K Number
K141136
Device Name
LEICA FL800
Date Cleared
2014-08-19

(110 days)

Product Code
Regulation Number
892.1600
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Leica FL800 is a Leica Surgical Microscope accessory used in viewing intra-operative blood flow in the cerebral vascular area and bypass grafts during coronary artery bypass (CABG) surgery, as well as blood flow during plastic and reconstructive surgery.
Device Description
The Leica FL800 device is an accessory to the Leica surgical microscopes. It allows the surgical microscope to produce excitation light and resolve fluorescence light from the fluorescent agent ICG. The generated fluorescence signal depicts the distribution of the infra-red dye in the patient's blood vessels during the operation (fluorescence video angiography).
More Information

Not Found

No
The summary describes a fluorescence imaging accessory for a surgical microscope that visualizes blood flow using a fluorescent agent. There is no mention of AI, ML, image processing beyond basic visualization, or any data processing that would suggest the use of such technologies.

No
The device is used for "viewing intra-operative blood flow" and "depicts the distribution of the infra-red dye," indicating it is a diagnostic or imaging accessory, not a therapeutic device.

Yes

Explanation: The device allows for viewing of intra-operative blood flow to "depict the distribution of the infra-red dye in the patient's blood vessels during the operation (fluorescence video angiography)," which provides visual information to the surgeon to help diagnose blood flow issues or confirm successful bypass grafts.

No

The device is described as an "accessory to the Leica surgical microscopes" and allows the microscope to "produce excitation light and resolve fluorescence light." This clearly indicates the presence of hardware components that interact with the physical world (light generation and detection), not just software processing.

Based on the provided information, the Leica FL800 is not an In Vitro Diagnostic (IVD).

Here's why:

  • IVDs are used to examine specimens derived from the human body. The Leica FL800 is used to visualize blood flow within the patient's body during surgery. It does not analyze samples taken from the patient.
  • The intended use describes direct visualization during surgical procedures. The device is an accessory to a surgical microscope and is used for real-time viewing of blood flow in vivo.
  • The device description focuses on generating and resolving fluorescence light from a fluorescent agent within the patient. This is an in-vivo imaging technique, not an in-vitro diagnostic test.

Therefore, the Leica FL800 falls under the category of an in-vivo imaging device used during surgery, not an IVD.

N/A

Intended Use / Indications for Use

The Leica FL800 is a Leica Surgical Microscope accessory used in viewing intra-operative blood flow in the cerebral vascular area and bypass grafts during coronary artery bypass (CABG) surgery, as well as blood flow during plastic and reconstructive surgery.

The Leica FL800is a Leica Surgical Microscope accessory used in viewing intra-operative blood flow in the cerebral vascular area, blood flow of the coronary vascular and bypass grafts during coronary artery bypass (CABG) surgery, as well as blood flow during plastic and reconstructive surgery.

Product codes

IZI, EPT

Device Description

The Leica FL800 device is an accessory to the Leica surgical microscopes. It allows the surgical microscope to produce excitation light and resolve fluorescence light from the fluorescent agent ICG. The generated fluorescence signal depicts the distribution of the infra-red dye in the patient's blood vessels during the operation (fluorescence video angiography).

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Fluorescence video angiography

Anatomical Site

cerebral vascular area, coronary vascular and bypass grafts

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Surgeon, operating room staff

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)

Not Found

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

Not Found

Predicate Device(s)

K061871, K080612

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

§ 892.1600 Angiographic x-ray system.

(a)
Identification. An angiographic x-ray system is a device intended for radiologic visualization of the heart, blood vessels, or lymphatic system during or after injection of a contrast medium. This generic type of device may include signal analysis and display equipment, patient and equipment supports, component parts, and accessories.(b)
Classification. Class II.

0

Image /page/0/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized representation of three human profiles facing right, arranged in a way that suggests unity and connection. The profiles are black and are set against a white background. Encircling the profiles are the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" in a circular arrangement.

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

August 19, 2014

Leica Biosystems Richmond, Inc. Barbara-Ann Conway-Myers Senior Regulatory Affairs Specialist 5205 Route 12 Richmond, Illinois 60071

Re: K141136

Trade/Device Name: Leica FL800 Regulation Number: 21 CFR 892.1600 Regulatory Name: Angiographic x-ray system Regulatory Class: Class II Product Code: IZI Dated: May 16, 2014 Received: May 21, 2014

Dear Ms. Conway-Myers:

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

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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 Industry and Consumer Education 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. 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 Industry and Consumer Education 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,

David Krause -S

Binita S. Ashar, M.D., M.B.A., F.A.C.S. for Director

Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

cc: Enclosed

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Indications for Use

510(k) Number (if known) K141136

Device Name Leica FL800

Indications for Use (Describe)

The Leica FL800 is a Leica Surgical Microscope accessory used in viewing intra-operative blood flow in the cerebral vascular area and bypass grafts during coronary artery bypass (CABG) surgery, as well as blood flow during plastic and reconstructive surgery.

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

2 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 FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

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K141136

Section 5- 510(k) Summary of Safety and Effectiveness

Submitter Leica Biosystems Richmond, Inc 5205 Route 12 Richmond, IL 60071 Barbara-Ann Conway-Myers - Contact Person April 24, 2014 - Date Summary was Prepared

Device Name:

  • Trade Name Leica FL800 ●
  • Common Name - Fluorescent Angiographic System
  • Classification Name System, X-Ray, Anqiographic per 21 CFR 892.1600 ●
  • FDA Product Code IZI; subsequent product code is EPT (Surgical Microscope and Accessory) ●

Devices for Which Substantial Equivalence in Claimed:

  • Leica Microsystems (Schweiz) AG, Leica FL800 (K061871)
  • Leica Microsystems (Schweiz) AG, Leica FL800 (K080612)

Device Description:

The Leica FL800 device is an accessory to the Leica surgical microscopes. It allows the surgical microscope to produce excitation light and resolve fluorescence light from the fluorescent agent ICG. The generated fluorescence signal depicts the distribution of the infra-red dye in the patient's blood vessels during the operation (fluorescence video angiography).

Intended Use of the Device:

The Leica FL800is a Leica Surgical Microscope accessory used in viewing intra-operative blood flow in the cerebral vascular area, blood flow of the coronary vascular and bypass grafts during coronary artery bypass (CABG) surgery, as well as blood flow during plastic and reconstructive surgery.

Substantial Equivalence:

The Leica FL800 is an existing device which was granted market clearance by the FDA following the submission of a 510(k) pre-market notification (K061871 and K080612). Leica Microsystems seeks only to include a variant of the Leica FL800 which is a modification of the existing devices cleared under the two 510(k) mentioned above. There will be no change to the intended use of the device nor the alteration of the device's fundamental scientific technology.

The table below depicts the modifications associated with the Leica FL800 variant.

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Image /page/4/Picture/1 description: The image shows the logo for Leica Biosystems. The word "Leica" is written in a stylized red font. Below the word "Leica" is the word "BIOSYSTEMS" written in a smaller, sans-serif font. The logo is simple and modern.

Proposed Accessory Description
K061871K080612Leica FL800Leica FL800 ULT
Standard Leica M520 OH3
Microscope (Class I
exempt)Additional Leica Surgical
Microscopes available for
use with the Leica FL800
as a result of extension to
indications for use.Accessory to Leica Surgical Microscopes intended for defined surgeries
Sony XC-E1 50 NIR (near
infra-red) camera (part of
Leica FL800 upgrade)No changeExternal NIR Camera
ICG FilterDual Video Adaptor
consisting of
• Internal NIR
Camera
Leica Dual CCD Surgical
Microscope Camera
Adapter (part of Leica
FL800 upgrade)No ChangeDual Video Adaptor
• Beam Splitter
• Beam Mirror• ICG Filter
• Beam Splitter
Leica modification of
standard 300 Watt Xe light
source (part of Leica
FL800 upgrade)Introduced possibility to
use 400Watt Xe
illumination as supplied on
some Leica Surgical
MicroscopesLight Source part of the Leica Surgical Microscope
Leica FL800 electronic
control unit (part of the
FL800 upgrade)No ChangeNo ChangeNo Change
ICG Fluorescence Dye
(labelled for use with the
Leica FL800)No ChangeNot part of the Leica System

Table 1: Comparison of Predicate devices (K061871 and K080612) to the Leica FL800 variant

Standards Used in Demonstrating Conformance

The Leica FL800 device is an accessory to the Leica surgical microscopes and as an accessory was not individually tested to any recognized standard. However, this accessary was tested in combination with the Leica surgical microscopes to demonstrate that it did not neqatively impact the safety and effectiveness of the Surgical Microscope.

For Electromagnetic Compatibility (EMC) the Leica FL800 ULT has been tested and showed conformance to standard IEC 60601-1-2 Edition 3:2007.

For Electrical Safety the Leica FL800 ULT has been tested and showed conformance to standard IEC 60601-1 Edition 3:2005.

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Image /page/5/Picture/1 description: The image shows the logo for Leica Biosystems. The logo consists of the word "Leica" in a stylized, red font. Below the word "Leica" is the word "BIOSYSTEMS" in a smaller, black font. The logo is simple and modern.

Conclusion

The modification of the Leica FL800 (variant) consists of the relocation of this accessory from an external configuration to an internal configuration which services 2 distinct advantages:

  • It decreases the likelihood of any external disturbances to the Leica FL800 either by the surgeon . or the operating room staff.
  • . The aesthetically pleasing design makes the device more ergonomic which is a value to the surgeon.

There is no alteration to either the intended use or the device's fundamental scientific technology and for this reason, Leica Microsystems seeks a Special 510k for the clearance of this device.