K Number
K130164
Manufacturer
Date Cleared
2013-03-24

(60 days)

Product Code
Regulation Number
878.4810
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The FiberLase Endure CO2 Fiber is intended for use in surgical procedures requiring ablation, vaporization, excision, incision and coagulation of soft tissue. The FiberLase Endure CO2 Fiber is indicated for use in open surgical procedures such as ENT surgery and laparoscopy and endoscopic procedures.

Device Description

The FiberLase Endure CO2 Fiber is a hollow, semi rigid, lightconducting delivery fiber, 2 meter length, designed to transmit laser energy from the CO2 laser system to the treatment site. The fiber also transmits a low power red diode or helium neon laser aiming beam to assist in targeting the tissue to be treated.

AI/ML Overview

The provided text describes a 510(k) premarket notification for a medical device called "FiberLase Endure CO2 Fiber." This document focuses on demonstrating substantial equivalence to a predicate device rather than presenting a study with specific acceptance criteria and performance data in the manner typically seen for new diagnostic algorithms or devices with measurable performance metrics like sensitivity/specificity.

Here's an analysis based on the information provided, addressing your questions where possible:

1. A table of acceptance criteria and the reported device performance

The document does not explicitly present a table of acceptance criteria and reported device performance in the traditional sense of a clinical study measuring outcomes like accuracy, sensitivity, or specificity. Instead, the "acceptance criteria" are implied by the standards the device complies with and the demonstration of substantial equivalence to its predicate device.

Acceptance Criteria (Implied)Reported Device Performance
Compliance with various medical device standards (e.g., sterilization, risk management, electrical safety, laser safety)."FiberLase Endure CO2 Fiber was tested and complies with the following standards: ANSI/AAMI/ISO 11135-1:2007, AAMI TIR30:2001, ISO 14971-1:2007, IEC 60601-2-22 ed3.0:2007, IEC 60825-1:2007, ANSI/AAMI/ISO 17665-1:2006."

The primary "performance" reported is that:

  • "Performance testing demonstrated that the FiberLase Endure CO2 Fiber is as safe and effective as the cleared predicate device."
  • "The minor differences do not raise any new questions of safety or efficacy."

2. Sample size used for the test set and the data provenance

This information is not provided in the document. The text refers to "performance testing" generally, but does not detail the nature of these tests, including the sample size, type of data (e.g., biological samples, simulated scenarios), or provenance (country of origin, retrospective/prospective). Given that the device is a laser fiber and the primary change is the sterilization method, the testing likely involved engineering and biocompatibility evaluations rather than clinical trials with human subjects for performance metrics.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts

This information is not provided and is not relevant to this type of device submission. The device is a CO2 laser fiber, and its performance testing would not typically involve expert review for diagnostic "ground truth."

4. Adjudication method for the test set

This information is not provided and is not relevant to this type of device submission. Adjudication methods are typically used in studies where human interpretation of medical images or data is involved to establish a ground truth or resolve discrepancies, which is not the case here.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

No, an MRMC comparative effectiveness study was not done. This type of study is relevant for AI-powered diagnostic tools or systems that assist human readers in interpretation. The FiberLase Endure CO2 Fiber is a physical medical device (a laser fiber), not an AI system.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

No. This question is applicable to AI algorithms. The device discussed is a laser fiber, which is a physical instrument, not an algorithm.

7. The type of ground truth used

The concept of "ground truth" as typically applied to diagnostic AI algorithms (e.g., expert consensus, pathology, outcome data) is not applicable to this device. The "ground truth" for this device's performance would relate to its physical properties, sterility, and ability to transmit laser energy safely and effectively, which would be established through engineering tests, sterilization validation, and biocompatibility studies, not clinical outcome data or expert consensus on a diagnosis.

8. The sample size for the training set

This information is not provided and is not applicable. The device is a physical instrument, not an AI algorithm that requires a training set.

9. How the ground truth for the training set was established

This information is not provided and is not applicable, as there is no training set for a physical laser fiber device.

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ENIS®

510(K) SUMMARY

MAR 2 4 2013

FiberLase Endure CO2 Fiber 510(k) Number K 130 1 64

Applicant's Name:Lumenis Ltd.
13 Hayetzira Street
Yokneam Industrial Park
Yokneam 20692 Israel
Tel. (972)4-959-9000
Fax: (972)4-959-9050
Contact Person:Yoram Levy, Qsite
31 Haavoda St.
Binyamina, Israel 30500
Tel (972)4-638-8837
Fax (972)4-638-0510
Yoram@qsitemed.com
Trade Name:FiberLase Endure CO2 Fiber
Device Type:CO2 Laser fiber
Preparation Date:January 20, 2013
Classification:Regulatory Name: Laser surgical instrument for use in general and
plastic surgery and in dermatology
Product Code: GEX
Regulation No: 21 CFR 878.4810
Class: II
Classification Panel: General & Plastic Surgery

Device Description:

: 上一篇:

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Image /page/1/Picture/0 description: The image shows the word "LUMENIS" in a bold, sans-serif font. The "L" is stylized with a circle around it. There is a small "c" in a circle to the right of the word, indicating a copyright or trademark symbol.

The FiberLase Endure CO2 Fiber is a hollow, semi rigid, lightconducting delivery fiber, 2 meter length, designed to transmit laser energy from the CO2 laser system to the treatment site. The fiber also transmits a low power red diode or helium neon laser aiming beam to assist in targeting the tissue to be treated.

Intended Use Statement:

The FiberLase Endure CO2 Fiber is intended for use in surgical procedures requiring ablation, vaporization, excision, incision and coagulation of soft tissue. The FiberLase Endure CO2 Fiber is indicated for use in open surgical procedures such as ENT surgery and laparoscopy and endoscopic procedures.

Predicate Devices:

Substantial equivalence to the following predicate device is claimed:

Device Name510k NoDate of Clearance
FiberLase CO2 Laser WaveGuideK100384April 12, 2010

Performance Standards

FiberLase Endure CO2 Fiber was tested and complies with the following standards:

  • ANSI/AAMI/ISO 11135-1:2007 Sterilization of health care products . - Ethylene oxide
  • AAMI TIR30:2001 Product adoption and process equivalency for . ethylene oxide sterilization
  • ISO 14971-1:2007 Risk management for medical devices .
  • IEC 60601-2-22 ed3.0:2007 Medical Electrical Equipment Part 2-. 22: Particular Requirements for Basic Safety and Essential Performance of Surgical, Cosmetic, Therapeutic and Diagnostic Laser Equipment.
  • IEC 60825-1:2007 Safety of Laser Products Part 1: Equipment . Classification. Requirements and User's Guide
  • · ANSI/AAMI/ISO 17665-1:2006 Sterilization of health care products - Moist Heat.

FiberLase ENDURE CO2 Fiber - 510k Notification

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તાલુ

A detailed description follows in Section 14.

Performance Testing

Performance testing demonstrated that the FiberLase Endure CO2 Fiber is as safe and effective as the cleared predicate device.

Comparison with the Predicate Devices

The FiberLase Endure CO2 Fiber is a modification to its predicate device, the FDA-cleared Lumenis Fiberlase CO2 laser WaveGuide (K100384).

The intended use of the FiberLase Endure CO2 Fiber is identical to the intended use of its predicate.

Both the FiberLase Endure CO2 Fiber and the Lumenis Fiberlase CO2 laser WaveGuide systems are fibers that transmit laser energy from the laser system to the treatment site. Both devices are comprised of a laser connector and a 2 meter long delivery fiber.

The structures, the materials and the dimensions of the FiberLase Endure CO2 Fiber are identical to the cleared Lumenis Fiberlase CO2 laser WaveGuide fiber.

The minor difference between the FiberLase Endure CO2 Fiber System and its predicate device is an addition of an Autoclave sterilization method for reprocessing the fiber instead of single use ETO. The minor differences do not raise any new questions of safety or efficacy. Moreover, performance testing demonstrated that the FiberLase Endure CO2 Fiber is as safe and effective as the predicate device. Thus, the FiberLase Endure CO2 Fiber is substantially equivalent to Lumenis FiberLase CO2 Laser WaveGuide (K100384).

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the seal of the U.S. Department of Health and Human Services. The seal features a stylized eagle with three stripes representing the three levels of government: federal, state, and local. The eagle is surrounded by the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

Public Health Service

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

Lumenis, Limited % Osite Mr. Yoram Levy General Manager 31 Haavoda Street Binyamina, Israel 30500

March 24, 2012

Re: K130164

Trade/Device Name: FiberLase Endure CO2 Fiber Regulation Number: 21 CFR 878.4810 Regulation Name: Laser surgical instrument for use in general and plastic surgery and in dermatology . Regulatory Class: Class II Product Code: GEX Dated: March 06. 2013 Received: March 11, 2013

Dear Mr. Levy:

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. Isting of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

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 device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set

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LUMENIS

INDICATIONS FOR USE STATEMENT

510(k) Number (if known): K130164

Device Name:

FiberLase Endure C02 Fiber

Indications for Use:

The FiberLase Endure C02 Fiber is intended for use in surgical procedures requiring ablation, vaporization, excision, incision and coagulation of soft tissue. FiberLase Endure C02 Fiber is indicated for use in open surgical procedures such as ENT surgery and laparoscopy and endoscopic procedures.

Prescription Use: × (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)

Neil R Ogden==================================================================================================================================================================

(Division Sign-Off) for MXM Division of Surgical Devices 510(k) Number _K130164

l of l FiberLase ENDURE C02 Fiber - 5/0k Notification

§ 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology.

(a)
Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.
(b)
Classification. (1) Class II.(2) Class I for special laser gas mixtures used as a lasing medium for this class of lasers. 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 § 878.9.