K Number
K103510
Device Name
UNIMAX SPECIMEN RETRIEVAL SYSTEM
Date Cleared
2011-05-06

(158 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Unimax Specimen Retrieval System is indicated for use as a receptacle for the collection and extraction of tissue, organs and calculi during general and laparoscopic surgical procedures.
Device Description
The Unimax Specimen Retrieval System is a sterile and single-use specimen container designed for use in retrieving specimens during endoscopic surgery. The Unimax Specimen Retrieval System is supplied in a dispending tube for ease of insertion through a standard 10, 11 or 12mm trocar sheath.
More Information

Not Found

No
The summary describes a physical device for specimen retrieval and does not mention any software, algorithms, or data processing that would indicate the use of AI/ML.

No
The device is used for collecting and extracting tissue, organs, and calculi during surgical procedures, not for treating a disease or condition.

No
Explanation: The device is described as a "receptacle for the collection and extraction of tissue, organs and calculi" during surgical procedures, indicating it is used for retrieving specimens rather than diagnosing conditions.

No

The device description explicitly states it is a "sterile and single-use specimen container designed for use in retrieving specimens during endoscopic surgery," indicating it is a physical hardware device.

Based on the provided information, the Unimax Specimen Retrieval System is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use is for the collection and extraction of tissue, organs, and calculi during surgical procedures. This is a surgical tool used in vivo (within the body) to handle specimens, not to perform diagnostic tests in vitro (outside the body) on those specimens.
  • Device Description: The description focuses on its function as a container for retrieving specimens during endoscopic surgery. It doesn't mention any components or processes related to analyzing or testing the specimens.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting specific analytes (proteins, DNA, etc.)
    • Providing diagnostic information
    • Reagents or testing procedures

The Unimax Specimen Retrieval System is a surgical accessory used to facilitate the removal of specimens from the body. It does not perform any diagnostic function itself.

N/A

Intended Use / Indications for Use

The Unimax Specimen Retrieval System is indicated for use as a receptacle for the collection and extraction of tissue, organs and calculi during general and laparoscopic surgical procedures.

Product codes (comma separated list FDA assigned to the subject device)

GCJ

Device Description

The Unimax Specimen Retrieval System is a sterile and single-use specimen container designed for use in retrieving specimens during endoscopic surgery. The Unimax Specimen Retrieval System is supplied in a dispending tube for ease of insertion through a standard 10, 11 or 12mm trocar sheath.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

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)

A series of in vitro and in vivo preclinical physical, mechanical and biocompatibility tests were performed to assess the safety and effectiveness of the Unimax Specimen Retrieval System. All the test results demonstrate the performance of Unimax Specimen Retrieval System meets the requirements of its pre-defined acceptance criteria and intended uses. The results of the non-clinical testing demonstrate that the Unimax Specimen Retrieval System is as safe and effective as the predicate devices.
The result of bench testing indicates that the new device is as safe and effective as the predicate device.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K100959

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 876.1500 Endoscope and accessories.

(a)
Identification. An endoscope and accessories is a device used to provide access, illumination, and allow observation or manipulation of body cavities, hollow organs, and canals. The device consists of various rigid or flexible instruments that are inserted into body spaces and may include an optical system for conveying an image to the user's eye and their accessories may assist in gaining access or increase the versatility and augment the capabilities of the devices. Examples of devices that are within this generic type of device include cleaning accessories for endoscopes, photographic accessories for endoscopes, nonpowered anoscopes, binolcular attachments for endoscopes, pocket battery boxes, flexible or rigid choledochoscopes, colonoscopes, diagnostic cystoscopes, cystourethroscopes, enteroscopes, esophagogastroduodenoscopes, rigid esophagoscopes, fiberoptic illuminators for endoscopes, incandescent endoscope lamps, biliary pancreatoscopes, proctoscopes, resectoscopes, nephroscopes, sigmoidoscopes, ureteroscopes, urethroscopes, endomagnetic retrievers, cytology brushes for endoscopes, and lubricating jelly for transurethral surgical instruments. This section does not apply to endoscopes that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.(b)
Classification —(1)Class II (special controls). The device, when it is an endoscope disinfectant basin, which consists solely of a container that holds disinfectant and endoscopes and accessories; an endoscopic magnetic retriever intended for single use; sterile scissors for cystoscope intended for single use; a disposable, non-powered endoscopic grasping/cutting instrument intended for single use; a diagnostic incandescent light source; a fiberoptic photographic light source; a routine fiberoptic light source; an endoscopic sponge carrier; a xenon arc endoscope light source; an endoscope transformer; an LED light source; or a gastroenterology-urology endoscopic guidewire, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I for the photographic accessories for endoscope, miscellaneous bulb adapter for endoscope, binocular attachment for endoscope, eyepiece attachment for prescription lens, teaching attachment, inflation bulb, measuring device for panendoscope, photographic equipment for physiologic function monitor, special lens instrument for endoscope, smoke removal tube, rechargeable battery box, pocket battery box, bite block for endoscope, and cleaning brush for endoscope. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807of this chapter, subject to the limitations in § 876.9.

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K103510

MAY - 6 2011

Page 1 of 4

Unimax Medical Systems Inc. 510(k) Notification

Unimax Specimen Retrieval System

510(k) Summary

  • Traditional Type of Submission: 5.1
5.2Submitter:Unimax Medical Systems Inc.
Address:8F-2, No. 127, Lane 235, Pao Chiao Rd., Hsin Tien City,
Taipei, Taiwan
Phone:886-2-89191698
Fax:886-2-89191528
Contact:Sophia Chiu
Establishment Registration Number:3007791595
  • Identification of the Device: 5.3 Proprietary/Trade name: Common Name: Classification Name: Device Classification: Regulation Number:
    Panel:

Product Code:

Unimax Specimen Retrieval System Tissue Bags laparoscope, general & plastic surgery II 876.1500 General & Plastic Surgery GCJ

5.4 Identification of the Predicate Device:

Predicate Device Name:Specimen Retrieval System
Manufacturer:Applied Medical Resources Corporation
510(k) Number or Clearance Information:K100959

5.5 Intended Use and Indications for Use of the subject device.

The Unimax Specimen Retrieval System is indicated for use as a receptacle for the collection and extraction of tissue, organs and calculi during general and laparoscopic surgical procedures.

1

-K103510

Page 2 of (4)

Unimax Medical Systems Inc. 510(k) Notification

Unimax Specimen Retrieval System

5.6 Device Description

The Unimax Specimen Retrieval System is a sterile and single-use specimen container designed for use in retrieving specimens during endoscopic surgery. The Unimax Specimen Retrieval System is supplied in a dispending tube for ease of insertion through a standard 10, 11 or 12mm trocar sheath.

5.7 Non-clinical Testing

A series of in vitro and in vivo preclinical physical, mechanical and biocompatibility tests were performed to assess the safety and effectiveness of the Unimax Specimen Retrieval System. All the test results demonstrate the performance of Unimax Specimen Retrieval System meets the requirements of its pre-defined acceptance criteria and intended uses. The results of the non-clinical testing demonstrate that the Unimax Specimen Retrieval System is as safe and effective as the predicate devices.

5.8 Safety and Effectiveness

The result of bench testing indicates that the new device is as safe and effective as the predicate device.

5.9 Substantial Equivalence Determination

The Unimax Specimen Retrieval System submitted in this 510(k) file is substantially equivalent in intended use, design, principles of operation, materials and performance to the cleared Applied Medical Specimen Retrieval System which is the subject of K100959. Differences between the devices cited in this section do not raise any new issues of safety or effectiveness.

2

K 103510

Page 3 of 4

Unimax Medical Systems Inc.
510(k) Notification

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..............................................................................................................................................................................

Unimax Specimen Retrieval System

| Item | Predicate Device
(Applied Medical Resources
Corporation Specimen Retrieval
System) | Proposed Device
(Unimax Medical Systems Inc
Specimen Retrieval System) |
|------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------|
| Similarity | | |
| Intended Use | Indicated for use as a receptacle for
the collection and extraction of
tissue, organs and calculi during
general and laparoscopic surgical
procedures. | Same |
| Material | Various Polymer
Stainless | Same |
| Specification | consists of a flexible polymer bag
and an introducer structure that fits
through a trocar port | Same |
| Biocompatibility | ISO 10993-1: 2003, Biological
evaluation of medical devices --
Part 1: Evaluation and testing
ISO 10993-10: 2002, Biological
evaluation of medical devices - Part
10: Tests for irritation and
delayed-type hypersensitivity
ISO 10993-12: 2007, Biological
evaluation of medical devices --
Part 12: Sample preparation and
reference materials | Same |
| Difference | | |
| Sterilization | gamma irradiation, Sterility
Assurance Level will be 10-6 | EtO Sterilization |

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K10 3510

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page 4 96

Unimax Medical Systems Inc. 510(k) Notification

Unimax Specimen Retrieval System

5.10 Conclusion

ं क

After analyzing bench tests, it can be concluded that Unimax Specimen Retrieval System is as safe and effective as the predicate device.

4

Image /page/4/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 three curved lines representing its body and wings. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the symbol.

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

MAY - 6 2011

Unimax Medical Systems, Inc. % Acmebiotechs Co., Ltd. Mr. Michael Lee No. 45, Minshen Road, Danshui Town Taipei County (Taiwan) 251 China

Re: K103510

Trade/Device Name: Unimax Specimen Retrieval System Regulation Number: 21 CFR 876.1500 Regulation Name: Endoscope and accessories Regulatory Class: II Product Code: GCJ Dated: April 11, 2011 Received: April 11, 2011

Dear Mr. Lee:

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. Iisting 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

5

Page 2 - Mr. Michael Lee

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 of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (OS) 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/ReportalProblem/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.

My B. nh
for

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

Enclosure

6

Unimax Medical Systems Inc. 510(k) Notification

Unimax Specimen Retrieval System

Indications for Use

510(k) Number (if known):

K103510

Device Name: Unimax Specimen Retrieval System

Indications for Use:

The Unimax Specimen Retrieval System is indicated for use as a receptacle for the collection and extraction of tissue, organs and calculi during general and laparoscopic surgical procedures.

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.P. Ogden for mxm

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

Page 1 of

510(k) Number K103510

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