K Number
K121135
Manufacturer
Date Cleared
2012-06-01

(49 days)

Product Code
Regulation Number
876.1500
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope is intended for physician use to examine the anal sphincter, anus, rectum, and to perform various diagnostic and therapeutic procedures by using additional accessories.

Device Description

The Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope are disposable, sterile rectoscopes, proctoscope and anoscopes with a light source which can be external or integrated on the handle. The devices are designed for the examination and treatment of anus (anoscopes) and the examination of rectum (proctoscopes and rectoscopes). The devices consist of plastic anoscopes, proctoscopes for diagnostic or therapeutic use. The Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope is made by two categories of devices: Diagnostic Anoscopes, Proctoscopes and Rectoscopes and Surgical Proctoscopes. The Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope includes both models which require the external light source and models which not require the external light source. In the latter case the light source is integrated on the handle. The external light source is provided as an accessory of the device family and it can be the THD Shining Light and the THD pen light.

AI/ML Overview

The manufacturer, THD S.p.A., submitted a 510(k) premarket notification for a "Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope". This submission is for device modifications to an already approved product family (K103647). The modifications include the availability of THD Light-scope devices in sterile condition and changes to the handle materials (ABS Terluran and ABS Novodur replacing ABS Lustran).

The document does not describe a study involving AI, human readers, or a test set in the traditional sense of diagnostic or clinical performance studies. Instead, the provided text details design verification tests to ensure the updated device's safety and effectiveness due to manufacturing material and sterilization changes.

Here's an analysis based on the provided text, focusing on the acceptance criteria and the "study" (design verification tests) that proves the device meets them, as much as possible given the context of a medical device modification submission:

1. Table of Acceptance Criteria and Reported Device Performance

ModificationTest PerformedAcceptance CriteriaReported Device Performance
Sterility of the productsValidation and effectiveness testSafety and effectiveness of sterilization methodThe design verification tests were performed as a result of the risk analysis assessment (Annex 4.2). A declaration of conformity with design controls is included in annex 1.1. (Implies satisfactory performance meeting criteria).
PackagingDesign verificationProduct shelf life maintenanceThe design verification tests were performed as a result of the risk analysis assessment (Annex 4.2). A declaration of conformity with design controls is included in annex 1.1. (Implies satisfactory performance meeting criteria).
Handle materialsDesign verificationSafety and effectiveness of the materialsThe design verification tests were performed as a result of the risk analysis assessment (Annex 4.2). A declaration of conformity with design controls is included in annex 1.1. (Implies satisfactory performance meeting criteria).

2. Sample Size for the Test Set and Data Provenance

The document does not detail specific sample sizes for these design verification tests. The tests are related to material changes and sterilization processes, so "test set" here refers to the samples of the modified devices subjected to validation. The data provenance is internal to THD S.p.A., an Italian company, performing design verification tests for a 510(k) submission to the FDA. These would be prospective tests performed on the modified devices.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Their Qualifications

For these types of engineering and sterilization validation tests, "experts" typically refers to qualified engineers, microbiologists, and materials scientists involved in the testing and evaluation process. The document does not specify the number or qualifications of these experts. The "ground truth" for these tests is established by industry standards, regulatory requirements, and validated test methodologies for sterilization efficacy and material biocompatibility/durability.

4. Adjudication Method for the Test Set

Not applicable in the context of these design verification tests. Adjudication methods like 2+1 or 3+1 are used for clinical trial endpoints or image interpretation by multiple readers. Here, the outcome of the tests (e.g., successful sterilization, material integrity) is determined by objective measurements against established criteria.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

No, an MRMC comparative effectiveness study was not done. This document describes a 510(k) submission for device modifications concerning materials and sterilization, not a diagnostic AI device requiring clinical performance or human reader studies.

6. If a Standalone (i.e., algorithm only without human-in-the-loop performance) Was Done

No, a standalone algorithm performance study was not done. This device is a physical medical instrument (anoscope, proctoscope, rectoscope, light-scope), not an AI algorithm.

7. The Type of Ground Truth Used

The ground truth used for these design verification tests is based on:

  • Sterilization Validation Standards: Demonstrating that the sterilization process achieves a specified sterility assurance level (SAL), typically accepted industry standards (e.g., ANSI/AAMI/ISO 11135 for ethylene oxide, or similar for other methods).
  • Material Safety Standards: Demonstrating the biocompatibility and physical properties of the new handle materials meet safety and performance requirements, often referencing ISO standards (e.g., ISO 10993 for biocompatibility) and relevant engineering specifications.
  • Packaging Integrity Tests: Ensuring the packaging maintains sterility and product integrity over the claimed shelf life, according to ISO and ASTM standards.

8. The Sample Size for the Training Set

Not applicable. This is not an AI/machine learning device, so there is no training set in that context.

9. How the Ground Truth for the Training Set Was Established

Not applicable, as there is no training set for an AI algorithm. The "ground truth" for the device's technical validation (as described above in point 7) is established through adherence to recognized international and national standards for medical device manufacturing, sterilization, and materials.

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K121/135
Page 1 of 3

THD S.p.A. 510(K) Notification

FAMILY OF DISPOSABLE, STERILE AND NOT STERILE THD ANOSCOPE, PROCTOSCOPE, RECTOSCOPE AND LIGHT-SCOPE

510(k) Summary for the

Family of disposable THD Anoscope, Proctoscope, Rectoscope and Light-scope

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

2.1. General Informațion

Submitter:

THD S.p.A. Via dell'Industria, 1 42015 - Correggio (RE) Italy

Establishment Registration Number: 3006680097

Contact Person:

Guido Bonapace ISEMED srl Via Borgo Santa Cristina 12 40026 Imola (BO) Italy Mob.phone: +39-335-5378686 +39-0542 683803 Telephone: Fax: +39-0542 698456 Email: gbonapace(@isemed.eu

Summary Preparation Date:

  • 2.2. Names Device Name:
    Classification Name: Product Code: Regulation number:

April 4, 2012

Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope Endoscope and accessories FER/GCP 876.1500

2.3. Predicate Devices

This 510(k) is related to the device modifications of the following devices:

21 Page

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K 12/135
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UF

THD S.p.A. 510(K) NOTIFICATION

FAMILY OF DISPOSABLE, STERILE AND NOT STERILE THD ANOSCOPE, PROCTOSCOPE, RECTOSCOPE AND LIGHT-SCOPE

ApplicantDevice name510(k) Number
THD S.p.A.Family of THD disposable Anoscope,K103647
Proctoscope, Rectoscope and Light-scope

The Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope and its predicate device are indicated for the same intended use and have the same technological characteristics. Both families include the anoscopes, proctoscope the rectoscopes with the same dimensions and manufactured with the same process.

The differences between the families are that:

  • The THD Light-scope devices are now available in sterile condition too. .
  • The handle material of the family is ABS Terluran and the cover of the integrated � LED light source is ABS Novodur to replace in both cases ABS Lustran.

2.4. Device Description

The Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope are disposable, sterile rectoscopes, proctoscope and anoscopes with a light source which can be external or integrated on the handle.

The devices are designed for the examination and treatment of anus (anoscopes) and the examination of rectum (proctoscopes and rectoscopes).

The devices consist of plastic anoscopes, proctoscopes for diagnostic or therapeutic use.

The Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope is made by two categories of devices:

  • Diagnostic Anoscopes, Proctoscopes and Rectoscopes .
  • Surgical Proctoscopes o

The Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope includes both models which require the external light source and models which not require the external light source. In the latter case the light source is integrated on the handle.

The external light source is provided as an accessory of the device family and it can be the THD Shining Light and the THD pen light. Both THD Shining Light and THD pen light have been already approved (K091490).

2.5. Indications for Use

The family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope is intended for physician use to examine the anal sphincter, anus, rectum

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THD S.p.A. 510(K) NOTIFICATION

FAMILY OF DISPOSABLE, STERILE AND NOT STERILE THD ANOSCOPE, PROCTOSCOPE, RECTOSCOPE AND LIGHT-SCOPE

and to perform various diagnostic and therapeutic procedures by using additional accessories.

The Indications for Use of disposable Anoscope, Proctoscope, Rectoscope and Lightscope have not been modified with respect to the previous submission (K103647).

2.6. Design Control Activities

The risk analysis method used to assess the impact of the modifications is described in the Annex 4.3 - Risk management plan. The design verification tests were performed as a result of this risk analysis assessment (see Annex 4.2). The design verification tests are listed in the following table.

ModificationTest PerformedAcceptance Criteria
Sterility of the productsValidation andeffectiveness testSafety and effectiveness ofsterilization method
PackagingDesign verificationProduct shelf lifemaintenance
Handle materialsDesign verificationSafety and effectiveness ofthe materials

A declaration of conformity with design controls is included in annex 1.1

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized emblem resembling an abstract caduceus or a symbol representing health and human services.

Public Health Service

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

THD S.p.a. % Mr. Guido Bonapace, General Manager ISEMED S.R.L. Via Borgo Santa Cristina, 12 Imola (BO) 40026 ITALY

JUN - 1 2012

Re: K121135

Trade/Device Name: Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope Regulation Number: 21 CFR& 876.1500 Regulation Name: Endoscope and accessories Regulatory Class: II Product Code: FER, GCP Dated: April 4, 2012 Received: April 13, 2012

Dear Mr. Bonapace:

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 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical

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Page 2-

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. Fisher, Ph.D.

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

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THD S.p.A. 510(K) NOTIFICATION

FAMILY OF DISPOSABLE, STERILE AND NOT STERILE THD ANOSCOPE, PROCTOSCOPE, RECTOSCOPE AND LIGHT-SCOPE

Indications for Use

510(k) Number (if known): K / 2 / / 3 5

Device Name: Family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope and Light-scope

Indications for Use:

The family of disposable, sterile and not sterile THD Anoscope, Proctoscope, Rectoscope I no Light-scope is intended for physician use to examine the anal sphincter, anus, rectum, and to perform various diagnostic and therapeutic procedures by using additional accessories.

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 OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

(Division Sign-Off)
Division of Reproductive, Gastro-Renal, and

CONFIDENTIAL

0(k) Number

§ 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.