K Number
K133857
Device Name
BRELLA-SPEC(TM) VAGINAL SPECULUM
Manufacturer
Date Cleared
2014-04-28

(130 days)

Product Code
Regulation Number
884.4530
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Brella-Spec™ Vaginal Speculum is used for visualization and exposure of the interior of the vagina by a medical professional during gynecological and obstetrical procedures and examinations. Brella-Spec™ Vaginal Speculum provides the light necessary to illuminate the field during procedures and examinations.
Device Description
The Brella-Spec™ Vaginal Speculum is a sterile, single-use device with built-in LED illumination system to provide optimal visualization and access during gynecological and obstetrical procedures. This speculum was designed to provide visualization and exposure of the interior of the vagina by a medical professional during gynecological and obstetrical procedures and examinations. The device is ergonomically designed to maximize the view window using two side blades that are opened by a manually operated ratchet mechanism. The device incorporates a fully enclosed LED illumination system. It is composed of medical grade, biocompatible plastic materials.
More Information

Not Found

No
The device description and performance studies focus on mechanical function, illumination, biocompatibility, sterilization, and electrical safety. There is no mention of AI, ML, image processing, or data analysis that would indicate the use of such technologies.

No
The device is described as a vaginal speculum used for visualization and exposure during examinations and procedures, not for treating a disease or condition.

No

Explanation: The device is a vaginal speculum used for visualization and exposure, primarily functioning as a tool for access and illumination during gynecological and obstetrical procedures and examinations. It does not perform any diagnostic function such as analyzing data, making a diagnosis, or providing diagnostic information.

No

The device description clearly states it is a physical, single-use device made of plastic with a built-in LED illumination system and a manual ratchet mechanism. It also mentions biocompatibility, sterilization, packaging, and electrical safety testing, all of which are associated with hardware components.

Based on the provided information, the Brella-Spec™ Vaginal Speculum is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use is for "visualization and exposure of the interior of the vagina by a medical professional during gynecological and obstetrical procedures and examinations." This describes a device used in vivo (within the body) for direct observation and access.
  • Device Description: The description details a physical instrument used to open the vaginal canal and provide light for examination. It does not mention any components or functions related to testing biological samples in vitro (outside the body).
  • Lack of IVD Characteristics: IVD devices are typically used to examine specimens like blood, urine, tissue, etc., to diagnose diseases or conditions. The Brella-Spec™ does not perform any such testing.

Therefore, the Brella-Spec™ Vaginal Speculum is a medical device used for examination and procedures, but it does not fit the definition of an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Brella-Spec™ Vaginal Speculum is used for visualization and exposure of the interior of the vagina by a medical professional during gynecological and obstetrical procedures and examinations.

Brella-Spec™ Vaginal Speculum provides the light necessary to illuminate the field during procedures and examinations.

Product codes (comma separated list FDA assigned to the subject device)

HIB

Device Description

The Brella-Spec™ Vaginal Speculum is a sterile, single-use device with built-in LED illumination system to provide optimal visualization and access during gynecological and obstetrical procedures. This speculum was designed to provide visualization and exposure of the interior of the vagina by a medical professional during gynecological and obstetrical procedures and examinations. The device is ergonomically designed to maximize the view window using two side blades that are opened by a manually operated ratchet mechanism. The device incorporates a fully enclosed LED illumination system. It is composed of medical grade, biocompatible plastic materials.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vagina

Indicated Patient Age Range

Not Found

Intended User / Care Setting

medical professional

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)

The Brella-Spec™ Vaginal Speculum has been tested for biocompatibility in accordance with the Food and Drug Administration Blue Book Memo, G95-1, use of international standard ISO-10993 Requirements for limited contact duration, surface contacting, breached mucosal membrane device and are demonstrated to be suitable for the intended use of this product. The sterilization method for the Brella-Spec™ Vaginal Speculum has been validated and tested in accordance with ISO 11137: -Sterilization of healthcare products-Radiation. The packaging for the Brella-Spec™ Vaginal Speculum has been validated and tested in accordance with ISO 11607-Packaging for terminally sterile medical devices. In addition, the Brolla-Speculum has been tested for electrically safety in accordance with IEC 60601-1, Medical electrical equipment - Part 1: General requirements for basic safety and essential performance.

Verification and validation tests were conducted in accordance with Proa Medical, Inc., design control procedures. The Brella-Speculum was tested using established testing procedures to ensure the performance parameters conform to the product design specifications. ISO 14971- Medical Devices-Application of Risk Management to medical devices was followed to mitigate risks that may be. associated with the device.

No clinical studies have been done for the purpose of obtaining safety and effectiveness data.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K072762

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

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

§ 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

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APR 2 8 2014

510(k) Summary

Applicant: Proa Medical, Inc. . 2512 Artesia Blvd. Suite 305C Redondo Beach, CA 90278-3269 United States Contact: Victoria Nadershahi 1-800-899-3385 victoria@proamedical.com

Date Summary Prepared:April 24th, 2014
Trade Name:Brella-SpecTM Vaginal Speculum
Common or Usual Name:Speculum, Vaginal, Nonmetal
Device Class:Class II
Classification Code:HIB
Classification Name:21 CFR 884.4530 Speculum, Vaginal, Nonmetal

Device Intended Use

The Brella-Spec™ Vaginal Speculum is used for visualization and exposure of the interior of the vagina by a medical professional during gynecological and obstetrical procedures and examinations.

Brella-Spec™ Vaginal Speculum provides the light necessary to illuminate the field during procedures and examinations.

Device Indications for use

·

The Brella-Spec"M Vaginal Speculum is used for visualization and exposure of the interior of the vagina by a medical professional during gynecological and obstetrical procedures and examinations.

Brella-Spec™ Vaginal Speculum provides the light necessary to illuminate the ficid during procedures and examinations.

1

Image /page/1/Picture/0 description: The image shows the logo for Proa Medical. The word "Proa" is in a bold, sans-serif font on the top line, with the "P" having a long vertical extension. Below it, "MEDICAL" is written in a similar but slightly smaller font. The entire logo is in black against a white background.

Predicate Device

  • Depalt Vaginal Speculum 2000 Series and Depalt Lighting System cleared for marketing under a) 510(k) notification number K072762.

Device Description

The Brella-Spec™ Vaginal Speculum is a sterile, single-use device with built-in LED illumination system to provide optimal visualization and access during gynecological and obstetrical procedures. This speculum was designed to provide visualization and exposure of the interior of the vagina by a medical professional during gynecological and obstetrical procedures and examinations. The device is ergonomically designed to maximize the view window using two side blades that are opened by a manually operated ratchet mechanism. The device incorporates a fully enclosed LED illumination system. It is composed of medical grade, biocompatible plastic materials.

Technological Characteristics

The Brella-Spec™ Vaginal Speculum has substantially equivalent technological characteristics and the same indications for use as the predicate device Depalt Vaginal Speculum 2000 Series and Depalt Lighting System. The use of polypropylene and acrylic polycarbonate along with providing the device in sterile PETG tray and Tyvek lid does not introduce any new concerns regarding safety or effectiveness. The design has been demonstrated as substantially equivalent using bench test data.

Performance Data

The Brclla-Spec™ Vaginal Speculum has been tested for biocompatibility in accordance with the Food and Drug Administration Blue Book Memo, G95-1, use of international standard ISO-10993 Requirements for limited contact duration, surface contacting, breached mucosal membrane device and are demonstrated to be suitable for the intended use of this product. The sterilization method for the Brella-Spec™ Vaginal Speculum has been validated and tested in accordance with ISO 11137: -Sterilization of healthcare products-Radiation. The packaging for the Brella-Spec"M Vaginal Speculum has been validated and tested in accordance with ISO 11607-Packaging for terminally sterile medical devices. In addition, the Brolla-Speculum has been tested for electrically safety in accordance with IEC 60601-1, Medical electrical equipment - Part 1: General requirements for basic safety and essential performance.

Verification and validation tests were conducted in accordance with Proa Medical, Inc., design control procedures. The Brella-Speculum was tested using established testing procedures to ensure the performance parameters conform to the product design specifications. ISO 14971- Medical Devices-Application of Risk Management to medical devices was followed to mitigate risks that may be. associated with the device.

No clinical studies have been done for the purpose of obtaining safety and effectiveness data.

2

Image /page/2/Picture/0 description: The image shows the logo for Proa Medical. The word "Proa" is in large, bold, sans-serif font, with each letter connected to the others. Below "Proa" is the word "Medical" in a smaller, sans-serif font, also in bold. The logo is black and white.

Substantial Equivalence

The Brella-Spec™ Vaginal Speculum has substantially equivalent technological characteristics and the same indications for use as the predicate Depart Vaginal Speculum 510(k) K072762. The differences in the design features do not have an impact on safety and effectiveness of the subject device.

ParameterSubject device (K133857)Predicate device (K072762)Differences
Device nameBrella-Spec™ Vaginal
SpeculumDepalt Vaginal Speculum and
Depalt Lighting System
Indications for
UseSame as the predicateUsed for the purposes of
visualization and exposure of the
interior of the vagina by a
medical professional during
gynecological and obstetrical
procedures/ examinations.
Depalt Lighting System provides
the light necessary to illuminate
the field during
procedures/examinations."
Dimension· Blade (stationary)
length 4.5"
· Blade (stationary) width
1.2"
· Handle length 2.5"· Blade length 4.4"
· Blade width 1.1"
· Handle length 3"The difference is minimal;
no safety or effectiveness
concerns
BladeTriple blades (1 stationary,
2 articulating)Dual blades (1 stationary, 1
articulating)The difference does not have
an impact on safety of the
subject device. With two
articulating blades, the
subject device should be
more effective because it
provides larger vagina-
contacting surface and view
window.
Blade
movement2 articulating blades move
horizontally1 articulating blade moves
verticallyThe difference does not
influence safety of subject
device. The subject device
should be more effective
because it provides larger
view window with two
articulating blades.
HingeSame as the predicate2-hinge system
Thumb paddle1 on left side, 1 on right
side1 on back sideThe difference does not
cause any safety and
effectiveness concerns.
Actually the subject device
should have better control
with two thumb paddles
Ratchet teethSimilar to the predicateVertical ratchet teeth
View windowAdjustable area (5.8-31
cm²)Fixed area (18 cm²)The difference makes the
subject device more flexible
and effective without safety
concerns
Illumination
systemSame as the predicateBuilt-in LED light with battery
MaterialsPolypropylene and Acrylic
PolycarbonatePolystyreneThe subject and predicate
devices are different in
materials. However, a full
battery of biocompatibility
testing was conducted on the
subject device to ensure
safety
SterilitySterileNon-sterileThe subject device is
provided sterile whereas the
predicate device is not. The
difference makes the subject
device safer
Use lifeSame as the predicateSingle-use, disposable

3

proa
MEDICAL

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K133857 Page 4 of 4

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Image /page/4/Picture/1 description: The image shows the seal of the Department of Health & Human Services - USA. The seal is circular, with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. In the center of the seal is a stylized emblem featuring a symbol of intertwined lines, possibly representing human services or health-related concepts. The emblem is black and stands out against the white background of the seal.

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

April 28, 2014

Proa Medical, Inc. Victoria Nadershahi RA/OA Manager 2512 Artesia Blvd. Suite 305C Redondo Beach, CA 90278

Re: K133857

Trade/Device Name: Brella-Spec Vaginal Speculum Regulation Number: 21 CFR§ 884.4530 Regulation Name: Obstetric-gynecologic specialized manual instrument Regulatory Class: II Product Code: HIB Dated: March 26, 2014 Received: March 27, 2014

Dear Victoria Nadershahi,

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.

5

Page 2 -- Victoria Nadershahi

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/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/ReportalProblem/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 -S

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

6

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Slatement on last page.

510(k) Number (if known)

K133857

Device Name

Brella-Spec Vaginal Speculum

Indications for Use (Describe)

Brella-Spec Vaginal Speculum is used for visualization and exposure of the vagina by a medical professional during gynecological and obstetrical procedures and examinations.

Brella-Spec Vaginal Speculum provides the light necessary to illuminate the field during procedures and examinations.

Type of Use (Select one or both, as applicable)

🇿 Prescription Use (Part 21 CFR 801 Subpart D)

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

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

( ) = = = = = = = FOR EDA USE ONLY = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

Benjamin R. Fisher S.
2014.04.28 14:54:22+04'00'

FORM FDA 3881 (1/14)

7

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