K Number
K120239
Device Name
ELEVANCE
Manufacturer
Date Cleared
2012-08-24

(211 days)

Product Code
Regulation Number
872.6640
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Elevance is intended for use by professional dental practitioners in providing treatment to dental patients in a dental operatory. The system is designed to deliver air, water, vacuum and low-voltage electricity to hand-held dental instruments.
Device Description
The Elevance Delivery Unit includes components to deliver air, water, electrical power, and vacuum to dental handpieces and accessories. The controls are contained in a Doctor's Unit, an Assistant's Unit, and a Cuspidor. Additional parts include mount arms, console mount housing, and a junction box that houses a power supply and air/water regulators. Handpiece accessories or instruments can be added to the Unit, Midmark does not manufacture these accessories but, do provide means to connect them into the Unit. These include high and low speed pneumatic handpiece tubing, electric handpiece motors, scalers, intraoral cameras, curing lights, air/water syringe, and SE and HVE vacuum instruments.
More Information

Not Found

No
The summary describes a standard dental delivery unit with components for air, water, vacuum, and electricity, and explicitly states "Mentions AI, DNN, or ML: Not Found".

No.
The device delivers air, water, vacuum, and low-voltage electricity to hand-held dental instruments but does not itself provide therapy. It is a support system for therapeutic instruments.

No

The description explicitly states its purpose is to "deliver air, water, vacuum and low-voltage electricity to hand-held dental instruments" for "providing treatment to dental patients," not for diagnosing conditions. It also lists various tools it can connect to, none of which are inherently diagnostic (e.g., handpieces, scalers, curing lights).

No

The device description clearly outlines multiple hardware components including delivery units, control units, mount arms, housing, and a junction box, all of which are physical components, not software.

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

Here's why:

  • Intended Use: The intended use is for providing treatment to dental patients in a dental operatory by delivering air, water, vacuum, and low-voltage electricity to hand-held dental instruments. This is a direct treatment application, not a diagnostic test performed on samples taken from the body.
  • Device Description: The device description details components for delivering utilities (air, water, power, vacuum) to dental instruments. It does not mention any components or processes related to analyzing biological samples (blood, urine, tissue, etc.) which is the core function of an IVD.
  • Lack of IVD-related information: There is no mention of sample collection, reagents, analytical methods, or diagnostic results, all of which are characteristic of IVD devices.

The Elevance is a dental delivery unit, which is a piece of equipment used to support dental procedures, not to diagnose conditions based on in vitro analysis.

N/A

Intended Use / Indications for Use

The Midmark Elevance Instrument Delivery System is intended for use by professional dental practitioners in providing treatment to dental patients in a dental operatory. The system is designed to deliver air, water, vacuum and lowvoltage electricity to hand-held dental instruments.

The Elevance is intended for use by professional dental practitioners in providing treatment to dental patients in a dental operatory. The system is designed to deliver air, water, vacuum and low-voltage electricity to hand-held dental instruments.

Product codes

EIA

Device Description

The Elevance Delivery Unit includes components to deliver air, water, electrical power, and vacuum to dental handpieces and accessories. The controls are contained in a Doctor's Unit, an Assistant's Unit, and a Cuspidor. Additional parts include mount arms, console mount housing, and a junction box that houses a power supply and air/water regulators. Handpiece accessories or instruments can be added to the Unit, Midmark does not manufacture these accessories but, do provide means to connect them into the Unit. These include high and low speed pneumatic handpiece tubing, electric handpiece motors, scalers, intraoral cameras, curing lights, air/water syringe, and SE and HVE vacuum instruments.

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

professional dental practitioners in a dental operatory.

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)

Non-clinical performance tests were conducted:
Qualification Run evaluation to verify design
EN 60601-1-2:2007 Part 1-2
EN 61000-3-2:2006 +A1:2009 +A2:2009 Part 3-2
EN 60601-1-2:2007 Part 1-2
IEC 60601-1 Part 1
ISO 7494-1:2004
ISO 7494-2:2003

The data shows that the Elevance demonstrates substantial equivalence to the predicate as a Dental Delivery Unit.

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

Not Found

Predicate Device(s)

K003090

Reference Device(s)

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

§ 872.6640 Dental operative unit and accessories.

(a)
Identification. A dental operative unit and accessories is an AC-powered device that is intended to supply power to and serve as a base for other dental devices, such as a dental handpiece, a dental operating light, an air or water syringe unit, and oral cavity evacuator, a suction operative unit, and other dental devices and accessories. The device may be attached to a dental chair.(b)
Classification. Class I (general controls). Except for dental operative unit, accessories are exempt from premarket notification procedures in subpart E of part 807 of this chapter subject to § 872.9.

0

K120239

510(k) Special Midmark Corporation Elevance

6. 510(k) Summary or 510(k) Statement
510(k) SUMMARY
AUG 2 4 2012
510(k) OwnerMidmark Corporation
60 Vista Drive
Versailles, Ohio 45380-0286
TEL: 937-526-8249
Contact personRobyn Scopis
Regulatory Consultant to Midmark Corp.
Regulatory Specialists, Inc.
3722 Ave. Sausalito
Irvine, CA 92606
TEL: 949.422.3853
FAX: 949.552.2821
EMAIL: robyn@regulatoryspecialists.com
Date summary was preparedAugust 22, 2012
Name of deviceElevance
Common NameDental Delivery Unit
Classification NameUnit, Operative Dental
Regulation872.6640
Product CodeEIA
Unmodified DeviceMidmark Procenter Instrument Delivery System
K003090
Description

Description

The Elevance Delivery Unit includes components to deliver air, water, electrical power, and vacuum to dental handpieces and accessories. The controls are contained in a Doctor's Unit, an Assistant's Unit, and a Cuspidor. Additional parts include mount arms, console mount housing, and a junction box that houses a power supply and air/water regulators. Handpiece accessories or instruments can be added to the Unit, Midmark does not manufacture these accessories but, do provide means to connect them into the Unit. These include high and low speed pneumatic handpiece tubing, electric handpiece motors, scalers, intraoral cameras, curing lights, air/water syringe, and SE and HVE vacuum instruments.

1

K120239

510(k) Special Midmark Corporation Elevance

Intended Use

The Midmark Elevance Instrument Delivery System is intended for use by professional dental practitioners in providing treatment to dental patients in a dental operatory. The system is designed to deliver air, water, vacuum and lowvoltage electricity to hand-held dental instruments.

Technological Characteristics

The Unmodified Device and the Elevance were compared in the following areas and found to have similar technological characteristics and to be · equivalent:

・ Indications for Use

Function of Handpiece Accessories Performance of Handpiece Accessories

The Unmodified Device and the Elevance were compared in the following areas and found to have minor different technological characteristics. The following differences have been determined to not have any impact on the safety or efficacy of the Elevance:

Centrally located controls for instruments Touch Pad on the Control Settings Air and Water Adjustment made via proportional solenoid valves

The following non-clinical performance tests were conducted:

Qualification Run evaluation to verify design EN 60601-1-2:2007 Part 1-2 EN 61000-3-2:2006 +A1:2009 +A2:2009 Part 3-2 EN 60601-1-2:2007 Part 1-2 IEC 60601-1 Part 1 ISO 7494-1:2004 ISO 7494-2:2003

Conclusions from non-clinical performance data

After performing non-clinical performance studies, the data shows that the Elevance demonstrates substantial equivalence to the predicate as a Dental Delivery Unit.

2

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/2/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 its wings spread, and the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle. The eagle is black, and the text is also black. The logo is simple and recognizable.

Public Health Service

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

Midmark Corporation C/O Ms. Robyn Scopis Regulatory Consultant Regulatory Specialists, Incorporated 1801 Edgecliff Drive Fullerton, California 92831

Re: K120239

Trade/Device Name: Elevance Regulation Number: 21 CFR 872.6640 Regulation Name: Dental Operative Unit and Accessories Regulatory Class: I Product Code: EIA Dated: August 15, 2012 Received: August 21, 2012

Dear Ms. Scopis:

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.

AUG 2 4 2012

3

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 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/ucm1115809.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.

Susan Runner

Anthony D. Watson, B.S., M.S., M.B.A. Director

Division of Anesthesiology, General Hospital, Infection Control and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

4

510(k) Special Midmark Corporation Elevance

K12.02.32

Indications for Use

510(k) Number (if known): ____________________________________________________________________________________________________________________________________________________ TBD

Device Name: Elevance

Indications for Use:

The Elevance is intended for use by professional dental practitioners in providing treatment to dental patients in a dental operatory. The system is designed to deliver air, water, vacuum and low-voltage electricity to hand-held dental instruments.

Prescription Use AND/OR (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

(Please DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Susan Runne

Division Sign-Off) . livision of Anesthesiology, General Hospital nfection Control, Dental Devices

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10(k) Number: K120039

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