K Number
K142249
Device Name
SCHOELLY SINUSCOPE
Date Cleared
2015-01-27

(166 days)

Product Code
Regulation Number
874.4760
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Schoelly Sinuscope is intended for use in otolaryngology and Head and Neck procedures, including thinology, and endoscopic plastic and reconstructive surgery.
Device Description
The Schoelly Sinuscope is a rigid reusable endoscope for visualization during Otolaryngology-Head and Neck surgery in conjunction with a commercially available and approved light guide, light source, video camera, monitor, and printer. Light source, video camera, monitor, and printer are not included in the scope of delivery and are further not within the scope of this application. Schoelly Sinuscopes are manufactured in multiple configurations that differ in insertion tube outer diameter and working length and with respect to optical parameters (direction of view, field of view). Several models of the Schoelly Sinuscope have already been cleared for marketing by FDA (K133682) for the visualization during arthroscopic procedures. Like other currently marketed sinuscopes, Schoelly Sinuscopes have outer surfaces mainly made from metal (Phynox cobalt-nickel-chromium alloy, 304 stainless steel) and further comprise fiber optics for light transmission and rigid rod-lenses for image transmission. The Schoelly Sinuscope is delivered in a non-sterile condition and is already CE marked.
More Information

No
The device description and performance testing focus on the physical and optical properties of a rigid endoscope, with no mention of software, image processing, or AI/ML capabilities.

No
The device is a rigid endoscope for visualization during surgical procedures, not a device that directly or indirectly treats medical conditions.

No

Explanation: The device is described as a "rigid reusable endoscope for visualization during Otolaryngology-Head and Neck surgery." Its purpose is to provide visualization, not to diagnose a condition. It is a tool for a surgeon to see during a procedure.

No

The device description explicitly states the device is a rigid reusable endoscope made from metal, fiber optics, and rigid rod-lenses, which are all hardware components.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for visualization during surgical procedures in otolaryngology and Head and Neck. This is a direct visualization tool used in vivo (within the body) to aid the surgeon.
  • Device Description: The description clearly states it's a rigid reusable endoscope for visualization. It transmits light and images from within the body to an external display.
  • Lack of Diagnostic Testing: IVD devices are used to examine specimens (like blood, tissue, or urine) in vitro (outside the body) to provide information for diagnosis, monitoring, or screening. This device does not perform any such testing on specimens.
  • Focus on Visualization: The entire description and performance testing focus on the device's ability to provide clear visualization and its physical properties for surgical use.

The Schoelly Sinuscope is a surgical instrument used for direct visualization during procedures, not a device for performing diagnostic tests on biological samples.

N/A

Intended Use / Indications for Use

The Schoelly Sinuscope is intended for use in otolaryngology and Head and Neck procedures, including thinology, and endoscopic plastic and reconstructive surgery.

Product codes

EOB

Device Description

The Schoelly Sinuscope is a rigid reusable endoscope for visualization during Otolaryngology-Head and Neck surgery in conjunction with a commercially available and approved light guide, light source, video camera, monitor, and printer. Light source, video camera, monitor, and printer are not included in the scope of delivery and are further not within the scope of this application.

Schoelly Sinuscopes are manufactured in multiple configurations that differ in insertion tube outer diameter and working length and with respect to optical parameters (direction of view, field of view). Several models of the Schoelly Sinuscope have already been cleared for marketing by FDA (K133682) for the visualization during arthroscopic procedures.

Like other currently marketed sinuscopes, Schoelly Sinuscopes have outer surfaces mainly made from metal (Phynox cobalt-nickel-chromium alloy, 304 stainless steel) and further comprise fiber optics for light transmission and rigid rod-lenses for image transmission.

The Schoelly Sinuscope is delivered in a non-sterile condition and is already CE marked.

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

The Schoelly Sinuscope was subjected to temperature, optical parameter, biocompatibility and performance testing with identical acceptance criteria for the Schoelly and the predicate devices. The results of this testing demonstrated that the Schoelly Sinuscope has met pre-determined acceptance criteria and is substantially equivalent to the predicate device. The risks associated with the use of the new device were found acceptable when evaluated in accordance with ISO 14971. Risks and benefits of predicate device are the same as compared to the Schoelly Sinuscope.

Temperature testing: The device was measured for surface temperatures at various locations over time using different light sources and found to meet requirements specified in IEC 60601-2-18 and IEC 60601-1.

Optical parameter testing: The device was tested for all relevant optical parameters and found to meet the minimum requirements defined in internal specifications and as specified in the ISO 8600 series of standards (field of view, direction of view, diopters, image eccentricity, size of view, and vignetting).

Biocompatibility testing: A series of biocompatibility testing according to ISO 10993, including cytotoxicity, sensitization, irritation, and acute systemic toxicity, demonstrated that the device components that are in contact with the patient are biocompatible.

Performance testing: Performance testing consisted of measurement of the bonding strength for the Sinuscope distal glass, with comparison to the distal glass bonding strength of the currently marketed predicate device.

Key Metrics

Not Found

Predicate Device(s)

K965233

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 874.4760 Nasopharyngoscope (flexible or rigid) and accessories.

(a)
Identification. A nasopharyngoscope (flexible or rigid) and accessories is a tubular endoscopic device with any of a group of accessory devices which attach to the nasopharyngoscope and is intended to examine or treat the nasal cavity and nasal pharynx. It is typically used with a fiberoptic light source and carrier to provide illumination. The device is made of materials such as stainless steel and flexible plastic. This generic type of device includes the antroscope, nasopharyngolaryngoscope, nasosinuscope, nasoscope, postrhinoscope, rhinoscope, salpingoscope, flexible foreign body claw, flexible biopsy forceps, rigid biopsy curette, flexible biospy brush, rigid biopsy forceps and flexible biopsy curette, but excludes the fiberoptic light source and carrier.(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 a human figure, with three overlapping profiles facing to the right. The profiles are rendered in black and are connected by flowing lines. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circular pattern around the figure.

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

January 27, 2015

Schoelly Fiberoptic Gmbh % Ms. Pamela Papineau, RAC President Delphi Medical Device Consulting, Inc. 5 Whitcomb Ave Ayer, Massachusetts 01432

K142249 Trade/Device Name: Schoelly Sinuscope Regulation Number: 21 CFR 874.4760 Regulation Name: Nasopharyngoscope (Flexible or Rigid) And Accessories Regulatory Class: Class II Product Code: EOB Dated: December 22, 2014 Received: December 24, 2014

Dear Ms. Papineau:

Re:

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 devicerelated adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in

1

the quality systems (OS) 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/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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,

Eric A. Mann -S

for Malvina B. Eydelman, M.D. Director Division of Ophthalmic and Ear, Nose, and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known)

Device Name Schoelly Sinuscope

Indications for Use (Describe)

The Schoelly Sinuscope is intended for use in otolaryngology and Head and Neck procedures, including thinology, and endoscopic plastic and reconstructive surgery.

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

X Prescription Use (Part 21 CFR 801 Subpart D)

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

CONTINUE ON A SEPARATE PAGE IF NEEDED.

This section applies only to requirements of the Paperwork Reduction Act of 1995.

DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff(@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

3

K142249 - 510(k) Summary

General Information

Preparation date:11/24/2014
Owner's Name:Schoelly Fiberoptic GmbH (Registration: 8043903)
Address:Robert-Bosch-Str. 1 - 3
79211 Denzlingen
Germany
Telephone Number:+49-7666-980-0
Fax Number:+49-7666-908-380
Contact Person:Dr. Sandra Baumann
Subject Device Name:Schoelly Sinuscope
Trade Name:Schoelly Sinuscope
Common/Usual Name:Sinuscope
Classification Name:EOB - Nasopharyngoscope (flexible or rigid)
21 CFR 874.4760; Class II
Predicate Device Name:SHARPSITE Ac
Trade Name:SHARPSITE Ac
Common/Usual Name:Rigid Rod Lense Endoscope
Classification Name:EOB - Nasopharyngoscope (flexible or rigid)
21 CFR 874.4760; Class II
Premarket Notification:K965233, Medtronic Xomed Inc., SE date April 4, 1997

Device Description

The Schoelly Sinuscope is a rigid reusable endoscope for visualization during Otolaryngology-Head and Neck surgery in conjunction with a commercially available and approved light guide, light source, video camera, monitor, and printer. Light source, video camera, monitor, and printer are not included in the scope of delivery and are further not within the scope of this application.

Schoelly Sinuscopes are manufactured in multiple configurations that differ in insertion tube outer diameter and working length and with respect to optical parameters (direction of view, field of view). Several models of the Schoelly Sinuscope have already been cleared for marketing by FDA (K133682) for the visualization during arthroscopic procedures.

Like other currently marketed sinuscopes, Schoelly Sinuscopes have outer surfaces mainly made from metal (Phynox cobalt-nickel-chromium alloy, 304 stainless steel) and further comprise fiber optics for light transmission and rigid rod-lenses for image transmission.

The Schoelly Sinuscope is delivered in a non-sterile condition and is already CE marked.

4

Technological Characteristics

Light that is created by an external light source is transmitted from the Sinuscope light guide connector through the Sinuscope itself to the tip via a fiber optic system. Images are transferred the other way back through a rigid rod lens system. Technical parameters of the Schoelly Sinuscopes that characterize the optical view are the Direction of View (0°-70°) and the Field of View (80°-100°). The image can be displayed by a camera/monitor system which can be connected to the Sinuscope eyepiece. The Schoelly Sinuscopes are available in two different configurations for the insertion tube: 4mm diameter, working length 175mm and 2.7mm diameter, working length 110mm. All configurations of the Schoelly Sinuscope do not have any working channel.

A detailed comparison of the technological characteristics with the predicate device is shown in the table below.

| | Proposed
Device
(current submission) | Predicate
Device (K965233) |
|--------------------------------------|-----------------------------------------------------------------|-----------------------------------------------------------------|
| Attribute | | |
| Light
transmission | Fiber optics | Fiber optics |
| Light source | External, connected via light
guide to light guide connector | External, connected via light
guide to light guide connector |
| Image
transmission | Rigid rod lenses | Rigid rod lenses |
| Direction of
view | $0°-70°$ | $0°-70°$ |
| Field of view | $80°-100°$ | $80°-100°$ |
| Image display | Camera/monitor connected via
the endoscope eyepiece | Camera/monitor connected via
the endoscope eyepiece |
| Working
channel | none | none |
| Single Use /
Reusable | Reusable | Reusable |
| Reprocessing | Cleaning, sterilization (steam,
STERRAD®) | Cleaning, sterilization (steam,
STERRAD®, EtO) |
| Materials | | |
| - insertion tube
(outer surface) | stainless steel, Co-Cr-Ni alloy | stainless steel |
| - insertion part
(distal surface) | stainless steel, glass | stainless steel, glass |
| - fiber optics | glass fibers | glass fibers |
| - lens bonding | AuSn brazing alloy, epoxy | epoxy |

Table 5.1 Technological Characteristics of the Proposed Device and the Predicate Device

5

| Attribute | Proposed
Device
(current submission) | Predicate
Device (K965233) |
|------------------------|--------------------------------------------|-------------------------------|
| Temperature
testing | IEC 60601-2-18 compliant | IEC 60601-2-18 compliant |
| Packaging | Case with foam insert | Case with foam insert |

Indications for Use

The Schoelly Sinuscope is intended for use in otolaryngology and Head and Neck procedures, including rhinology, and endoscopic plastic and reconstructive surgery.

The indications for use of the proposed devices are identical to the indications for use of the Medtronic predicate device.

Non-clinical Performance Testing

The Schoelly Sinuscope was subjected to temperature, optical parameter, biocompatibility and performance testing with identical acceptance criteria for the Schoelly and the predicate devices. The results of this testing demonstrated that the Schoelly Sinuscope has met pre-determined acceptance criteria and is substantially equivalent to the predicate device. The risks associated with the use of the new device were found acceptable when evaluated in accordance with ISO 14971. Risks and benefits of predicate device are the same as compared to the Schoelly Sinuscope.

Temperature testing: The device was measured for surface temperatures at various locations over time using different light sources and found to meet requirements specified in IEC 60601-2-18 and IEC 60601-1.

Optical parameter testing: The device was tested for all relevant optical parameters and found to meet the minimum requirements defined in internal specifications and as specified in the ISO 8600 series of standards (field of view, direction of view, diopters, image eccentricity, size of view, and vignetting).

Biocompatibility testing: A series of biocompatibility testing according to ISO 10993, including cytotoxicity, sensitization, irritation, and acute systemic toxicity, demonstrated that the device components that are in contact with the patient are biocompatible.

Performance testing: Performance testing consisted of measurement of the bonding strength for the Sinuscope distal glass, with comparison to the distal glass bonding strength of the currently marketed predicate device.

Reprocessing

The Schoelly Sinuscope is the subject of completed reprocessing validations including manual cleaning, automated cleaning, steam sterilization, as well as STERRAD® 100S, STERRAD® 100NX and STERRAD® NX sterilization.

Cleaning studies have been performed in accordance with AAMI TIR12:2010 (Designing. Testing and Labeling Reusable Medical Devices for Reprocessing in Health Care Facilities: A

6

Guide for Device Manufacturers), AAMI TIR30:2011 (A compendium of processes, materials, test methods, and acceptance criteria for cleaning reusable devices), and ANSI/AAMI ST15883-1: 2009 (Washer-disinfectors - Part 1 - General requirements, terms, and definitions and tests). Devices that have been used for testing had been undergo multiple reprocessing cycles and surface marring artificially created by scratching with metal tools to simulate end of lifetime use and to address the FDA Draft Guidance Processing Medical Devices in Healthcare Settings (dated: May 2, 2011).

Sterilization studies have been performed in accordance with ISO 14937:2009 (Sterilization of health care products - General requirements for characterization of sterilizing agent and the development, validation and routine control of a sterilization process for medical devices), ANSI/AAMI ST81:2004 (Sterilization of medical devices - Information to be provided by the manufacturer for the processing of resterilizable medical devices), ISO 17664:2004 (Sterilization of medical devices - Information to be provided by the manufacturer for the processing of resterilizable medical devices), and ANSI/AAMI/ISO 17665-1:2006 (Sterilization of health care products - Moist heat - Requirements for the development, validation and routine control of sterilization process for medical devices).

Conclusion

The Schoelly Sinuscope meets all the pre-determined acceptance criteria of the testing performed to demonstrate substantial equivalence to the predicate device.