K Number
K111681
Device Name
HISTOBRUSH
Date Cleared
2012-01-19

(218 days)

Product Code
Regulation Number
884.4530
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
To obtain endocervical cells for Pap smear cytology test
Device Description
The Puritan Histobrush consists of nylon bristles secured by stainless steel to a plastic handle. The device is used to obtain endocervical samples for Pap smear cytology. The device is for single use only and is non-sterile.
More Information

Not Found

No
The device description and performance studies focus on the physical characteristics and mechanical performance of a brush for cell collection, with no mention of AI/ML or image processing.

No.
The device is used to obtain samples for diagnostic testing, not to treat a medical condition.

No
The device is described as "used to obtain endocervical samples for Pap smear cytology," which is a sample collection tool, not a diagnostic device that performs analysis or interpretation.

No

The device description clearly states it is a physical brush with nylon bristles, stainless steel, and a plastic handle, indicating it is a hardware device, not software-only.

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

Here's why:

  • Intended Use: The intended use is "To obtain endocervical cells for Pap smear cytology test." This describes a device used to collect a sample, not a device that performs a diagnostic test on the sample.
  • Device Description: The description details a physical brush used for sample collection. It doesn't mention any components or processes related to analyzing the sample or providing a diagnostic result.
  • Lack of Diagnostic Function: The information focuses on the physical characteristics and performance of the brush in collecting cells. There is no mention of any diagnostic capabilities or analysis of the collected sample by the device itself.
  • Predicate Devices: The predicate devices listed are also cervical cytology brushes, which are sample collection devices, not IVDs.

IVDs are devices used to examine specimens derived from the human body to provide information for the diagnosis, prevention, monitoring, treatment, or alleviation of disease. This brush is a tool used in preparation for an IVD test (the Pap smear cytology test), but it is not the IVD itself.

N/A

Intended Use / Indications for Use

To obtain endocervical cells for Pap smear cytology test

Product codes

HI-IT

Device Description

The Puritan Histobrush consists of nylon bristles secured by stainless steel to a plastic handle. The device is used to obtain endocervical samples for Pap smear cytology. The device is for single use only and is non-sterile.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

cervical

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

Non-clinical testing included: biocompatibility, tensile strength of brush fibers, force to remove fibers from wire, and force to remove wire from handle. The results of the testing demonstrate substantial equivalence to predicate cervical cytology brushes.

Key Metrics

Not Found

Predicate Device(s)

Histobrush, Spectrum Companies, K874604, Cell Collecting Brush, Anderson Winn, K924908

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 884.4530 Obstetric-gynecologic specialized manual instrument.

(a)
Identification. An obstetric-gynecologic specialized manual instrument is one of a group of devices used during obstetric-gynecologic procedures to perform manipulative diagnostic and surgical functions (e.g., dilating, grasping, measuring, and scraping), where structural integrity is the chief criterion of device performance. This type of device consists of the following:(1) An amniotome is an instrument used to rupture the fetal membranes.
(2) A circumcision clamp is an instrument used to compress the foreskin of the penis during circumcision of a male infant.
(3) An umbilical clamp is an instrument used to compress the umbilical cord.
(4) A uterine curette is an instrument used to scrape and remove material from the uterus.
(5) A fixed-size cervical dilator is any of a series of bougies of various sizes used to dilate the cervical os by stretching the cervix.
(6) A uterine elevator is an instrument inserted into the uterus used to lift and manipulate the uterus.
(7) A gynecological surgical forceps is an instrument with two blades and handles used to pull, grasp, or compress during gynecological examination.
(8) A cervical cone knife is a cutting instrument used to excise and remove tissue from the cervix.
(9) A gynecological cerclage needle is a looplike instrument used to suture the cervix.
(10) A hook-type contraceptive intrauterine device (IUD) remover is an instrument used to remove an IUD from the uterus.
(11) A gynecological fibroid screw is an instrument used to hold onto a fibroid.
(12) A uterine sound is an instrument used to determine the depth of the uterus by inserting it into the uterine cavity.
(13) A cytological cervical spatula is a blunt instrument used to scrape and remove cytological material from the surface of the cervix or vagina.
(14) A gynecological biopsy forceps is an instrument with two blades and handles used for gynecological biopsy procedures.
(15) A uterine tenaculum is a hooklike instrument used to seize and hold the cervix or fundus.
(16) An internal pelvimeter is an instrument used within the vagina to measure the diameter and capacity of the pelvis.
(17) A nonmetal vaginal speculum is a nonmetal instrument used to expose the interior of the vagina.
(18) A fiberoptic nonmetal vaginal speculum is a nonmetal instrument, with fiberoptic light, used to expose and illuminate the interior of the vagina.
(b)
Classification. (1) Class II (special controls). The device, when it is an umbilical clamp with or without a cutter, a uterine tenaculum which is sterile and does not use suction and is intended for single use, a nonmetal vaginal speculum, or a fiberoptic nonmetal vaginal speculum, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 884.9.(2) Class I for the amniotome, uterine curette, cervical dilator (fixed-size bougies), cerclage needle, IUD remover, uterine sound, and gynecological biopsy forceps. 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 § 884.9.

0

11681 JAN 1 9 2012

510(K) SUMMARY OF SAFETY AND EFFECTIVENESS

This Summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirement of SMDA 1990 and 21 CFR 807.92.

1.Submitted by:Puritan Medical Products Co LLC
Contact person:William M. Young
Date of preparation:December 19, 2011
2.Trade Name of Device:Histobrush Model 2188
Common name:Cervical cytology brush
Classification name:Cytological endocervical brush
3.Predicate Devices:Histobrush, Spectrum Companies, K874604
Cell Collecting Brush, Anderson Winn, K924908
4.Device description:The Puritan Histobrush consists of nylon bristles
secured by stainless steel to a plastic handle. The device is used to
obtain endocervical samples for Pap smear cytology. The device is for
  • Indications for use: To obtain endocervical cells for Pap smear cytology test. 5.
    1. The Puritan Histobrush is used to obtain cervical samples for Intended use: transfer to a microscope slide or specimen preservation vial.
Histobrush ® (Model 2188)Predicate device
Tip materialNylonNylon
Tip length (inches)0.7500.600
Tip diameter
maximum/minimum
(inches)0.250/0.2000.280/0.120
Twisted wireStainless steel 304Stainless steel 304
Handle materialPolystyrenePolystyrene
Overall length (inches)86
  • Comparison of technological characteristics to predicates: 7.
    single use only and is non-sterile.

Discussion of non-clinical tests 8.

Non-clinical testing included: biocompatibility, tensile strength of brush fibers, force to remove fibers from wire, and force to remove wire from handle. The results of the testing demonstrate substantial equivalence to predicate cervical cytology brushes.

1

Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three stripes forming its wing and body. The eagle is positioned to the right of a circular text element that reads "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter.

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

Mr. William Young Vice President, Quality Systems Puritan Medical Products Co LLC 31 School Street GUILFORD MA 04443

JAN 1 9 2012

KI11681 Re: Trade Name: Histobrush® (Model 2188) Regulation Number: 21 CFR §884.4530 Regulation Name: Obstetric-gynecologic specialized manual instrument Regulatory Class: II Product Code: HI-IT Dated: December 19, 2011 Received: December 21, 2011

Dear Mr. Young:

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 for associated in the encreations of 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 r ou may, alcreve, mains 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 001); with an 170 ); labeling (21 CFR Part 801); medical device reporting (reporting of medical

2

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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/Resourcesfor You/Industry/default.htm.

Sincerely yours,

Benjamin R. Tucker

Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

3

Indications for Use Form

510(k) Number (if known): __K111681

Device Name: Histobrush® Model 2188

Indications for Use:

To obtain endocervical cells for Pap smear cytology test

Prescription Use _ ﮯ (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 OF NEEDED)

Helend Seeman

sion Signve, Gastro-Renal, and

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