K Number
K162436
Device Name
EndoVac Pure
Manufacturer
Date Cleared
2016-12-21

(112 days)

Product Code
Regulation Number
872.4200
Panel
Dental
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The EndoVac™ Pure System is intended for the delivery and evacuation of endodontic irrigation solutions and removing debris of injured or necrotic pulp tissue during root canal procedures.

Device Description

The EndoVac Pure™ system builds on the EndoVac System and presents a unique way to irrigate during root canal treatments. The system is an apical negative pressure system that draws fluid apically by way of evacuation, reducing the risk of apical irrigant extrusion during root canal procedures. The vacuum is routed through the system and controlled independently through the dental chair vacuum system. The fluid delivery is controlled by peristaltic pumps. The pumps are driven by Printed Circuit Board Assemblies (PCBA) and controlled by Field Programmable Gate Array (FPGA) configuration files.

AI/ML Overview

Here's an analysis of the provided text regarding the acceptance criteria and study information for the EndoVac Pure device:

1. Table of Acceptance Criteria and Reported Device Performance

The document does not explicitly present a table of "acceptance criteria" with direct performance metrics alongside the reported performance of the EndoVac Pure. Instead, it details various "performance tests were conducted as part of design verification" and then provides a comparison table (Table 7.1) outlining technological characteristics between the proposed EndoVac Pure and its predicate device. This comparison implicitly serves as evidence of meeting performance requirements by demonstrating similarity to a legally marketed device.

Therefore, the table below is constructed by interpreting the "Technological Characteristics Non-Clinical Performance Data" section and the "Predicate and Proposed Device Comparison Table" (Table 7.1) as the reported performance, and the fact that these tests were conducted as "design verification" implies they met established internal acceptance criteria for substantial equivalence to the predicate.

Acceptance Criteria (Implied by Design Verification & Predicate Equivalence)Reported Device Performance (EndoVac Pure)
Functional Performance:
Flow Rate Delivery and SelectionPerformed, met design requirements
Suction Flow Rate Performance (MicroCannula)5ml/min ± 15%
Suction Flow Rate Performance (MacroCannula)40ml/min ± 20%
Unclogging MechanismBuilt-in, allows clearing without disconnecting from vacuum line
System Purge (Emptying reservoirs)Double press purge button to empty each reservoir
MicroCannula Working Length AdjustmentUses rigid hood and ratcheting slider to set working length (prevents inadvertent adjustment)
MacroCannula Working Length AdjustmentCan be adjusted by clinician if needed
Alarm SystemMultiple alarms incorporated (Low fluid: audible alarm/yellow flashing light; System malfunction: red flashing light)
Sterility/Biocompatibility:
Cleaning and Disinfection ValidationMeets Requirements
BiocompatibilityMeets requirements
Sterilization ValidationMeets requirements
Shelf Life ValidationPerformed, met design requirements
Cross contaminationPatient contacting portion is single use and sterile. Handheld controller cleaned/disinfected and covered with cleared dental barrier
Adverse Tissue Reaction and BiocompatibilityMeets requirements
Electrical/Software:
Electromagnetic Compatibility (EMC) TestingMeets requirements
Electrostatic Discharge (ESD) SuppressionPerformed, met design requirements
Software ValidationMeets requirements
Mechanical/Physical:
MicroCannula Suction PerformancePerformed, met design requirements
Suction Adapter OD (HVE adapter)11.0 ±0.1 mm (0.434 in)
MacroCannula OD (on Apex Cartridge)0.595 ±0.012 mm (0.023 inch)
MicroCannula OD (on Apex Cartridge)0.0125 to 0.0118 in

Study Proving Device Meets Acceptance Criteria

The study primarily relies on non-clinical performance testing and a comparison to a legally marketed predicate device (EndoVac® Apical Negative Pressure Irrigation System K140685) to demonstrate substantial equivalence. The document explicitly states: "The EndoVac Pure™ and the predicate EndoVac System (K140685) perform the same function, which is a method to deliver irrigant, rinse and evacuate during root canal procedures. The following performance tests were conducted as part of design verification:" followed by a list of tests.

The conclusion further reinforces this: "The proposed EndoVac Pure™ is substantially equivalent to the predicate Endo Vac System (K140685) based on design, performance, biocompatibility testing, and the intended use."

2. Sample Sizes Used for the Test Set and Data Provenance

The document does not explicitly state specific sample sizes for each non-clinical performance test. It lists the types of tests conducted (e.g., Flow Rate Delivery, Suction Flow Rate, Biocompatibility, Sterilization, etc.) but not the number of units or datasets used for each.

The data provenance is from non-clinical performance testing, presumably conducted internally by Sybron Dental Specialties. There is no information provided about country of origin of data (apart from the manufacturer being in Orange, CA). The studies are inherently prospective with respect to the device's design verification.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Their Qualifications

This information is not applicable as the evaluation is based on non-clinical performance testing against engineering specifications and comparison to a predicate device. There is no mention of human experts establishing "ground truth" for the performance tests in the context of diagnostic accuracy or clinical outcomes.

4. Adjudication Method for the Test Set

This information is not applicable for non-clinical performance testing. Adjudication methods (like N+1 consensus) are typically used in clinical studies where expert reviewers evaluate cases and make subjective judgments, which is not the nature of the tests performed here.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done

No, a Multi-Reader Multi-Case (MRMC) comparative effectiveness study was not done. The document explicitly states: "Clinical performance testing has not been performed for EndoVac Pure™" in section 8.

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 a physical dental system, not an algorithm or AI software. There is no "standalone" algorithm performance to evaluate. The device's performance is inherently tied to its use by a human operator within a clinical procedure.

7. The Type of Ground Truth Used

The "ground truth" for the non-clinical performance tests was established by engineering specifications, accepted industry standards (e.g., ISO, IEC), and the performance characteristics of the legally marketed predicate device. For instance, flow rates were expected to fall within a specified range, and biocompatibility tests were conducted according to ISO standards.

8. The Sample Size for the Training Set

This information is not applicable. The EndoVac Pure is a physical medical device, not an AI or machine learning model that requires a training set.

9. How the Ground Truth for the Training Set Was Established

This information is not applicable for the same reason as point 8.

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Image /page/0/Picture/1 description: The image shows the 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" arranged around the perimeter. Inside the circle is a stylized symbol that resembles a caduceus, featuring a staff with three intertwined snakes and a pair of wings at the top.

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

December 21, 2016

Kerr Corporation % Mohammad Ansari Regulatory Affairs Specialist II Sybron Dental Specialties 1717 W. Collins Ave. Orange, California 92867

Re: K162436

Trade/Device Name: EndoVac Pure Regulation Number: 21 CFR 872.4200 Regulation Name: Dental Handpiece And Accessories Regulatory Class: Class I Product Code: NYL Dated: November 22, 2016 Received: November 25, 2016

Dear Mr. Mohammad Ansari:

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

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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 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,

Sincerely,

Susan Runno DDS, MA

Tina Kiang, Ph.D. Acting Director Division of Anesthesiology. General Hospital, Respiratory, Infection Control, and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known)

Device Name

EndoVac Pure™

Indications for Use (Describe)

The EndoVac™ Pure System is intended for the delivery and evacuation of endodontic irrigation solutions and removing debris of injured or necrotic pulp tissue during root canal procedures.

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)

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K162436 510(k) SUMMARY

    1. Submitter Information:
      Sybron Dental Specialties 1717 W. Collins Ave. Orange CA, 92867
Contact Person:Mohammad Saad Ansari
Telephone Number:909-962-5644
Fax Number:909-962-5694

Date Prepared: December 22, 2016

    1. Device Name:
• Proprietary Name:EndoVac Pure
• Classification Name:Handheld controller, air-powered, root canal irrigation
  • CFR Number: 872.4200 . Device Class: Class I
  • Product Code: . NYL
    1. Predicate Device:

The EndoVac Pure™ product is substantially equivalent to the legally marketed device EndoVac® Apical Negative Pressure Irrigation System (K140685) cleared on July 2nd, 2014, product code NYL.

    1. Description of Device:
      The EndoVac Pure™ system builds on the EndoVac System and presents a unique way to irrigate during root canal treatments. The system is an apical negative pressure system that draws fluid apically by way of evacuation, reducing the risk of apical irrigant extrusion during root canal procedures. The vacuum is routed through the system and controlled independently through the dental chair vacuum system. The fluid delivery is controlled by peristaltic pumps. The pumps are driven by Printed Circuit Board Assemblies (PCBA) and controlled by Field Programmable Gate Array (FPGA) configuration files.
    1. Intended Use
      The EndoVac Pure™ System is intended for the delivery and evacuation of endodontic irrigation solutions during root canal procedures.
    1. Indications for Use:

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The EndoVac Pure™ System is intended for the delivery and evacuation of endodontic irrigation solutions and removing debris of injured or necrotic pulp tissue during root canal procedures.

    1. Description of Safety and Substantial Equivalence:
      The EndoVac Pure™ product is substantially equivalent to the legally marketed device EndoVac® Apical Negative Pressure Irrigation System (K140685) cleared on July 2nd, 2014. product code NYL.

Technological Characteristics Non-Clinical Performance Data

The technological characteristics of EndoVac Pure™ is very similar to the predicate EndoVac® (K140685) negative pressure irrigation systems. The EndoVac Pure™ and the predicate EndoVac System (K140685) perform the same function, which is a method to deliver irrigant, rinse and evacuate during root canal procedures. The following performance tests were conducted as part of design verification:

  • · Flow Rate Delivery and Selection
  • · Suction Flow Rate Performance
  • Cleaning and Disinfection Validation
  • · Biocompatibility
  • Sterilization Validation
  • Shelf Life Validation
  • · Electromagnetic Compatibility (EMC) Testing
  • · Electrostatic Discharge (ESD) Suppression
  • · MicroCannula Suction Performance

Applicable Standards

  • · ISO 14971: 2007 Medical Devices Application of risk management
  • · ISO 10993-1:2009 Biological Evaluation of Medical Devices Part 1 Evaluation and Testing
  • · ISO 10993-5:2009 Biological Evaluation of Medical Devices Part 5 Tests for in vitro cvtotoxicitv
  • · ISO 10093-7:2008: Biological evaluation of medical devices -- Part 7: Ethylene oxide sterilization residuals
  • · ISO 10993-10:2009 Biological Evaluation of Medical Devices Part 10 Tests for irritation and skin sensitization
  • IEC 60601-1 Issued: 2005/01/01 Ed: 3 Medical electrical equipment Part 1: General requirements for basic safety and essential performance
  • · IEC 60601-1-2:2007 Medical electrical equipment Part 1-2: General requirements for safety - Collateral standard: Electromagnetic compatibility - Requirements and tests (3rd Edition)
  • · IEC 60601-1-2:2014 Medical electrical equipment Part 1-2: General requirements for

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safety - Collateral standard: Electromagnetic compatibility - Requirements and tests (4th Edition)

  • · IEC 62304:2006/Amd 1:2015 Medical device software Software life cycle processes
  • · ISO 11135:2014 Sterilization of healthcare products Ethylene oxide Part 1: Requirements for development, validation and routine control of a sterilization process for medical devices
  • · ISO 14937: 2009 Sterilization of health care products General requirements for characterization of a sterilizing agent and the development, validation and routine control of a sterilization process for medical devices.
  • · ISO 11138:2006 Sterilization of healthcare products Biological indicators –Part 1: General requirements, Part 2: Biological indicators for ethylene oxide sterilization processes
  • · ISO 14161:2009 Sterilization of healthcare products Biological indicators -Guidance for the selection, use and interpretation of results.
  • · ISO 11607-1:2006 Packaging for Terminally Sterilized Medical Devices
  • · ISO 11607-2:2006 Packaging for Terminally Sterilized Medical Devices Part 2: Validation requirements for forming, sealing and assembly processes
ElementPredicateEndoVac SystemProposedEndoVac Pure
510(k)K140685K162436
Trade NameEndoVac Apical NegativePressure Irrigation SystemEndoVac Pure™
ClassClass 1Class 1
Product CodeNYLNYL
Classification NameHandheld controller, Air-Powered, Root Canal IrrigationHandheld controller, Air-Powered,Root Canal Irrigation
Target UsersLicensed Dental ProfessionalsLicensed Dental Professionals
Intended UseThe EndoVac system is intendedfor the delivery and evacuationof endodontic irrigation solutionsduring root canal procedures.The EndoVac Pure™ system isintended for the delivery andevacuation of endodontic irrigationsolutions during root canalprocedures.
Indications For UseThe EndoVac system is intendedfor the delivery and evacuationof endodontic irrigation solutionsduring root canal procedures.The EndoVac Pure™ System isintended for the delivery andevacuation of endodontic irrigationsolutions and removing debris ofinjured or necrotic pulp tissueduring root canal procedures.
Device ComponentsSyringes, Multi-Port Adapter,Master Delivery Tip,Fingerpiece, HandheldBase Unit, HVE Adapter, Handheldcontroller, Apex Cartridge (withMicroCannula and MacroCannula).
ElementPredicateEndoVac SystemProposedEndoVac Pure
Suction Adaptercontroller, MicroCannula andMacroCannula, Connectiontubing,The Multi-Port Adaptercritical to functionality dimensionin this component is the OuterDiameter (OD) due tocompatibility with dental chairhigh evacuation line OD = 0.434in)AC Supply, Universal Latches,Connection tubing,HVE adapter:Critical to functionality dimensionin this component is the OuterDiameter (OD) due to compatibilitywith dental chair High evacuationline (OD = 11.0 ±0.1 mm) (0.434in)
Fluid DeliveryFeatureDelivery Needle in MasterDelivery Tip and Luer LockConnectionDelivery Needle in Apex Cartridgeand Handheld controllerConnection
MacroCannulaDimensionsThe MacroCannulacritical to functionalitydimension in this component isthe OD due to the clinicalapplication into the root canalcleaning procedure (OD = 0.020±0.001 in)MacroCannula on Apex Cartridgecritical to functionality dimensionin this component is the OD due tothe clinical application into the rootcanal cleaning procedure (OD =0.595 ±0.012 mm) (0.023 inch)
MacroCannulamaterialTitan Petchem SM598 (EthylenePropylene Copolymer) / colorant(BLMT 2070)Polyamide (PI)
MicroCannulaDimensionsMicroCannula critical tofunctionality dimension in thiscomponent is the OD due to theclinical application into the rootcanal cleaning procedure (OD =0.0125 to 0.0118 in)MicroCannula on Apex Cartridgecritical to functionality dimensionin this component is the OD due tothe clinical application into the rootcanal cleaning procedure (OD =0.0125 to 0.0118 in)
MicroCannulaMaterialAISI 304 Stainless SteelAISI 304 Stainless Steel
Mounting SystemNoneUniversal Latch
Mode of OperationManually OperatedManually Operated
Fluid Delivery SystemManual operation of syringeplungerBase Unit contains two peristalticpumps that are manually operatedby fluid delivery buttons in thehandheld controller
AC SupplyConnectionNone100-240V AC, 1.0-0.5A, 50-60Hz
ElementPredicateEndoVac SystemProposedEndoVac Pure
Flow UptakeMicroCannula uptake flow5ml/min ± 15%MacroCannula uptake flow40ml/min ± 20%MicroCannula uptake flow5ml/min ± 15%MacroCannula uptake flow40ml/min ± 20%
MicroCannula,Working LengthMicroCannula working length isfrom 14 to 30 mm ±0.5 mmMicroCannula working length isfrom 14 to 30 mm ±0.5mm
System PurgeRemove syringe plunger andempty each syringe, manuallypush the plunger to empty eachsyringeDouble press purge button to emptyeach reservoir
Hood Design1 ConfigurationsMaster Delivery Tip Hood2 ConfigurationsMacroCannula HoodApex Irrigation Hood
Vacuum EvacuationSystemMicroCannula andMacroCannula are twoindependent single usecomponentsSingle Use, sterile Apex Cartridgeincludes coaxial MicroCannula andMacroCannula
Vacuum ConnectionMulti-Port AdapterHVE Adapter
Liquid StorageSyringes20 ml syringe NaOCl3 ml syringe EDTALiquid Reservoirs100 ml NaOCl25 ml EDTA
UncloggingMechanismRequires MacroCannula andMicroCannula to be disconnectedfrom the vacuum line. TheMacroCannula andMicroCannula are independentlyconnected to another syringe andpositive pressure is applied todislodge and unclog any debris.Built-in unclogging mechanismallows MacroCannula andMicroCannula withoutdisconnecting from the vacuumline. The MicroCannula can beused to drive out any cloggeddebris in the MacroCannula bysliding in and out of it. TheMicroCannula can be pulled backinto the MacroCannula removingany debris on the external sides ofthe MicroCannula. TheMicroCannula can also be pulledback into the head of the ApexCartridge system allowingmaximum vacuum pressure todislodge any clogged debris on theinside of the MicroCannula.
MicroCannula andMacroCannulaNegative pressure used to cleanroot canal on both MicroCannulaand MacroCannula.MacroCannula doesn't requireNegative pressure used to cleanroot canal on both MicroCannulaand MacroCannula.MacroCannula doesn't require any
ElementPredicateEndoVac SystemProposedEndoVac Pure
any working length measurementbut can be adjusted by clinicianif needed.MicroCannula working lengthutilizes a sliding rubber stop as adatum and can be used to set theworking length. The rubber stopmay move accidentally ifpressure is applied to it.working length measurement butcan be adjusted by clinician ifneeded.MicroCannula working lengthutilizes a rigid hood as a datum anda ratcheting slider to set theworking length. The ratchet on theslider prevents the working lengthfrom being adjusted inadvertently.
Cross contamination(cleaning,disinfection,sterilization)Meets RequirementsPatient contacting portion isAutoclaveableMeets RequirementsPatient contacting portion is singleuse and sterile.Handheld controller is cleanedand disinfected between uses,then covered with an FDAcleared dental barrier sleevewhich is non-sterile and intendedfor single patient use only.
Alarm SystemNoneAlarm at Device Malfunction.Multiple alarms have beenincorporated in the EndoVacPureTM system to alert the user incase of issues that may affect theclinical outcome.- Issue #1 - Low fluid with anaudible alarm and yellow flashinglight- Issue #2 - System malfunctionwith a red flashing light
Adverse TissueReaction andBiocompatibilityMeets requirementsMeets requirements
ElectromagneticCompatibilityNoneMeets requirements
SterilizationValidationMeets requirementsMeets requirements
Software ValidationNot ApplicableMeets requirements

Table 7.1: Predicate and Proposed Device Comparison Table

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8. Clinical Performance Data

Clinical performance testing has not been performed for EndoVac Pure™

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9. Conclusion as to Substantial Equivalence

The EndoVac System (K140685) and the proposed EndoVac Pure™ have the same Intended Use: for the delivery and evacuation of endodontic irrigation solutions during root canal procedures. The proposed Indications for Use statement adds "and removing debris of injured or necrotic pulp tissue" to better describe root canal cleaning and the setting and use-site environment where the system is used. The EndoVac Pure™ is a less-complex non-automated technology. The technological characteristics of EndoVac Pure™ are very similar to the predicate EndoVac System (K140685). The proposed EndoVac Pure™ has similarities in select performance characteristics and design features as compared to the predicate. The technological characteristics of EndoVac Pure™ are very similar to the predicate EndoVac (K140685) negative pressure irrigation systems. The EndoVac Pure™ and the predicate EndoVac System (K140685) perform the same function, which is a method to deliver irrigant, rinse and evacuate during root canal procedures. The proposed Endo Vac Pure™ is substantially equivalent to the predicate Endo Vac System (K140685) based on design, performance, biocompatibility testing, and the intended use. Any noted differences in technological characteristics between the proposed and predicate products do not raise new questions of safety and effectiveness. The EndoVac Pure™ and the predicate EndoVac System (K140685) perform the same function. which is a method to deliver irrigant, rinse and evacuate during root canal procedures. Based on biocompatibility studies, identical intended use, and performance characteristics, the Endo Vac Pure™ is substantially equivalent to the predicate EndoVac System (K140685).

§ 872.4200 Dental handpiece and accessories.

(a)
Identification. A dental handpiece and accessories is an AC-powered, water-powered, air-powered, or belt-driven, hand-held device that may include a foot controller for regulation of speed and direction of rotation or a contra-angle attachment for difficult to reach areas intended to prepare dental cavities for restorations, such as fillings, and for cleaning teeth.(b)
Classification. Class I.