K Number
K153675
Date Cleared
2016-01-15

(25 days)

Product Code
Regulation Number
878.4400
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The ArthroCare ArthroWands are indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures:

Arthroscopic and Orthopedic ProceduresJoint Specific or All Joints (ankle, elbow, hip, knee, shoulder, and wrist)
Ablation and Debridement
• ACL/PCLKnee
• AcromioplastyShoulder
• Articular CartilageAll Joints
• BursectomyAll Joints
• ChondroplastyAll Joints
• FaciaAll Joints
• LigamentAll Joints
• NotchplastyKnee
• Scar TissueAll Joints
• Soft TissueAll Joints
• Subacromial DecompressionShoulder
• SynovectomyAll Joints
• TendonAll Joints
Excision and Resection
• Acetabular LabrumHip
• Articular LabrumAll Joints
• CapsuleAll Joints
• Capsular ReleaseKnee
• Cartilage FlapsKnee
• CystsAll Joints
• Discoid MeniscusKnee
• Frozen Shoulder ReleaseShoulder
• Glenoidale LabrumShoulder
• Lateral ReleaseKnee
• LigamentAll Joints
• Loose BodiesAll Joints
• Meniscal CystectomyKnee
• MeniscectomyKnee
• Plica RemovalAll Joints
• Scar TissueAll Joints
• Soft TissueAll Joints
• Synovial MembraneAll Joints
• TendonAll Joints
• Triangular Fibrocartilage (TFCC)Wrist
• VillusectomyKnee
Coagulation
• ACL/PCLKnee
• Articular CartilageAll Joints
• Carpal LigamentsWrist
Arthroscopic and Orthopedic ProceduresJoint Specific or All Joints (ankle, elbow, hip, knee, shoulder, and wrist)
• Glenohumeral CapsuleShoulder
• LigamentAll Joints
• Medial RetinaculumKnee
• Rotator CuffShoulder
• TendonAll Joints
• Wrist TendonsWrist
Device Description

The ArthroCare ArthroWands are bipolar, single use, sterile, high frequency electrosurgical devices designed for specific indications in arthroscopic and orthopedic procedures.

The Paragon T2 Wand with Integrated Cable is a part of the family of ArthroCare ArthroWands and is specifically indicated for resection, and coagulation of soft tissue, and hemostasis of blood vessels in arthroscopic and orthopedic procedures of the knee.

Consistent with the predicate device, the Paragon T2 Wand with Integrated Cable is compatible with the System 2000, Quantum, Quantum 2, or Atlas System Controller is designed to deliver radiofrequency energy to the active electrode(s) at the distal end of the wand. The Wand is designed for soft tissue procedures where tissue resection, ablation, coagulation, and hemostasis are desired.

The wand consists of an active electrode, temperature indicator epoxy, a return electrode, a spacer, insulation, a connector block, a bent bead blasted shaft, nylon tubing, and a handle that connects via an integrated cable to the controller. The cable consists of wires that communicate with the active and return electrodes as well as the controller.

The Paragon T2 Wand with Integrated Cable is a Coblation wand designed to effectively ablate articular cartilage with minimal thermal effect on surrounding tissue. This Wand incorporates a Temperature Indicating Marker (TIM) as a visual indicator to the user that the temperature around the tip has reached 43°C-57°C degrees.

AI/ML Overview

The provided text does not contain information about the acceptance criteria or a study that proves the device meets specific acceptance criteria in relation to a diagnostic or AI-driven medical device.

The document is a 510(k) premarket notification for the ArthroCare Corporation's Paragon T2 Wand with Integrated Cable. This device is an electrosurgical cutting and coagulation device, not a diagnostic imaging or AI product.

The relevant sections discuss:

  • Performance Data: States that "Performance bench testing, including functional testing, ablation life, and biocompatibility testing were performed on the proposed Paragon T2 Wand with Integrated Cable, which demonstrated the modified temperature sensitive dye met the required specifications."
  • Verification Testing: Lists various electrical and mechanical tests performed, such as "Visual Inspection," "TIM Color Change," "Ablation 1X/2X/3X Life Testing," "Coagulation Testing," and "Dielectric Withstand / HiPot Testing." The reported result is that "Both the Paragon T2 Wand with Integrated Cable and predicate device have substantially equivalent testing specifications and both performed within acceptance criteria. These results support that the Paragon T2 Wand with Integrated Cable and predicate device are substantially equivalent."
  • Biocompatibility Testing: Confirms that "all testing demonstrates that the Paragon T2 Wand with Integrated Cable performs as intended and has acceptable mechanical properties when used in accordance with its labeling."

Therefore, I cannot provide the requested information for acceptance criteria and a study proving a device meets them in the context of AI or diagnostic performance, as this document pertains to a surgical instrument's mechanical and electrical performance.

However, based on the provided text, I can infer a general structure for how such criteria and studies are presented for this specific electrosurgical device:

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

Testing TypeAcceptance Criteria (Implied)Reported Device Performance
Verification TestingPerformance within "substantially equivalent testing specifications" and meeting "required specifications""Both... performed within acceptance criteria."
Visual Inspection(Not explicitly stated, but implies no defects)Performed within acceptance criteria.
TIM Color Change(Not explicitly stated, but implies correct indication)Met required specifications.
Ablation Life (1X, 2X, 3X)(Implies maintaining function for specified life cycles)Performed within acceptance criteria.
Coagulation Testing(Implies effective coagulation within standards)Performed within acceptance criteria.
Dielectric Withstand/HiPot(Implies electrical safety standards met)Performed within acceptance criteria.
Side Load Testing(Implies structural integrity under load)Performed within acceptance criteria.
Temperature Testing(Implies temperature regulation/indication accuracy)Met required specifications for modified temperature sensitive dye.
Accelerated Aging(Implies device integrity over simulated lifespan)Performed within acceptance criteria.
Biocompatibility Testing(Implies compliance with biocompatibility standards)"The Paragon T2 Wand... and the predicate device are biocompatible."

The remaining points (2-9) are not applicable or cannot be answered from the provided text, as they relate to AI/diagnostic studies, which this document does not cover. Specifically:

  1. Sample size used for the test set and the data provenance: Not applicable. The "test set" here refers to physical devices undergoing bench testing, not a dataset of patient cases.
  2. Number of experts used to establish the ground truth for the test set and the qualifications of those experts: Not applicable. Ground truth for electrosurgical device performance is established through engineering and material science standards, not expert consensus on medical images or patient outcomes.
  3. Adjudication method: Not applicable.
  4. If a multi-reader multi-case (MRMC) comparative effectiveness study was done: No, not relevant for this device.
  5. If a standalone (i.e., algorithm only without human-in-the-loop performance) was done: Not applicable.
  6. The type of ground truth used: For this device, the "ground truth" is defined by engineering specifications, material properties, and functional performance standards (e.g., specific thresholds for electrical safety, validated ablation capabilities, and biocompatibility standards).
  7. The sample size for the training set: Not applicable. There is no AI model or "training set."
  8. How the ground truth for the training set was established: Not applicable.

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Image /page/0/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract symbol that resembles a stylized caduceus, with three intertwined strands and three human profiles facing right.

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

January 15, 2016

ArthroCare Corporation Ms. Krystle Danuz Regulatory Affairs Specialist 7000 West William Cannon Drive Austin, Texas 78735

Re: K153675

Trade/Device Name: Paragon T2 Wand with Integrated Cable Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: Class II Product Code: GEI Dated: December 16, 2015 Received: December 21, 2015

Dear Ms. Danuz:

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/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,

Jennifer R. Stevenson -S

For Binita S. Ashar, M.D., M.B.A., F.A.C.S. Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K153675

Device Name Paragon T2 Wand with Integrated Cable

Indications for Use (Describe) Please see attached.

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 FDA USE ONLY

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

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

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Image /page/3/Picture/0 description: The image contains the logo for ArthroCare. The logo consists of a stylized, abstract symbol on the left and the word "ArthroCare" on the right. The symbol is made up of several curved lines, arranged in a way that suggests movement or flow. The word "ArthroCare" is written in a clear, sans-serif font, with the "A" in "ArthroCare" being slightly larger than the other letters.

Indications for Use

The ArthroCare ArthroWands are indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures:

Arthroscopic and Orthopedic ProceduresJoint Specific or All Joints (ankle, elbow,hip, knee, shoulder, and wrist)
Ablation and Debridement
• ACL/PCLKnee
• AcromioplastyShoulder
• Articular CartilageAll Joints
• BursectomyAll Joints
• ChondroplastyAll Joints
• FaciaAll Joints
• LigamentAll Joints
• NotchplastyKnee
• Scar TissueAll Joints
• Soft TissueAll Joints
• Subacromial DecompressionShoulder
• SynovectomyAll Joints
• TendonAll Joints
Excision and Resection
• Acetabular LabrumHip
• Articular LabrumAll Joints
• CapsuleAll Joints
• Capsular ReleaseKnee
• Cartilage FlapsKnee
• CystsAll Joints
• Discoid MeniscusKnee
• Frozen Shoulder ReleaseShoulder
• Glenoidale LabrumShoulder
• Lateral ReleaseKnee
• LigamentAll Joints
• Loose BodiesAll Joints
• Meniscal CystectomyKnee
• MeniscectomyKnee
• Plica RemovalAll Joints
• Scar TissueAll Joints
• Soft TissueAll Joints
• Synovial MembraneAll Joints
• TendonAll Joints
• Triangular Fibrocartilage (TFCC)Wrist
• VillusectomyKnee
Coagulation
• ACL/PCLKnee
• Articular CartilageAll Joints
• Carpal LigamentsWrist
Arthroscopic and Orthopedic ProceduresJoint Specific or All Joints (ankle, elbow, hip, knee, shoulder, and wrist)
• Glenohumeral CapsuleShoulder
• LigamentAll Joints
• Medial RetinaculumKnee
• Rotator CuffShoulder
• TendonAll Joints
• Wrist TendonsWrist

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Image /page/4/Picture/0 description: The image shows the logo for ArthroCare. The logo consists of a red circular design on the left and the word "ArthroCare" in gray on the right. The circular design is made up of several curved lines that come together to form a circle.

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Image /page/5/Picture/0 description: The image contains the logo for ArthroCare. The logo consists of a circular design on the left, made up of several curved lines in a maroon color. To the right of the circular design is the word "ArthroCare" in a gray, sans-serif font. The word is slightly italicized, giving it a sense of movement.

510(k) Summary

ArthroCare Corporation Paragon T2 Wand with Integrated Cable

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR 807.92.

General Information

Submitter Name:ArthroCare Corporation
Address7000 West William Cannon DriveAustin, TX 78735
Contact Person:Ms. Krystle Danuz, B.A., B.S.Regulatory Affairs SpecialistPhone: 512-385-5769Fax: 512-895-1489
Date Prepared:December 16, 2015
Device Name
Proprietary Name:Paragon T2 Wand with Integrated Cable
Common Name:Electrosurgical devices and accessories
Classification Name:Electrosurgical cutting and coagulation device and accessories
Device Class:Class II
Product Code:GEI
CFR Section:21 CFR 878.4400
Predicate Device

ArthroCare ArthroWands (Paragon T2 Wand with Integrated Cable)

K033584 (November 28, 2003)

Description

The ArthroCare ArthroWands are bipolar, single use, sterile, high frequency electrosurgical devices designed for specific indications in arthroscopic and orthopedic procedures.

The Paragon T2 Wand with Integrated Cable is a part of the family of ArthroCare ArthroWands and is specifically indicated for resection, and coagulation of soft tissue, and hemostasis of blood vessels in arthroscopic and orthopedic procedures of the knee.

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Consistent with the predicate device, the Paragon T2 Wand with Integrated Cable is compatible with the System 2000, Quantum, Quantum 2, or Atlas System Controller is designed to deliver radiofrequency energy to the active electrode(s) at the distal end of the wand. The Wand is designed for soft tissue procedures where tissue resection, ablation, coagulation, and hemostasis are desired.

The wand consists of an active electrode, temperature indicator epoxy, a return electrode, a spacer, insulation, a connector block, a bent bead blasted shaft, nylon tubing, and a handle that connects via an integrated cable to the controller. The cable consists of wires that communicate with the active and return electrodes as well as the controller.

The Paragon T2 Wand with Integrated Cable is a Coblation wand designed to effectively ablate articular cartilage with minimal thermal effect on surrounding tissue. This Wand incorporates a Temperature Indicating Marker (TIM) as a visual indicator to the user that the temperature around the tip has reached 43°C-57°C degrees.

Intended Use/Indications For Use

The ArthroCare ArthroWands are indicated for resection, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures:

Arthroscopic and Orthopedic ProceduresJoint Specific or All Joints(ankle, elbow, hip, knee,shoulder, and wrist)
Ablation and Debridement
• ACL/PCLKnee
• AcromioplastyShoulder
• Articular CartilageAll Joints
• BursectomyAll Joints
• ChondroplastyAll Joints
• FaciaAll Joints
• LigamentAll Joints
• NotchplastyKnee
• Scar TissueAll Joints
• Soft TissueAll Joints
• Subacromial DecompressionShoulder
• SynovectomyAll Joints
• TendonAll Joints
Excision and Resection
• Acetabular LabrumHip
• Articular LabrumAll Joints
• CapsuleAll Joints
• Capsular ReleaseKnee
• Cartilage FlapsKnee
• CystsAll Joints
• Discoid MeniscusKnee
• Frozen Shoulder ReleaseShoulder
• Glenoidale LabrumShoulder
• Lateral ReleaseKnee

{7}------------------------------------------------

Arthroscopic and Orthopedic ProceduresJoint Specific or All Joints(ankle, elbow, hip, knee,shoulder, and wrist)
LigamentAll Joints
Loose BodiesAll Joints
Meniscal CystectomyKnee
MeniscectomyKnee
Plica RemovalAll Joints
Scar TissueAll Joints
Soft TissueAll Joints
Synovial MembraneAll Joints
TendonAll Joints
Triangular Fibrocartilage (TFCC)Wrist
VillusectomyKnee
Coagulation
ACL/PCLKnee
Articular CartilageAll Joints
Carpal LigamentsWrist
Glenohumeral CapsuleShoulder
LigamentAll Joints
Medial RetinaculumKnee
Rotator CuffShoulder
TendonAll Joints
Wrist TendonsWrist

Summary of Technological Characteristics

No changes or modifications have been made to the indications for use, technology, or principle of operation previously cleared in 510(k) K033584. The following table represents a summary of the technological characteristics of the modified device.

PREDICATE DEVICE:ArthroCare ArthroWands(K033584)MODIFIED DEVICE:Paragon T2 Wand with IntegratedCable
ElectricalSafety/EMCIEC 60601-2-2 compliantSame as predicate
ElectrodeConfigurationsStraight, Screen, Loop, Sheet,"Multi-Electrodes in Series",TubeLoop
Spacer ConfigurationsMulti-Lumen, Single Lumen (Tube)Single Lumen
Rigid ConstructionYesSame as predicate
Single use disposableYesSame as predicate
Operates in salineenvironmentYesSame as predicate
Bipolar/monopolarBipolarSame as predicate
ActivationFoot Control, Hand Switch orWand with Integrated FingerSwitchHand Switch or Foot Control

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Coagulation VoltageSettingNon-adjustable (1 set point)Adjustable (3 set points),2 Active Set PointsAdjustable (3 set points)
TemperatureIndicating MarkerYesYes
Bendable ShaftFeatureNoYes
Patient UsageSingle UseSame as predicate
SterilizationIrradiation to SAL of 10-6Same as predicate

Clinical Data

No clinical data are included in this submission.

Performance Data

Performance bench testing, including functional testing, ablation life, and biocompatibility testing were performed on the proposed Paragon T2 Wand with Integrated Cable, which demonstrated the modified temperature sensitive dye met the required specifications.

Testing TypeTest DescriptionResult Supporting SubstantialEquivalence
VerificationTesting■ Visual Inspection■ TIM Color Change (Pre-Ablation andPost-1X Life Ablation)■ Ablation 1X Life / 1st Insertion Testing■ Ablation 2X Life Testing■ Ablation 3X Life Testing at MaximumSet Point■ Coagulation Testing■ Dielectric Withstand / HiPot Testing■ Side Load Testing■ Ablation Testing■ Temperature Testing■ Accelerated AgingBoth the Paragon T2 Wand withIntegrated Cable and predicatedevice have substantiallyequivalent testing specificationsand both performed withinacceptance criteria. These resultssupport that the Paragon T2 Wandwith Integrated Cable andpredicate device are substantiallyequivalent.
BiocompatibilityTesting■ Cytotoxicity■ Sensitization■ Irritation■ Toxicity■ Chemical AnalysisThe Paragon T2 Wand withIntegrated Cable and the predicatedevice are biocompatible. Theseresults support that the Paragon T2Wand with Integrated Cable andpredicate device are substantiallyequivalent.

Conclusion

All testing demonstrates that the Paragon T2 Wand with Integrated Cable performs as intended and has acceptable mechanical properties when used in accordance with its labeling.

As the intended use, operating principle, materials and technological characteristics are unchanged from the predicate device, the Paragon T2 Wands with Integrated Cable are substantially equivalent. The modifications do not affect the safety or efficacy of the devices.

§ 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.