K Number
K150248
Date Cleared
2015-07-23

(170 days)

Product Code
Regulation Number
874.4760
Panel
EN
Reference & Predicate Devices
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Jedmed ORL Video Nasopharyngo-Laryngoscopes are intended to examine the larynx, nasal cavity and nasal pharynx. They are used between the upper respiratory tracts of the nasal passage and vocal cords.

Device Description

This flexible scope is designed with the insertion tube with its bendable distal tip w/camera, the handle, the umbilical unit which has the leakage tester, and connection for light source port and power/video port The handle incorporates the control lever to bend the distal tip.

AI/ML Overview

The provided text describes a 510(k) premarket notification for the "ORL Video Nasopharyngo-Laryngoscope." It references a study conducted to demonstrate substantial equivalence to predicate devices, but it does not describe an AI medical device or a study involving AI. Therefore, I will respond to the prompt by extracting the relevant information about the non-AI device's acceptance criteria and study, indicating where certain AI-specific questions are not applicable.

Here's the information extracted from the provided text, formatted to address your questions:


Acceptance Criteria and Device Performance Study for the ORL Video Nasopharyngo-Laryngoscope

This document describes a 510(k) premarket notification for a medical device that does not involve Artificial Intelligence (AI). The study conducted was to demonstrate substantial equivalence to predicate devices based on functional performance and cleaning/disinfection validation.

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

The document does not explicitly list "acceptance criteria" for the functional tests with specific numerical targets. Instead, it states that the device was "found to be comparable" to the predicate device in several functional areas. The table below compares the specifications of the device under review with its predicate devices. The "acceptance criteria" here implicitly means that the performance values should be similar to or within acceptable ranges of the predicate devices for achieving substantial equivalence.

FeaturePredicate Device (K132039) Performance / CriteriaDevice Under Review Performance
Field of View90°90°
Depth of View10mm-55mm10mm-55mm
Angulation (Up/Down)130° Up / 130° Down130° Up / 130° Down
Working Length310mm310mm
Tube Diameter4mm4mm
Video FormatNTSC---PALNTSC---PAL/NTSC
Resolution320x240 & 500x582/510x492320x240 500x582 510x492
Cleaning/DisinfectionSignificant microbial reduction (implied)Fully met validation requirements

Predicate Device (K102733) Differences Noted:

  • Working Length: 300mm (Device under review: 310mm)
  • Depth of View: 3mm-50mm (Device under review: 10mm-55mm)
  • Tube Diameter: 3mm (Device under review: 4mm)
  • Angulation: 140° Up / 140° Down (Device under review: 130° Up / 130° Down)
  • Product Code: EOB and HRX and GCJ (Device under review: EQN)
  • Resolution: (Not explicitly stated for K102733, but K132039 provides a direct comparison)

2. Sample size used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

The document does not specify a "sample size" in terms of number of patients or cases for the functional comparison. Instead, the "test set" consisted of the ORL Video Nasopharyngo-Laryngoscope itself and the predicate device (ErgoFlex Naso-Pharyngo-Laryngoscope K132039) which were tested in a controlled environment.

  • Sample Size for Functional Test: Two devices (the new device and one predicate).
  • Sample Size for Cleaning/Disinfection Test: The ORL Video Naso-Pharyngo-Laryngoscope.
  • Data Provenance: The testing appears to have been conducted by the manufacturer (JEDMED Instrument Company) or a contracted laboratory (Geneva Laboratories for disinfection). The location is implied to be in the USA (St. Louis, Missouri). This was a prospective test conducted for the purpose of this 510(k) submission.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

For the functional testing, the comparison was performed by "knowledgeable field staff." The document does not specify the exact number of staff or their detailed qualifications (e.g., years of experience, specific certifications). For the cleaning and high-level disinfection test, it was performed by "Geneva Laboratories per the IFU," implying qualified laboratory personnel.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

This question is not applicable as the study described is a technical comparison of device specifications and functional performance, not a clinical trial requiring ground truth adjudication by multiple experts for diagnostic outputs.

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

This question is not applicable as the device is not an AI medical device, and no MRMC study was conducted. The study was a comparison of device specifications and a validation of cleaning/disinfection.

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

This question is not applicable as the device is not an AI medical device. The functional comparison focuses on the device's inherent physical and optical characteristics.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

For the functional tests (Field of View, Depth of View, Angulation, Color Output, Clarity, Tip Diameter), the "ground truth" was established by direct measurement and observation of the device's technical specifications and performance against the known specifications of the predicate device.

For the cleaning and high-level disinfection test, the ground truth was microbiological reduction efficacy, validated against established standards for sterilization/disinfection (implied by "significant level of microbial reduction must result from tests for both vegetative microorganisms and mycobacteria").

8. The sample size for the training set

This question is not applicable as the device is not an AI medical device and does not involve a training set.

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

This question is not applicable as the device is not an AI medical device and does not involve a training set.

§ 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.