies, Inc. SPY Intra Operative Imaging System: SP2000 (K042961, K060867, K063345, K071037, K072222, K071619, K073088)
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SECTION 5.
510(K) SUMMARY
INTENDED USE
INFRARED 800 with the FLOW 800 option used during fluorescence guided surgery aids in viewing the visual assessment of intra-operative blood flow as well as vessel patency in surgical procedures in neurosurgery, plastic and reconstructive procedures and coronary artery bypass graft surgery.
INDICATIONS FOR USE
The Carl Zeiss Surgical INFRARED 800 with the FLOW 800 option is a surgical microscope accessory used in viewing and visual assessment of intra-operative blood flow in the cerebral vascular area including, but not limited to, assessing cerebral aneurysm and vessel branch occlusion, as well as patency of very small perforating vessels. It also aids in the real-time visualization of blood flow and visual assessment of vessel types before and after Arteriovenous Malformation (AVM) surgery. Likewise, INFRARED 800 with the FLOW 800 option used during fluorescence guided surgery aids in the visual assessment of intra-operative blood flow as well as vessel patency in bypass surgical procedures in neurosurgery, plastic and reconstructive procedures and coronary artery bypass graft surgery.
DEVICE DESCRIPTION
INFRARED 800 with the FLOW 800 option is an accessory to the OPMI Pentero surgical microscope for visualizing blood flow intraoperatively. INFRARED 800 allows the surgical microscope to produce light to illuminate the fluorescence properties of the Indocyanine Green (ICG) dye and to detect the emitted fluorescent signal to examine the human vascular system during surgery. FLOW 800 provides the surgeon with a processing mode that allows convenient handling and visualization of the INFRARED 800 video data.
SUBSTANTIAL EQUIVALENCE
INFRARED 800 with the FLOW 800 option is substantially equivalent to the Leica FL800 and Novadaq SPY Intra Operative Imaging System. Each system utilizes either a surgical stereo microscope or angiographic optical imaging system, and has the same basic functions for viewing, recording, and replaying fluorescent images. Similar CCD cameras are utilized as sensors and the infrared options are equivalent. Each device utilizes the same type of fluorescent agent, Indocyanine Green (ICG), to visualize blood flow. Using white light and/or fluorescence and similar ICG excitation. realtime visualization of images takes place in equivalent transmission ranges.
The indications for use for INFRARED 800 with the FLOW 800 option are similar to the indications for use for the predicate devices cited in this application. A technological comparison and testing demonstrate that the INFRARED 800 with the
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SECTION 5.
510(K) SUMMARY
FLOW 800 option is functionally equivalent to the predicate devices. Evaluation performed on the INFRARED 800 with the FLOW 800 option supports the indications for use statement and demonstrates that the device is substantially equivalent to the predicate devices and does not raise new questions regarding safety and effectiveness.
CLINICAL EVALUATION
Clinical data on INFRARED 800 with the FLOW 800 option has been collected by various researchers and is reported in the clinical literature. A review of the clinical literature that discusses the relevant studies has been included in this Premarket Notification. It includes citations from peer-reviewed medical literature which documents that the Carl Zeiss Surgical INFRARED 800 accessory with Indocyanine Green (ICG) angiography has been used in hundreds of patients to visualize and assess blood flow for various types of surgeries including cerebral aneurysms, arteriovenous malformations (AVM), bypass surgery and free flap transfers.
The clinical report describes the following applications and findings for the INFRARED 800 accessory with the FLOW 800 option:
CEREBRAL ANEURYSMS:
- 치 Assessment of cerebral aneurysm via evaluating complete or incomplete closure of aneurysm sac after clipping
- Visualization of aneurysm neck remnants
- Vessel branch occlusion via assessing flow of parent and branching vessels I
- . Evaluation of patency of very small perforating vessels not visible by digital subtraction angiography
AVMs:
- I Detection of AVM vessels via real-time visualization of blood flow in feeding arteries, nidal vessels and draining veins
Bypass surgery and free flap transplantation:
- . Assessment of patency of vessels joined by anastomosis in neurosurgery, plastic and reconstructive procedures and coronary artery bypass graft surgery
SUMMARY
As described in this 510(k) Summary, all testing deemed necessary was conducted on INFRARED 800 with the FLOW 800 option to ensure that the device is safe and effective for its intended use when used in accordance with its Instructions for Use.
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Food and Drug Administration 10903 New Hampshire Avenue Document Control Room W-O66-0609 Silver Spring, MD 20993-0002
MAR - 3 2010
Carl Zeiss Surgical GmbH % Underwriters Laboratories, Inc. Mr. Ned Devine 333 Pfingsten Road Northbrook, Illinois 60062
Re: K100468
Trade/Device Name: INFRARED 800™ with FLOW® 800 option Regulation Number: 21 CFR 892.1600 Regulation Name: Angiographic x-ray system Regulatory Class: Class II Product Code: IZI Dated: February 11, 20102 Received: February 18, 2010
Dear Mr. Devine:
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 comply with all the Act's requirements, including, but not limited to: registration and listing (21
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Page 2 - Mr. Ned Devine -
CFR Part 807); labeling (21 CFR Part 801); medical device reporting (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/ucm11.5809.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 N. Melkerso Director Division of Surgical, Orthopedic And Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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SECTION 4.
INDICATIONS FOR USE STATEMENT
- INDICATIONS FOR USE STATEMENT
510(k) Number (if known):
Device Name:
INFRARED 800™ with FLOW® 800 option
Indications for Use:
The Carl Zeiss Surgical INFRARED 800 with the FLOW 800 option is a surgical microscope accessory used in viewing and visual assessment of intra-operative blood flow in the cerebral vascular area including, but not limited to, assessing cerebral aneurysm and vessel branch occlusion, as well as patency of very small perforating vessels. It also aids in the real-time visualization of blood flow and visual assessment of vessel types before and after Arteriovenous Malformation (AVM) surgery. Likewise, INFRARED 800 with the FLOW 800 option used during fluoressence guided surgery aids in the visual assessment of intra-operative blood flow as well as vessel patency in bypass surgical procedures in neurosurgery, plastic and reconstructive procedures and coronary artery bypass graft surgery.
Prescription Use x (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) | Neil R for man |
|---|---|
| (Division Sign-Off) | |
| Division of Surgical, Orthopedic, and Restorative Devices | Page 1 of 1 |
| 510(k) Number | K100468 |
§ 892.1600 Angiographic x-ray system.
(a)
Identification. An angiographic x-ray system is a device intended for radiologic visualization of the heart, blood vessels, or lymphatic system during or after injection of a contrast medium. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II.