K Number
K131012
Device Name
SUTTER BIPOLAR FORCEPS - SUPERGLISS
Date Cleared
2013-08-23

(134 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Intended Use: Sutter Bipolar Forceps SuperGliss are designed to grasp, manipulate and coagulate selected tissue. They are to be connected to the bipolar output of an electrosurgical generator with an appropriate bipolar cable and must only be used with parameters for bipolar coagulation. Indications: General surgery, Orthopaedic coagulation, Thoracic coagulation, Neurosurgical coagulation, Gynaecological coagulation (except for use in female sterilisation), Urological coagulation, Ear-, Nose- and Throat coagulation.
Device Description
Sutter Bipolar Forceps - SuperGliss is an electrosurgical tool in tweezers configuration with differences in tip size and branches styles. It is constructed with medical grade stainless steel (branches), coated with Polyamid PA 11 as electrical insulator and possesses a tip made of silver alloy that is not insulated. The forceps can be connected through an appropriate bipolar cable with the bipolar output of an electrosurgical generator. As an electrosurgical accessory it is designed to grasp, manipulate and coagulate selected tissue. The maximum peak voltage to use the forceps is 500 Vp. The forceps are provided non-sterile, are reusable and must be sterilized prior initial and subsequent use.
More Information

Not Found

No
The device description and performance studies focus on the mechanical and electrical properties of bipolar forceps for coagulation, with no mention of AI or ML technologies.

Yes

The device is intended for coagulation of selected tissue in various surgical procedures, which is a therapeutic function.

No

Explanation: The device is described as an electrosurgical tool designed to "grasp, manipulate and coagulate selected tissue." Its function is therapeutic (coagulation), not diagnostic.

No

The device description clearly states it is an electrosurgical tool constructed with physical materials (stainless steel, Polyamid PA 11, silver alloy) and is designed to grasp, manipulate, and coagulate tissue, indicating it is a hardware device.

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

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, tissue samples) to provide information about a person's health. This testing is done outside of the body (in vitro).
  • Device Function: The Sutter Bipolar Forceps SuperGliss is an electrosurgical tool used directly on tissue within the body during surgical procedures. Its purpose is to grasp, manipulate, and coagulate tissue.
  • Lack of In Vitro Testing: The description focuses on its use in surgery and mentions performance testing on meat and bench testing according to standards, but there is no mention of testing biological samples taken from a patient.

Therefore, the device's function and intended use clearly fall outside the scope of In Vitro Diagnostics.

N/A

Intended Use / Indications for Use

Intended Use: Sutter Bipolar Forceps SuperGliss are designed to grasp, manipulate and coagulate selected tissue. They are to be connected to the bipolar output of an electrosurgical generator with an appropriate bipolar cable and must only be used with parameters for bipolar coagulation.

Indications: General surgery, Orthopaedic coagulation, Thoracic coagulation, Neurosurgical coagulation, Gynaecological coagulation (except for use in female sterilisation), Urological coagulation, Ear-, Nose- and Throat coagulation.

Contraindications: Sutter Bipolar Forceps SuperGliss have not been shown to be effective for tubal sterilisation or tubal coagulation for sterilisation procedures and should not be used for this purpose.

Product codes

GEI

Device Description

Sutter Bipolar Forceps - SuperGliss is an electrosurgical tool in tweezers configuration with differences in tip size and branches styles. It is constructed with medical grade stainless steel (branches), coated with Polyamid PA 11 as electrical insulator and possesses a tip made of silver alloy that is not insulated. The forceps can be connected through an appropriate bipolar cable with the bipolar output of an electrosurgical generator. As an electrosurgical accessory it is designed to grasp, manipulate and coagulate selected tissue. The maximum peak voltage to use the forceps is 500 Vp. The forceps are provided non-sterile, are reusable and must be sterilized prior initial and subsequent use.

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)

Non-clinical laboratory performance testing was done on different types of meat with determination of coagulation areas for various tip sizes and statistical analysis of the results. Bench testing according to standards series IEC 60601 has also been performed.

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

Not Found

Predicate Device(s)

K101080, K051429

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.

0

K131012

Page 1 of 2

APPLICANT: SUTTER MEDIZINTECHNIK GMBH AFTERS: SUTTER BIPOLAR FORCEPS - SUPERGLISS

510(k) SUMMARY OF SAFETY AND EFFECTIVENESS

Section 807.92(c)

| Date:

807.92(a)(1)August 20, 2013
Submitter:
807.92(a)(1)Name:
Address:SUTTER MEDIZINTECHNIK GmbH
Tullastrasse 87
79108 Freiburg
Germany
Managing Director:
Telephone:
Fax:
Contact person:
Telephone:
E-mail:Bert Sutter
+49 (0) 761 51551-0
+49 (0) 761 51551-30
Dr. Sabine Klugbauer
+49 (0) 761 51551-14
klugbauer@sutter-med.deAUG 2 3 2013
Product:
807.92(a)(2)Trade Name:
Classification:
Common Name:
Product Code and
Classification Name:Sutter Bipolar Forceps - SuperGliss
Class II; CFR 21 § 878.4400
Electrosurgical Instruments and Accessories
GEI - Electrosurgical Cutting & Coagulation
Device & Accessories
Predicate
Device:
807.92(a)(3)Predicate devices to which Sutter Bipolar Forceps SuperGliss are
claimed to be substantially equivalent are manufactured by
• Egon Faulhaber Surgical Instruments Pinzetten, Bipolar, Nonstick
bipolar forceps (K101080)
• Guenter Bissinger, Claris Non-Stick Bipolar Forceps (K051429)
Device
Description:
807.92(a)(4)Sutter Bipolar Forceps - SuperGliss is an electrosurgical tool in
tweezers configuration with differences in tip size and branches styles.
It is constructed with medical grade stainless steel (branches), coated
with Polyamid PA 11 as electrical insulator and possesses a tip made of
silver alloy that is not insulated. The forceps can be connected through
an appropriate bipolar cable with the bipolar output of an electrosurgical
generator. As an electrosurgical accessory it is designed to grasp,
manipulate and coagulate selected tissue. The maximum peak voltage
to use the forceps is 500 Vp. The forceps are provided non-sterile, are
reusable and must be sterilized prior initial and subsequent use.
Intended
Use:
807.92(a)(5)Intended Use: Sutter Bipolar Forceps SuperGliss are designed to
grasp, manipulate and coagulate selected tissue. They are to be
connected to the bipolar output of an electrosurgical generator with an
appropriate bipolar cable and must only be used with parameters for
bipolar coagulation.
Indications: General surgery, Orthopaedic coagulation, Thoracic
coagulation, Neurosurgical coagulation, Gynaecological coagulation
(except for use in female sterilisation), Urological coagulation, Ear-
Nose- and Throat coagulation.
Contraindications: Sutter Bipolar Forceps SuperGliss have not been
shown to be effective for tubal sterilisation or tubal coagulation for
sterilisation procedures and should not be used for this purpose.
Performance
Testing:
807.92(b)(1)Non-clinical laboratory performance testing was done on different types
of meat with determination of coagulation areas for various tip sizes and
statistical analysis of the results. Bench testing according to standards
series IEC 60601 has also been performed.
Substantial
Equivalence:
807.92(b)(3)Comparison of Basic Features, design, testing results and intended
uses show that Sutter Bipolar Forceps SuperGliss are substantial
equivalent to the predicate devices.
FeatureSutter SuperGlissPredicate devices
K101080/K051429
Intended UseAs shown above under
Intended UseSame/Same
Branches StyleStraight, angled, bayonetSame/Same
Dimensions
Length [mm]:
Tip size [mm]:110 - 280
0.2 - 2.5110 - 250 / 110 - 240
0.25 - 2.0 / 0.25 - 2.0
Material
Tips:
Coating:
Connector:
Branches:Silver Alloy
Polyamide (PA) 11
Stainless steel/PEEK
Stainless steelSame/Same
BipolaryesSame/Same
Meets IEC 60601-2-2yesSame/Same
Maximum peak voltage500 VpSame/Same
SterilityNon-sterile, reusableSame/Same
Sterilization methodSteam-sterilisation by userSame/Same

1

.

APPLICANT: SUTTER MEDIZINTECHNIK GMBH SUTTER BIPOLAR FORCEPS - SUPERGLISS DEVICES:

必,

2

Image /page/2/Picture/0 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo consists of a stylized eagle with three stripes representing the three branches of government. The eagle is facing right and is surrounded by the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

August 23, 2013

Sutter Medizintechnik GmbH % Dr. Sabine Klugbauer Manager, Regulatory Affairs Tullastrasse 87 79108 Freiburg, Germany

Re: K131012

Trade/Device Name: Sutter Bipolar Forceps - SuperGliss Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagnlation device and accessories Regulatory Class: Class II Product Code: GEI Dated: July 3, 2013 Received: July 12, 2013

Dear Dr. Klugbauer:

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 docs 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 (2 l CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse cvents) (21 CFR 803); good manufacturing practice requirements as set

3

Page 2 - Dr. Sabine Klugbauer

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 contact the Division of Small Manufacturers, International and Consumer Assistance at its tollfree number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. 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/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Mark N. Melkerson -S

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

Enclosure

4

APPLICANT: SUTTER MEDIZINTECHNIK GMBH DEVICES:

Indications for Use Form

Indications for Use

K131012 510(k) Number (if known):

Device Name:

Sutter Bipolar Forceps - SuperGliss

Indications for Use:

Intended Use:

Sutter Bipolar Forceps SuperGliss are designed to grasp, manipulate and coagulate selected tissue. They are to be connected to the bipolar output of an electrosurgical generator with an appropriate bipolar cable and must only be used with parameters for bipolar coagulation.

Indications:

General surgery, Orthopaedic coagulation, Thoracic coagulation, Neurosurgical coagulation, Gynaecological coagulation (except for use in female sterilisation), Urological coagulation, Ear-, Nose- and Throat coagulation.

Contraindications:

Sutter Bipolar Forceps SuperGliss have not been shown to be effective for tubal sterilisation or tubal coagulation for sterilisation procedures and should not be used for this purpose.

× 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 OF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

DSD-DIVISION SIGN-OFFJoshua C. Nipper
Division of Surgical Devices-S
510(k) Number: K131012